Biological Therapy in Non Ischaemic Optic Neuritis Associated to Immune-mediated Inflammatory Diseases: Multicenter Study

DIANA PRIETO- PENA¹, Vanesa Calvo Río ², Mónica Calderón-Goercke ³, Olga Maíz Alonso ⁴, A Blanco ⁵, Javier Narváez ⁶, Santos Castañeda ⁷, E Vicente ⁸, Susana Romero-Yuste ⁹, Rosalia Demetrio ¹⁰, Ana Urriticoechea Arana ¹¹, JL García Serrano ¹², JL Callejas Rubio ¹², Norberto Ortego Centeno ¹², Julio Sanchez ¹³, Lucia Cristina Dominguez Casas ¹⁰, Lara Sanchez-Bilbao ², Iñigo Gonzalez-Mazon ¹, Miguel Angel González-Gay ¹⁴ and Ricardo Blanco ², ¹Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain, ²Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Spain, ³Hospital Marqués de Valdecilla, Santander, Cantabria, Spain, ⁴H. Donostia, San Sebastián, Spain, ⁵H. Donostia, Donostia, Spain, ⁶Rheumatology Department, Hospital Universitario de Bellvitge, Barcelona, Spain, Barcelona, Catalonia, Spain, ⁷Rheumatology Department, Hospital Universitario de la Princesa, IIS-Princesa, Madrid, Spain, Madrid, Spain, ⁸H. Princesa, Madrid, Spain, ⁹Complejo Hospitalario Universitario Pontevedra, Pontevedra, Galicia, Spain, ¹⁰Hospital Universitario Marqués de Valdecilla, Santander, Spain, ¹¹H. Can Misses, Ibiza, Spain, ¹²H. San Cecilio, Granada, Spain, ¹³H. 12 de Octubre, Madrid, Spain, ¹⁴Universidad de Cantabria and IDIVAL, Hospital Universitario Marqués de Valdecilla, Santander, Spain

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Biologic agents and NONI

Session Information

Date: Monday, November 11, 2019

Title: Miscellaneous Rheumatic & Inflammatory Disease Poster II: Autoinflammation Related Diseases & Therapies

Session Type: Poster Session (Monday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Non ischaemic optic neuritis (NION) is a severe inflammation of the optic nerve that may lead to blindness. It can be primary or associated to immune mediated inflammatory diseases (IMIDs). The treatment of the NION is based on systemic corticosteroids and conventional immunosuppressive drugs. Our aim was to assess the efficacy of the biological treatment in refractory NION to conventional treatment.

Methods: Multicenter study of 12 patients diagnosed with NION refractory to systemic corticosteroids and at least one conventional immunosuppressive drug. The main outcomes were visual acuity (VA) and optical coherence tomography (OCT) of the optic nerve and the ganglionar cells. Comparisons were made between baseline and the 1^st week, 1^st and 6^th month and 1^st year. (STATISTICA, StatSoft Inc. Tulsa, Oklahoma, USA).

Results: We studied 12 patients (19 affected eyes) (5 men/ 7 women); mean age of 29.8 ±12.9 years. The underlying diseases were systemic lupus erythematosus (n=1), neuromyelitis optica (n=1), neuroretinitis (n=1), relapsing polychondritis (n=1), pars planitis (n=1), Behçet´s disease (n=2) and idiopathic (n=5). Before biological treatment and besides oral corticosteroids, patients had received intravenous (IV) methylprednisolone boluses (n=9), cyclosporine A (n=1), cyclophosphamide (n=2), mycophenolate (n=2), hydroxychloroquine (n=1), methotrexate (n=8) and azathioprine (n=5). Biological treatment was bases on rituximab (n=2) (2 IV, doses of 1 g/every 2 weeks and every 6 moths), adalimumab (n=5) (40 mg/1-2 week), tocilizumab (n=4) (8 mg/kg/2-4 weeks) and infliximab (n=3) (5 mg /kg at 0, 2 and 6 week and then every 8 weeks). The characteristics of the 12 patients are shown in the TABLE.

After biological treatment we observed an improvement in the ocular parameters: VA [0.66±0.32 to 0.84±0.29; p= 0.03], OCT of the optic nerve [123.20±58.28 to 190.54±175.38; p= 0.11], and OCT of the ganglionar cells [369.55±137.37 to 270.67±23.21; p= 0.03] at one year. After a mean follow-up of 29.09 ±19.23 months, there were no severe adverse effects.

Conclusion: Biologic therapy in NION idiopathic or associated to IMIDs, refractory to conventional treatment, seems to be effective.

Disclosure: D. PRIETO- PENA, None; V. Calvo Río, None; M. Calderón-Goercke, None; O. Maíz Alonso, None; A. Blanco, None; J. Narváez, None; S. Castañeda, None; E. Vicente, None; S. Romero-Yuste, None; R. Demetrio, None; A. Urriticoechea Arana, None; J. García Serrano, None; J. Callejas Rubio, None; N. Ortego Centeno, None; J. Sanchez, None; L. Dominguez Casas, None; L. Sanchez-Bilbao, None; I. Gonzalez-Mazon, None; M. González-Gay, AbbVie, 2, 5, 8, Abbvie, 2, 5, 8, Celgene, 5, 8, Eli Lilly, 2, 5, EliLilly, 2, 5, Jansen, 2, Janssen, 2, MSD, 2, 5, 8, Novartis, 2, 5, Pfizer, 5, 8, Roche, 2, 5, 8, Sanofi, 2, 5, 8, Sobi, 5, 8; R. Blanco, None.

To cite this abstract in AMA style:

PRIETO- PENA D, Calvo Río V, Calderón-Goercke M, Maíz Alonso O, Blanco A, Narváez J, Castañeda S, Vicente E, Romero-Yuste S, Demetrio R, Urriticoechea Arana A, García Serrano J, Callejas Rubio J, Ortego Centeno N, Sanchez J, Dominguez Casas L, Sanchez-Bilbao L, Gonzalez-Mazon I, González-Gay M, Blanco R. Biological Therapy in Non Ischaemic Optic Neuritis Associated to Immune-mediated Inflammatory Diseases: Multicenter Study [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/biological-therapy-in-non-ischaemic-optic-neuritis-associated-to-immune-mediated-inflammatory-diseases-multicenter-study/. Accessed .

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