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Ординатура / Офтальмология / Английские материалы / New Treatments in Noninfectious Uveitis_Miserocchi, Modorati, Foster_2012

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Quan Dong Nguyen, MD, MSc

Diseases of the Retina and Vitreous, and Uveitis

Wilmer Eye Institute

Johns Hopkins University School of Medicine 600 North Wolfe Street, Maumenee 745 Baltimore, MD 21287 (USA)

E-Mail qnguyen4@jhmi.edu

New Treatment Options for Noninfectious Uveitis

161

Subject Index

Abatacept 152

Adalimumab

adverse events 70–72

Behçet’s disease-associated uveitis management 67

dosing 65 indications 65

intravitreal injection 116

juvenile idiopathic arthritis-associated uveitis management 69

ocular surgery precautions 72 overview 51, 54, 66 sarcoidosis-associated uveitis

management 70 spondyloarthropathy-associated uveitis

management 67, 68

switching with other tumor necrosis factor-α antagonists 72

Adhesion molecules, uveitis pathogenesis 139 therapeutic targeting 152

AIN457, interleukin-17 antagonism 85, 86, 152 Alemtuzumab 153

AMG714 152

Anakinra, interleukin-1 receptor antagonism 83, 148, 149

ARC1905 153

Azathioprine contraindications 39 dosing 30, 34, 38 drug interactions 39 history of use 3, 37 indications 30 pharmacology 37 side effects 38, 42

Systemic Immunosuppressive Therapy for Eye Disease Study 38

therapeutic value 38

Behçet’s disease-associated uveitis interferon-α therapy 92, 93 rituximab therapy 101, 102 tumor necrosis factor-α antagonist

therapy 66–68 Bevacizumab

intravitreal injection 115 overview 52

Biologic agent, definition 81

Canakinumab, interleukin-1 antagonism 148 Cataract, corticosteroid induction 25

CD20 antagonism, see Rituximab Certolizumab-pegol 66, 152 Children

corticosteroid precautions 27 mycophenolate mofetil for pediatric uveitis

management 59, 60 Chlorambucil

contraindications 34 dosing 30, 34 history of use 3, 33 indications 30 pharmacology 33, 34 side effects 34, 42, 50

Systemic Immunosuppressive Therapy for Eye Disease Study 34, 35

therapeutic value 34

CME, see Cystoid macular edema Corticosteroids (CS)

guidelines for use 4, 5, 19–23 high-risk patients

children 27 elderly 27 lactation 27

162

pregnancy 26 history of use 2

indications in noninfectious uveitis 8 intravitreal implants

efficacy 126–128

implant design and pharmacology 124– 126

scenarios for uveitis management no systemic disease 131 specific medical conditions 131

systemic autoimmune disease 129, 130

systemic therapy comparison 128, 129 intravitreal injection 116, 117 iontophoresis 13, 156

overview 7, 8

periocular preparations and injection 13–15

pharmacology 9, 10, 123, 124 potency by type

regional injection 13 systemic delivery 10 topical delivery 11

side effects cataract 25

endocrine system 26

fluid and electrolyte disturbances 25 gastrointestinal system 25

immune system 26

intraocular pressure elevation 24, 25 musculoskeletal system 25

nervous system 26 psychiatric effects 26 skin 26

systemic administration adjunctive therapy 15, 16 alternate-day therapy 19 dependence 18

discontinuation and tapering 17, 18 induction therapy 16, 17 preparations 15

resistance 18, 19 topical preparations and

administration 10–13 CS, see Corticosteroids CsA, see Cyclosporin A Cyclophosphamide

contraindications 33 dosing 30, 32

history of use 2, 3, 30, 31 indications 30

pharmacology 31 side effects 32, 33, 42

Systemic Immunosuppressive Therapy for Eye Disease Study 33, 49

therapeutic value 31, 32 Cyclosporin A (CsA)

contraindications 41 dosing 30, 34, 40 drug interactions 41 history of use 3, 38 indications 30

mechanism of action 50 pharmacology 39

side effects 40–42

Systemic Immunosuppressive Therapy for Eye Disease Study 41, 50

therapeutic value 39, 40 Cystoid macular edema (CME)

interferon-α therapy 92, 94, 95 treatment overview 137, 139

Daclizumab, interleukin-1 receptor antagonism 52, 83, 84

EAU, see Experimental autoimmune uveitis Efalizumab 152

EIU, see Endotoxin-induced uveitis Elderly, corticosteroid precautions 27 Enbrel, see Etanercept Endotoxin-induced uveitis (EIU) 135 ESBA105 73

Etanercept (Enbrel) adverse events 70–72 dosing 65

history of use 4 indications 65

juvenile idiopathic arthritis-associated uveitis management 69

ocular surgery precautions 72 overview 64 spondyloarthropathy-associated uveitis

management 68

switching with other tumor necrosis factor-α antagonists 72

Experimental autoimmune uveitis (EAU) 135

FK506, see Tacrolimus

Gevokizumab, interleukin-1 antagonism 149 Glucocorticoids, see Corticosteroids Golimumab 66, 152

