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New Immunosuppressive Therapies and Strategies in Chronic Uveitis Treatment
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New Immunosuppressive Therapies and Strategies in Chronic Uveitis Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (30 October 2019) | Viewed by 3214

Special Issue Editor

Prof. Gabriele Simonini

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Guest Editor
Pediatric Rheumatologist, Professor of Paediatrics Rheumatology, Anna Meyer Children's Hospital, University of Florence, Musculoskeletal Research Programme Epidemiology group, University of Aberdeen, Aberdeen, UK
Interests: childhood chronic uveitis; paediatric rheumatic diseases; biological modifier drugs (biologics); epidemiology research; outcome measures; meta-analysis

Special Issue Information

Dear Colleagues,

Non-infectious chronic uveitis represents a serious and disabling sight-threatening disease accounting for up to 10% of pathologies leading to blindness. Currently, a step-by step escalating immunosuppressive therapy is generally used, in children as well as in adults, and anti-TNF biologic therapies have markedly increased the treatment options for sight-threatening uveitis refractory to conventional immune-modulatory therapy (DMARD) in addition to topical and/or systemic corticosteroids. Recently, the evidence coming from RCTs made a significant step-forward in defining the optimal treatment of auto-immune chronic uveitis. However, a subset of patients, overall 25%, fails to respond to TNFα-blockers or is unable to tolerate these therapies and may there fore benefit from using a different treatment strategies or a second TNF blocker. In this clinical setting, the availability of several different molecules is often puzzling because their heterogeneity, utility and safety. In order to optimize the treatment, a strong communication between ophthalmologists and immunologists/rheumatologists, sharing same language and outcome measures, is mandatory

The present Issue aims to provide current insights into the recent therapeutic options, to summarize the current available evidence of theirs use and disseminate recommended treatment strategies in such complicating, but fascinating, disease.

Prof. Gabriele Simonini
Guest Editor

Manuscript Submission Information

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Keywords

  • Anti-TNF a strategies
  • Anti-IL-6 therapy
  • Anti-IL-1
  • Anti CD20
  • Abatacept
  • Current evidence and guidelines
  • Randomized clinical trials in uveitis
  • Biological modifier drugs: time for starting/time for stopping

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Published Papers (1 paper)

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Research

15 pages, 4261 KiB  
Article
Intraocular Inflammation Control and Changes in Retinal and Choroidal Architecture in Refractory Non-Infectious Uveitis Patients after Adalimumab Therapy
by Vittorio Pirani, Paolo Pelliccioni, Serena De Turris, Alessandro Rosati, Alessandro Franceschi, Pierangelo Pasanisi, Rosaria Gesuita, Michele Nicolai and Cesare Mariotti
J. Clin. Med. 2020, 9(2), 510; https://doi.org/10.3390/jcm9020510 - 13 Feb 2020
Cited by 7 | Viewed by 2908
Abstract
Background: Non-infectious uveitis represents a leading cause of visual impairment, and inflammation control represents a major priority in tackling visual acuity loss due to complications such as macular edema; different immunomodulatory drugs are currently being used, including anti-TNF-alpha Adalimumab. Methods: This [...] Read more.
Background: Non-infectious uveitis represents a leading cause of visual impairment, and inflammation control represents a major priority in tackling visual acuity loss due to complications such as macular edema; different immunomodulatory drugs are currently being used, including anti-TNF-alpha Adalimumab. Methods: This was a monocentric observational study of 18 eyes of 18 patients with non-infectious uveitis treated with Adalimumab. The primary endpoint was the control of ocular inflammation. The secondary endpoints included the study of macular and choroidal thickness and architecture, visual acuity, changes in other treatments, and adverse effects. Results: Ocular inflammation was controlled at 12 months for 83.3% of patients. Central macular thickness improved from a median of 229.75 µm at baseline to 213 µm at 12 months, while choroidal thickness decreased by 11.54% at the end of the follow-up. A reduction of vasculitis on fluorescein angiography and of hyperreflective spots on optical coherence tomography was noted. Visual acuity also improved from 0.51 (logMAR) before treatment to 0.24 at more than 12 months (p = 0.01). A total of 11.1% of patients experienced side effects. Conclusion: Our study confirms the efficacy of adalimumab for the control of ocular inflammation, visual acuity preservation, and for corticosteroid sparing. Full article
(This article belongs to the Special Issue New Immunosuppressive Therapies and Strategies in Chronic Uveitis Treatment)
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