Biological therapy in treatment of uveitis. Contemporary trends
DOI:
https://doi.org/10.31288/oftalmolzh201756065Keywords:
uveitis, anti TNF, adalimumabAbstract
Uveitis is a cause of blindness in about 10% of cases. According to many studies, TNF-? plays an important role in the development of uveitis. Anti-TNF-? are widely used in rheumatology and recently in ophthalmology. We carried out the analysis of literature on the use of anti-TNF-?. Large studies have been carried out and good results of anti-TNF-? usage in uveitis associated with JIA, Behcet's disease, ankylosing spondylarthropathies, sarcoidosis have been obtained. The profile of side effects and safety anti-TNF-? is quite acceptable for use in clinical practice. It is highly important that anti-TNF-? has a corticosteroid preserving effect which reduces side-effects associated with treatment, at this time has high efficacy of therapy.
References
1.Bloch-Michel E, Nussenblatt RB. International Uveitis Study Group: recommendations for the evaluation of intraocular inflammatory disease. Am. J. Ophthalmol. 1987;103:234-5.https://doi.org/10.1016/S0002-9394(14)74235-7
2.Chang JH, Wakefield D. Uveitis: a global perspective. Ocul. Immunol. Inflamm. 2002;10:263-79.https://doi.org/10.1076/ocii.10.4.263.15592
3.Smit RL, Baarsma GS. Epidemiology of uveitis. Curr Opin Ophthalmol. 1995;6:57- 61.https://doi.org/10.1097/00055735-199506000-00010
4.Rothova A, Buitenhuis HJ, Meenken C et al. Uveitis and systemic disease. Br J Ophthalmol. 1992;76:137- 41.https://doi.org/10.1136/bjo.76.3.137
5.Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005.;140(3):509-16.https://doi.org/10.1016/j.ajo.2005.03.057
6.Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005;140(3):509-16.https://doi.org/10.1016/j.ajo.2005.03.057
7.Mahendradas P, Khanna A, Kawali A et al. Quantification of inflammation in inflammatory eye diseases.Internet journal of rheumatology and and clinical immunology. 2014;2:1.https://doi.org/10.15305/ijrci/v2iS1/102
8.Lightman S, Towler H. Immunopathology and altered immunity in posterior uveitis in man: a review. Curr Eye Res. 1992;11:11-15.https://doi.org/10.3109/02713689208999506
9.Becker MD, Adamus G, Davey MP, Rosenbaum JT. The role of T cells in autoimmune uveitis. Ocul Immunol Inflamm. 2000;8:93-100.https://doi.org/10.1076/0927-3948(200006)821-0FT093
10.Murray PI. Anti-TNF-alpha therapy for uveitis: Beh?et and beyond. Sivaraj Eye (Lond). - 2005;19:831- 8.https://doi.org/10.1038/sj.eye.6701792
11.Tracey D, Klareskog L, Sasso EH et al. Tumor necrosis factor antagonist mechanisms of action: a comprehensive review. Pharmacol Ther. 2008;117(2):244-79.https://doi.org/10.1016/j.pharmthera.2007.10.001
12.Feldmann M. Development of anti-TNF therapy for rheumatoid arthritis. Nat Rev Immunol. 2002; 2(5):364-71.https://doi.org/10.1038/nri802
13.Neri P, Zucchi M, Allegri P. Adalimumab (Humira): a promising monoclonal anti-tumor necrosis factor alpha in ophthalmology. Int Ophthalmol. 2011;31(2):165-73.https://doi.org/10.1007/s10792-011-9430-3
14.P?rez-Guijo V, Santos-Lacomba M, S?nchez-Hern?ndez M. Tumour necrosis factor-alpha levels in aqueous humour and serum from patients with uveitis: the involvement of HLA-B27.Curr Med Res Opin. 2004;20:155-7.https://doi.org/10.1185/030079903125002847
15.Santos Lacomba M, Marcos Mart?n C, Gallardo Galera JM et al. Aqueous humor and serum tumor necrosis factoralpha in clinical uveitis. Ophthalmic Res. 2001;33:251-5.https://doi.org/10.1159/000055677
16.Dick A D. Immune mechanisms of uveitis: insights into disease pathogenesis and treatment. Int. Ophthalmol. Clin. 2000;40(2):1-18.https://doi.org/10.1097/00004397-200004000-00003
17.Diaz-Llopis M, Salom D, Garcia-de-Vicuna C. Treatment of refractory uveitis with adalimumab: a prospective multicenter study of 131 patients. Ophthalmology. 2012; 119(8):1575-81.https://doi.org/10.1016/j.ophtha.2012.02.018
18.Makamura S, Yamakawa T, Sugita M et al. The role of tumor-necrosis factor alpha in the induction of experimental autoimmune uveoretinitis in mice. Invest Ophthalm Vis Sei. 1994;35:3884-89.
