This article is more than 5 years old. Information may no longer be current.
Intravitreal sirolimus shows good results in treatment of noninfectious uveitis
Click Here to Manage Email Alerts
NICE, France — Intravitreal sirolimus provides long-term resolution of posterior segment inflammation in patients with active noninfectious uveitis, according to the 1-year results of the SAKURA study.
“[Noninfectious uveitis] of the posterior segment is in the vast majority of cases a chronic condition, requiring long-term treatment to prevent cumulative structural damage and vision loss,” Phuc Hoang, MD, PhD, said at the Euretina meeting.
Phuc Hoang
Corticosteroids and immunomodulatory therapy, the current long-term treatment options, are only partially effective and associated with severe adverse effects.
“We need something with a safer profile that can be administered locally by the sole ophthalmologist, without the help of an internist or uveitis specialist,” he said.
Sirolimus is a novel immunoregulatory agent that interrupts T-cell proliferation driven by IL-2 and other proinflammatory cytokines. Administered intravitreally, it has minimal systemic penetration.
In the randomized, controlled SAKURA study of 347 patients, sirolimus 440 µg proved effective in reducing vitreous haze and improving and then maintaining vision throughout the follow-up. No significantly different rates or types of adverse effects were reported in comparison with controls, and no change in IOP occurred in any of the eyes.
“There was quite a lot of inflammation initially, which was due to discontinuation of topical and systemic steroids or [immunomodulatory therapies] prior to entering the study,” Hoang said.
The benefit-risk profile of intravitreal sirolimus supports its potential use as a long-term corticosteroid-sparing therapy for noninfectious uveitis of the posterior segment, according to Hoang. An additional advantage is that it can be administered by any ophthalmologist with experience in intravitreal injections, even if the physician is not a uveitis expert, he said. – by Michela Cimberle
Disclosure: Hoang reports he is a consultant to Allergan, Novartis and Santen and receives grant support from Alimera Sciences, Allergan, Novartis and Théa.