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Clin Exp Rheumatol. 2018 Jul-Aug;36(4):652-657. Epub 2017 Dec 15.

Golimumab in refractory uveitis associated to juvenile idiopathic arthritis: multicentre study of 7 cases and literature review.

Author information

1
Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
2
Ophthalmology and Rheumatology, Hospital Clinic, Barcelona, Spain.
3
Ophthalmology, Hospital de León, Spain.
4
Rheumatology, Hospital de Donostia, San Sebastian, Spain.
5
Ophthalmology, Hospital Clínico Universitario San Carlos, Madrid, Spain.
6
Ophthalmology, Hospital de Pontevedra, Spain.
7
Ophthalmology, Hospital Miguel Servet Zaragoza, Spain.
8
Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain. miguelaggay@hotmail.com.
9
Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain. rblanco@humv.es.

Abstract

OBJECTIVES:

To assess the efficacy of golimumab (GLM), a fully humanised anti-TNF-α monoclonal antibody, in refractory juvenile idiopathic arthritis (JIA)-associated uveitis.

METHODS:

This was a multicentre study of JIA-associated uveitis refractory to standard synthetic immunosuppressive drugs and in most cases to other anti-TNF-α agents. Results were expressed as mean±standard deviation or as median (range or interquartile range). The Wilcoxon signed-rank test was used to compare continuous variables. A literature review of the efficacy of GLM in uveitis related to JIA was also conducted.

RESULTS:

We studied 7 patients (5 females; mean age 21.7±7.5 years; 13 affected eyes). Uveitis was bilateral in 6. Cystoid macular oedema (CME) occurred in 3 patients (5 eyes). Besides corticosteroids and synthetic immunosuppressive drugs, patients had received before GLM a median of 2 biologic agents (range 0-3) including adalimumab (n=6), etanercept (n=2), infliximab (n=3) and abatacept (n=2). GLM dose was 50 mg/sc every 4 weeks. After 6 months of therapy the number of anterior chamber cells decreased from 1 [0.25-1.5] to 0 [0-0.5] (p=0.02) and optical coherence tomography (in patients with CME) from 313.6±77.05 to 261.4±75.1 μm (p=0.03). The best-corrected visual acuity increased from 0.5 to 0.62 (p=0.018). Complete remission of uveitis was achieved in 4 of 7 patients after 16.8±11.4 months of follow-up. However, 2 of the seven patients had to be switched to tocilizumab due to inefficacy. Local erythema at the injection site was observed in 2.

CONCLUSIONS:

GLM may be considered in the management of refractory JIA-related uveitis.

PMID:
29303704
[Indexed for MEDLINE]
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