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[Therapeutic strategy for the treatment of non-infectious uveitis proposed by an expert panel]

Authors :
E, Diwo
P, Sève
S, Trad
P, Bielefeld
D, Sène
S, Abad
A, Brézin
P, Quartier
I, Koné Paut
M, Weber
C, Chiquet
M H, Errera
J, Sellam
P, Cacoub
G, Kaplanski
L, Kodjikian
B, Bodaghi
D, Saadoun
Source :
La Revue de medecine interne. 39(9)
Publication Year :
2018

Abstract

Conventional immunosuppressive drugs, anti-TNF alpha and other biotherapies used in clinical practice are capable of controlling non-infectious anterior uveitis, posterior uveitis and panuveitis. The present work has been led by a multidisciplinary panel of experts, internists, rheumatologists and ophthalmologists and is based on a review of the literature. In case of corticodependency or sight-threatening disease, conventional immunosuppressive drugs (methotrexate, azathioprine and mycophenolate mofetil) and/or anti-TNF alpha (adalimumab, infliximab) are used to achieve and maintain remission. Interferon is an efficient immunomodulatory treatment, as a second-line therapy, for some therapeutic indications (refractory macular edema, Behçet's vascularitis). Other biologics, especially tocilizumab, are showing promising results. Local treatments (corticosteroids, sirolimus etc.) are adjuvant therapies in case of unilateral inflammatory relapse. Therapeutic response must be evaluated precisely by clinical examination and repeated complementary investigations (laser flare photometry, multimodal imaging, perimetry, electroretinography measures).

Details

Language :
French
ISSN :
17683122
Volume :
39
Issue :
9
Database :
OpenAIRE
Journal :
La Revue de medecine interne
Accession number :
edsair.pmid..........b016cc0f849c86c4fa662d235e8daece