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

Calvo-Río, V.; Blanco, Ricardo; Santos-Gόmez, M.; Rubio‐Romero, Esteban; Cordero‐Coma, Miguel; Gallego-Flores, Adela; Veroz, Raúl; Torre, I.; Hernández, Félix Francisco; Atanes, A.; Loricera, J.; González‐Vela, M. Carmen; Palmou, Natalia; Hernández, José L.; González-Gay, Miguel Á.

doi:10.1016/j.semarthrit.2016.03.002

Cited by 79 publications

(50 citation statements)

References 54 publications

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“…These studies demonstrate successful control of severe, complicated and recalcitrant uveitis associated with JIA, BD, HLA‐B27 positivity and idiopathic retinitis . The largest data come from four retrospective interventional case series involving 12–17 patients with recalcitrant uveitis, which show that monthly golimumab achieved rapid and complete control of ocular inflammation in >80% of patients, allowed significant tapering of concurrent immunosuppression and maintained remission for >6 months . The profile of adverse events, while theoretically predicted to be similar to other TNF‐α inhibitors, was less severe with golimumab, though this may be due to small study sizes.…”

Section: Tnf‐α Inhibitorsmentioning

confidence: 97%

“…[67][68][69][70] The largest data come from four retrospective interventional case series involving 12-17 patients with recalcitrant uveitis, which show that monthly golimumab achieved rapid and complete control of ocular inflammation in >80% of patients, allowed significant tapering of concurrent immunosuppression and maintained remission for >6 months. [71][72][73][74] The profile of adverse events, while theoretically predicted to be similar to other TNF-α inhibitors, was less severe with golimumab, though this may be due to small study sizes. Isolated case reports showed no remarkable adverse events at all, with most patients having only mild localised cutaneous reactions.…”

Section: Golimumabmentioning

confidence: 98%

“…Isolated case reports showed no remarkable adverse events at all, with most patients having only mild localised cutaneous reactions. However, there was one reported case of renal adenocarcinoma, malignant hypertension, bacterial pneumonia, and desquamative skin eruption across the case series. An advantage of golimumab over the other TNF‐α inhibitors is its s.c. monthly dosing that eliminates the expense and time‐commitment for infusions such as infliximab.…”

Section: Tnf‐α Inhibitorsmentioning

confidence: 99%

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The use of biologic agents in the management of uveitis

Trivedi

Katelaris

2019

Internal Medicine Journal

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The uveitides are a heterogenous group of ocular inflammatory disorders that account for the third highest cause of blindness worldwide, responsible for 5–10% of visual impairment globally. Up to 35% of patients with uveitis can suffer significant vision loss. To prevent irreversible structural damage and blindness, it is important that the diagnosis and commencement of appropriate therapy occurs promptly. Management includes topical and systemic corticosteroid therapy and conventional immunomodulatory agents, including methotrexate, azathioprine, mycophenolate mofetil and cyclosporin. Significant progress has been made in the past decade in our understanding of the immunopathological pathways that drive intraocular inflammation, allowing the development of targeted therapy with biologic agents. These include TNF‐α inhibitors, such as infliximab, adalimumab and etanercept; interleukin blockers, such as tocilizumab and daclizumab; and other targeted therapies, such as rituximab and abatacept. The efficacy of these agents has been studied in cases of severe uveitis that are refractory to conventional immunomodulatory agents and provide exciting results that have revolutionised uveitis management. Though the biologic era has provided a large armamentarium to treat uveitis, ongoing challenges and cases of recalcitrant uveitis remain, posing a challenge to internal medicine physicians. This comprehensive review aims to construct an updated summary on the existing evidence pertaining to the use of biologic agents in the treatment of uveitis. Methods include a systematic search for studies between 2000 and 2018 using PubMed, EMBASE, Ovid MEDLINE and Cochrane libraries.

