Anti-tumor necrosis factor-α monoclonal antibody agents have been widely applied in the management of autoimmune diseases. Among them, Adalimumab and Infliximab have been used for years in clinical practice in treating non-infectious uveitis and achieved satisfactory effects and safety. However, no guideline or expert consensus for their usage is available in China currently. It hopefully promotes standardized clinical application of anti-tumor necrosis factor -α monoclonal antibody in treating non-infectious uveitis, together with other senior experts in uveitis, the Ocular Immunology Group of Immunology and Rheumatology Academy in Cross-Straits Medicine Exchange Association form this evidence-based recommendations for clinicians’ reference.
As a new treatment option after conventional corticosteroids and immunomodulatory drugs, biologics have been widely used in the clinical management of non-infectious uveitis in many countries due to their approved efficacy and safety. Anti-tumor necrosis factor-alpha monoclonal antibody is the most commonly used one. However, the guidance on its standardized application is lacking. The Ocular Immunology Group of Immunology and Rheumatology Academy in Cross-Straits Medicine Exchange Association compiled the Chinese expert consensus on treatment of non-infectious uveitis with anti-tumor necrosis factor-alpha monoclonal antibody. This evidence-based consensus is made according to the principle of consensus building and combines the clinical experience of the experts. Twelve recommendations are formatted on the application of Adalimumab and Infliximab. The interpretation of this consensus point will help improve the normative and effective application of anti-tumor necrosis factor-alpha monoclonal antibody in ophthalmologists, rheumatologists and immunologists.
Uveitis is a common ocular immune-mediated disorder characterized by a protracted course and high recurrence rate. Corticosteroids remain the cornerstone for managing this intra-ocular inflammation. In recent years, advances in pharmaceutical technology have driven the development of novel intravitreal corticosteroid implants, particularly long-acting sustained-release formulations. These devices have been increasingly integrated into the clinical management of a broad spectrum of immune-mediated and vascular ocular diseases, among which the dexamethasone intravitreal implant and fluocinolone acetonide intravitreal implant are emerging as preferred options for non-infectious uveitis. However, standardized clinical practice guidelines or expert consensus statements regarding the use of these implants remain lacking in China. Appropriate administration of such implants enables rapid suppression of intraocular inflammation, mitigation of inflammatory tissue damage, and effective prevention of disease recurrence. Conversely, inappropriate use may lead to suboptimal therapeutic outcomes, disease reactivation, or even severe adverse events. To promote the standardized application of long-acting sustained-release intravitreal corticosteroid implants in the management of non-infectious uveitis, the the Ocular Immunology Group of the Chinese Ophthalmological Society and the Uveitis and Immunology Group of the Chinese Medical Doctor Association has formulated the present recommendations based on the best available evidence from both domestic and international clinical studies, with the aim of guiding clinicians in the rational implementation of intravitreal corticosteroid therapy.