Immunosuppressive Treatment of Non-infectious Uveitis: History and Current Choices.

摘要: Non-infectious uveitis is one of the leading causes preventable blindness worldwide. Long-term immunosuppressive treatment generally required to achieve durable control inflammation in posterior and panuveitis. Although systemic corticosteroids have been gold standard immunosup- pressive for since first introduced 1950s, its side effects long-term use often warrant an adjuvant reduce dosage/duration needed maintain disease control. Conventional drugs, classified into alkylating agent, antimetabolites T cell inhibitors, widely used as corticosteroid-sparing agents, each with characteristic safety/tolerance profiles on different entities. Recently, biologic which target specific molecules immunopathogenesis uveitis, gained great interest alternative treatments refractory based their favorable safety effectiveness a variety However, lack large randomized controlled clinical trials, concerns about efficacy usage, economic burden are limiting biologics non-infectious uveitis. Local administration drugs (from biologics) through intraocular drug delivery systems represent another direction development now under intense investigation, but more evidences support regular With numerous choices belonging modalities (conventional local systems) hand, practice patterns reported vary greatly from center center. Factors influence specialists' agents may be complex include personal familiarity, availability, safety/tolerability, effectiveness, patient compliance, cost suggestions related specialists such rheumatologists pediatricians. The focus this review provide overview modality safety/tolerability believed two most important factors affecting decision making.