Optimizing glucocorticoid therapy for Behçet's uveitis: efficacy, adverse effects, and advances in combination approaches

Abstract

Behçet's uveitis (BU) is a debilitating manifestation of Behçet's disease, often requiring prompt and aggressive treatment to prevent vision loss. Glucocorticoids (GCS) serve as a first-line therapy for BU; however, their long-term, high-dose use can result in significant adverse effects. This review summarizes the efficacy, adverse effects, and advances in combination therapy involving GCS for the management of BU. We discuss the benefits and drawbacks of various GCS administration routes, including periocular and intravitreal injections, intravitreal sustained-release devices, and systemic therapy, highlighting the role of fluocinolone acetonide and dexamethasone as primary sustained-release formulations. Moreover, we underscore the importance of combining GCS with immunosuppressive drugs and biological agents to minimize adverse reactions and optimize therapeutic outcomes. The review concludes that, while GCS remain a crucial component of BU treatment, careful consideration of their administration and combination with other therapies is essential to achieve long-term remission and improved visual outcomes for patients with BU.

The impact of glucocorticoids therapy on cutaneous wounds in Kawasaki disease: A meta‐analysis of randomized controlled trials

“…21 Understanding the nuanced relationship between glucocorticoid therapy and cutaneous manifestations in KD is imperative for optimizing therapeutic approaches and tailoring interventions to achieve comprehensive disease management. 22 While the impact of glucocorticoids on the resolution of systemic manifestations has been extensively studied, there remains a paucity of comprehensive analyses focusing specifically on their effect on cutaneous manifestations, notably skin wounds. 23 This meta-analysis seeks to systematically evaluate the existing body of evidence derived from randomized controlled trials investigating the influence of glucocorticoid therapy on skin wounds in KD.…”

Efficacy of Corticosteroids in the Treatment of Autoimmune Uveitis and its Effect on T Helper Cell and S100 Protein Levels in Peripheral Blood

“…Glucocorticoids are the first-line medications for treating uveitis, preventing severe visual loss and significantly improving visual outcomes [3] . However, their use is limited by side effects, such as diabetes, gastrointestinal ulcers, Cushing's syndrome, hypertension, and osteoporosis [4] . Most uveitis cases are autoimmune diseases primarily mediated, developed, and progressed by Clusters of Differentiation (CD) 4 T helper cells (Th cells).…”