National Multicenter Study of 80 Patients with Refractory Uveitis Due to Immune-Mediated Inflammatory Diseases Treated with Certolizumab Pegol

José Luis Martín-Varillas¹, Lara Sánchez-Bilbao², Vanesa Calvo Río³, Alf Adán⁴, Inés Hernanz Rodríguez⁴, Emma Beltrán Catalán⁵, Sonia Castro Oreiro⁶, Patricia Fanlo⁷, Alvaro Garcia⁸, Ignacio Torre⁹, Miguel Cordero Coma¹⁰, Juan Ramón de Dios¹¹, A. Garcia-Aparicio¹², Marisa Hernandez Garfella¹³, Amalia Sánchez Andrade¹⁴, A. García-valle¹⁵, Olga Maiz¹⁶, Juan Roberto Miguelez Sanchez¹², Sergio Rodriguez Montero¹⁷, Ana Urruticoechea¹⁸, Raul Veroz¹⁹, Arantxa Conesa²⁰, Cristina Fernández-Carballido²¹, Vega Jovani Casano²², Olga Martinez²³, Patricia Moya Alvarado²⁴, Susana Romero Yuste²⁵, Paula Rubio Muñoz²⁶, eva Peña Sainz-Pardo²⁷, Marta Garijo Bufort²⁸, José Luis Hernández² and Ricardo Blanco²⁹, ¹Hospital de Laredo, Laredo, Cantabria, Spain, ²Hospital Universitario Marqués de Valdecilla, Santander, Spain, ³Valdecilla Hospital, Santander, Spain, ⁴H. Clinic, Barcelona, Spain, ⁵Hospital del Mar, Barcelona, Spain, ⁶H. Universitario Joan XXIII, Barcelona, Spain, ⁷Complejo Hospitalario de Navarra, Navarra, Spain, ⁸Hospital Tajo, Madrid, Spain, ⁹Hospital de Basurto, Basurto, Spain, ¹⁰Hospital de León, León, Spain, ¹¹Hospital de Araba, Araba, Spain, ¹²Hospital Universitario de Toledo, Toledo, Spain, ¹³Hospital Universitario General de Valencia, València, Spain, ¹⁴Hospital Universitario Lucus Augusti, Lugo, Spain, ¹⁵Completo Asistencial Palencia, Palencia, Spain, ¹⁶Hospital Universitario de Donostia, San Sebastián, Spain, ¹⁷Virgen de Valme University Hospital, Sevilla, Spain, ¹⁸Hospital Can Misses, Ibiza, Spain, ¹⁹Hospital de Mérida, Mérida, Spain, ²⁰Hospital Universitario de Castellón, València, Spain, ²¹Agencia Valenciana de Salud, Alicante, Spain, ²²National Health system, Alicante, Spain, ²³Hospital Clínico Universitario de Salamanca, Zamora, Spain, ²⁴Hospital Parc Tauli, Barcelona, Spain, ²⁵Complexo Hospitalario Universitario, Pontevedra, Spain, ²⁶H. Esperit Sant, Barcelona, Spain, ²⁷Hospital Universitario 12 de Octubre, Madrid, Spain, ²⁸Hospital Sagunto, València, Spain, ²⁹Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain

Meeting: ACR Convergence 2022

Keywords: Anti-TNF Drugs, Vasculitis

Session Information

Date: Saturday, November 12, 2022

Title: Miscellaneous Rheumatic and Inflammatory Diseases Poster I

Session Type: Poster Session A

Session Time: 1:00PM-3:00PM

Background/Purpose: Adalimumab remains the only biologic approved by the EMA and FDA for the treatment of noninfectious uveitis. There are few reports on the effectiveness of other anti-TNF drugs such as certolizumab pegol (CZP). Our aims were to determine the efficacy and safety of CZP in refractory uveitis secondary to Immune-mediated Inflammatory Diseases (IMIDs).

Methods: national multicenter study of 80 patients with uveitis due to IMID refractory to glucocorticoids and conventional immunosuppressants treated with CZP. Efficacy was assessed with the following ocular parameters: best corrected visual acuity (BCVA), anterior chamber cells, vitritis, macular thickness and presence of retinal vasculitis. The efficacy of CZP was compared between the baseline visit, 1st week, 1st and 6th month, and 1st year. Statistical analysis was performed with IBM SPSS Statistics v.23.

