Emerging treatments

Intravitreal sirolimus

Combined analysis of two phase 3, randomized, double-blind trials indicates that intravitreal sirolimus improves ocular inflammation (compared with low-dose active control) in patients with noninfectious uveitis.[95] Corticosteroid tapering was reported in approximately 70% of patients receiving the higher dose. Mean changes from baseline intraocular pressure were minimal.[95]

Tocilizumab

In one small phase 2 multicenter randomized clinical trial, the majority of patients (>77%) receiving tocilizumab (an interleukin-6 antagonist monoclonal antibody) experienced a positive clinical response (ascertained using a composite end point scoring system to assess the inflammatory outcomes in patients with noninfectious uveitis).[96] Tocilizumab may be considered in cases of noninfectious uveitis refractory to tumor necrosis factor (TNF)-alpha inhibitors.[60]

Janus kinase (JAK) inhibitors

Baricitinib, an oral JAK inhibitor, is undergoing phase 3 trials in patients with chronic anterior antinuclear antibody-positive uveitis.[97] Brepocitinib, an investigational oral JAK1 and tyrosine kinase 2 (TYK2) inhibitor, is being evaluated in a phase 2 trial of patients with active noninfectious intermediate, posterior, and panuveitis.[98]

Suprachoroidal triamcinolone

Triamcinolone suprachoroidal injection has been approved by the Food and Drug Administration (FDA) for the treatment of macular edema associated with uveitis.[99]​  

Ixekizumab

A phase 4 study to evaluate the efficacy of ixekizumab (an interleukin-17A antagonist monoclonal antibody) for the treatment of noninfectious intermediate, posterior, or panuveitis (or chronic corticosteroid-dependent anterior uveitis that has been resistant to treatment with a classic synthetic disease-modifying anti-rheumatic drug [DMARD]) is currently recruiting.[100]

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