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

作者：Calvo Rio Vanesa; Blanco Ricardo^*; Santos Gomez Montserrat; Rubio Romero Esteban; Cordero Coma Miguel; Gallego Flores Adela; Veroz Raul; Torre Ignacio; Francisco Hernandez Felix; Atanes Antonio; Loricera Javier; Gonzalez Vela M C; Palmou Natalia; Hernandez Jose L; Gonzalez Gay Miguel A^*

来源：Seminars in Arthritis and Rheumatism, 2016, 46(1): 95-101.

DOI：10.1016/j.semarthrit.2016.03.002

• Spondyloarthritis
• Uveitis
• Refractory
• Anti-TNF-alpha therapy
• Golimumab

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-alpha 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 +/- 03 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.

• 出版日期2016-8