{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T22:59:09Z","timestamp":1783465149604,"version":"3.55.0"},"reference-count":115,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The uveitides are a heterogenous group of ocular inflammatory disorders that account for the third highest cause of blindness worldwide, responsible for 5\u201310% of visual impairment globally. Up to 35% of patients with uveitis can suffer significant vision loss. To prevent irreversible structural damage and blindness, it is important that the diagnosis and commencement of appropriate therapy occurs promptly. Management includes topical and systemic corticosteroid therapy and conventional immunomodulatory agents, including methotrexate, azathioprine, mycophenolate mofetil and cyclosporin. Significant progress has been made in the past decade in our understanding of the immunopathological pathways that drive intraocular inflammation, allowing the development of targeted therapy with biologic agents. These include TNF\u2010\u03b1 inhibitors, such as infliximab, adalimumab and etanercept; interleukin blockers, such as tocilizumab and daclizumab; and other targeted therapies, such as rituximab and abatacept. The efficacy of these agents has been studied in cases of severe uveitis that are refractory to conventional immunomodulatory agents and provide exciting results that have revolutionised uveitis management. Though the biologic era has provided a large armamentarium to treat uveitis, ongoing challenges and cases of recalcitrant uveitis remain, posing a challenge to internal medicine physicians. This comprehensive review aims to construct an updated summary on the existing evidence pertaining to the use of biologic agents in the treatment of uveitis. Methods include a systematic search for studies between 2000 and 2018 using PubMed, EMBASE, Ovid MEDLINE and Cochrane libraries.<\/jats:p>","DOI":"10.1111\/imj.14215","type":"journal-article","created":{"date-parts":[[2018,12,24]],"date-time":"2018-12-24T04:19:38Z","timestamp":1545625178000},"page":"1352-1363","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["The use of biologic agents in the management of uveitis"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7442-9756","authenticated-orcid":false,"given":"Amruta","family":"Trivedi","sequence":"first","affiliation":[{"name":"Campbelltown Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4412-1336","authenticated-orcid":false,"given":"Constance","family":"Katelaris","sequence":"additional","affiliation":[{"name":"Campbelltown Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2017.03.029"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(14)74235-7"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2005.03.057"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.17925\/EOR.2007.00.00.77"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2015.06.002"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/09273948.2016.1196713"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.5301\/ejo.5000278"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-9071.1986.tb00034.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/09273948.2016.1158283"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.04.001"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2011.05.032"},{"key":"e_1_2_12_13_1","first-page":"92","article-title":"Uveitis in juvenile idiopathic arthritis","volume":"112","author":"Heiligenhaus A","year":"2015","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.01.006"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12348-014-0017-9"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-015-0345-6"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI42440"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00281-014-0433-9"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICU.0000000000000466"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.2174\/1566524015666150731100012"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2015.07.001"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.09.041"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2013.02.002"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)05497-6"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2008.09.010"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-140-5-200403020-00025"},{"key":"e_1_2_12_27_1","first-page":"1362","article-title":"Efficacy, safety and pharmacokinetics of multiple administration of infliximab in Behcet's disease with refractory uveoretinitis","volume":"31","author":"Ohno S","year":"2004","journal-title":"J Rheumatol"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.123.7.903"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-008-0606-8"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2006.01.005"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.07.019"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem101"},{"key":"e_1_2_12_33_1","first-page":"1","article-title":"Ten\u2010year retention rate of infliximab in patients with Behcet's disease\u2010related uveitis","volume":"3","author":"Fabiani C","year":"2017","journal-title":"Ocul Immunol Inflamm"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10384-006-0425-y"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2014.04.042"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq366"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/039463200902200301"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22214"},{"key":"e_1_2_12_39_1","first-page":"S65","article-title":"Infliximab treatment\u2010induced formation of autoantibodies is common in Behcet's disease","volume":"25","author":"Elezoglou A","year":"2007","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.3109\/09273948.2013.779727"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.160072"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199809)41:9<1552::AID-ART5>3.0.CO;2-W"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020888"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker124"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-010-0370-y"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket260"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1089\/jop.2007.0104"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.eye.6702352"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.3109\/09273948.2010.483314"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.02.018"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2012-302292"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509852"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31339-3"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2017.12.039"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-009-1178-y"},{"key":"e_1_2_12_56_1","first-page":"S54","article-title":"Efficacy