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Biologic therapy for Behçet’s uveitis: a systematic review
  1. Perpetual Uke1,
  2. Rachel Gorodkin1,
  3. Nicholas Beare2
  1. 1Rheumatology, University of Manchester, Manchester, UK
  2. 2Ophthalmology, University of Liverpool, Liverpool, UK
  1. Correspondence to Dr Perpetual Uke, Rheumatology, Biomedical Department, University of Manchester, Manchester, UK; perpetual.uke{at}nhs.net

Abstract

Background Biologics are increasingly used in management of Behçet’s Disease (BD) including ocular BD, but the evidence base is limited, mostly from studies of uveitis and BD manifestations.

Objective To review the evidence base for biologics in the treatment of ocular BD.

Methods Systematic literature search was made using exploded key words—Behçet’s, ocular, biologics in MEDLINE, Cochrane library, Database of Abstracts Reviews and Effects, Clinical Trials.gov, Science Direct and Google Scholar. There was no limitation on region, language or date (Search updated 16th October 2018). Literature retrieval was restricted to randomised controlled trials (RCTs) of biologics.

Results Of 237 papers retrieved, eight met the inclusion criteria. RCTs on interferon alpha 2a (INF-α 2a), adalimumab, secukinumab, gevokizumab, rituximab and daclizumab were retrieved (two for adalimumab and gevokizumab). The outcome measures were not met for secukinumab, daclizumab and gevokizumab. Rituximab and INF-α 2a showed promising preliminary results but sufficiently powered RCTs are needed to provide adequate evidence of efficacy. The RCTs on adalimumab did not evaluate efficacy for BD uveitis specifically, hence are of limited value for this review.

Conclusion Some biologics show promise in treating BD uveitis, but more RCTs are needed for firm conclusions about efficacy. A phase IV study or, registry of adalimumab could provide data on its efficacy in BD uveitis compared to other forms.

  • vision
  • optic nerve
  • inflammation
  • posterior chamber
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Footnotes

  • Collaborators Nicholas Beare; Rachel Gorodkin.

  • Contributors Conception or design of the work—PU and RG. Data collection—PU. Data analysis and interpretation—PU. Drafting the article—PU. Critical revision of the article—NB. Final approval of the version to be published—PU, RG and NB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Nicholas Beare—Advisory Board for Alimera Sciences, Consultancy for Abbvie, Expert Advisor for The Wellcome Trust on Research Supervisory Group for uveitis related grant.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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