New pharmacotherapy options for noninfectious posterior uveitis

Int Ophthalmol. 2021 Jun;41(6):2265-2281. doi: 10.1007/s10792-021-01763-8. Epub 2021 Feb 25.

Abstract

Introduction: Noninfectious inflammation of the posterior eye segment represents an important cause of visual impairment. It often affects relatively young people and causes a significant personal and social impact. Although steroids and nonbiologic- Disease-Modifying Antirheumatic Drugs (nbDMARDs) are effective both in acute and long- lasting diseases, however they are increasingly being replaced by biologic (DMARDs). bDMARD. This article therefore aims to identify recent advances in the therapy of noninfectious posterior segment uveitis.

Methods: A Medline-search was conducted using the terms: nbDMARD, bDMARD, posterior uveitis, intermediate uveitis, treatment, corticosteroid. In addition, clinical studies were included as registered at ClinicalTrials.gov.

Results: Currently two major lines of treatments can be identified: (1) the intraocular application of anti-inflammatory agents and (2) the introduction of new agents, e.g., (bDMARDs) and small-molecule-inhibitors. Whereas intravitreal treatments have the advantage to avoid systemic side effects, new systemic agents are progressively earning credit on the basis of their therapeutic effects.

Conclusion: Even when current treatment strategies are still hampered by the limited number of randomized controlled trials, promising progress and continuous efforts are seen.

Keywords: Corticosteroid; Therapy; Uveitis; bDMARD; nbDMARD; tsDMARD.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Antirheumatic Agents* / therapeutic use
  • Humans
  • Uveitis* / drug therapy
  • Uveitis, Intermediate*
  • Uveitis, Posterior* / diagnosis
  • Uveitis, Posterior* / drug therapy

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Antirheumatic Agents