What is the treatment for uveitis?

From the Guidelines

The treatment for uveitis typically involves corticosteroids as first-line therapy to reduce inflammation, with the specific approach depending on the type, cause, and severity of the uveitis, as well as the presence of any underlying conditions, as recommended by recent guidelines 1.

Key Considerations

• The treatment approach may involve eye drops, periocular injections, intravitreal injections, or oral prednisone, with dosages and administration routes tailored to the individual case.
• For chronic or steroid-resistant cases, immunosuppressive agents such as methotrexate, mycophenolate mofetil, azathioprine, or biologics like adalimumab may be necessary, as supported by studies 1.
• Cycloplegic drops like atropine 1% or cyclopentolate 1% are often added to reduce pain and prevent complications like synechiae.
• Regular follow-up is essential to monitor treatment response and adjust therapy accordingly, as well as to screen for medication side effects and complications like cataracts or glaucoma, as emphasized in guidelines 1.

Treatment Options

• Corticosteroids: prednisolone acetate 1% or dexamethasone 0.1% eye drops, used 4-6 times daily initially and tapered based on response.
• Immunomodulatory therapy: methotrexate (15-25 mg weekly), mycophenolate mofetil (1-3 g daily), azathioprine (1-3 mg/kg/day), or biologics like adalimumab (40 mg every 1-2 weeks), as recommended by studies 1.
• Cycloplegic drops: atropine 1% or cyclopentolate 1% to reduce pain and prevent complications like synechiae.

Important Recommendations

• Subcutaneous methotrexate is conditionally recommended over oral methotrexate for children and adolescents with JIA and CAU who are starting systemic treatment for uveitis 1.
• Regular ophthalmology screening and monitoring are crucial for early detection and management of uveitis, as emphasized in guidelines 1.

From the FDA Drug Label

1.9 Uveitis HUMIRA is indicated for the treatment of non-infectious intermediate, posterior, and panuveitis in adults and pediatric patients 2 years of age and older.

The treatment for uveitis is HUMIRA (adalimumab), which is indicated for the treatment of non-infectious intermediate, posterior, and panuveitis in adults and pediatric patients 2 years of age and older 2.

• Key points:
  • HUMIRA is used to treat non-infectious uveitis.
  • It is indicated for adults and pediatric patients 2 years of age and older.
  • The treatment has been shown to reduce the risk of treatment failure in patients with uveitis.
• Dosage: The dosage of HUMIRA for uveitis is not specified in the provided text, but it is mentioned that patients received an initial dose of 80 mg followed by 40 mg every other week starting one week after the initial dose in studies UV I and II 2 2.

From the Research

Treatment for Uveitis

The treatment for uveitis typically involves a combination of medications to reduce inflammation and prevent tissue damage.

• Noninfectious intermediate, posterior, and panuveitides are typically treated with oral corticosteroids and immunosuppression 3.
• The goal of treatment is to achieve and maintain disease quiescence, with a reduction in corticosteroid dose to minimize side effects 4, 5.
• Conventional immunosuppressive drugs, such as methotrexate, azathioprine, and mycophenolate mofetil, can be used to achieve and maintain disease quiescence 5, 6, 7.
• Biological therapies, such as anti-TNF alpha treatments (adalimumab, infliximab), can also be used to treat non-infectious uveitis 5.
• Local treatments, such as steroids and sirolimus, can be used as adjuvant therapies in case of unilateral relapse 5.
• The choice of treatment depends on the specific type and severity of uveitis, as well as the patient's overall health and medical history.

Medications Used to Treat Uveitis

• Corticosteroids, such as prednisolone, to reduce inflammation 3, 4, 7.
• Immunosuppressive drugs, such as methotrexate, azathioprine, and mycophenolate mofetil, to reduce inflammation and prevent tissue damage 4, 5, 6, 7.
• Biological therapies, such as anti-TNF alpha treatments (adalimumab, infliximab), to reduce inflammation and prevent tissue damage 5.
• Interferon, an efficient immunomodulatory drug, can be proposed as second-line therapy in specific indications 5.

Monitoring and Follow-up

• Regular follow-up appointments with an ophthalmologist to monitor the condition and adjust treatment as needed 4, 5.
• Clinical examination and appropriate ancillary investigations to evaluate therapeutic response 5.
• Monitoring for side effects of medications, such as corticosteroids and immunosuppressive drugs 4, 6, 7.