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Section: Tnf‐α Inhibitorsmentioning

confidence: 97%

Section: Golimumabmentioning

confidence: 98%

Section: Tnf‐α Inhibitorsmentioning

confidence: 99%

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The use of biologic agents in the management of uveitis

Trivedi

Katelaris

2019

Internal Medicine Journal

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“…Adalimumab or infliximab are preferred over etanercept for the treatment of AS in patients with recurrent uveitis. Certolizumab or golimumab may also be considered, although supporting data are less substantial (39,40). Data from clinical trials suggest that rates of uveitis flares were not different between patients with AS treated with secukinumab and those treated with placebo, but more evidence is needed.…”

Section: Recommendations For Adults With As-related Comorbiditiesmentioning

confidence: 99%

American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis

Ward

Deodhar

Akl

et al. 2015

Arthritis Care & Research

118

158

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Objective To provide evidence-based recommendations for the treatment of patients with ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (SpA). Methods A core group led the development of the recommendations, starting with the treatment questions. A literature review group conducted systematic literature reviews of studies that addressed 57 specific treatment questions, based on searches conducted in OVID Medline (1946–2014), PubMed (1966–2014), and the Cochrane Library. We assessed the quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method. A separate voting group reviewed the evidence and voted on recommendations for each question using the GRADE framework. Results In patients with active AS, the strong recommendations included use of nonsteroidal antiinflammatory drugs (NSAIDs), use of tumor necrosis factor inhibitors (TNFi) when activity persists despite NSAID treatment, not to use systemic glucocorticoids, use of physical therapy, and use of hip arthroplasty for patients with advanced hip arthritis. Among the conditional recommendations was that no particular TNFi was preferred except in patients with concomitant inflammatory bowel disease or recurrent iritis, in whom TNFi monoclonal antibodies should be used. In patients with active nonradiographic axial SpA despite treatment with NSAIDs, we conditionally recommend treatment with TNFi. Other recommendations for patients with nonradiographic axial SpA were based on indirect evidence and were the same as for patients with AS. Conclusion These recommendations provide guidance for the management of common clinical questions in AS and nonradiographic axial SpA. Additional research on optimal medication management over time, disease monitoring, and preventive care is needed to help establish best practices in these areas.

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“…Due to its higher affinity for the TNF receptor, golimumab has shown positive outcomes in a multicentre study of patients with refractory uveitis related to spondyloarthritis . Similarly, other studies have also shown the efficacy of golimumab in refractory cases of HLA‐B27, JIA and immune mediated associated uveitis .…”

Section: Current Therapiesmentioning

confidence: 94%

New therapies in development for the management of non‐infectious uveitis: A review

Hassan

Karkhur

Bae

et al. 2019

Clinical Exper Ophthalmology

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Uveitis is a spectrum of inflammatory disorders characterized by ocular inflammation and is one of the leading causes of preventable visual loss. The main aim of the treatment of uveitis is to control the inflammation, prevent recurrences of the disease and preserve vision while minimizing the adverse effects associated with the therapeutic agents. Initial management of uveitis relies heavily on the use of corticosteroids. However, monotherapy with high‐dose corticosteroids is associated with side effects and cannot be maintained long term. Therefore, steroid‐sparing agents are needed to decrease the burden of steroid therapy. Currently, the therapeutic approach for non‐infectious uveitis (NIU) consists of a step‐ladder strategy with the first‐line option being corticosteroids in various formulations followed by the use of first‐, second‐ and third‐line agents in cases with suboptimal steroid response. Unfortunately, the agents currently at our disposal have limitations such as having a narrow therapeutic window along with their own individual potential side‐effect profiles. Therefore, research has been targeted to identify newer drugs as well as new uses for older drugs that target specific pathways in the inflammatory response. Such efforts are made in order to provide targeted and safer therapy with reduced side effects and greater efficacy. Several specially designed molecular antibodies are currently in various phases of investigations that can potentially halt the inflammation in patients with NIU. In the review, we have provided a comprehensive overview of the current and upcoming therapeutic options for patients with NIU.

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

Cited by 79 publications

References 54 publications

The use of biologic agents in the management of uveitis

The use of biologic agents in the management of uveitis

American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis

New therapies in development for the management of non‐infectious uveitis: A review

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