The role of biologic agents in the management of non-infectious uveitis.
BACKGROUND
Uveitis is an intriguing group of disorders characterized by inflammation of the uveal tract. Due to the potential grave consequences of the disease process, it is important to assess the various therapeutic options available for treating uveitis, and their outcomes.


METHODS
This review discusses the use of conventional agents in the management of uveitis, including discussion of the molecular and clinical properties of corticosteroids, antimetabolites, calcineurin inhibitors and alkylating agents and their side effects. In addition, it also discusses the molecular and clinical properties of novel biologic agents and their side effects. Moreover, recommendations as to when biologic agents should be employed are also discussed.


CONCLUSIONS
We recommend that in general (except in selected cases of Adamantiades-Behçet's disease) biologics should not be used as a first-line therapy for uveitis due to inconvenience, high cost, and potential immunosuppressive effects. However, many biologics are potent in inducing drug-free remission of uveitis and may be employed to manage recurrent diseases or diseases not responsive to conventional agents.
Johns Hopkins University School of Medicine, Wilmer Eye Institute, Johns Hopkins Hospital, Retinal Imaging Research and Reading Center, 600 North Wolfe Street, Maumenee 745, Baltimore, MD 21287, USA.
Jangwon
J
Heo
Yasir J
YJ
Sepah
Jithin
J
Yohannan
Morgan
M
Renner
Abeer
A
Akhtar
Anthony
A
Gregory
Mathew
M
Shulman
Diana V
DV
Do
Quan Dong
QD
Nguyen
D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D001688:Biological Products / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D006801:Humans; D018579:Patient Selection; D018570:Risk Assessment; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy* / Q000191:economics
D000893:Anti-Inflammatory Agents; D001688:Biological Products