Effectiveness of infliximab, adalimumab and golimumab for non-infectious refractory uveitis in adults.

Aim: To discuss the available data regarding the off-label uses of anti-TNF agents in non-infectious uveitis.

Data Source: A literature search was performed in Medline through PubMed from January 2001 to January 2014.

Study Selection And Data Extraction: English-language articles about uveitis treatment with anti-TNF drugs in adult patients were reviewed.

Data Synthesis: The use of anti-TNF-Î ± drugs for treatment of several refractory manifestations of refractory uveitis in adult patients is increasing. However, due to the lack of evidence from randomized controlled trials, the use of anti-TNF in uveitis remains “off-label” in most countries. There is no trial-based evidence to support it except for the experience provided by cases and case series. This experience, which is continuously increasing, has yielded encouraging results. Anti-TNF-Î ± drugs, such as infliximab, adalimumab, and golimumab, are reasonably effective for controlling ocular inflammation and sparing patients corticosteroid treatment in non-infectious refractory uveitis. Approximately 80% of patients on infliximab, adalimumab, or golimumab were able to achieve sustained control of inflammation by 6 months.

Conclusion: Anti-TNF-Î ± therapy is effective in inducing clinical remission for refractory uveitis, with a relatively low rate of treatment-ending adverse events. However, randomized and controlled trials are required to adequately assess the maintained clinical efficacy and safety profile in the long term of anti-TNF agents for non-infectious refractory uveitis.