Biologic Agents
These therapies tend to be used in cases where the antimetabolites and T-cell inhibitors have failed to be effective.
They are costly and while some patients’ systemic disease may mean a particular drug is approved for the disease, rheumatologists may have to present a special case to the hospital’s Trust to get funding for other patients.
Newer biologic therapies for uveitis.
Specialist uveitis centres conduct trials and small case studies on newer biologic therapies such as: rituximab, golimumab and gevokizumab
Arthritis information sheet: Rituximab
This is a treatment which is self-injected every two weeks. It may be used in combination with antimetabolites or calcineurin inhibitors. Its effect on uveitic activity can be swift, with an effect seen within days or weeks.
Information about Adalimumab can be found here:
Infliximab is given through intravenous infusion every six to eight weeks. The infusion takes about two hours and blood tests are done before the infusion begins. If you have an infection, the infusion will be delayed until you recover. As with Adalimumab, a response is swift and some patients will notice an improvement in their sight by the time an infusion ends. Infliximab is effective in resolving cystoid macular oedema.
Information about infliximab can be found here:
This is an endogenous cytokine which is self-injected and has recently been trialed with Behcet’s uveitis patients. It was hoped that this treatment would not only prevent flares of their uveitis, but that the uveitis would be placed in remission for several years. Like Infliximab, it has resolved cystoid macular oedema rapidly.
Information about Interferon alpha and Behcet’s uveitis can be found here.