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 one
immunosuppressive drug. The main outcome variables were degree of anterior and
posterior chamber inflammation, visual acuity, and macular thickness.
Results: Fifteen 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). Ten of them had also been treated with TNF-? 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.
Fuente: Seminars in Arthritis and Rheumatism Volume 46, Issue 1, August 2016, Pages 95-101
Publisher: W.B. Saunders
Publication date: 04/03/2016
No. of pages: 27
Publication type: Article
DOI: 10.1016/j.semarthrit.2016.03.002
ISSN: 0049-0172,1532-866X