Results: we studied 80 patients/111 affected eyes (33 men/47 women) with a mean age of 41.6±11.7 years. The IMIDs included were: spondyloarthritis (n=43), Behçet’s disease (10), psoriatic arthritis (8), Crohn’s disease (4), sarcoidosis (2), JIA (1), reactive arthritis (1), rheumatoid arthritis (1), relapsing polychondritis (1), TINU (1), pars planitis (1), Birdshot (1) and idiopathic uveitis (6). Anterior was the most frequent uveitis pattern (n=61).

In 20 patients, besides the presence of refractory uveitis, desire of pregnancy was the reason for CZP initiation.

Prior to CZP, patients had received: methotrexate (n=38), sulfasalazine (28), azathioprine (14), cyclosporine (10), leflunomide (3), mycophenolate mofetil (4), and cyclophosphamide (1). Previous biologic therapy was administered in 52 patients (63%), with a median [IQR] of 2 [1-3] drugs per patient. The most used biologic was adalimumab (n=48), followed by infliximab (32), golimumab (15), tocilizumab (5), etanercept (7), rituximab (1), anakinra (1) and secukinumab (1). CZP was administered as monotherapy in 39 patients.

After 24 [12-36] months of follow-up, all parameters analyzed showed a rapid and maintained improvement (TABLE). A decrease in the mean number of uveitis flares was observed before and after CZP, (2.6±2.3 vs. 0.6±0.4, p< 0.001). CZP was discontinued in 16 patients due to: ocular remission (n=3), insufficient ocular response (4) and incomplete response of extraocular manifestations (9). No serious adverse effects were found.

Conclusion: CZP seems to be effective and safe in the control of uveitis associated to different IMIDs.

Main ocular parameters analyzed in 80 patients with uveitis due to IMID and treated with CZP.

Disclosures: J. Martín-Varillas, AbbVie/Abbott, Pfizer, Janssen, UCB, Celgene; L. Sánchez-Bilbao, Eli Lilly; V. Calvo Río, AbbVie/Abbott, Eli Lilly, Merck/MSD, UCB; A. Adán, None; I. Hernanz Rodríguez, None; E. Beltrán Catalán, None; S. Castro Oreiro, None; P. Fanlo, None; A. Garcia, None; I. Torre, None; M. Cordero Coma, None; J. de Dios, None; A. Garcia-Aparicio, None; M. Hernandez Garfella, None; A. Sánchez Andrade, None; A. García-valle, None; O. Maiz, None; J. Miguelez Sanchez, None; S. Rodriguez Montero, None; A. Urruticoechea, None; R. Veroz, None; A. Conesa, None; C. Fernández-Carballido, None; V. Jovani Casano, None; O. Martinez, None; P. Moya Alvarado, None; S. Romero Yuste, Pfizer, Lilly, AbbVie, Biogen, Sanofi; P. Rubio Muñoz, None; e. Peña Sainz-Pardo, None; M. Garijo Bufort, None; J. Hernández, None; R. Blanco, Eli Lilly, Pfizer, Roche, Janssen, MSD, AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Galapagos, Novartis, Sanofi.

To cite this abstract in AMA style:

Martín-Varillas J, Sánchez-Bilbao L, Calvo Río V, Adán A, Hernanz Rodríguez I, Beltrán Catalán E, Castro Oreiro S, Fanlo P, Garcia A, Torre I, Cordero Coma M, de Dios J, Garcia-Aparicio A, Hernandez Garfella M, Sánchez Andrade A, García-valle A, Maiz O, Miguelez Sanchez J, Rodriguez Montero S, Urruticoechea A, Veroz R, Conesa A, Fernández-Carballido C, Jovani Casano V, Martinez O, Moya Alvarado P, Romero Yuste S, Rubio Muñoz P, Peña Sainz-Pardo e, Garijo Bufort M, Hernández J, Blanco R. National Multicenter Study of 80 Patients with Refractory Uveitis Due to Immune-Mediated Inflammatory Diseases Treated with Certolizumab Pegol [abstract]. Arthritis Rheumatol. 2022; 74 (suppl 9). https://acrabstracts.org/abstract/national-multicenter-study-of-80-patients-with-refractory-uveitis-due-to-immune-mediated-inflammatory-diseases-treated-with-certolizumab-pegol/. Accessed .

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