Tumour necrosis factor inhibitor treatment and occurrence of anterior uveitis in ankylosing spondylitis: results from the Swedish biologics register

Lie, Elisabeth; Lindström, Ulf; Zverkova-Sandström, Tatiana; Olsen, I.C.; Forsblad-d’Elia, Helena; Askling, Johan; Kapetanovic, Meliha C; Kristensen, Lars Erik; Jacobsson, Lennart

doi:10.1136/annrheumdis-2016-210931

Cited by 106 publications

(81 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Choice of therapy should take into consideration factors such as extra‐articular manifestations of SpA like uveitis, inflammatory bowel disease and skin psoriasis, and social factors including financial cost, convenience and insurance coverage. For instance, etanercept is associated with higher risk of anterior uveitis and inflammatory bowel disease and thus should be avoided in patients with these concurrent conditions . Similarly, there is no evidence to show that IL17i is effective in inflammatory bowel disease and other bDMARDs may be preferred in these patients .…”

Section: Resultsmentioning

confidence: 99%

Update on recommendations for eligibility of government subsidization of biologic disease‐modifying antirheumatic drugs for the treatment of axial spondyloarthritis in Singapore

et al. 2019

View full text Add to dashboard Cite

Aims The field of axial spondyloarthritis (axSpA) has undergone significant changes recently in particular with disease classification, assessment of disease activity and increased treatment options for biologics. In order to reflect these developments, we aimed to update the local consensus recommendations for subsidization of biologics. Methods A modified Delphi approach was used. Six published guidelines from major rheumatology societies and healthcare authorities on axSpA were reviewed. Findings were synthesized and used in formulating updated recommendation statements. Recommendations were rated by 10 practicing rheumatologists in Singapore. Consensus was reached if there was more than 70% agreement or disagreement. Results Ten statements achieved consensus. Patients may be considered for subsidization of biologic therapy if they fulfill the Assessment of Spondyloarthritis International Society or modified New York criteria, with persistently active disease (defined either by Ankylosing Spondylitis Disease Activity Score ≥ 2.1 or Bath Spondylitis Disease Activity Index ≥ 4), despite 4 weeks of full‐dose non‐steroidal anti‐inflammatory drugs and regular exercise. Either tumor necrosis factor inhibitors or interleukin 17 inhibitors may be used as first‐line therapy, and should be continued if adequate response is achieved at 6 months. Conclusion Recommendation statements were formulated through a formal consensus process by local experts with a view to assist relevant authorities in funding considerations and for use in clinical practice.

show abstract

Section: Resultsmentioning

confidence: 99%

Update on recommendations for eligibility of government subsidization of biologic disease‐modifying antirheumatic drugs for the treatment of axial spondyloarthritis in Singapore

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Although meta‐analyses of randomized controlled trials with ETN in patients with ankylosing spondylitis show lower uveitis rates after ETN than in controls with placebo and similar to sulfasalazine in an active comparator trial, real‐world data are contradictory. Cohort studies indicate that ETN does not lower the incidence rate of uveitis or may even increase the incidence rate of uveitis flares in patients with ankylosing spondylitis . Patients treated with ETN have a significantly higher risk of uveitis compared to ADA and IFX .…”

Section: Paradoxical Adverse Eventsmentioning

confidence: 99%

“…Cohort studies indicate that ETN does not lower the incidence rate of uveitis or may even increase the incidence rate of uveitis flares in patients with ankylosing spondylitis . Patients treated with ETN have a significantly higher risk of uveitis compared to ADA and IFX . The possible mechanism remains elusive.…”

Section: Paradoxical Adverse Eventsmentioning

confidence: 99%

“…123 Patients treated with ETN have a significantly higher risk of uveitis compared to ADA 123,124 and IFX. 123 The possible mechanism remains elusive. Whether new onset of uveitis in patients with ankylosing spondylitis during treatment with ETN is caused by the insufficient efficacy of ETN to prevent uveitis or paradoxical uveitis induction still require further studies.…”

Section: Uveitismentioning

confidence: 99%

See 1 more Smart Citation

The Safety Profile of Tumor Necrosis Factor Inhibitors in Ankylosing Spondylitis: Are TNF Inhibitors Safer Than We Thought?

Wroński

Fiedor

2018

The Journal of Clinical Pharma

View full text Add to dashboard Cite

Tumor necrosis factor (TNF) inhibitors significantly improved the treatment options for patients with ankylosing spondylitis. Unfortunately, currently, there is no strategy for sustaining remission of the disease with TNF inhibitors; after discontinuation, a high percentage of patients experience flares in a short time. Therefore, up‐to‐date, long‐term use of TNF inhibitors in patients with ankylosing spondylitis remains necessary. For this reason, the issue of the long‐term safety of TNF inhibitors in patients with ankylosing spondylitis raises concerns. Although TNF inhibitors are well established in ankylosing spondylitis treatment, the majority of studies on TNF inhibitors’ safety have been performed in patients with rheumatoid arthritis. Until recently, there were very few studies of TNF inhibitors’ safety in ankylosing spondylitis. Meanwhile, TNF inhibitors appear to have different safety profiles in ankylosing spondylitis and rheumatoid arthritis. In this review, we describe available data on the occurrence of adverse events associated with TNF inhibitor treatment in ankylosing spondylitis, including serious adverse events, infections, serious infections, tuberculosis, opportunistic infections, hepatitis B reactivation, malignancies, laboratory test abnormalities, autoimmune diseases, paradoxical adverse events, and heart failure.

