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Biologic Therapy for HLA-B27-associated Ocular Disorders
Authors:Julie Gueudry  Jennifer E. Thorne  Rakesh Bansie  Juergen Braun  P. Martin van Hagen
Affiliation:1. Department of Ophthalmology, Charles Nicolle University Hospital, Rouen, France;2. Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA;3. Department of Clinical Immunology, Erasmus Medical Center, Rotterdam, the Netherlands;4. Department of Rheumatology, Rheumazentrum Ruhrgebiet, Herne, Germany
Abstract:The treatment of articular and extra-articular manifestations associated with HLA-B27 has undergone dramatic changes over the past two decades, mainly as a consequence of the introduction of biologic agents and in particular anti-tumor necrosis factor α (anti-TNFα) agents. Uveitis is known to be the most frequent extra-articular feature in HLA-B27-associated spondyloarthritides. Topical corticosteroids and cycloplegic agents remain the cornerstones of treatment. However, biologic therapy may be effective in the management of refractory or recurrent forms of uveitis. This review gives an update on the management of HLA-B27-associated ocular disorders with biologics, including anti-TNFα agents and non-anti-TNFα biologic modifier drugs. There is an emerging role for newer biologics targeting interleukin-12/23 and interleukin-17 for the treatment of spondyloarthritides but data on their efficacy on anterior uveitis are sparse.
Keywords:Anti-TNFα  biologics  HLA-B27  spondyloarthritis  uveitis
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