The Management of Acute Anterior Uveitis Complicating Spondyloarthritis: Present and Future

Biggioggero, Martina; Crotti, Chiara; Becciolini, Andrea; Miserocchi, Elisabetta; Favalli, Ennio Giulio

doi:10.1155/2018/9460187

Cited by 17 publications

(23 citation statements)

References 104 publications

(98 reference statements)

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“…Spondyloarthritis (SpA) refers to a group of chronic inflammatory diseases, including axial spondyloarthritis (axSpA), that are characterised by involvement of the axial and peripheral skeleton. 1 Although SpA is primarily a musculoskeletal condition, ocular involvement, particularly acute anterior uveitis (AAU), is considered to be an important Reduction of anterior uveitis flares in patients with axial spondyloarthritis on certolizumab pegol treatment: final 2-year results from the multicenter phase IV C-VIEW study clinical feature of the disease. 2 AAU, which is a non-infectious, acute inflammation of the anterior uveal tract and adjacent structures, is the most common extra-musculoskeletal manifestation in axSpA.…”

Section: Introductionmentioning

confidence: 99%

“…11 Considering the potential consequences of AAU, it would be beneficial if treatment for patients with axSpA and AAU both targets axSpA symptoms and effectively reduces the risk of AAU flares, particularly in the high-risk patient populations described. 1 While most AAU attacks typically resolve with first-line, topical corticosteroid treatment combined with mydriatics, some patients develop refractory or highly recurrent AAU, which may require further medical intervention. 1,2 The onset of flares in highly recurrent AAU is unpredictable, with variable remission periods spanning from weeks to months, and effective preventive treatments are limited.…”

Section: Introductionmentioning

confidence: 99%

“…2,22 There remains a paucity of specific data for HLA-B27 positive patients with AAU, as well as data from well-controlled trials for the general axSpA population; to date, most studies have either been observational or limited to patients with r-axSpA. 1,14,15,17,18 Certolizumab pegol (CZP) is a PEGylated Fc-free TNFi, indicated for the treatment of adult patients with active axSpA, and is the only FDA-approved TNFi for both r-axSpA and nr-axSpA. 23,24 It has been shown to improve the signs and symptoms of axSpA as well as extra-musculoskeletal manifestations, including AAU, in patients across the full axSpA spectrum.…”

Section: Introductionmentioning

confidence: 99%

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Reduction of anterior uveitis flares in patients with axial spondyloarthritis on certolizumab pegol treatment: final 2-year results from the multicenter phase IV C-VIEW study

Horst-Bruinsma¹,

Bentum

Verbraak

et al. 2021

Therapeutic Advances in Musculoskeletal

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Introduction: Acute anterior uveitis (AAU), affecting up to 40% of patients with axial spondyloarthritis (axSpA), risks permanent visual deficits if not adequately treated. We report 2-year results from C-VIEW, the first study to prospectively investigate certolizumab pegol (CZP) on AAU in patients with active axSpA at high risk of recurrent AAU. Patients and methods: C-VIEW (NCT03020992) was a 104-week (96 weeks plus 8-week safety follow-up), open-label, multicenter study. Eligible patients had active axSpA, human leukocyte antigen-B27 (HLA-B27) positivity and a history of recurrent AAU (⩾2 AAU flares in total; ⩾1 in the year prior to baseline). Patients received CZP 400 mg at weeks 0, 2 and 4, then 200 mg every 2 weeks to week 96. The primary efficacy endpoint was the AAU flare event rate during 96 weeks’ CZP versus 2 years pre-baseline. Results: Of 115 enrolled patients, 89 initiated CZP (male: 63%; radiographic/non-radiographic axSpA: 85%/15%; mean disease duration: 9.1 years); 83 completed week 96. There was a significant 82% reduction in AAU flare event rate during CZP versus pre-baseline [rate ratio (95% confidence interval): 0.18 (0.12–0.28), p < 0.001]. One hundred percent and 59.6% of patients experienced ⩾1 and ⩾2 AAU flares pre-baseline, respectively, compared to 20.2% and 11.2% during treatment. Age, sex and axSpA population subgroup analyses were consistent with the primary analysis. There were substantial improvements in axSpA disease activity with no new safety signal identified. Conclusion: CZP treatment significantly reduced AAU flare event rate in patients with axSpA and a history of AAU, indicating CZP is a suitable treatment option for patients at risk of recurrent AAU. Trial Registration ClinicalTrials.gov: NCT03020992, URL: https://clinicaltrials.gov/ct2/show/NCT03020992

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reduction of anterior uveitis flares in patients with axial spondyloarthritis on certolizumab pegol treatment: final 2-year results from the multicenter phase IV C-VIEW study

Horst-Bruinsma¹,

Bentum

Verbraak

et al. 2021

Therapeutic Advances in Musculoskeletal

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“…Cetrolizumab is a PEGylated humanized monoclonal antibody. 39 There are limited studies on the efficacy of cetrolizumab in uveitis. Favorable results have been noted in rheumatoid arthritis, spondyloarthropathies, and Crohn's disease.…”

Section: Cetrolizumabmentioning

confidence: 99%

“…Favorable results have been noted in rheumatoid arthritis, spondyloarthropathies, and Crohn's disease. [39][40][41]…”

Section: Cetrolizumabmentioning

confidence: 99%

Biologics in uveitis: An update

Magesan

Shah²,

Biswas³

2019

IJIR

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Uveitis is' the term used to describe inflammation of the uvea. It can be due to infective or non-infective agents. Most of the non-infectious uveitides are autoimmune or auto-inflammatory in nature, and the management of non-infective uveitis is often crucial. Advancements in biotechnology and understanding the pathophysiologies of autoimmune diseases have enabled the development of the new class of drugs named 'biologics'. These drugs act at cellular level inhibiting the actions of pro-inflammatory cytokines including tumor necrosis factor-α (TNF-α), interleukin-1, and IL-6, and B and T lymphocytes. Biologics have been proven to be less toxic and can be used in uveitic cases that are refractory to conventional therapy. Though the efficacy of biologics is based on insufficient clinical trials, majority of them indicate preferable outcomes on refractory uveitis, with remarkable promise to increase the possibility of long-term remission. In this review, we aimed to outline the ideal characteristics of each biologic drug and review the data to support the use of current and emerging biological therapies.

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