Noninfectious uveitis is a common blinding eye disease, and an autoimmune response is involved in its pathogenesis. Biological agents have gradually been introduced into the treatment of noninfectious uveitis. The authors reviewed the clinical application and side effects of different biological agents on noninfectious uveitis. Biological agents that target TNF-α are widely used in the clinic. Other biological agents, such as IL-6- and IL-1-neutralizing antibodies, are used in patients who do not respond to TNF inhibitors. The efficacy of IL-17 neutralizing antibodies in noninfectious uveitis is controversial. Biological agents targeting T cells and signaling pathways provide new drug options for treatment of noninfectious uveitis. However, it cannot be ignored that these biological agents have side effects, such as increasing risk of infection.
Keywords: IL-1 neutralizing antibody; IL-17 neutralizing antibody; IL-6 neutralizing antibody; TNF-α inhibitors; autoimmunity; biological agents; cytokines; noninfectious uveitis.
For patients with noninfectious uveitis, if uveitis is severe and vision-threatening or if glucocorticoids and immunosuppressants are tried but do not control uveitis or cannot be used for medical reasons, biological agents offer a new choice. Many biologics are currently on the market for autoimmune diseases; some are approved for the treatment of noninfectious uveitis, and others are in clinical trials. TNF-α inhibitors are widely used in the clinic and effective in the treatment of noninfectious intermediate, posterior and pan uveitis associated with ankylosing spondylitis, Behcet’s disease and juvenile idiopathic arthritis. All of these biological agents have side effects, such as increasing risk of infection or malignant tumors. Development of side effects should be closely monitored.