Noninfectious uveitis: Management with biologic agents

Uveitis is an inflammatory condition involving the iris, ciliary body, and choroid, and it represents a significant cause of vision loss in both children and adults. The primary goals of uveitis management are to control inflammation, prevent recurrences, and minimize structural damage and subsequent visual impairment. Currently, corticosteroids remain the mainstay of therapy for noninfectious uveitis. In patients with sight-threatening disease, immunosuppressive or steroid-sparing agents are commonly employed. However, for individuals who are intolerant of or refractory to corticosteroids and conventional immunosuppressive therapies, biologic agents have emerged as effective alternative treatments. Among these, anti-tumor necrosis factor alpha (TNF-α) agents have demonstrated efficacy in both uveitis and systemic autoimmune disorders. Adalimumab, an anti-TNF-α agent, was the first biologic approved by the U.S. Food and Drug Administration for the treatment of noninfectious uveitis. Prior to initiating biologic therapy, potential safety concerns, including the risk of infections and demyelinating diseases, must be carefully evaluated. Other biologic agents, such as interferons, interleukin inhibitors, and Janus kinase inhibitors, are emerging as promising therapeutic options for noninfectious uveitis. Further studies are required to better establish the long-term safety and efficacy of biologic therapies. This review highlights the role and effectiveness of biologic agents in the management of noninfectious uveitis.