Biologic therapy for uveitis

Biologic agents have become a valuable tool in the treatment of uveitis. Clinical experience is greatest with the tumor necrosis factor antagonists, of which infliximab has been used the most extensively for ocular inflammatory disease. However, while results have been promising, especially for Adamantiades-Behets disease, few controlled studies have been published and uncontrolled studies have significant methodologic flaws. Serious side effects from these drugs may occur. Randomized controlled clinical trials comparing different biologic agents or the biologics to other immunosuppressive drugs are lacking. Adverse effects, expense and possible diminution of effect over time may all limit the usefulness of these drugs. Nonetheless, the development of biologic agents that target specific mediators of the inflammatory process holds enormous potential in the treatment of vision-threatening uveitis.