Biosimilars in Adult and Pediatric Noninfectious Uveitis

To review and compare the efficacy and safety of adult and pediatric biologic biosimilar use for the treatment of noninfectious uveitis (NIU).

A review of the literature from inception to December 2025 was conducted using Pubmed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science to identify studies that included data or discussion on the use of biosimilar biologic agents for adult and/or pediatric NIU. Articles related to these topics were included and discussed within this review.

Most studies examining biosimilar use in adult and pediatric noninfectious uveitis have evaluated the efficacy and safety of anti-tumor necrosis factor alpha (anti-TNF-α) agents, primarily adalimumab and infliximab biosimilars. Identified studies in both adults and children largely consisted of two designs: those comparing reference biologics with biosimilars and switch studies assessing outcomes following conversion to biosimilar therapy. Golimumab, certolizumab pegol, tocilizumab, sarilumab, and rituximab reference biologic studies offer promising results for treatment of NIU, but clinical trials evaluating biosimilar biologics lack in the literature. Compared with adult populations, pediatric cohorts treated with biosimilars for NIU are underrepresented in the literature.

Current evidence suggests that adalimumab and infliximab biosimilars are effective and safe in comparison to reference biologics for treatment of NIU in the adult and pediatric populations. Expanded investigation in pediatric cohorts, including prospective clinical trials and inclusion of other biosimilar biologic agents are needed to address current gaps in evidence and to inform clinical decision-making.