SynthesisGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2025
Network meta-analysis of immunomodulatory therapies for Behçet's disease-associated uveitis: comparative evaluation of safety and efficacy profiles.
Synthesis in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo systematically evaluate and compare the efficacy and safety profiles of various immunomodulatory therapies for Behçet's Disease-associated uveitis (BDU) through network meta-analysis, providing evidence-based guidance for clinical practice.
methodsWe conducted a comprehensive systematic review following PRISMA guidelines. Electronic databases (PubMed, Cochrane CENTRAL, Scopus, Google Scholar) were searched for studies published between 2000 and 2025. Randomized controlled trials and observational studies comparing immunomodulatory treatments for BDU were included. Risk of bias was assessed using RoB2 and ROBINS-I tools. Network meta-analysis was performed using R version 4.4.1, with treatments ranked via Surface Under the Cumulative Ranking Curve Analysis (SUCRA). Efficacy was defined as the achievement of ocular inflammatory remission and visual acuity improvement. Benefit-risk profiles incorporated therapeutic effectiveness weighted against treatment-related adverse events. Pairwise comparisons and comprehensive safety analyses were conducted.
resultsSeventeen studies comprising 1,339 patients were included after screening 714 records. The network meta-analysis revealed that IL-1 inhibitors (SUCRA 75.2%) and TNF inhibitors (SUCRA 74.0%) ranked highest in efficacy for controlling inflammation and preventing relapses. Conventional treatments ranked lowest (SUCRA 14.4%). Safety analysis demonstrated that IL-1 inhibitors had the most favorable profile (serious adverse events: 2.4%, treatment discontinuation: 3.6%), while cyclophosphamide showed the least favorable profile (adverse events: 64%, infections: 24%, discontinuation: 16%). TNF inhibitors achieved the highest benefit-risk balance score (77/100). Publication bias assessment revealed potential bias in older, non-randomized studies.
conclusionsThis network meta-analysis provides compelling evidence that biologics, particularly TNF and IL-1 inhibitors, offer superior efficacy and safety profiles compared to conventional immunosuppressants for BDU. The findings suggest a treatment paradigm where TNF inhibitors appeared to rank highly in efficacy; however, without subgroup analysis, this observation remains exploratory. Treatment selection should be individualized based on disease severity, patient-specific factors, and risk profiles. These results provide a comprehensive evidence-based framework for clinical decision-making in BDU management.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.