Abstract
Purpose: :
To evaluate the efficacy of Golimumab (a newer human anti-TNF monoclonal antibody) in patients with chronic uveitis recalcitrant to other biologic agents.
Methods: :
Retrospective study. Nine patients (18 eyes) with chronic bilateral uveitis who had an inadequate response in controlling uveitis to one or more consecutive biologic agent (TNF blockers including etanercept, infliximab, adalimumab; or anti-CD20 rituximab) received Golimumab therapy. Six patients had juvenile idiopathic arthritis (JIA) -associated uveitis, and 3 patients were HLA-B27 positive. Golimumab was given at the dose of 50 mg per injection subcutaneously every 4 weeks. Data collected: age at onset of uveitis, characteristics of the uveitis, previous systemic immunosuppressants, local corticosteroids, number of Golimumab injections, follow-up. We evaluated: decrease in uveitis activity, visual acuity, reduction of concomitant local and systemic corticosteroid and/or immunosuppressants, occurrence of adverse events.
Results: :
5 males, 4 females with a mean age of 31 years (range: 21-42) were treated. The mean age at onset of uveitis was 5 years for the JIA patients and 28 years for HLA-B27 patients; the mean ocular disease duration was 18.4 years (range 10-33). Four patients had anterior uveitis and 5 patients had panuveitis. The mean follow-up time on Golimumab was 6.2 months (range: 3-9). The mean number of Golimumab injections received was 6.2. At last visit eight out of nine patients achieved complete control of the uveitis and were on persistent clinical remission. No visual acuity changes were observed during the follow-up on golimumab treatment. No serious adverse events occurred in our treated patients. Cortico-sparing effect was seen in 4 out of nine patients at last follow-up visit.
Conclusions: :
Golimumab may be a new promising therapeutic option for refractory JIA and B27 associated-uveitis, in particular the most recalcitrant cases who have not previously responded to other biologic agents.
Keywords: uveitis-clinical/animal model • inflammation • immunomodulation/immunoregulation