Ocular involvement in patients with spondyloarthritis

Bacchiega, Ana Beatriz; Balbi, Gustavo Guimarães Moreira; Ochtrop, Manuella Lima Gomes; Andrade, Fernanda; Levy, Roger A.; Baraliakos, Xenofon

doi:10.1093/rheumatology/kex057

Cited by 30 publications

(30 citation statements)

References 48 publications

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“…AAU is the most common extra-articular manifestation (32.7%), showing a higher frequency in r-axSpA compared with nr-axSpA [ 12 , 21 ]. This could be explained by the difference in prevalence of HLA-B27 in some cohorts of nr- and r-axSpA, which is associated both with the development of AAU and with structural damage on SIJs [ 2 , 41 ]. Moreover, the higher prevalence of AAU among r-axSpA patients can also be explained by the longer mean disease duration in this subgroup, leading to a higher cumulative probability of appearance of this symptom.…”

Section: Co-morbidities and Extra-articular Manifestationsmentioning

confidence: 99%

Non-radiographic versus radiographic axSpA: what’s in a name?

2020

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Axial spondyloarthritis is a heterogeneous inflammatory condition with variable clinical presentations and outcomes. The complexity of its diagnosis and absence of biomarkers hamper the development of diagnostic criteria with the risk of misuse of the available classification criteria in clinical practice and its consequences. Axial spondyloarthritis should be regarded as a continuum in which some patients, but not all, will have a more severe phenotype characterized by progression into new bone formation and joint fusion. Growing understanding of the factors that might drive disease progression and treatment response will allow for better characterization of treatment options and outcome for each affected individual. The aim of this review is to update the current evidence of what is axial spondyloarthritis and to highlight the need to focus on the concept rather than its classification.

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Section: Co-morbidities and Extra-articular Manifestationsmentioning

confidence: 99%

Non-radiographic versus radiographic axSpA: what’s in a name?

2020

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“…1 Although SpA is primarily a musculoskeletal condition, ocular involvement, particularly acute anterior uveitis (AAU), is considered to be an important Reduction of anterior uveitis flares in patients with axial spondyloarthritis on certolizumab pegol treatment: final 2-year results from the multicenter phase IV C-VIEW study clinical feature of the disease. 2 AAU, which is a non-infectious, acute inflammation of the anterior uveal tract and adjacent structures, is the most common extra-musculoskeletal manifestation in axSpA. 1,2 Reports from patients with radiographic axial spondyloarthritis (r-axSpA) suggest that as many as 40% of patients will experience at least one AAU flare during the course of their disease.…”

Section: Introductionmentioning

confidence: 99%

“…However, approval is only indicated for intermediate uveitis, posterior uveitis and panuveitis, and does not extend to AAU. 2,22 There remains a paucity of specific data for HLA-B27 positive patients with AAU, as well as data from well-controlled trials for the general axSpA population; to date, most studies have either been observational or limited to patients with r-axSpA. 1,14,15,17,18 Certolizumab pegol (CZP) is a PEGylated Fc-free TNFi, indicated for the treatment of adult patients with active axSpA, and is the only FDA-approved TNFi for both r-axSpA and nr-axSpA.…”

Section: Introductionmentioning

confidence: 99%

Reduction of anterior uveitis flares in patients with axial spondyloarthritis on certolizumab pegol treatment: final 2-year results from the multicenter phase IV C-VIEW study

