title: [Biologics in uveitis].
abstract: Biotherapies used in clinical practice for the treatment of uveitis include monoclonal antibodies and fusion proteins (anti-TNFα, anakinra, tocilizumab and rituximab), interferons (IFN) and intravenous immunoglobulins (IVIg). IFN is capable of inducing prolonged remission and continued after his discontinuation, in 20-40% of patients. Side effects (flu-like, psychological effects) limit its use in practice. Anti-TNFα (infliximab and adalimumab) represents an attractive alternative therapeutic in severe uveitis refractory to immunosuppressants, especially in Behçet's disease. They are generally (>90% of cases) and rapidly effective but their action is often suspensive. Anti-TNFα requires an extended prescription or takes over from another immunosuppressant once ocular inflammation has been controlled. IVIg are used for the treatment of Birdshot's disease. Tolerance of IVIg is good but their efficacy is transient. Rituximab showed an efficacy in few observations of various inflammatory eye diseases (uveitis, scleritis and idiopathic inflammatory pseudo-tumors or associated with granulomatosis with polyangiitis) and cicatricial pemphigoid. The risk of infection limits its use in refractory diseases to conventional therapy. Anakinra (a soluble antagonist of IL-1r) showed interesting results in terms of efficiency in one small open study in Behçet's disease. Its safety profile is good and with a quick action that could be interesting for the treatment of severe uveitis.
authors.affiliation: Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université de Lyon, 103, Grande-Rue-de-la-Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: E
authors.initials: E
authors.lastname: Feurer
authors.affiliation: Service de médecine interne, hôpital Général de Dijon, 3, rue du Faubourg-Raines, 21000 Dijon, France.
authors.forename: P
authors.initials: P
authors.lastname: Bielefeld
authors.affiliation: Service de médecine interne, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Saadoun
authors.affiliation: Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université de Lyon, 103, Grande-Rue-de-la-Croix-Rousse, 69317 Lyon cedex 04, France. Electronic address: pascal.seve@chu-lyon.fr.
authors.forename: P
authors.initials: P
authors.lastname: Sève
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001528:Behcet Syndrome / Q000150:complications / Q000188:drug therapy; D001688:Biological Products / Q000627:therapeutic use*; D001691:Biological Therapy / Q000379:methods; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069283:Rituximab / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000276:immunology; D014605:Uveitis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab; C502936:tocilizumab
keywords: Anti-TNFα; Behçet disease; Biological; Biothérapie; Interferon; Interféron; Maladie de Behçet; TNFα blockers; Uveitis; Uvéite