Perspectives for immunotherapy in noninfectious immune mediated uveitis

Area of Science:

• Ophthalmology
• Immunology

Background:

• Noninfectious uveitis (NIU) is a significant global cause of vision loss.
• Corticosteroids are standard for anterior NIU, while systemic treatments and biotherapies are used for more severe forms.

Purpose of the Study:

• To provide an updated overview of biologics and biotherapies for managing noninfectious uveitis.
• To discuss expert opinions on the use of these advanced therapies.

Main Methods:

• Review of current literature and expert clinical experience regarding biologics in NIU.
• Discussion of treatment algorithms, including first-line, second-line, and novel therapeutic options.

Main Results:

• Anti-TNF-α agents are the primary biologics for achieving inflammation quiescence in NIU.
• Anti-interleukin-6 and interferon therapies offer alternative or adjunctive treatment options.
• Novel agents targeting Janus-associated-kinase and phosphodiesterase-4 are emerging for refractory cases.

Conclusions:

• Biotherapies, particularly anti-TNF-α, are crucial for managing sight-threatening noninfectious uveitis.
• Treatment selection depends on disease severity, prior treatment responses, and patient tolerance.
• Ongoing evaluation of therapeutic response through clinical assessment and ancillary tests is essential.