SAT0416 Significantly Reduced Recurrence Rate of Acute Anterior Uveitis in Ankylosing Spondylitis during Treatment with Golimumab
Authors: S.C. Heslinga, M.T. Nurmohamed, A.H. Gerards, E.N. Griep, C. Koehorst, M.R. Kok, A.M. Schilder, M. Verhoef, I.E. Van der Horst-Bruinsma
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Acute anterior uveitis (AAU) is common in ankylosing spondylitis (AS) (1). Golimumab, a tumor necrosis factor alpha (TNF-α) blocker, has proven to be effective in the treatment of AS (2). We have shown earlier that treatment with adalimumab, another TNF-α blocker, leads to a significant decrease in the recurrence rate of AAU (3) in AS. At present, the effect of golimumab on the recurrence rate of AAU in AS is unknown. <h3>Objectives</h3> To investigate the effect of golimumab treatment on the recurrence rate of AAU attacks in AS patients. <h3>Methods</h3> Consecutive AS patients were enrolled who all fulfilled the 1984 Modified New York criteria, and fulfilled the criteria for initiating treatment with a TNF-α blocker in the Netherlands. All patients were treated with golimumab 50mg once a month for 12 months. During treatment, all occurring AAU attacks were assessed. The historic presence of AAU attacks was assessed from the year before baseline for non-biological treated patients, or the year before the first treatment with a TNF-α blocker in case of a switch from another TNF-α blocker to golimumab. Disease activity was measured with the Ankylosing Spondylitis Disease Activity Score – C-reactive protein (ASDAS). Response to treatment was assessed with the ASAS-20. <h3>Results</h3> In total, 93 patients (65% male) were evaluable as per protocol, with a mean age of 44±13 years and a median disease duration of 7 (0–53) years. Fifty-one patients (55%) were TNF-α blocker naive. Median ASDAS score at baseline was 3.1 (0.7–5.5), which decreased to 1.9 (0.1–5.1) at 12 months. ASAS-20 response was achieved by 36% of patients at month three (p&lt;0.001), and by 49% of patients at month twelve (p&lt;0.001). Six patients (7%) had a prior history of AAU with a total of nine attacks in the year prior to the first TNF-α blocker use (9.8/100 patient years). During golimumab treatment, the rate of recurring AAU attacks was reduced to two new attacks (2.2/100 patient years), a significant reduction of 78% (p&lt;0.001). These two AAU attacks occurred in two separate patients, of whom one had no history of AAU. <h3>Conclusions</h3> Treatment of AS patients with golimumab leads to a significant decrease in disease activity. Simultaneously, the rate of recurring AAU attacks decreased significantly during golimumab treatment. <h3>References</h3> Stolwijk C, van TA, Castillo-Ortiz JD, Boonen A. Prevalence of extra-articular manifestations in patients with ankylosing spondylitis: a systematic review and meta-analysis. Ann Rheum Dis 2015 Jan;74(1):65–73. Inman RD, Davis JC, Jr., Heijde D, Diekman L, Sieper J, Kim SI, et al. Efficacy and safety of golimumab in patients with ankylosing spondylitis: results of a randomized, double-blind, placebo-controlled, phase III trial. Arthritis Rheum 2008 Nov;58(11):3402–12. Van Denderen JC, Visman IM, Nurmohamed MT, Suttorp-Schulten MS, van der Horst-Bruinsma IE. Adalimumab significantly reduces the recurrence rate of anterior uveitis in patients with ankylosing spondylitis. J Rheumatol 2014 Sep;41(9):1843–8. <h3>Disclosure of Interest</h3> S. Heslinga: None declared, M. Nurmohamed: None declared, A. Gerards: None declared, E. Griep: None declared, C. Koehorst: None declared, M. Kok: None declared, A. Schilder: None declared, M. Verhoef Employee of: Merck Sharp &amp; Dohme the Netherlands, a subsidiary of Merck &amp; Co., Inc., Kenilworth, NJ, USA., I. Van der Horst-Bruinsma Grant/research support from: This study was funded by Merck Sharp &amp; Dohme the Netherlands, a subsidiary of Merck &amp; Co., Inc., Kenilworth, NJ, USA.