A comprehensive review and update on the non-biologic treatment of adult noninfectious uveitis: part I
| Autor: | C. Stephen Foster, Clovis Arcoverde Freitas-Neto, Jamie Lynne Metzinger, Asima Bajwa, Kyungmin Lee, Bailey A Wentworth |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Alkylating Agents medicine.medical_specialty Antimetabolites medicine.drug_class Inflammation Disease Biologic treatment Uveitis Intraocular inflammation Infectious uveitis Adrenal Cortex Hormones medicine Humans Immunologic Factors Pharmacology (medical) Intensive care medicine Glucocorticoids Pharmacology Autoimmune disease business.industry Anti-Inflammatory Agents Non-Steroidal General Medicine medicine.disease Anti-Bacterial Agents Immunology Corticosteroid medicine.symptom business |
| Zdroj: | Expert Opinion on Pharmacotherapy. 15:2141-2154 |
| ISSN: | 1744-7666 1465-6566 |
| DOI: | 10.1517/14656566.2014.948417 |
| Popis: | Treatment of adult, noninfectious uveitis remains a challenge for ophthalmologists around the world. The disease accounts for almost 10% of preventable blindness in the US and can be idiopathic or associated with infectious and systemic disorders. Strong evidence is still emerging to indicate that pharmacologic strategies presently used in rheumatologic or autoimmune disease may be translated to the treatment of intraocular inflammation. Corticosteroid monotherapy is widely regarded as wholly inappropriate, due to the unfavorable risk/benefit profile and poor long-term outcomes. Treatment plans have shifted away from low-dose, chronic corticosteroid therapy for maintenance, towards medium- to high-dose therapy for acute inflammation, followed immediately by initiation of immunomodulatory therapy. These therapies follow the 'stepladder approach', whereby least to more aggressive therapies are trialed to induce remission of inflammation, eventually without corticosteroids of any form (topical, local and systemic).This two-part review gives a comprehensive overview of the existing medical treatment options for patients with adult, noninfectious uveitis, as well as important advances for the treatment of ocular inflammation. Part I covers classic immunomodulation and latest information on corticosteroid therapy.The hazard of chronic corticosteroid use for the treatment of adult, noninfectious uveitis is well-documented. Corticosteroid-sparing therapies, which offer a very favorable risk-benefit profile when administered properly, should be substituted. |
| Databáze: | OpenAIRE |
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