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Optimizing the Use of Tumor Necrosis Factor Inhibitors in Refractory Uveitis

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read with great interest the results of the phase II clinical trial on infliximab in refractory uveitis.¹ We congratulate Dr Suhler and colleagues on emphasizing pretreatment screening and the potential systemic complications.

Contrary to previous descriptions of tumor necrosis factor (TNF) inhibitors for refractory uveitis,² it is implied that the stringent investigations and observations in this study projected more systemic complications leading to cessation of therapy in 50% of the patients. Some of the described complications may suggest preexisting risk factors or even an unrelated occurrence.

It would be interesting to know whether it is preferred practice to use infliximab as the first choice of TNF- inhibitor in refractory uveitis and whether the treatments were switched to other TNF- inhibitors when the patients developed adverse effects. There are studies suggesting different therapeutic efficacy for the available TNF- inhibitors, namely, etanercept, infliximab, and adalimumab.³ However, there have been no comparative . . . [Full Text of this Article]

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AUTHOR INFORMATION
Rani T. Sebastian, MRCOphth; Simon P. Harding, MD, FRCOphth, FRCS; Roger C. Bucknall, FRCP; Ian A. Pearce, FRCOphth