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非感染性后葡萄膜炎治疗的最新进展

Recent advances in the management of non-infectious posterior uveitis.

作者信息

Singh Rohan Bir, Sinha Shruti, Saini Chhavi, Elbasiony Elsayed, Thakur Sahil, Agarwal Aniruddha

机构信息

Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear, Boston, MA, 02114, USA.

Department of Ocular Epidemiology, Singapore Eye Research Center, Singapore, 169856, Singapore.

出版信息

Int Ophthalmol. 2020 Nov;40(11):3187-3207. doi: 10.1007/s10792-020-01496-0. Epub 2020 Jul 2.

Abstract

PURPOSE

To review the current regimens and novel therapeutic modalities in various stages of research and development for the management of non-infectious posterior uveitis (NIPU).

METHODS

We performed a thorough review of current literature using PubMed, Google Scholar and Clinicaltrials.gov to identify the published literature about the available therapeutics and novel drugs/therapies in different stages of clinical trials.

RESULTS

The current management regimen for non-infectious posterior uveitis includes corticosteroids, immunomodulatory therapies and anti-metabolites. However, NIPU requires long-term management for efficacious remission of the disease and to prevent disease relapse. Long-term safety issues associated with steroids have led to efforts to develop novel therapeutic agents including biological response modulators and immunosuppressants. The current therapeutic agents in various stages of development include calcineurin inhibitors, biologic response modifiers and a more a comprehensive modalities like ocular gene therapy as well as novel drug delivery mechanisms for higher bioavailability to the target tissues, with minimal systemic effects.

CONCLUSION

Novel efficacious therapeutic modalities under development will help overcome the challenges associated with the traditional therapeutic agents.

摘要

目的

回顾非感染性后葡萄膜炎(NIPU)管理中处于不同研发阶段的当前治疗方案和新型治疗方式。

方法

我们使用PubMed、谷歌学术和Clinicaltrials.gov对当前文献进行了全面回顾,以确定已发表的关于不同临床试验阶段可用治疗方法和新型药物/疗法的文献。

结果

非感染性后葡萄膜炎的当前管理方案包括皮质类固醇、免疫调节疗法和抗代谢药物。然而,NIPU需要长期管理以有效缓解疾病并预防疾病复发。与类固醇相关的长期安全性问题促使人们努力开发新型治疗药物,包括生物反应调节剂和免疫抑制剂。处于不同开发阶段的当前治疗药物包括钙调神经磷酸酶抑制剂、生物反应调节剂以及更全面的方式,如眼部基因治疗以及用于提高对靶组织的生物利用度且全身作用最小的新型药物递送机制。

结论

正在开发的新型有效治疗方式将有助于克服与传统治疗药物相关的挑战。

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