Golimumab may reduce uveitis risk in patients with ankylosing spondylitis
medwireNews: Findings from the real-world GO-EASY study suggest that treatment with the tumor necrosis factor (TNF) inhibitor golimumab is associated with a significant reduction in the risk for acute anterior uveitis (AAU) among patients with ankylosing spondylitis (AS).
The study included 93 AS patients aged an average of 44 years with a median disease duration of 7 years, of whom 45% had previously been treated with a TNF inhibitor and 27% had a history of AAU. All patients received subcutaneous golimumab 50 mg/month for 1 year.
Irene van der Horst-Bruinsma (VU University Medical Center, Amsterdam, the Netherlands) and fellow researchers report that two patients, both with a history of uveitis, experienced AAU during golimumab treatment, whereas 10 attacks were reported in seven patients in the year before first TNF inhibitor treatment.
These results translate into a significant reduction in the AAU occurrence rate during golimumab treatment, at 2.2 per 100 patient–years compared with 11.1 per 100 patient–years before the initial TNF inhibitor (rate ratio=0.2).
These findings suggest that golimumab “can be considered a good choice in patients with AS who need a TNF [inhibitor], especially in cases of recurrent AAU,” write the investigators in The Journal of Rheumatology.
They note, however, that due to “the overall low incidence of AAU, it was not possible to compare the change in the occurrence of AAU in subgroups,” such as those with and without prior TNF inhibitor exposure and patients with different levels of disease activity.
The researchers also found that golimumab-treated patients experienced improvements in disease activity over the study period. The median ASDAS improved significantly from 3.1 points at baseline to 1.9 points at the 1-year follow-up, with a nonsignificant decrease seen after 3 months of treatment. A total of 41% of participants experienced a clinically important improvement in ASDAS (≥1.1 points) from baseline to month 3, and 19% achieved a major improvement (≥2.0 points).
Therefore, golimumab has “good efficacy […] in a large group of patients with AS in a real-world setting,” say van der Horst-Bruinsma and colleagues.
They add that the TNF inhibitor was well tolerated, with 82% of patients remaining on golimumab treatment throughout the study. Of the 17 participants who discontinued golimumab, eight did so due to lack of treatment effect, five due to adverse events, two as a result of nonadherence, and two after deciding to withdraw from the study.
Seven patients experienced serious adverse events during the study, most commonly infections.
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