What I should do before considering biologic agents

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By definition, a biologic agent is a molecule produce by a living organism but chemically synthesized or modified product such as peptides or nucleotides are also sometimes include. Biological agents usually referred to molecules that precisely interact with crucial pathways involved in disease development. In the context of non infectious uveitis, and with the important exception of interferon's, biological agents are classically highly specific immunosuppressive agents. Some of them have been associated with tremendous clinical effects in severe non infectious uveitis patient. A common problem with their use is related to serious primary infection or reactivation of latent infectious diseases such as tuberculosis. The issue of worsening or inducing MS in intermediate uveitis in the case of anti-TNF is also important as well as their high cost. They are thus usually proposed to patients resistant to conventionnal immunosuppressive treatment, after having eliminated infectious causes and latent systemic infection. However, their used as first line agent in certain uveitis conditions is often debated. In this SIS, we will review all those important general questions related to the use of biological agents in non infectious uveitis.

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