Use of immunosuppressive agents in uveitis.
OBJECTIVE
This review summarizes current patterns in the use of immunosuppressive agents in patients with uveitis.


RESULTS
A number of immunosuppressive agents are currently available for the treatment of uveitis. Reports of safety and efficacy, although numerous, have been largely nonrandomized and performed without controls, limiting, to some extent, the strength and generalizability of their conclusions. Nonetheless, the volume of case reports and case series provides compelling evidence that immunosuppressive agents are effective at providing long-term control in patients with moderate to severe chronic or recurrent uveitis. The choice of immunosuppressive agent is complex, and depends on the cause and severity of the patient's underlying inflammation, the presence or absence of associated systemic inflammation, and the patient's prior response to immunosuppressive treatments.


CONCLUSIONS
Although corticosteroids remain the primary initial treatment for patients with uveitis, use of noncorticosteroid immunosuppressive agents in selected patients with uveitis allows for improved control and decreased risk of corticosteroid-induced side effects.
Lustig
Marc J
MJ
Department of Ophthalmology, New York University School of Medicine, and Manhattan Eye, Ear, and Throat Hospital, New York, 10021, USA.
Cunningham
Emmett T
ET
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000963:Antimetabolites / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000150:complications*; D001688:Biological Products / Q000627:therapeutic use; D003432:Cross-Linking Reagents / Q000627:therapeutic use; D004247:DNA / Q000187:drug effects; D004268:DNA-Binding Proteins / Q000037:antagonists & inhibitors; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007425:Intracellular Membranes / Q000378:metabolism; D016328:NF-kappa B / Q000037:antagonists & inhibitors; D050778:NFATC Transcription Factors; D009687:Nuclear Proteins; D015398:Signal Transduction / Q000187:drug effects; D014157:Transcription Factors / Q000037:antagonists & inhibitors; D014605:Uveitis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000963:Antimetabolites; D001688:Biological Products; D003432:Cross-Linking Reagents; D004268:DNA-Binding Proteins; D007166:Immunosuppressive Agents; D016328:NF-kappa B; D050778:NFATC Transcription Factors; D009687:Nuclear Proteins; D014157:Transcription Factors; D004247:DNA