Neri Piergiorgio, Arapi Ilir, Nicolai Michele, Pirani Vittorio, Saitta Andrea, Luchetti Michele M, Giovannini Alfonso, Mariotti Cesare
Eye Clinic, Via conca 71, 60121 Ancona, Italy.
Curr Drug Saf. 2016;11(1):47-54. doi: 10.2174/1574886310666151014114925.
Non-infectious uveitis can be a potentially sight threatening disease. Very recently, therapeutic strategies have turned towards a new methodology, which includes biologic agents. The introduction of biologic drugs has started a Copernican revolution in ophthalmology: biologic therapies represent a revolutionary option for those patients who present non-responder, sight threatening uveitis. The availability of these therapies has improved the uveitis outcome. The present review shows the most relevant medical literature on biologic agents in ophthalmology, such as tumor necrosis factor blockers, anti-interleukins and other related biologics. Several papers reported the efficacy of biologic agents in a large number of refractory uveitides, which suggest a promising role of biologic drugs for selected cases. On the other hand, the medical literature does not have consistent numbers yet, which hopefully will validate the promising preliminary results. Biologic agents are not only promising drugs for the treatment of nonresponder uveitis, but also they show an apparently favourable safety profile, although several topics remain unsolved: it is still not clear when commencing the treatment, which agent to choose, and the length of biologic therapy. Moreover, the high costs and the still not clear safety profile have very often limited their use only for severe, non-responder uveitis in highly specialized uveitis centres.
非感染性葡萄膜炎可能是一种潜在的致盲性疾病。最近，治疗策略已转向一种新方法，其中包括生物制剂。生物药物的引入在眼科领域引发了一场哥白尼式的革命：生物疗法对于那些患有难治性、威胁视力的葡萄膜炎患者而言是一种革命性的选择。这些疗法的出现改善了葡萄膜炎的治疗效果。本综述展示了眼科领域中关于生物制剂的最相关医学文献，如肿瘤坏死因子阻滞剂、抗白细胞介素及其他相关生物制剂。多篇论文报道了生物制剂在大量难治性葡萄膜炎中的疗效，这表明生物药物在特定病例中具有广阔前景。另一方面，医学文献目前尚无一致的数据，有望能证实这些初步的良好结果。生物制剂不仅是治疗难治性葡萄膜炎的有前景的药物，而且它们的安全性也表现良好，尽管仍有几个问题尚未解决：治疗何时开始、选择何种药物以及生物治疗的时长仍不明确。此外，高昂的成本以及尚不明确的安全性常常限制了它们仅在高度专业化的葡萄膜炎中心用于治疗严重的难治性葡萄膜炎。
