MS Therapies Could Potentially Be Repurposed to Treat Uveitis

Nucleic acid synthesis inhibitors, S1P modulators, interferons, fumarates and anti-CD20 monoclonal antibodies are associated with a protective effect for NIU in MS. If confirmed, these medications could be targeted for personalized MS treatment and potentially repurposed to treat NIU in other patient populations. Photo: Michael Trottini, OD, and Candice Tolud, OD. Click image to enlarge. Over the last three decades, nearly 20 disease-modifying therapies (DMTs) have been developed to treat multiple sclerosis (MS), with a commensurate number of clinical trials demonstrating their effectiveness in reducing MS relapses and preventing progression and disability. In a recent retrospective clinical cohort study, researchers examined the comparative risk of non-infectious uveitis (NIU) following the initiation of various DMTs for MS and found that interferons, fumarates and anti-CD20 monoclonal antibodies are also associated with less NIU, showing that these medications possibly be targeted for personalized MS treatment. The findings were reported in American Journal of Ophthalmology.Adults with MS who received one or more DMT prescriptions and had two or more years of prior enrollment were included. Participants could contribute multiple treatment episodes if they switched therapies. Users of interferons, fumarates, nucleic acid synthesis inhibitors/sphingosine-1-phosphate (S1P) modulators, natalizumab and anti-CD20 monoclonal antibodies were compared to glatiramer acetate as the reference. Researchers adjusted for potential confounders such as age, sex, comorbidities and MS severity.The study analyzed 48,221 treatment episodes across 43,501 patients and the median follow-up ranged from 562 to 703 days. “Different anatomic types of uveitis (e.g. anterior, intermediate, posterior) were not defined as distinct outcomes because the overwhelming majority of cases were anterior,” the researchers wrote in their paper. The findings showed that people taking certain therapies for MS may have a lower risk of NIU, especially those taking nucleic acid inhibitors, S1P modulators or fumarates.The authors proposed a few plausible mechanistic reasons in their paper. “Nucleic acid synthesis inhibitors reduce lymphocyte production and maturation, and other medications with a similar mechanism of action (e.g., methotrexate) are currently used to treat NIU,” they wrote. Also, “S1P modulators prevent the egress of lymphocytes from lymph nodes, impounding autoreactive lymphocytes away from their target tissue irrespective of the autoimmune process at play, adding that one S1P modulator, ozanimod, is FDA approved for the treatment of ulcerative colitis, “a condition that is also associated with an increased risk of NIU.” If these findings are confirmed in additional studies of other cohorts (e.g., inflammatory bowel disease, for which fumarates and S1P modulators are also prescribed), such medications could eventually have a role in treating MS patients who have a higher risk of NIU as well as treating NIU outside the context of MS.“Our work suggests that MS can serve as another “discovery cohort” for identifying novel treatments for NIU, and similar strategies may be applied to other patient populations too,” the authors concluded in their paper.Click here for the source. Cordisco AJ, Jin F, Hamedani AG, VanderBeek BL. Risk of non-infectious uveitis associated with disease-modifying therapies for multiple sclerosis. Amer J Ophthalmol. April 30, 2026. [Epub ahead of print.]  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.