Nonsteroidal anti-inflammatory drugs in the treatment of anterior uveitis associated with spondyloarthritis

Abstract

Передний увеит традиционно является типичным внескелетным проявлением спондилоартритов (СпА). Течение переднего увеита при СпА характеризуется частыми рецидивами. В данном обзоре рассматривается вопрос местного и системного применения нестероидных противовоспалительных препаратов (НПВП) в лечении и предотвращении обострений увеита, ассоциированного со СпА.

Untitled

“…Therefore, patients who received particularly benzketosone ointment for conjunctivitis or blepharitis showed faster relief of inflammation than those treated conventionally, which is likely associated with the capacity of NSAIDs to arrest the synthesis of prostaglandins responsible for inflammation by inhibiting cyclooxygenase, a prostaglandin synthesis enzyme. Our findings are in agreement with those of the studies by Slonimskii and colleagues [12] and Razumova and Godzenko [13] who compared four NSAIDs (bromfenac, keterolac, diclofenac and indometacin) for treatment efficacy. They also explain the anti-inflammatory, antipyretic and analgetic effects of NSAIDs by their capacity to inhibit cyclooxygenase and thus disrupt prostaglandin synthesis.…”

“…As opposed to GCS, NSAIDs do not induce glaucoma or cataract, and do not potentiate infection. Although NSAIDs do not cause the GCS-specific side effects, they possess somewhat lower anti-inflammatory activity compared to GCS, and this is the reason why few of them are manufactured in the form of ocular pharmaceuticals [12,13].…”

“…Anti-inflammatory therapy is a mainstay of treatment for patients with ocular inflammatory disorders [7][8][9][10][11], with the anti-inflammatory medications being targeted primarily on the prevention of and reduction in the release of inflammatory mediators. Glucocorticosteroids (GCS) and non-steroidal anti-inflammatory agents (NSAIDs) can exert impact on this process [12,13]. Although GCS demonstrate a potent anti-inflammatory and antiallergic effect, their application is associated with a risk of reduction in immune protection, and this is why they are not recommended for viral corneal (superficial keratitis with epithelial defects) and conjunctival disorders, mycobacterial and fungal ocular infections.…”