19.Sartani G. Anti-tumor necrosis factor alpha therapy suppresses the induction of experimental autoimmune uveoretinitis in mice by inhibiting antigen priming. Invest Ophthalmol Vis Sci. 1996;37:2211-8.
20.Mo JS, Matsukawa A, Ohkawara S et al. Involvement of TNF alpha, IL-1 beta and IL-1 receptor antagonist in LPS-induced rabbit uveitis. Exp Eye Res. 1998;66(5):547-57.https://doi.org/10.1006/exer.1997.0451
21.Dunn JP. Uveitis. Prim Care. 2015;42(3):305-23.https://doi.org/10.1016/j.pop.2015.05.003
22.Taylor SR, Isa H, Joshi L et al. New developments in corticosteroid therapy for uveitis. Ophthalmologica. 2010;224:46 -53.https://doi.org/10.1159/000318021
23.Castiblanco С, Foster C. Stephen. Review of Systemic Immunosuppression for Autoimmune Uveitis. Ophthalmol. Ther. 2014;3(1-2):17-36.https://doi.org/10.1007/s40123-014-0023-x
24.Balevic SJ, Rabinovich CE. Profile of adalimumab and its potential in the treatment of uveitis. Drug Des Devel Ther. 2016;10: 2997-3003.https://doi.org/10.2147/DDDT.S94188
25.Rabinovich CE. Use of tumor necrosis factor inhibitors in uveitis. Curr Opin Rheumatol. 2007; 19(5):482-6.https://doi.org/10.1097/BOR.0b013e32825f5481
26.Imrie FR, Dick AD. Biologics in the treatment of uveitis. Curr Opin Ophthalmol. 2007;18:481- 6.https://doi.org/10.1097/ICU.0b013e3282f03d42
27.Nestorov I. Clinical pharmacokinetics of tumor necrosis factor antagonists. J Rheumatol Suppl. 2005;74:13-8.
28.Nestorov I. Clinical pharmacokinetics of TNF antagonists: how do they differ? Semin Arthritis Rheum. 2005;34(5 Suppl 1):12-8.https://doi.org/10.1016/j.semarthrit.2005.01.004
29.Instructions for medical use of Humira®. The Order of MOH of Ukraine No247 from 09.03.2017 (as a single-use pen of adalimumab, 40 mg/0.8 ml). Authorization No UA/13612/01/01.
30.Sarah L, Clarke N, Ethan S. Juvenile idiopathic arthritis-associated uveitis. Pediatric Rheumatology. 2016;14:27.https://doi.org/10.1186/s12969-016-0088-2
31.Simonini G, Druce K, Cimaz R et al. Current evidence of anti-tumor necrosis factor alpha treatment efficacy in childhood chronic uveitis: a systematic review and meta-analysis approach of individual drugs. Arthritis Care Res (Hoboken). 2014; 66(7):1073-84.https://doi.org/10.1002/acr.22214
32.Ramanan AV, Dick AD, Benton D et al. A randomised controlled trial of the clinical effectiveness, safety and cost-effectiveness of adalimumab in combination with methotrexate for the treatment of juvenile idiopathic arthritis associated uveitis (SYCAMORE Trial).Trials. 2014;15:14.https://doi.org/10.1186/1745-6215-15-14
33.Ramanan AV, Dick AD, McKay A. A randomised controlled trial of the clinical effectiveness, safety and cost-effectiveness of adalimumab in combination with methotrexate for the treatment of juvenile idiopathic arthritis associated uveitis [abstract]. Arthritis Rheumatol. 2015;67 (Suppl 10).
34.Simonini G, Taddio A, Cattalini M et al. Prevention of flare recurrences in childhood refractory chronic uveitis: an openlabel comparative study of adalimumab versus infliximab. Arthitis Care Res (Hoboken). 2011;63:612-8.https://doi.org/10.1002/acr.20404
35.Zannin ME, Birolo C, Gerloni VM et al. Safety and efficacy of infliximab and adalimumab for refractory uveitis in juvenile idiopathic arthritis: 1-year follow up data from the Italian Registry. J Rheumatol. 2013;40(1):74-9.https://doi.org/10.3899/jrheum.120583
36.Levy-Clarke G, Jabs DA, Read RW et al. Expert panel recommendations for the use of anti-tumor necrosis factor biologic agents in patients with ocular inflammatory disorders. Ophthalmology. 2014;121(3):785-96.https://doi.org/10.1016/j.ophtha.2013.09.048
37.Rajesh K, Kataria DO, Lawrence H et al. Spondyloarthropathies. Am Fam Physician. 2004;69(12):2853-60.
