The Use of Biologic Therapies in Uveitis View Full Text


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Article Info

DATE

2014-11-29

AUTHORS

Sergio Schwartzman, Monica Schwartzman

ABSTRACT

Therapy for autoimmune ophthalmic disease is currently evolving. The improved understanding of the abnormal immune response in the various forms of uveitis has resulted in targeted therapy. The aberrations of the immune system have been characterized by atypical cell populations, cytokine expression, and cell–cell interactions. Different patterns of cytokine expression have now been delineated in the abnormal uveal tract with exaggerated and/or abnormal expression of TNF, IL-1, IL-2, IL-6, and IL-17. The development of therapies for other conditions in which these cytokines play an important role has resulted in the availability of biological agents that have been adopted for use in the therapy for uveitis. Adalimumab and infliximab have been the best studied anti-TNF agents and indeed have now been recommended by an expert panel as first-line treatment of ocular manifestations of Behçet’s disease and second-line treatment for other forms of uveitis (Levy-Clarke et al. (Ophthalmology, 2013). Other anti-TNF agents have been studied as well. Daclizumab, a monoclonal antibody directed against the IL-2 receptor, has also demonstrated utility in treating uveitis as have some of the anti-IL1 agents. Gevokizumab has been granted orphan drug designation for the treatment of resistant forms of uveitis. Therapies affecting IL-6, including tocilizumab are being studied, and available medications that block antigen presenting cell and T cell interaction such as abatacept have been reported to be effective in uveitis. Interferons as well as rituximab have also been evaluated in small studies. Although these biologic therapies have provided a larger armamentarium to treat uveitis, challenges remain. Uveitis is not a single illness; rather, it is a manifestation of many potential systemic diseases that may have very specific individual therapeutic targets. Identifying and characterizing these underlying diseases is not always achieved, and more importantly, the most effective therapies for each entity have not been defined. More... »

PAGES

307-316

References to SciGraph publications

  • 2012-10-30. Treatment of recurrent anterior uveitis with infliximab in patient with ankylosing spondylitis in JAPANESE JOURNAL OF OPHTHALMOLOGY
  • 2002-02-01. Treatment of acute uveitis associated with Crohn's disease and sacroileitis with infliximab in THE AMERICAN JOURNAL OF GASTROENTEROLOGY
  • 2012-01-06. Adalimumab specifically induces CD3+ CD4+ CD25high Foxp3+ CD127− T-regulatory cells and decreases vascular endothelial growth factor plasma levels in refractory immuno-mediated uveitis: a non-randomized pilot intervention study in EYE
  • 2011-11-27. Adalimumab successful in sarcoidosis patients with refractory chronic non-infectious uveitis in GRAEFE'S ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
  • 2009-10-09. Successful switching to adalimumab in an infliximab-allergic patient with severe Behçet disease-related uveitis in RHEUMATOLOGY INTERNATIONAL
  • 2012-05-14. Golimumab for the treatment of refractory juvenile idiopathic arthritis-associated uveitis in JOURNAL OF OPHTHALMIC INFLAMMATION AND INFECTION
  • 2006-04-07. Adalimumab for sight-threatening uveitis in Behçet's disease in EYE
  • 2014-01-09. A randomised controlled trial of the clinical effectiveness, safety and cost-effectiveness of adalimumab in combination with methotrexate for the treatment of juvenile idiopathic arthritis associated uveitis (SYCAMORE Trial) in TRIALS
  • 2003-04-10. Therapeutic experience with infliximab in a patient with polyarticular juvenile idiopathic arthritis and uveitis in RHEUMATOLOGY INTERNATIONAL
  • 2010-10-05. Abatacept: a potential therapy in refractory cases of juvenile idiopathic arthritis-associated uveitis in GRAEFE'S ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
  • 2008-08-01. Treatment of Recurrent Crohn's Uveitis With Infliximab in THE AMERICAN JOURNAL OF GASTROENTEROLOGY
  • 2007-01-11. Anti-Tac (daclizumab, Zenapax) in the Treatment of Leukemia, Autoimmune Diseases, and in the Prevention of Allograft Rejection: A 25-Year Personal Odyssey in JOURNAL OF CLINICAL IMMUNOLOGY
  • 2013-07-27. Tocilizumab treatment for refractory uveitis-related cystoid macular edema in GRAEFE'S ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
  • 2013-04-15. Superior efficacy of Adalimumab in treating childhood refractory chronic uveitis when used as first biologic modifier drug: Adalimumab as starting anti-TNF-α therapy in childhood chronic uveitis in PEDIATRIC RHEUMATOLOGY
  • 2004-09-24. Long-term treatment of refractory posterior uveitis with anti-TNFα (infliximab) in EYE
  • 2013-03-01. Adalimumab for juvenile idiopathic arthritis-associated uveitis in GRAEFE'S ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
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    URI

    http://scigraph.springernature.com/pub.10.1007/s12016-014-8455-6

    DOI

    http://dx.doi.org/10.1007/s12016-014-8455-6

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1018977357

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/25431348


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