Secukinumab in the Treatment of Noninfectious Uveitis

We read with interest the article by Dick et al on the efficacy and safety of different doses of secukinumab in patients with noninfectious uveitis in 3 multicenter, randomized, double-masked, placebo-controlled, dose-ranging, phase III studies in the United States. Although the study suggested secukinumab had a beneficial effect in reducing the use of concomitant immunosuppressive medication, the researchers did not discover any differences in uveitis recurrence between the secukinumab treatment groups and placebo groups. The studies' authors believed that the relatively small sample size, the differences in the severity of the disease in patients, the differences in the immune expression of interleukin (IL)-17 in individual patients, and the potentially confounding effects of the concomitant immunosuppressive medication may have played roles in the lack of significant differences between the experimental and placebo groups. Not mentioned, however, were 2 points that we believe are pertinent to exploring the efficacy and safety of different doses of secukinumab versus placebo in treating noninfectious uveitis, as well as relevant to the factors that influence the results.