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Reduced Occurrence Rate of Acute Anterior Uveitis in Ankylosing Spondylitis Treated with Golimumab - The GO-EASY
Rianne E van Bentum1,2, Sjoerd C Heslinga1,2, Michael T Nurmohamed1,2
1From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, locations Reade and VU University Medical Center, Amsterdam; Department of Rheumatology, Franciscus Vlietland Hospital, Schiedam; Department of Rheumatology, Antonius Hospital, Sneek; Department of Rheumatology, Gelre Hospital, Apeldoorn; Department of Rheumatology, Maasstad Hospital, Rotterdam; Department of Rheumatology, Medical Centre Leeuwarden, Leeuwarden; Department of Immunology, Merck Sharp & Dohme (MSD), Haarlem, the Netherlands.
Objective:
Acute anterior uveitis (AAU) is common in ankylosing spondylitis (AS). Golimumab (GOL), a tumor necrosis factor-α inhibitor (TNFi), has proven to be effective in the treatment of AS. To date, the effect of GOL on the incidence of AAU in AS is unknown. The objective was to study the AAU occurrence rate in patients with AS during GOL treatment and secondarily, the efficacy of GOL in daily clinical practice.
Methods:
The study was a multicenter prospective study in a real-world setting in patients with AS who were treated with GOL for 12 months. The occurrence of AAU was assessed in the year before the initial TNFi treatment and during GOL treatment and calculated for the period at risk for a new AAU. Measures for disease activity [Ankylosing Spondylitis Disease Activity Score (ASDAS)] and treatment response [Assessment of Spondyloarthritis international Society (ASAS20 score)] were collected.
Results:
In total, 93 patients (65% male, 55% TNFi-naive, 27% history of AAU) were included, with a median disease duration of 7 years and ASDAS score of 3.1. During GOL treatment, the AAU occurrence rate was reduced from 11.1 to 2.2 per 100 patient-years (rate-ratio 0.20, 95% CI 0.04-0.91). After 3 months of treatment, 41% of the patients experienced a clinically important improvement of the ASDAS score (p < 0.001) and 36% an ASDAS20 response (p < 0.001). At month 12, 49% had achieved an ASAS20 response (p < 0.001).
Conclusion:
In AS, the AAU occurrence rate and disease activity decreased significantly during GOL treatment. Therefore, GOL can be considered a good choice in patients with AS who need a TNFi, especially in cases of recurrent AAU. (EudraCT number: 2012-002458-21).
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