A review of advances in biologic therapy for Behçet uveitis_Chinese Journal of Ocular Fundus Diseases

Authors：

Li Biao , Li Haoran , Huang Hui ,  Zheng Yanlin

Department of Ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610032, China;

Corresponding author：

Zheng Yanlin, Email: zyl3327@163.com

Keywords：

Behcet syndrome; Uveitis; Biological agents; Review

DOI：

10.3760/cma.j.cn511434-20201014-00493

Video：

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Behçet uveitis (BU), one of the common manifestations of Behçet syndrome, has a poor prognosis, high blinding rate, and severely impairs the quality of patients’ life. The current treatment principle mainly induce and maintain inflammation remission by suppressing the immune response. The glucocorticoid combined with immunosuppressive therapy for the treatment of BU has disadvantages such as long medication time, severe adverse effects, and poor long-term prognosis, whereas biologics have gradually attracted attention about the treatment of BU because of their high efficacy, low toxicity, and good long-term prognosis. The biologics used to treat BU include tumor necrosis factor-α inhibitors, interferon-α, interleukin blockers, and lymphocyte targeting preparations. It is believed that with the progress of various studies and clinical trials, the stepwise application of biologics is promising, and it is hopeful to provide more accurate and effective treatment for patients with BU in the future.

Citation： Li Biao, Li Haoran, Huang Hui, Zheng Yanlin. A review of advances in biologic therapy for Behçet uveitis. Chinese Journal of Ocular Fundus Diseases, 2021, 37(9): 737-742. doi: 10.3760/cma.j.cn511434-20201014-00493 Copy

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1. 刘新书, 高斐, 赵潺, 等. 白塞综合征葡萄膜炎临床特点分析[J]. 中华眼科杂志, 2020, 56(3): 217-223. DOI: 10.3760/cma.j.issn.0412-4081.2020.03.010.Liu XS, Gao F, Zhao C, et al. Clinical features of patients with Behcet’s uveitis[J]. Chin J Ophthalmol, 2020, 56(3): 217-223. DOI: 10.3760/cma.j.issn.0412-4081.2020.03.010.
2. Hamzaoui K. Th17 cells in Behçet's disease: a new immunoregulatory axis[J]. Clin Exp Rheumatol, 2011, 29(Suppl 67): S71-76.
3. Sota J, Cantarini L, Vitale A, et al. Long-term outcomes of Behcet's syndrome-related uveitis: a monocentric Italian experience[J/OL]. Mediators Inflamm, 2020, 2020: 6872402[2020-05-15]. https://pubmed.ncbi.nlm.nih.gov/32508524/. DOI: 10.1155/2020/6872402.
4. Hatemi G, Christensen R, Bang D, et al. 2018 update of the EULAR recommendations for the management of Behçet's syndrome[J]. Ann Rheum Dis, 2018, 77(6): 808-818. DOI: 10.1136/annrheumdis-2018-213225.
5. Rao NA, Kimoto T, Zamir E, et al. Pathogenic role of retinal microglia in experimental uveoretinitis[J]. Invest Ophthalmol Vis Sci, 2003, 44(1): 22-31. DOI: 10.1167/iovs.02-0199.
6. Derevjanik NL, Vinores SA, Xiao WH, et al. Quantitative assessment of the integrity of the blood-retinal barrier in mice[J]. Invest Ophthalmol Vis Sci, 2002, 43(7): 2462-2467.
7. El Menyawi M, Fawzy M, Al-Nahas Z, et al. Serum tumor necrosis factor alpha (TNF-α) level in patients with Behçet’s disease: relation to clinical manifestations and disease activity[J]. The Egyptian Rheumatologist, 2014, 36(3): 139-143. DOI: 10.1016/j.ejr.2014.01.004.
8. Takeuchi M, Karasawa Y, Harimoto K, et al. Analysis of Th cell-related cytokine production in Behçet disease patients with uveitis before and after infliximab treatment[J]. Ocul Immunol Inflamm, 2017, 25(1): 52-61. DOI: 10.3109/09273948.2016.1158276.
9. Levy-Clarke G, Jabs DA, Read RW, et al. Expert panel recommendations for the use of anti-tumor necrosis factor biologic agents in patients with ocular inflammatory disorders[J]. Ophthalmology, 2014, 121(3): 785-796. DOI: 10.1016/j.ophtha.2013.09.048.
10. Sugita S, Yamada Y, Kaneko S, et al. Induction of regulatory T cells by infliximab in Behcet's disease[J]. Invest Ophthalmol Vis Sci, 2011, 52(1): 476-484. DOI: 10.1167/iovs.10-5916.
11. Yamada Y, Sugita S, Tanaka H, et al. Comparison of infliximab versus ciclosporin during the initial 6-month treatment period in Behcet disease[J]. Br J Ophthalmol, 2010, 94(3): 284-288. DOI: 10.1136/bjo.2009.158840.
12. Al Rashidi S, Al Fawaz A, Kangave D, et al. Long-term clinical outcomes in patients with refractory uveitis associated with Behçet disease treated with infliximab[J]. Ocul Immunol Inflamm, 2013, 21(6): 468-474. DOI: 10.3109/09273948.2013.779727.
13. Sfikakis PP, Theodossiadis PG, Katsiari CG, et al. Effect of infliximab on sight-threatening panuveitis in Behcet's disease[J]. Lancet, 2001, 358(9278): 295-296. DOI: 10.1016/s0140-6736(01)05497-6.
14. Atienza-Mateo B, Martín-Varillas JL, Calvo-Rio V, et al. Comparative study of infliximab versus adalimumab in refractory uveitis due to Behcet's disease: national multicenter study of 177 cases[J]. Arthritis Rheumatol, 2019, 71(12): 2081-2089. DOI: 10.1002/art.41026.
15. Fabiani C, Sota J, Vitale A, et al. Ten-year retention rate of infliximab in patients with Behcet's disease-related uveitis[J]. Ocul Immunol Inflamm, 2019, 27(1): 34-39. DOI: 10.1080/09273948.2017.1391297.
16. Urruticoechea-Arana A, Cobo-Ibanez T, Villaverde-Garcia V, et al. Efficacy and safety of biological therapy compared to synthetic immunomodulatory drugs or placebo in the treatment of Behcet's disease associated uveitis: a systematic review[J]. Rheumatol Int, 2019, 39(1): 47-58. DOI: 10.1007/s00296-018-4193-z.
17. Sakai T, Kanetaka A, Noro T, et al. Intraocular surgery in patients receiving infliximab therapy for Behçet disease[J]. Jpn J Ophthalmol, 2010, 54(4): 360-361. DOI: 10.1007/s10384-010-0824-y.
18. Hamza MM, Macky TA, Sidky MK, et al. Intravitreal infliximab in refractory uveitis in Behcet’s disease: a safety and efficacy clinical study[J]. Retina, 2016, 36(12): 2399-2408. DOI: 10.1097/IAE.0000000000001109.
19. Neri P, Arapi I, Nicolai M, et al. Biologic therapy in inflammatory eye conditions (ophtalmology): safety profile[J]. Curr Drug Saf, 2016, 11(1): 47-54. DOI: 10.2174/1574886310666151014114925.
20. Yamada Y, Sugita S, Tanaka H, et al. Timing of recurrent uveitis in patients with Behcet's disease receiving infliximab treatment[J]. Br J Ophthalmol, 2011, 95(2): 205-208. DOI: 10.1136/bjo.2009.168856.
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Chinese Journal of Ocular Fundus Diseases

A review of advances in biologic therapy for Behçet uveitis

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