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

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• 作者：Vanesa Calvo-Rí ; o ; MD ; PhD^a ; ¹ ; Ricardo Blanco ; MD ; PhD^a ; ¹ ; Montserrat Santos-Gó ; mez ; MD^a ; Esteban Rubio-Romero ; MD^b ; Miguel Cordero-Coma ; MD ; PhD^c ; Adela Gallego-Flores ; MD^d ; Raú ; l Veroz ; MD^d ; Ignacio Torre ; MD^e ; Fé ; lix Francisco Herná ; ndez ; MD^f ; Antonio Atanes ; MD ; PhD^g ; Javier Loricera ; MD ; PhD^a ; M.C. Gonzá ; lez-Vela ; MD ; PhD^a ; Natalia Palmou ; MD ; PhD^a ; José ; L. Herná ; ndez ; MD ; PhD^h ; ² ; Miguel A. Gonzá ; lez-Gay ; MD ; PhD^a ; ² ; ^{miguelaggay@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; ^{rblanco@humv.es" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Spondyloarthritis ; Uveitis ; Refractory ; Anti-TNF-α therapy ; Golimumab
• 刊名：Seminars in Arthritis and Rheumatism
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：46
• 期：1
• 页码：95-101
• 全文大小：575 K

文摘

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 (50 mg/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.