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SPECIAL REPORT
Year : 2018  |  Volume : 8  |  Issue : 3  |  Page : 117-120

Recommendation of using systemic anti-tumor necrosis factor-alpha for the treatment of noninfectious uveitis in Taiwan


1 Department of Ophthalmology, Taipei Veterans General Hospital; Department of Ophthalmology, School of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
2 Department of Ophthalmology, Chang Gung Memorial Hospital; Department of Ophthalmology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
3 Department of Ophthalmology, Taipei Tzu-Chi General Hospital, Taipei; Department of Medicine, Buddhist Tzu-Chi University, Hualien, Taiwan
4 Department of Ophthalmology, China Medical University Hospital; Department of Ophthalmology, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
5 Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan
6 Department of Ophthalmology, School of Medicine, Kaohsiung Medical University; Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
7 Department of Ophthalmology, School of Medicine, College of Medicine, China Medical University; Department of Medicine, Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
8 Department of Internal Medicine, Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital; Ph.D. Program of Business, Feng Chia University, Taichung, Taiwan
9 Department of Ophthalmology, School of Medicine, National Yang-Ming University School of Medicine, Taipei; Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
10 Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan

Correspondence Address:
Dr. Chang-Ping Lin
No. 7, Zhongshan South Road, Zhongzheng District, Taipei 10002
Taiwan
Dr. Shwu-Jiuan Sheu
No. 386, Dazhong 1st Road, Zuoying District, Kaohsiung City 81362
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjo.tjo_32_18

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Abstract: Noninfectious uveitis is a sight-threatening disease with an autoimmune or autoinflammatory basis. Systemic treatment is required if intraocular inflammation threatens a patient's vision or cannot be controlled locally and when it is associated with systemic rheumatic diseases. Corticosteroids and immunomodulatory chemotherapy are the conventional initial treatments. However, the various side effects of these therapies increase the burden on patients, not only physically but also mentally. Moreover, uncontrolled inflammation and poor visual outcomes have sometimes been recorded despite the combination of these medications or their high dosage. Antitumor necrosis factor-alpha (anti-TNF-α) and other biologic agents have been widely used to treat rheumatic diseases for >15 years. Randomized controlled clinical trials have demonstrated that anti-TNF-α can reduce and delay episodes of intraocular inflammation not only in patients with active uveitis but also in corticosteroid-dependent patients with inactive uveitis. The Taiwan Food and Drug Administration approved the use of adalimumab, an anti-TNF-α agent, for treating nonanterior noninfectious uveitis (NANIU) in 2017. This report provides a recommendation and a proposed stepladder approach for using anti-TNF-α agents to treat NANIU in Taiwan.


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