Biologic therapy for Behçet's uveitis: a systematic review

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Biologics are increasingly utilized for Behçet's Disease (BD), including ocular manifestations.
• However, the evidence supporting their use in ocular BD is limited, primarily derived from studies on general uveitis and other BD symptoms.

Purpose of the Study:

• To systematically review the existing evidence base for the efficacy of biologic agents in the treatment of ocular Behçet's Disease.

Main Methods:

• A comprehensive systematic literature search was conducted across multiple databases (MEDLINE, Cochrane Library, etc.) up to October 2018.
• The search focused on randomized controlled trials (RCTs) of biologics for ocular BD, with no restrictions on region, language, or publication date.

Main Results:

• Eight randomized controlled trials (RCTs) met the inclusion criteria, evaluating biologics such as interferon alpha 2a, adalimumab, secukinumab, gevokizumab, rituximab, and daclizumab.
• While rituximab and interferon alpha 2a demonstrated promising preliminary results, further large-scale RCTs are required.
• The efficacy of adalimumab for BD uveitis specifically was not evaluated in the retrieved RCTs, limiting their direct applicability.

Conclusions:

• Certain biologics exhibit potential therapeutic benefits for ocular Behçet's Disease.
• More high-quality RCTs are essential to establish definitive conclusions regarding the efficacy of biologics in managing ocular BD.
• Further research, potentially through a phase IV study or a dedicated registry for adalimumab, could clarify its specific role in treating BD uveitis.