Golimumab in refractory uveitis related to spondyloarthritis. Multicenter study of 15 patients.

Abstract

OBJECTIVE:

To assess the efficacy of golimumab (GLM) in refractory uveitis associated to spondyloarthritis (SpA).

METHODS:

Multicenter study of SpA-related uveitis refractory to at least 1 immunosuppressive drug. The main outcome variables were degree of anterior and posterior chamber inflammation, visual acuity, and macular thickness.

RESULTS:

A total of 15 patients (13 men/2 women; 18 affected eyes; mean age 39 ± 6 years) were evaluated. The underlying SpA subtypes were ankylosing spondylitis (n = 8), psoriatic arthritis (n = 6) and non-radiographic axial SpA (n = 1). The ocular involvement patterns were recurrent anterior uveitis in 8 patients and chronic anterior uveitis in 7. Before GLM they have received methotrexate (n = 13), sulfasalazine (n = 6), pulses of methylprednisolone (n = 4), azathioprine (n = 3), leflunomide (n = 2), and cyclosporine (n = 1). Overall, 10 of them had also been treated with TNF-α blockers; etanercept (n = 7), adalimumab (n = 7), infliximab (n = 6), and certolizumab (n = 1). GLM was given at the standard dose (50mg/sc/monthly) as monotherapy (n = 7) or in combination with conventional immunosuppressive drugs (n = 8), mainly methotrexate. Most patients had rapid and progressive improvement of intraocular inflammation parameters. The median number of cells in the anterior chamber at 2 years [0 (0-0)] was significantly reduced compared to baseline findings [1 (0-3); p = 0.04]. The mean best corrected visual acuity value also improved (0.84 ± 0.3 at 2 years versus 0.62 ± 0.3 at baseline; p = 0.03). Only minor side effects were observed after a mean follow-up of 23 ± 7 months.

CONCLUSIONS:

Our results indicate that GLM may be a useful therapeutic option in refractory SpA-related uveitis.

• Authors: Vanesa Calvo-Río, Ricardo Blanco, Montserrat Santos-Gómez, Esteban Rubio-Romero, Miguel Cordero-Coma, Adela Gallego-Flores, Raúl Veroz, Ignacio Torre, Félix Francisco Hernández, Antonio Atanes, Javier Loricera, M C González-Vela, Natalia Palmou, José L Hernández, Miguel A González-Gay
• Journal: Seminars in arthritis and rheumatism (Semin Arthritis Rheum) Vol. 46 Issue 1 Pg. 95-101 (08 2016) ISSN: 1532-866X [Electronic] United States
• PMID: 27060872 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Chemical References

• Antibodies, Monoclonal
• Immunosuppressive Agents
• golimumab

Topics

• Adult
• Antibodies, Monoclonal (therapeutic use)
• Female
• Humans
• Immunosuppressive Agents (therapeutic use)
• Male
• Middle Aged
• Spondylarthritis (complications)
• Treatment Outcome
• Uveitis (drug therapy, etiology)