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Biologics in Uveitis

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Handbook of Biologics for Rheumatological Disorders

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Abstract

Biologics are currently widely used for various immune-mediated diseases. However, they are relatively new therapy for ocular inflammatory diseases including noninfectious uveitis. Many data have supported the role of infliximab and adalimumab in controlling uveitis, particularly uveitis associated with Behçet’s disease and juvenile idiopathic arthritis. Golimumab and certolizumab may be useful as alternative tumor necrosis factor (TNF) inhibitors. Besides uveitis, rituximab can be a potent treatment for scleritis, ocular cicatricial pemphigoid, orbital inflammatory disease, retinal vasculitis, and non-paraneoplastic autoimmune retinopathy. Tocilizumab and interferons can particularly be efficacious for uveitic cystoid macular edema. Evidences showed that etanercept, gevokizumab, and abatacept may not be effective to treat uveitis. Several biologics such as anti-interleukin-12/23 (ustekinumab) and Janus kinase (JAK) inhibitors (tofacitinib, baricitinib, and filgotinib) have been studied for ocular indications.

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References

  1. Becker MD, Heiligenhaus A, Hudde T, et al. Interferon as a treatment for uveitis associated with multiple sclerosis. Br J Ophthalmol. 2005;89(10):1254–7.

    Article  CAS  Google Scholar 

  2. Birolo C, Zannin ME, Arsenyeva S, et al. Comparable efficacy of Abatacept used as first-line or second-line biological agent for severe juvenile idiopathic arthritis-related uveitis. J Rheumatol. 2016;43(11):2068–73.

    Article  CAS  Google Scholar 

  3. Deodhar AA, Miceli-Richard C, Baraliakos X, et al. Incidence of uveitis in Secukinumab-treated patients with ankylosing spondylitis: pooled data analysis from three phase 3 studies. ACR Open Rheumatol. 2020;2(5):294–9.

    Article  Google Scholar 

  4. Dick AD, Meyer P, James T, et al. Campath-1H therapy in refractory ocular inflammatory disease. Br J Ophthalmol. 2000;84(1):107–9.

    Article  CAS  Google Scholar 

  5. Fabiani C, Vitale A, Emmi G, et al. Interleukin (IL)-1 inhibition with Anakinra and Canakinumab in Behçet’s disease-related uveitis: a multicenter retrospective observational study. Clin Rheumatol. 2017;36(1):191–7.

    Article  Google Scholar 

  6. Fabiani C, Sota J, Vitale A, et al. Ten-year retention rate of infliximab in patients with Behçet’s disease-related uveitis. Ocul Immunol Inflamm. 2019;27(1):34–9.

    Article  Google Scholar 

  7. Galor A, Perez VL, Hammel JP, Lowder CY. Differential effectiveness of Etanercept and infliximab in the treatment of ocular inflammation. Ophthalmology. 2006;113(12):2317–23.

    Article  Google Scholar 

  8. Jaffe GJ, Dick AD, Brézin AP, et al. Adalimumab in patients with active noninfectious uveitis. N Engl J Med. 2016;375(10):932–43.

    Article  CAS  Google Scholar 

  9. Kötter I, Günaydin I, Zierhut M, Stübiger N. The use of interferon alpha in Behçet disease: review of the literature. Semin Arthritis Rheum. 2004;33(5):320–35.

    Article  Google Scholar 

  10. Kruh JN, Yang P, Suelves AM, Foster CS. Infliximab for the treatment of refractory noninfectious uveitis: a study of 88 patients with long-term follow-up. Ophthalmology. 2014;121(1):358–64.

    Article  Google Scholar 

  11. Lasave AF, You C, Ma L, et al. Long-term outcomes of rituximab therapy in patients with noninfectious posterior uveitis refractory to conventional immunosuppressive therapy. Retina. 2018;38(2):395–402.

    Article  CAS  Google Scholar 

  12. Letko E, Yeh S, Foster CS, et al. Efficacy and safety of intravenous Secukinumab in noninfectious uveitis requiring steroid-sparing immunosuppressive therapy. Ophthalmology. 2015;122(5):939–48.

    Article  Google Scholar 

  13. Liew SH, Nichols KK, Klamerus KJ, Li JZ, Zhang M, Foulks GN. Tofacitinib (CP-690,550), a Janus kinase inhibitor for dry eye disease: results from a phase I/II trial. Ophthalmology. 2012;119(7):1328–35.

    Article  Google Scholar 

  14. Mesquida M, Molins B, Llorenç V, et al. Twenty-four month follow-up of tocilizumab therapy for refractory uveitis-related macular edema. Retina. 2018;38(7):1361–70.

    Article  CAS  Google Scholar 

  15. Miserocchi E, Giuffrè C, Cornalba M, et al. JAK inhibitors in refractory juvenile idiopathic arthritis-associated uveitis. Clin Rheumatol. 2020;39(3):847–51.

    Article  Google Scholar 

  16. Nguyen QD, Merrill PT, Jaffe GJ, et al. Adalimumab for prevention of Uveitic flare in patients with inactive non-infectious uveitis controlled by corticosteroids (VISUAL II): a multicentre, double-masked, randomised, placebo-controlled phase 3 trial. Lancet. 2016;388(10050):1183–92.

    Article  CAS  Google Scholar 

  17. Paley MA, Karacal H, Rao PK, Margolis TP, Miner JJ. Tofacitinib for refractory uveitis and Scleritis. Am J Ophthalmol Case Rep. 2018;13:53–5.

