Biologics in the treatment of uveitis
Biologics in the treatment of uveitis
复制标题
DOI：
10.1097/icu.0b013e3282f03d42
复制
发表时间：
2007-11-01
影响因子：
3.7
通讯作者：
Dick, Andrew D.
中科院分区：
文献类型：
--
作者：
Imrie, Fraser R.;Dick, Andrew D.
综述的目的本综述总结了目前生物疗法治疗葡萄膜炎的证据。最近的研究发现抗肿瘤坏死因子-α-英夫利昔单抗和阿达木单抗在控制血清阴性脊柱关节病和幼年特发性关节炎相关的葡萄膜炎方面显示出显著的疗效;然而，依那西普在这些疾病相关的葡萄膜炎中未能显示出类似的治疗效果。大多数关于后葡萄膜炎生物疗法的报道都是免疫抑制剂抵抗性葡萄膜炎的非对照试验或回顾性研究。令人鼓舞的是，成功地控制这种难治性眼内炎症一直报告与英夫利昔单抗和干扰素α，特别是白塞氏病相关的葡萄膜炎。有限数量的报告，抗白细胞介素疗法，daclizumab和阿那白滞素，支持这些疗法在某些类型的葡萄膜炎的作用。尽管有实验依据，但缺乏随机对照研究的证据限制了我们对何时开始治疗，选择哪种药物以及持续治疗多久的理解。此外，所有生物制剂的高成本和潜在的副作用限制了它们目前用于免疫抑制难治性葡萄膜炎。
Purpose of reviewThis review summarizes the current evidence for biologic therapies in the treatment of uveitis. The review emphasizes published research in this field since 2005.Recent findingsThe anti-tumour necrosis factor-alpha- infliximab and adalimumab have demonstrated significant efficacy in controlling uveitis associated with seronegative spondyloarthropathies and juvenile idiopathic arthritis; however, etanercept has failed to show a similar treatment effect in uveitis associated with these conditions. The majority of reports of biologic therapies in posterior uveitis have been uncontrolled trials, or retrospective studies, of uveitis resistant to immunosuppression. Encouragingly, successful control of such refractory intraocular inflammation has been consistently reported with infliximab and interferon a, particularly Behcet's disease-associated uveitis. A limited number of reports of anti-interleukin therapies, daclizumab and anakinra, have supported a role for these therapies in some types of uveitis.SummaryBiologic therapies have increased the treatment options for sight-threatening uveitis. Despite experimental rationale, the lack of evidence from randomized controlled studies limits our understanding of when to commence therapy, which agent to choose and how long to continue treatment. Additionally, the high cost and potential side effects of all biologic agents have limited their current use to uveitis refractory to immunosuppression.