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AB0588 Golimumab in Refractory Uveitis to Other Anti-TNFα Drugs
  1. F.M. Ortiz Sanjuán1,
  2. R. Blanco1,
  3. J. Cañal2,
  4. M. Cordero-Coma3,
  5. A. Adán4,
  6. M. Mesquida4,
  7. M.V. Hernández5,
  8. E. Rubio-Romero6,
  9. Ά. M. García-Aparicio7,
  10. A. Atanes8,
  11. I. Torre9,
  12. F. Francisco10,
  13. M.C. Fernández-Espartero11,
  14. N. Palmou12,
  15. V. Calvo-Río1,
  16. J. Loricera1,
  17. J. Ventosa-Ayarza2,
  18. T. Pina1,
  19. M.A. González-Gay1
  1. 1Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL
  2. 2Ophthalmology, Hospital Universitario Marqués de Valdecilla. Santander, Santander
  3. 3Ophthalmology, Hospital de Leόn, Leόn
  4. 4Ophthalmology
  5. 5Rheumatology, Hospital Clínic, Barcelona
  6. 6Rheumatology, Hospital Universitario Virgen del Rocío, Sevilla
  7. 7Rheumatology, Hospital de Toledo, Toledo
  8. 8Rheumatology, HUCA La Coruña, La Coruña
  9. 9Rheumatology, Hospital de Basurto, Bilbao
  10. 10Rheumatology, Hospital Dr. Negrín, Las Palmas de Gran Canaria
  11. 11Rheumatology, Hospital Universitario de Mόstoles, Madrid
  12. 12Rheumatology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain

Abstract

Objectives To assess the efficacy and safety of Golimumab in patients with refractory uveitis to other anti-TNFα drugs.

Methods Study of patients from a single center with refractory uveitis to previous standard synthetic immunosuppressive drugs and at least 1 anti-TNFα drug. Golimumab was given at the standard dose of 50 mg/sc/month.

Results A total of 25 patients (39 affected eyes) (19 men/6 women); mean age, 32.5±8.9 years (range 11-47); fulfilled the above-mentioned criteria. In 14 cases uveitis was bilateral and in 11 cases it was unilateral. The underlying diseases were spondylarthritis (n=7), psoriatic arthropathy (n=4), juvenile idiopathic arthritis (n=4), sarcoidosis (n=3), Behçet disease (n=2), uveitis associated with HLA-B27 and ulcerative colitis (n=1), pars planitis (n=1) and Vogt-Koyanagi-Harada (n=1).

Besides oral steroids and before Golimumab onset they had received: intraocular corticosteroids (n=10), methylprednisolone i.v. boluses (n=6), methotrexate (n=20), cyclosporine A (n=6), azathioprine (n=6), adalimumab (n=17), infliximab (n=14), abatacept (n=2) and certolizumab (n=1). Golimumab was started because inefficacy (n=23) and/or toxicity (n=2) to other biologics. Golimumab was used as monotherapy (n=9) or in combination with methotrexate (n=9), azathioprine (n=3), leflunomide (n=2) and mycophenolate (n=2). There was a rapid (from 1st week) and maintained (1st year) improvement of visual acuity, anterior chamber inflammation, vitritis and OCT. The mean OCT improved from 319.9±77.9 μm (baseline) to 270.2±54.8 μm (1st month) (p<0.01) and to 244.3±43.2 μm (1st year) (p=0.02). After a mean follow-up of 13.3±8.3 (range 2-30) months the most important side-effects observed were local erythema in injection area (n=1) and herpes zoster (n=1).

Conclusions Golimumab seems an effective and safe treatment for those patients with uveitis even refractory to other anti-TNFα drugs.

Acknowledgements This study was supported by a grant from “Fondo de Investigaciones Sanitarias” PI12/00193 (Spain). This work was also partially supported by RETICS Programs, RD08/0075 (RIER) and RD12/0009/0013 from “Instituto de Salud Carlos III” (ISCIII) (Spain).

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.4758

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