    Article  Google Scholar 

  18. Prieto-Peña D, Calderón-Goercke M, Adán A, et al. Efficacy and safety of Certolizumab Pegol in pregnant women with uveitis. Recommendations on the management with immunosuppressive and biologic therapies in uveitis during pregnancy. Clin Exp Rheumatol. 2021;39(1):105–14.

    Article  Google Scholar 

  19. Ramanan AV, Dick AD, Guly C, et al. Tocilizumab in patients with anti-TNF refractory juvenile idiopathic arthritis-associated uveitis (APTITUDE): a multicentre, single-arm, phase 2 trial. Lancet Rheumatol. 2020;2(3):e135–41.

    Article  Google Scholar 

  20. Roos JCP, Moran C, Chatterjee VK, Jones J, Coles A, Murthy R. Immune reconstruction after Alemtuzumab therapy for multiple sclerosis triggering graves’ Orbitopathy: a case series. Eye (Lond). 2019;33(2):223–9.

    Article  Google Scholar 

  21. Rudwaleit M, Rosenbaum JT, Landewé R, et al. Observed incidence of uveitis following Certolizumab Pegol treatment in patients with axial Spondyloarthritis (the RAPID-axSpA study). Arthritis Care Res (Hoboken). 2016;68(6):838–44.

    Article  CAS  Google Scholar 

  22. Sepah YJ, Sadiq MA, Chu DS, et al. Primary (Month-6) outcomes of the STOP-uveitis study: evaluating the safety, tolerability, and efficacy of tocilizumab in patients with noninfectious uveitis. Am J Ophthalmol. 2017;183:71–80.

    Article  CAS  Google Scholar 

  23. Smith JA, Thompson DJ, Whitcup SM, et al. A randomized, placebo-controlled, double-masked clinical trial of Etanercept for the treatment of uveitis associated with juvenile idiopathic arthritis. Arthritis Rheum. 2005;53(1):18–23.

    Article  CAS  Google Scholar 

  24. Suhler EB, Smith JR, Giles TR, et al. Infliximab therapy for refractory uveitis: 2-year results of a prospective trial. Arch Ophthalmol. 2009;127(6):819–22.

    Article  CAS  Google Scholar 

  25. Suhler EB, Lim LL, Beardsley RM, et al. Rituximab therapy for refractory orbital inflammation: results of a phase 1/2, dose-ranging, Randomized. Clin Trial JAMA Ophthalmol. 2014a;132(5):572–8.

    Article  CAS  Google Scholar 

  26. Suhler EB, Lim LL, Beardsley RM, et al. Rituximab therapy for refractory Scleritis: results of a phase I/II dose-ranging, randomized. Clin Trial Ophthalmol. 2014b;121(10):1885–91.

    Google Scholar 

  27. Suhler EB, Adán A, Brézin AP, et al. Safety and efficacy of adalimumab in patients with noninfectious uveitis in an ongoing open-label study: VISUAL III. Ophthalmology. 2018;125(7):1075–87.

    Article  Google Scholar 

  28. Suhler EB, Jaffe GJ, Fortin E, et al. Long-term safety and efficacy of adalimumab in patients with noninfectious intermediate uveitis, posterior uveitis, or Panuveitis. Ophthalmology 2021;128(6):899−909.

    Google Scholar 

  29. Tappeiner C, Miserocchi E, Bodaghi B, et al. Abatacept in the treatment of severe, longstanding, and refractory uveitis associated with juvenile idiopathic arthritis. J Rheumatol. 2015;42(4):706–11.

    Article  CAS  Google Scholar 

  30. van Bentum RE, Heslinga SC, Nurmohamed MT, et al. Reduced occurrence rate of acute anterior uveitis in ankylosing spondylitis treated with Golimumab – the GO-EASY study. J Rheumatol. 2019;46(2):153–9.

    Article  Google Scholar 

  31. Vegas-Revenga N, Calvo-Río V, Mesquida M, et al. Anti-IL6-receptor tocilizumab in refractory and noninfectious Uveitic cystoid macular edema: multicenter study of 25 patients. Am J Ophthalmol. 2019;200:85–94.

    Article  CAS  Google Scholar 

  32. Willis MD, Pickersgill TP, Robertson NP, Lee RWJ, Dick AD, Carreño E. Alemtuzumab-induced remission of multiple sclerosis-associated uveitis. Int Ophthalmol. 2017;37(5):1229–33.

    Article  Google Scholar 

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Acknowledgment

This work was supported by NIH Grant EY026572, the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness.

Both authors are investigators for Santen and for Gilead. Dr. Rosenbaum receives financial support from Abbvie, Gilead, Santen, UCB, Novartis, Eyevensys, Celldex, Corvus, Kyverna, Revolo, Affibody, and Roche. Pfizer and Horizon provide clinical trial support to OHSU. He receives royalties from UpToDate.

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Authors and Affiliations

  1. Legacy Devers Eye Institute, Oregon, USA

    Sirichai Pasadhika & James T. Rosenbaum

  2. Departments of Ophthalmology, Medicine and Cell Biology, Oregon Health & Science University, Oregon, USA

    James T. Rosenbaum

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  1. Sirichai Pasadhika
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  2. James T. Rosenbaum
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Correspondence to Sirichai Pasadhika .

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  1. Sir Ganga Ram Hospital, New Delhi, India

    Neeraj Jain  & Lalit Duggal  & 

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Pasadhika, S., Rosenbaum, J.T. (2022). Biologics in Uveitis. In: Jain, N., Duggal, L. (eds) Handbook of Biologics for Rheumatological Disorders. Springer, Singapore. https://doi.org/10.1007/978-981-16-7200-2_21

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  • DOI: https://doi.org/10.1007/978-981-16-7200-2_21

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-16-7199-9

  • Online ISBN: 978-981-16-7200-2

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