ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1337

Effectiveness of Certolizumab Pegol in Patients with Uveitis Refractory to Other Tumor Necrosis Factor Inhibitors. Report of 22 Cases

M. Victoria Hernández1, Marina Mesquida2, Victor Llorens2, Maite Sainz de la Maza2, Gerard Espinosa3, Ricardo Blanco4, Vanesa Calvo4, Olga Maiz5, Ana Blanco6, Juan Ramon De Dios7, Pilar Ahijado-Guzman8, Enrique Judez9, Patricia Tejón10, M Soledad Peña11, Raimon Sanmarti1 and Alfredo Adan12, 1Rheumatology Department, Hospital Clínic de Barcelona, Barcelona, Spain, 2Ophthalmology Department. Hospital Clínic de Barcelona, Barcelona, Spain, 3Autoimmune Diseases Department. Hospital Clínic de Barcelona, Barcelona, Spain, 4Rheumatology Department. Hospital Universitario Marqués de Valdecilla, Santander, Spain, 5Rheumatology Department. Donostia University Hospital, San Sebastian, Spain, 6Ophthalmology Department. Donostia University Hospital, Donostia, Spain, 7Rheumatology, Hospital Universitario de Araba, Vitoria, Spain, 8Avda. Reyes Catolicos, 21, Rheumatology Department. Hospital Infanta Elena, Valdemoro, Madrid, Spain, 9Rheumatology Department. Hospital de Albacete, Albacete, Spain, 10Rheumatology Department. Hospital Universitario General de Castellón, Castellon, Spain, 11Ophtalmology Dpt. Hospital Universitario General de Castellón, Castellon, Spain, 12Ophthalmology, Ophthalmology Department. Hospital Clínic de Barcelona, Barcelona, Spain

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: , , ,

Session Information

Date: Monday, November 14, 2016

Title: Miscellaneous Rheumatic and Inflammatory Diseases - Poster II

Session Type: ACR Poster Session B

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

Background/Purpose: Refractory uveitis may requiere the use of biological therapy, especially tumour necrosis factors inhibitors (TNFi), being the most currently used infliximab and adalimumab. However, in cases of failure or adverse events related to these drugs, another TNFi such as certolizumab pegol (CZP) could be an effective option (1) as we have previously reported (2). Moreover, given that CZP does not cross the placental barrier (3), this drug could be a safer option in women considering pregnancy. Our purpose is to study the efficacy and safety of CZP in patients with uveitis refractory to other immunomodulatory treatments

Methods: Observational, multicentric, retrospective study. All the patients with a diagnosis of uveitis, confirmed by an Ophtalmologist, treated with CZP for at least 6 months were included. Variables analyzed: age, sex, diagnosis, type of uveitis and duration since the first uveitis episode; previous treatment (NSAID, disease-modifying anti-rheumatic drugs (DMARDs), immunossuppressive or biological therapy); outcome and time to follow-up

Results: Forty eyes of 22 patients (10 women); age 44.6 ± 12.6 (range 29-71 years) were included in the study. Diagnosis were: 8 ankylosing spondylitis; 5 Behçet disease; 4 psoriatic arthritis; and one of each of the following (nonradiographic axial spondyloarthritis, rheumatoid arthritis, juvenile idiopathic arthritis, punctate inner coroiditis, and idiopathic panuveitis). Type of uveitis: 10 anterior, 7 panuveitis, 4 posterior and 1 intermediate; mean disease duration of 139.8 ± 112.9 months (range 5-420). 86.4% patients had received previous biological therapy (59% ≥ 2 biological agents). 72.7% received CZP with no concomitant DMARD treatment (only 6 patients received concomitant DMARD: 3 methotrexate and 3 azathioprine). In four women CZP was indicated due to pregnancy desire. In the remaining cases CZP was started due to inefficacy to previous treatment except for 2 cases that was by adverse event. After a follow-up of 17.3 ± 11.6 months (range 6-48), 16 patients are still on CZP treatment. Eighteen eyes showed improvement of visual acuity (45%), 17 remained stable and 5 worsened. One patient had retinal vasculitis at baseline that resolved after 1 month of CZP. During the follow-up only 3 patients suffered 7 uveitis flares and 2 required switch to tocilizumab. No serious adverse events were reported. Only 4 cases withdrawn treatment: 2 due to worsening of articular symptoms but with no uveitis activity; 1 due to macular edema and 1 due to persistent uveitis activity

Conclusion: CZP has demonstrated effectiveness in patients with refractory uveitis to previous TNFi treatment, showing a safety profile that even allows its use in patients with pregnancy desire References: 1. Rudwaleit M et al Arthritis Care Res (Hoboken). 2016; 68: 838-44. 2. Llorenç V et al. Ocul Immunol Inflamm. 2016; 24: 167-72. 3. Porter C. J Reprod Immunol. 2016; 116: 7-12

Disclosure: M. V. Hernández, None; M. Mesquida, None; V. Llorens, None; M. Sainz de la Maza, None; G. Espinosa, None; R. Blanco, None; V. Calvo, None; O. Maiz, None; A. Blanco, None; J. R. De Dios, None; P. Ahijado-Guzman, None; E. Judez, None; P. Tejón, None; M. S. Peña, None; R. Sanmarti, None; A. Adan, AbbVie, Santen and Allergan, 9.

To cite this abstract in AMA style:

Hernández MV, Mesquida M, Llorens V, Sainz de la Maza M, Espinosa G, Blanco R, Calvo V, Maiz O, Blanco A, De Dios JR, Ahijado-Guzman P, Judez E, Tejón P, Peña MS, Sanmarti R, Adan A. Effectiveness of Certolizumab Pegol in Patients with Uveitis Refractory to Other Tumor Necrosis Factor Inhibitors. Report of 22 Cases [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/effectiveness-of-certolizumab-pegol-in-patients-with-uveitis-refractory-to-other-tumor-necrosis-factor-inhibitors-report-of-22-cases/. Accessed .

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