A phase 3, double-masked, multinational trial found that low-dose sirolimus (rapamycin) injected every 2 months can reduce vitreous haze in non-infectious posterior segment-involving uveitis, with low rates of ocular side effects.
Sirolimus is a bacteria-derived immunosuppressant that inhibits the activation of T cells and B cells and reduces cytokine production.
Investigators randomized 347 subjects with a spectrum of intermediate, posterior and panuveitis to 2 different doses of intravitreal sirolimus (880 μg or 440 μg) or active control (44 μg). At 5 months, more patients receiving 440-μg injections of sirolimus every other month achieved complete resolution of inflammation than those treated with an active control dose of 44 μg or 880-μg (22.8%, 10.3% and 16.4%, respectively).