Successful Certolizumab Pegol Treatment of Chronic Anterior Uveitis Associated with Psoriasis Vulgaris

Abstract

This report presents details on a 45-year-old male Japanese patient with chronic and refractory anterior uveitis associated with psoriasis vulgaris who was administered certolizumab pegol (CZP), which is an anti-tumor necrosis factor alpha (TNF-α) monoclonal antibody. Although CZP has only been formally approved for rheumatoid arthritis treatment in Japan, a clinical trial allowed us to assess CZP effectiveness in this patient. The grade 3+ anterior chamber inflammation (for both the cells and flare) observed at baseline improved to grade 0 at 3 months post-treatment. Dermatologically, the psoriasis area severity index (PASI) score was 25.4, while the body surface area (BSA) was 88% at baseline. At 3 months after treatment, the scores improved to 2.8 for PASI and less than 1% for BSA. After the treatment, remission has lasted for at least 9 months. No adverse events were seen during the CZP treatment. These findings suggest that CZP could be an effective therapeutic alternative in some refractory anterior uveitis patients with psoriasis vulgaris.

Successful secukinumab treatment of erythrodermic psoriasis and psoriatic arthritis concomitant with severe noninfectious uveitis: a case report

“…Additionally, chronic anterior uveitis associated with psoriasis vulgaris successfully treated with certolizumab pegol has been reported. 8 However, some patients do not benefit from anti-TNF therapy. Whether the uveitis in our patient is related to the use of etanercept or infliximab remains unclear.…”

New therapies in development for the management of non‐infectious uveitis: A review

“…It was found to effectively settle active inflammation in five out of seven patients with no adverse effects encountered, leading to the suggestion that certolizumab may be of use in the management of NIU . A case study from Japan has likewise confirmed resolution of anterior uveitis associated with psoriatic arthritis treated with certolizumab …”

“…106 A case study from Japan has likewise confirmed resolution of anterior uveitis associated with psoriatic arthritis treated with certolizumab. 107 A large phase 3 randomized trial involving the use of certolizumab in 325 patients with axial spondyloarthritis for up to 4 years showed a relatively good safety profile with serious adverse events occurring in only 21.9% of the population. Along with the complications associated with TNF inhibition, common effects of certolizumab include GI irritation, increased risk of infection and elevated liver function tests.…”

Systemic immunosuppressive therapies for uveitis in developing countries

“…Recent emerging and adopted therapies, including tocilizumab (STOP study),[ 67 ] sarilumab (SATURN study),[ 68 ] and S irolimus as a Therapeutic A pproach UVE itis (SAVE)-2 study (sirolimus),[ 69 ] have shown encouraging outcomes of these agents in the treatment of NIU with regard to minimizing corticosteroid dosage, reducing vitreous haze score (≥2 steps), and improving visual acuity with a relatively benign safety profile. However, other therapies such as secukizumab (INSURE study),[ 70 ] gevokizumab (EYEGUARD study),[ 71 ] ustekizumab (STELABEC study), apremilast,[ 74 ] and sotrastaurin[ 73 ] have shown no difference in the recurrence rate between placebo and treatment groups or lack of efficacy. Other promising therapies, including certolizumab,[ 74 ] canakinumab,[ 75 ] anakinra,[ 76 ] IFN-α,[ 77 78 79 ] abatacept,[ 80 81 82 83 84 85 ] filgotinib,[ 86 ] tofacitinib,[ 87 ] alemtuzumab,[ 88 89 ] and adrenocorticotropic hormone[ 90 ] have demonstrated efficacy in small case reports.…”

“…However, other therapies such as secukizumab (INSURE study),[ 70 ] gevokizumab (EYEGUARD study),[ 71 ] ustekizumab (STELABEC study), apremilast,[ 74 ] and sotrastaurin[ 73 ] have shown no difference in the recurrence rate between placebo and treatment groups or lack of efficacy. Other promising therapies, including certolizumab,[ 74 ] canakinumab,[ 75 ] anakinra,[ 76 ] IFN-α,[ 77 78 79 ] abatacept,[ 80 81 82 83 84 85 ] filgotinib,[ 86 ] tofacitinib,[ 87 ] alemtuzumab,[ 88 89 ] and adrenocorticotropic hormone[ 90 ] have demonstrated efficacy in small case reports. Phase 2 clinical trials evaluating the safety and efficacy of filgotinib,[ 77 ] tofacitinib,[ 87 ] and adrenocorticotropic hormone[ 90 ] in NIU are currently ongoing.…”