Comparative Five-Year Risks of Systemic Complications with Biologic versus Conventional Therapy in Noninfectious Uveitis.
Biologic therapy for uveitis is associated with higher risk of low blood cell counts than no treatment
Comparative Five-Year Risks of Systemic Complications with Biologic versus Conventional Therapy in Noninfectious Uveitis.
To compare 5-year systemic complication risks in noninfectious uveitis (noninfectious uveitis) patients treated with systemic biologic versus conventional therapy.
Adult patients (≥18 years old) with noninfectious uveitis from the TriNetX Collaborative Network.
biologic therapy raised the chance of low blood cell counts
After propensity score matching, cohorts were balanced on all measured covariates (all standardized mean differences [SMDs] <0.1).
Risks of heart failure, thromboembolic events, psychiatric illness, diabetes, and all-cause mortality did not significantly differ between groups.
When compared with conventional immunomodulatory therapy, biologic treatment demonstrated a largely comparable 5-year safety profile, with the primary exceptions of higher rates of hematologic cytopenias (HR, 1.28, 95% CI, 1.16-1.41), psychiatric illness (HR, 1.13, 95% CI, 1.01-1.27), and hospitalization (HR, 1.20, 95% CI, 1.07-1.35).
In patients with noninfectious uveitis, systemic biologic therapy was associated with higher risks of serious infections and hematologic cytopenias compared with no systemic treatment, while demonstrating a 5-year safety profile broadly comparable to conventional immunomodulatory therapy.
These findings support guideline-concordant stepwise immunosuppression and underscore the importance of individualized risk assessment, infection surveillance, and hematologic monitoring for patients requiring systemic therapy.