Current and Emerging Pharmaceutical Therapies for Noninfectious Uveitis

Abstract

The term “uveitis” refers to a heterogeneous group of diseases that are classified into anterior, intermediate, posterior, and panuveitis by the Standardization of Uveitis Nomenclature (SUN) working group according to the primary site of intraocular inflammation.1 The disease has been estimated to account for up to 15% of all cases of blindness in the United States.2,3 Uveitis requiring systemic therapy is managed with systemic corticosteroids to treat acute inflammation and steroid-sparing immunomodulatory therapies (IMTs) prescribed in the long term to both induce and maintain quiescence and reduce the duration of systemic corticosteroid therapy.4 IMT is typically introduced using a “stepladder” approach, with antimetabolites or T-cell inhibitors usually prescribed as first-line agents and biologics reserved for patients requiring an escalation in therapy, although there are some circumstances in which biologics are recommended as first-line treatment.4–6 In recent years, there has been an expansion in the therapeutic options available for the treatment of uveitis. The aim of this review article is to provide an overview of both existing therapies and advances in treatment for noninfectious uveitis, with a focus on biological agents and potential therapies in the pipeline. The emerging treatments discussed will include new corticosteroid therapies, biological agents with novel cytokine targets, small molecular inhibitors, and intravitreal sirolimus.