show abstract

“…The adjusted hazard ratio for AU in 1127 patients who were free for AU in the last 2 years before TNFi start were significantly higher for etanercept versus adalimumab and for etanercept versus infliximab. These data suggested differences in the effect on AU risk between adalimumab, etanercept and infliximab with a clear advantage for adalimumab and infliximab over etanercept [ 37 ].…”

Section: Biologic Treatment Of Uveitis In Spamentioning

confidence: 99%

Advances in the treatment of uveitis in patients with spondyloarthritis - is it the time for biologic therapy?

Mitulescu¹,

Trandafir²,

Dimăncescu³

et al. 2018

rjo

View full text Add to dashboard Cite

Spondyloarthritis (SpA) is a heterogeneous group of diseases that includes ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis (ReA), inflammatory bowel disease-associated spondyloarthritis (IBD-SpA), and undifferentiated spondyloarthritis (unSpA). This group of diseases shares several clinical, imaging, and genetic features; the integration of these diseases in the group of SpA is needed for an early diagnosis and a prompt treatment. Uveitis is the most common extra-articular manifestation of SpA. HLA-B27-associated acute anterior uveitis (AAU) is the most frequent form of uveitis encountered in the SpA group. The general prevalence of HLA-B27-associated AAU in the group of SpA is about 30% and the general prevalence of SpA in patients with HLA-B27-associated AAU is over 50%. There are several differences in the clinical picture and evolution of HLA-B27-associated AAU in patients with SpA and knowing this is very important for the best therapeutic decision. Tumor necrosis factor α (TNFα) is a very important mediator not only in the pathogenic mechanisms of SpA, but also in the immune reactions that characterize HLA-B27-associated AAU in SpA. There is much evidence of the role of TNFα in SpA and HLA-B27-associated AAU, multiple studies showing efficacy of anti-TNFα drugs not only on rheumatic manifestations but also on ocular involvement. Conventional therapy of HLA-B27-associated AAU with local or systemic glucocorticoids and immunosuppressive drugs (sulfasalazine, methotrexate, azathioprine, etc.) in order to diminish the ocular inflammation is associated with many side effects, some of them being very severe and even life threatening. Therefore, new treatments, especially biologic therapy with anti-TNFα drugs, open a new opportunity for the treatment of these patients. It is very important to emphasize that antibody anti-TNFα agents (infliximab, adalimumab, golimumab) may be more efficient than soluble receptors of TNFα (etanercept) in decreasing the risk of HLA-B27-associated AAU in patients with SpA. The aim of this review made by a group of ophthalmologists and rheumatologists with recent and fruitful experience regarding the anti-TNF treatment of 2018; 62(2): 114-122 115 Romanian Society of Ophthalmology © 2018 uveitis in patients with SpA is to make the community of ophthalmologists aware of this biologic therapy and that it is the right time to use it. Keywords: acute anterior uveitis, spondyloarthritis, anti-TNF drugs Abbreviations: AU = anterior uveitis; AAU = acute anterior uveitis; AS = ankylosing spondylitis; ASAS = Assessment of SpondyloArthritis Society; DBP = vitamin D binding protein; ESSG = European Spondyloarthropathy Study Group; HLA-B27 = human leukocyte antigen B27; IBD = inflammatory bowel disease; PsA = psoriatic arthritis; ReA = reactive arthritis; SpA = spondyloarthritis; TLRs = Toll-like receptors; TNFα = tumor necrosis factor α; unSpA = undifferentiated spondyloarthritis Romanian Journal of Ophthalmology

show abstract

Tumour necrosis factor inhibitor treatment and occurrence of anterior uveitis in ankylosing spondylitis: results from the Swedish biologics register

Abstract: The results suggest differences in effect on AU risk between ADA, ETN and IFX, with a clear advantage for ADA/IFX over ETN.

Cited by 106 publications

References 24 publications

Update on recommendations for eligibility of government subsidization of biologic disease‐modifying antirheumatic drugs for the treatment of axial spondyloarthritis in Singapore

Update on recommendations for eligibility of government subsidization of biologic disease‐modifying antirheumatic drugs for the treatment of axial spondyloarthritis in Singapore

The Safety Profile of Tumor Necrosis Factor Inhibitors in Ankylosing Spondylitis: Are TNF Inhibitors Safer Than We Thought?

Advances in the treatment of uveitis in patients with spondyloarthritis - is it the time for biologic therapy?

Contact Info

Product

Resources

About