Acute Anterior Uveitis Incidence Reduced With Golimumab in Ankylosing Spondylitis

A significant reduction in the incidence of acute anterior uveitis has been reported in patients with ankylosing spondylitis (AS) treated with golimumab, according to the results of a 12-month multicenter prospective study published in The Journal of Rheumatology.

The investigators sought to explore the rate of acute anterior uveitis occurrence in patients who underwent golimumab treatment. The secondary objective was to evaluate the efficacy and safety of golimumab in AS disease activity in routine daily practice. Patients with AS were enrolled consecutively between December 2012 and April 2014 at the Amsterdam Rheumatology and Immunology Center and 9 large outpatient rheumatology clinics in The Netherlands.

The researchers assessed the occurrence of acute anterior uveitis in the year prior to initial tumor necrosis factor-α inhibitor (TNFi) therapy and during golimumab treatment, calculating the period at risk for a new episode of acute anterior uveitis. Measures of disease activity (Ankylosing Spondylitis Disease Activity Score [ASDAS]) and treatment response (20% improvement in Assessment of Spondyloarthritis International Society criteria [ASAS20 score]) were collected.

A total of 93 participants were included in the study; 65% were men, 55% were TNFi-naive, and 27% had a history of acute anterior uveitis. Median disease duration was 7 years and median ASDAS score was 3.1. The acute anterior uveitis occurrence rate in patients undergoing golimumab treatment decreased from 11.1 to 2.2 per 100 patient-years (rate ratio, 0.20; 95% CI, 0.04-0.91). After 3 months of therapy, 41% of participants experienced a clinically significant improvement in ASDAS score (P <.001) and 36% of patients experienced an ASAS20 treatment response (P <.001). At 12 months, 49% of participants had attained an ASAS20 response (P <.001).

The investigators concluded that based on the results of this analysis, golimumab can be considered a good treatment choice in patients with AS who require treatment with a TNFi, particularly in cases of recurrent acute anterior uveitis. Golimumab was well tolerated and led to an improvement in AS disease activity in the majority of patients evaluated.

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Reference

van Bentum RE, Heslinga SC, Nurmohamed MT, et al. Reduced occurrence rate of acute anterior uveitis in ankylosing spondylitis treated with golimumab — the GO-EASY study [published online November 1, 2018]. J Rheumatol. doi:10.3899/jrheum.180312