of adalimumab in patients with Behcet's disease unsuccessfully treated with infliximab","volume":"29","author":"Olivieri I","year":"2011","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes130"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.065615"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.112847"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201544"},{"key":"e_1_2_12_61_1","first-page":"784825","article-title":"Antibodies to infliximab and adalimumab in patients with rheumatoid arthritis in clinical remission: a cross\u2010sectional study","volume":"2015","author":"Eng GP","year":"2015","journal-title":"Art Ther"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.1097\/00124743-200106000-00008"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200106)44:6<1411::AID-ART235>3.0.CO;2-O"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.121.4.437"},{"key":"e_1_2_12_65_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20904"},{"key":"e_1_2_12_66_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22918"},{"key":"e_1_2_12_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.09.048"},{"key":"e_1_2_12_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.05.019"},{"key":"e_1_2_12_69_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12348-012-0081-y"},{"key":"e_1_2_12_70_1","doi-asserted-by":"publisher","DOI":"10.3109\/09273948.2012.741744"},{"key":"e_1_2_12_71_1","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.12207"},{"key":"e_1_2_12_72_1","doi-asserted-by":"publisher","DOI":"10.3109\/09273948.2013.844265"},{"key":"e_1_2_12_73_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/717598"},{"key":"e_1_2_12_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2016.03.002"},{"key":"e_1_2_12_75_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10792-016-0239-y"},{"key":"e_1_2_12_76_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22848"},{"key":"e_1_2_12_77_1","first-page":"167","article-title":"Certolizumab pegol, a new anti\u2010TNF\u2010alpha in the armamentarium against ocular inflammation","volume":"24","author":"Llorenc V","year":"2016","journal-title":"Ocul Immunol Inflamm"},{"key":"e_1_2_12_78_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.120583"},{"key":"e_1_2_12_79_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.171006"},{"key":"e_1_2_12_80_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-018-3928-6"},{"key":"e_1_2_12_81_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20404"},{"key":"e_1_2_12_82_1","doi-asserted-by":"publisher","DOI":"10.3109\/09273948.2011.633205"},{"key":"e_1_2_12_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2015.06.005"},{"key":"e_1_2_12_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2005.01.005"},{"key":"e_1_2_12_85_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0029742"},{"key":"e_1_2_12_86_1","doi-asserted-by":"publisher","DOI":"10.3109\/09273948.2011.606593"},{"key":"e_1_2_12_87_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.120010"},{"key":"e_1_2_12_88_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-013-2436-y"},{"key":"e_1_2_12_89_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2014.06.050"},{"key":"e_1_2_12_90_1","first-page":"S54","article-title":"Tocilizumab in uveitis refractory to other biologic drugs: a study of 3 cases and a literature review","volume":"32","author":"Calvo\u2010Rio V","year":"2014","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_12_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2015.11.012"},{"key":"e_1_2_12_92_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-018-4007-4"},{"key":"e_1_2_12_93_1","doi-asserted-by":"publisher","DOI":"10.1111\/aos.13015"},{"key":"e_1_2_12_94_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39940"},{"key":"e_1_2_12_95_1","first-page":"1","article-title":"Tocilizumab for the treatment of Behcet uveitis that failed interferon on alpha and anti\u2010tumour necrosis factor\u2010alpha therapy","volume":"11","author":"Ozturk E","year":"2017","journal-title":"Ocul Immunol Inflamm"},{"key":"e_1_2_12_96_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex480"},{"key":"e_1_2_12_97_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2017.08.019"},{"key":"e_1_2_12_98_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-016-3506-4"},{"key":"e_1_2_12_99_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjo.2011.06.008"},{"key":"e_1_2_12_100_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2014.12.033"},{"key":"e_1_2_12_101_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.09.040"},{"key":"e_1_2_12_102_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2015-306790"},{"key":"e_1_2_12_103_1","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000001563"},{"key":"e_1_2_12_104_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20115"},{"key":"e_1_2_12_105_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.151389"},{"key":"e_1_2_12_106_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2017.09.002"},{"key":"e_1_2_12_107_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2017.08.007"},{"key":"e_1_2_12_108_1","doi-asserted-by":"publisher","DOI":"10.2174\/1574886310666151014115401"},{"key":"e_1_2_12_109_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2013.216"},{"key":"e_1_2_12_110_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-04-494096"},{"key":"e_1_2_12_111_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.17.4.770-782.2004"},{"key":"e_1_2_12_112_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22864"},{"key":"e_1_2_12_113_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.149419"},{"key":"e_1_2_12_114_1","first-page":"CD008794","article-title":"Adverse effects of biologics: a network meta\u2010analysis and Cochrane review","volume":"2","author":"Singh JA","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_115_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2012.09.006"},{"key":"e_1_2_12_116_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-014-8455-6"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.14215","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.14215","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.14215","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.14215","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T05:30:13Z","timestamp":1694237413000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.14215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":115,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1111\/imj.14215"],"URL":"https:\/\/doi.org\/10.1111\/imj.14215","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]},"assertion":[{"value":"2018-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}