Systemic immunosuppressive therapies for uveitis in developing countries

• Published in: Indian journal of ophthalmology Vol. 68; no. 9; pp. 1852 - 1862
• Main Authors: Agrawal, Hitesh, Doan, Hien, Pham, Brandon, Khosla, Amit, Babu, Manohar, McCluskey, Peter, Nguyen, Quan, Sangwan, Virender, Reddy, Subhakar, Sawhney, Sujata, Tyagi, Mudit
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.09.2020; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Adrenal Cortex Hormones; biologicals; Comparative analysis; Corticosteroid drugs; Corticosteroids; Developing Countries; Diagnosis; Drug therapy; Humans; Immune response; Immunosuppression; Immunosuppressive Agents; Inflammation; LDCs; non infectious uveitis; Review; Side effects; Uveitis; Uveitis - drug therapy; India; non infectious uveitis; immunosuppression; corticosteroids; inflammation; Biologicals
• ISSN: 0301-4738; 1998-3689
• DOI: 10.4103/ijo.IJO_1548_20

There are multiple approaches to inhibit inflammatory molecules and pathways in noninfectious uveitis. The cornerstone of local and systemic anti-inflammatory treatment is corticosteroid therapy. Corticosteroids remain the most potent and efficacious drugs for treating intraocular inflammation. However, their long-term use is limited by their medium- and long-term side effects, which are a major concern. The approach taken to limit corticosteroid side effects is to introduce steroid-sparing agents that suppress the inflammatory pathways and immune response differently than corticosteroids. There are several classes of such drugs that are affordable, effective, and generally well-tolerated. Relatively recently, an increasing range of biologic agents has become available to treat intraocular inflammation. However, the relatively expensive cost of these therapies limits their use in the developing world. This systemic review aimst to discuss the use of corticosteroids and different immunosuppressive regimens in the management of various uveitides.