Horst-Bruinsma¹,

Bentum

Verbraak

et al. 2021

Therapeutic Advances in Musculoskeletal

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Introduction: Acute anterior uveitis (AAU), affecting up to 40% of patients with axial spondyloarthritis (axSpA), risks permanent visual deficits if not adequately treated. We report 2-year results from C-VIEW, the first study to prospectively investigate certolizumab pegol (CZP) on AAU in patients with active axSpA at high risk of recurrent AAU. Patients and methods: C-VIEW (NCT03020992) was a 104-week (96 weeks plus 8-week safety follow-up), open-label, multicenter study. Eligible patients had active axSpA, human leukocyte antigen-B27 (HLA-B27) positivity and a history of recurrent AAU (⩾2 AAU flares in total; ⩾1 in the year prior to baseline). Patients received CZP 400 mg at weeks 0, 2 and 4, then 200 mg every 2 weeks to week 96. The primary efficacy endpoint was the AAU flare event rate during 96 weeks’ CZP versus 2 years pre-baseline. Results: Of 115 enrolled patients, 89 initiated CZP (male: 63%; radiographic/non-radiographic axSpA: 85%/15%; mean disease duration: 9.1 years); 83 completed week 96. There was a significant 82% reduction in AAU flare event rate during CZP versus pre-baseline [rate ratio (95% confidence interval): 0.18 (0.12–0.28), p < 0.001]. One hundred percent and 59.6% of patients experienced ⩾1 and ⩾2 AAU flares pre-baseline, respectively, compared to 20.2% and 11.2% during treatment. Age, sex and axSpA population subgroup analyses were consistent with the primary analysis. There were substantial improvements in axSpA disease activity with no new safety signal identified. Conclusion: CZP treatment significantly reduced AAU flare event rate in patients with axSpA and a history of AAU, indicating CZP is a suitable treatment option for patients at risk of recurrent AAU. Trial Registration ClinicalTrials.gov: NCT03020992, URL: https://clinicaltrials.gov/ct2/show/NCT03020992

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“…5 AAU is associated with a significant burden, including blurred vision, photophobia, pain, risk of complications, and an important decrease in quality of life. 14 15 Recurrent AAU may lead to glaucoma, cataract development, and visual loss. 16…”

Section: Introductionmentioning

confidence: 99%

The impact of certolizumab pegol treatment on the incidence of anterior uveitis flares in patients with axial spondyloarthritis: 48-week interim results from C-VIEW

Horst‐Bruinsma¹,

Bentum²,

Verbraak

et al. 2020

RMD Open

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BackgroundAcute anterior uveitis (AAU) is the most common extra-articular manifestation in patients with axial spondyloarthritis (axSpA). C-VIEW investigates the impact of the Fc-free TNF inhibitor certolizumab pegol (CZP) on AAU flares in patients with active axSpA at high risk of recurrent AAU.MethodsC-VIEW (NCT03020992) is a 96-week ongoing, multicentre, open-label, phase 4 study. Included patients had an axSpA diagnosis, a history of recurrent AAU (≥2 AAU flares, ≥1 flare in the year prior to study entry), HLA-B27 positivity, active disease, and failure of ≥2 non-steroidal anti-inflammatory drugs. Patients received CZP 400 mg at Weeks 0/2/4, then 200 mg every 2 weeks up to 96 weeks. This 48-week pre-planned interim analysis compares AAU flare incidence in the 48 weeks before and after initiation of CZP treatment, using Poisson regression to account for possible within-patient correlations.ResultsIn total, 89 patients were included (male: 63%; radiographic/non-radiographic axSpA: 85%/15%; mean axSpA disease duration: 8.6 years). During 48 weeks’ CZP treatment, 13 (15%) patients experienced 15 AAU flares, representing an 87% reduction in AAU incidence rate (146.6 per 100 patient-years (PY) in the 48 weeks pre-baseline to 18.7 per 100 PY during CZP treatment). Poisson regression analysis showed that the incidence rate of AAU per patient reduced from 1.5 to 0.2 (p<0.001). No new safety signals were identified.ConclusionsThere was a significant reduction in the AAU flare rate during 48 weeks of CZP treatment, indicating that CZP is a suitable treatment option for patients with active axSpA and a history of recurrent AAU.

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Ocular involvement in patients with spondyloarthritis

Cited by 30 publications

References 48 publications

Non-radiographic versus radiographic axSpA: what’s in a name?

Non-radiographic versus radiographic axSpA: what’s in a name?

Reduction of anterior uveitis flares in patients with axial spondyloarthritis on certolizumab pegol treatment: final 2-year results from the multicenter phase IV C-VIEW study

The impact of certolizumab pegol treatment on the incidence of anterior uveitis flares in patients with axial spondyloarthritis: 48-week interim results from C-VIEW

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