Table 2 A summary of selected biologics used to treat uveitis in Behçet’s Disease, their targets, doses, routes of administration and side effects
Agent | Target | Route of administration | Typical dosage | Adverse effects | Price of typical course of treatment for Behçet’s uveitis (£GBP)a |
|---|---|---|---|---|---|
Tumour Necrosis Factor (TNF) inhibitors [41] | |||||
Infliximab | TNF-α | Intravenous | Loading course of 3 × 3-5 mg/kg doses at 2-week intervals, followed by maintenance doses of 5-10 mg/kg at 4-week intervals [38] | Heart failure (congestive), infections, (particularly reactivation of tuberculosis), malignancy, thromboembolism, lupus-like disease, hypersensitivity reactions, neoplasia | 80,776.85 |
Adalimumab | TNF-α | Subcutaneous | 40 mg injection at 2-week intervals [38] | 15,476.53 | |
Etanercept | TNF-α, β | Subcutaneous | 25 mg subcutaneously twice weekly [42] | 9295.00 | |
Golimumab | TNF-α | Subcutaneous | 50 mg every month [38] | 9115.64 | |
Specific receptor antagonists | |||||
Canakinumab | IL-1β | Intravenous or subcutaneous | 150 mg at 4–8 week intervals [39] | Infections, nausea, abdominal discomfort | 119,133.60 |
Tocilizumab | IL-6 receptor | Intravenous | Infections and hypersensitivity reactions | 1638.40 | |
Anakinra | IL-1 receptor | Subcutaneous | 1 mg/kg/day [38] | Infections, injection-site reaction, headache, fever and gastrointestinal disturbance | 4466.14 |
Gevokizumab | IL-1β | Intravenous or subcutaneous | 0.3 mg/kg single infusion [38] | Infections and hypersensitivity reactions | n/ab |
Lymphocyte Inhibitors | |||||
Rituximab | B-cells via CD20 | Intravenous | 2 doses of 1 g 15 days apart [46] | Infections, muscular spasms, gastrointestinal discomfort, headaches and cardiovascular events | 3492.60 |
Interferons | |||||
Interferon α | Non-specific | Subcutaneous | 6–9 MIU/day for 7 days, tapered down to 3 MIU 3 times a week and then discontinued [47] | Flu-like symptoms, bone marrow suppression, injection-site reaction | 4132.20 |