Subject Index

163

Historical perspective, uveitis management 1–5

HuMax-IL15 84

IFN-α, see Interferon-α IFN-β, see Interferon-β IL-1, see Interleukin-1 Implant, see Corticosteroids Infliximab

adverse events 70–72

Behçet’s disease-associated uveitis management 67

dosing 65 indications 65

intravitreal injection 116

juvenile idiopathic arthritis-associated uveitis management 69

ocular surgery precautions 72 overview 50, 51, 65 sarcoidosis-associated uveitis

management 69 spondyloarthropathy-associated uveitis

management 68

switching with other tumor necrosis factor-α antagonists 72

Interferon-α (IFN-α)

animal studies of immune suppression 92

Behçet’s disease-associated uveitis management 92, 93

cystoid macular edema management 92, 94, 95

mechanism of action 90, 91 overview of therapy 51 pharmacology 91, 92 preparations 91

side effects 95, 96

Interferon-β (IFN-β), preparations 91 Interleukin-1 (IL-1)

receptor antagonists, see Interleukin antagonists

uveitis pathogenesis 146 Interleukin antagonists

AIN457 and interleukin-17 antagonism 85, 86

anakinra and interleukin-1 receptor antagonism 83, 148, 149

canakinumab and interleukin-1 antagonism 148

daclizumab and interleukin-1 receptor antagonism 83, 84

gevokizumab and interleukin-1 antagonism 149

HuMax-IL15 84 indications 82

interdisciplinary approach in use 82 rationale for uveitis management 79–81,

135–137, 139

rilonacept and interleukin-1 receptor antagonism 147, 148

safety 81, 82

tocilizumab and interleukin-6 antagonism 84, 85, 149–151

Intraocular lymphoma-associated uveitis, rituximab therapy 103, 104

Intraocular pressure (IOP), corticosteroid elevation 24, 25

Intravenous immunoglobulin 52 Intravitreal implant, see Corticosteroids Intravitreal injection

adalimumab 116 anatomy 111 bevacizumab 115 corticosteroids 116, 117 infliximab 116 methotrexate 113

nonsteroidal anti-inflammatory drugs 117, 118

posterior segment drug delivery techniques 111, 112

ranibizumab 115 tacrolimus 114 technique 112, 113

tumor necrosis factor-α antagonists 114– 116

Iontophoresis corticosteroids 13, 156 drug delivery 153–156

IOP, see Intraocular pressure ISIS-2302 152

Juvenile idiopathic arthritis-associated uveitis rituximab therapy 102, 103

tumor necrosis factor-α antagonist therapy 69

Lactation, corticosteroid precautions 27 Lymphoma, see Intraocular lymphoma-

associated uveitis

Methotrexate (MTX)

contraindications 36

164

Subject Index

dosing 30, 34, 36 drug interactions 37 history of use 35, 49 indications 30 injection 52

intravitreal injection 113 pharmacology 35, 36 side effects 36, 42

Systemic Immunosuppressive Therapy for Eye Disease Study 37

therapeutic value 36

MMF, see Mycophenolate mofetil MTX, see Methotrexate

Multiple sclerosis, tumor necrosis factor-α antagonist precautions 71

Murmonab (OKT3), history of use 3, 4 Mycophenolate mofetil (MMF)

algorithms for uveitis treatment 60–62 indications 58

mechanism of action 57 overview 49

pediatric uveitis management 59, 60 uveitis trials 58, 59

Nanoparticles, drug delivery 150, 151, 153 Natalizumab 152

Nonsteroidal anti-inflammatory drugs (NSAIDs), intravitreal injection 117, 118

NSAIDs, see Nonsteroidal anti-inflammatory drugs

Ocular vasculitis, rituximab therapy 105 OKT3, see Murmonab

POT-4 153

Pregnancy, corticosteroid precautions 26

Ranibizumab

intravitreal injection 115 overview 52

Rilonacept, interleukin-1 receptor antagonism 147, 148

Rituximab (RTX) mechanism of action 100

ocular vasculitis management 105 overview 51, 98–100, 153 prospects for study 107 retreatment 107

safety 106, 107

scleritis management 104, 105

Sjögren’s syndrome management 105, 106

systemic autoimmune disease management 100

uveitis management

Behçet’s disease-associated uveitis 101, 102

intraocular lymphoma-associated uveitis 103, 104

juvenile idiopathic arthritis-associated uveitis 102, 103

RTX, see Rituximab

Sarcoidosis, tumor necrosis factor-α antagonists

induction 72

uveitis treatment 69, 70 Scleritis, rituximab therapy 104, 105 Sirolimus

efficacy evaluation 145, 146 intravitreal injection 52 mechanism of action 142, 144, 145 side effects 146

Sjögren’s syndrome, rituximab therapy 105, 106

Spondyloarthropathy-associated uveitis, tumor necrosis factor-α antagonist therapy 67, 68

Stepladder algorithm, uveitis management 4, 5

Tacrolimus (FK506) intravitreal injection 114 overview 50

T cell

therapeutic targeting 141–146 uveitis pathogenesis 135–138

TB, see Tuberculosis

TNF-α, see Tumor necrosis factor-α Tocilizumab, interleukin-6 antagonism 84, 85,

149–151

Triamcinolone acetonide, intravitreal injection 117

Tuberculosis (TB), tumor necrosis factor-α antagonist precautions 70, 71

Tumor necrosis factor-α (TNF-α) antagonist therapy, see specific antagonists

and diseases

functional overview 63, 64 uveitis pathogenesis 135

Vascular endothelial growth factor antagonists, see Bevacizumab; Ranibizumab

Vasculitis, see Ocular vasculitis

Subject Index

165

Voclosporin

Vogt-Koyangi-Harada disease-associated

efficacy evaluation 141, 143

uveitis, tumor necrosis factor-α antagonist

mechanism of action 142

therapy 70

overview 141

 

side effects 143, 144

 

166

Subject Index