38.Zeboulon N, Dougados M, Gossec L. Prevalence and characteristics of uveitis in the spondyloarthropathies: a systematic literature review. Ann Rheum Dis. 2008;67(7):955-9.https://doi.org/10.1136/ard.2007.075754
39.Rudwaleit M, Rodevand E, Holck P et al. Adalimumab effectively reduces the rate of anterior uveitis flares in patients with active ankylosing spondylitis: results of a prospective open-label study. Ann Rheum Dis. 2009;68(5):696-701.https://doi.org/10.1136/ard.2008.092585
40.Vallet H, Riviere S, Sanna A et al. Efficacy of anti-TNF alpha in severe and/or refractory Behcet's disease: multicenter study of 124 patients. J Autoimmun. 2015;62:67-74.https://doi.org/10.1016/j.jaut.2015.06.005
41.Takase K, Ohno S, Ideguchi H et al. Successful switching to adalimumab in an infliximab-allergic patient with severe Beh?et disease-related uveitis. Rheumatol Int. 2011;31:243-5.https://doi.org/10.1007/s00296-009-1178-y
42.Erckens RJ, Mostard RL, Wijnen PA et al. Adalimumab successful in sarcoidosis patients with refractory chronic non-infectious uveitis. Graefes Arch Clin Exp Ophthalmol. 2012; 250(5):713-20.https://doi.org/10.1007/s00417-011-1844-0
43.Hamam RN, Barikian AW, Antonios RS et al. Intravitreal adalimumab in active noninfectious uveitis: a pilot study. Ocul Immunol Inflamm. 2016;24(3):319-26.
44.Callejas-Rubio JL, S?nchez-Cano D, Garc?a Serrano JL et al. Adalimumab therapy for refractory uveitis: a pilot study [letter]. J. Ocul. Pharmacol. Ther. 2008;24:613-4.https://doi.org/10.1089/jop.2008.0073
45.Suhler EB, Lowder CY, Goldstein DA. Adalimumab therapy for refractory uveitis: results of a multicentre, open-label, prospective trial. Br J Ophthalmol. 2013;97(4):481-6.https://doi.org/10.1136/bjophthalmol-2012-302292
46.Durrani K, Kempen JH. Adalimumab for ocular inflammation. Ying Ocul Immunol Inflamm. 2016:1-8.
47.Diak P, Siegel J, La Grenade L, Choi L et al. Tumor necrosis factor alpha blockers and malignancy in children: forty-eight cases reported to the Food and Drug Administration. Arthritis Rheum. 2010;62(8):2517-24.https://doi.org/10.1002/art.27511
48.Mariette X, Matucci-Cerinic M, Pavelka K. et al. Malignancies associated with tumour necrosis factor inhibitors in registries and prospective observational studies: a systematic review and meta-analysis. Ann Rheum Dis. 2011;70 (11):1895-904.https://doi.org/10.1136/ard.2010.149419
49.Park HJ, Ranganathan P. TNF-alpha antagonism and cancer risk in rheumatoid arthritis: is continued vigilance warranted? Discov Med. 2012;13(70):229-34.
50.Schmeling H, Minden K, Foeldvari I et al. Efficacy and safety of adalimumab as the first and second biologic agent in juvenile idiopathic arthritis: the German Biologics JIA Registry. Arthritis Rheumatol. 2014; 66(9):2580-9.https://doi.org/10.1002/art.38741
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 А. В. Зборовская, А. В. Дорохова

This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) that allows users to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author as long as they cite the source.
COPYRIGHT NOTICE
Authors who publish in this journal agree to the following terms:
- Authors hold copyright immediately after publication of their works and retain publishing rights without any restrictions.
- The copyright commencement date complies the publication date of the issue, where the article is included in.
DEPOSIT POLICY
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) during the editorial process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work with an acknowledgement of its initial publication in this journal.
- Post-print (post-refereeing manuscript version) and publisher's PDF-version self-archiving is allowed.
- Archiving the pre-print (pre-refereeing manuscript version) not allowed.








