AB1055 CERTOLIZUMAB PEGOL: A SAFE AND EFFICIENT TREATMENT IN PATIENTS WITH UVEITIS DURING PREGNANCY.
Authors: D. Prieto-Peña, M. Calderón-Goercke, A. Adan, L. Chamorro-López, O. Maiz, J. De Dios-Jiménez Aberásturi, R. Veroz Gonzalez, S. Blanco, J. M. Santos, F. Navarro, A. Gallego, S. González-Suárez, A. Conesa, A. García-Valle, M. Cordero-Coma, N. Pardiñas-Barón, R. Demetrio-Pablo, V. Calvo-Río, V. M. Mora-Cuesta, S. Castañeda, J. L. Hernández, M. A. González-Gay, R. Blanco
Journal: Annals of the Rheumatic Diseases (2020)

Background: Anti-TNFα agents are useful in uveitis (1-5). Certolizumab pegol (CZP) differs from other anti-TNFα agents due to its limited placental transfer. Objectives: To assess efficacy and safety of CZP in women with uveitis during pregnancy. Methods: Multicenter study of women with uveitis under CZP during pregnancy and their neonates. Results: 14 women (23 eyes); mean age 34.3±5.5 yrs (TABLE 1). Pattern of uveitis: 10 anterior, 2 posterior, 1 intermediate, 1 panuveitis. Uveitis was bilateral in 9 and chronic in 7. CZP was started before conception in 10 patients and after in 4. All patients obtained or maintained ocular remission throughout pregnancy ( FIGURE ). Prednisone was reduced from a mean dose of 21.7±19.7 mg/day to 4.1±3.8 mg/day at 6 months (p=0.03), leading to complete discontinuation in 4. 15 healthy infants were born. Only 1 woman presented a mild infection. No infections or malformations were found in neonates after a follow-up of 6 months. 6 infants were breastfed and all received scheduled vaccinations without complications (TABLE 2). TABLE 1. Age Underlying disease Immunosuppressants before CZP Combined treatment 1 34 SpA MTX, AZA, ADA AZA 2 37 SpA MTX, AZA, IFX, ADA, GOLI 3 39 SpA AZA, ADA AZA 4 46 SpA CyA, ETN, ADA, IFX, GOLI 5 32 SpA SSZ, ADA SSZ 6 36 SpA MTX, HCQ, ADA 7 40 SpA MTX, LFN, HCQ, IFX, ADA, GOLI HCQ 8 31 Idiopathic MTX, MMF, CyA, ADA 9 33 Idiopathic MTX, AZA, ADA, ETN 10 32 RA MTX AZA 11 23 Vogt-Koyanagi-Harada AZA, ADA AZA 12 36 Juvenil Idiopathic Arthritis ADA 13 32 Punctate inner choroidopathy ADA 14 29 Behcet CyA, IFX, ADA Conclusion: CZP seems to be effective and safe in female patients with uveitis during pregnancy and neonates. References: [1]Llorenç V et al. Certolizumab Pegol, a New Anti-TNF-α in the Armamentarium against Ocular Inflammation. Ocul Immunol Inflamm. 2016;24(2):167-72. doi: 10.3109/09273948.2014.967779 [2]Urruticoechea-Arana A et al. Efficacy and safety of biological therapy compared to synthetic immunomodulatory drugs or placebo in the treatment of Behçet’s disease associated uveitis: a systematic review. Rheumatol Int. 2019 Jan;39(1):47-58. doi: 10.1007/s00296-018-4193-z [3]Martín-Varillas JL et al. Successful Optimization of Adalimumab Therapy in Refractory Uveitis Due to Behçet’s Disease Ophthalmology. 2018 Sep;125(9):1444-1451. doi: 10.1016/j.ophtha.2018.02.020 [4]Santos-Gómez M et al. The effect of biologic therapy different from infliximab or adalimumab in patients with refractory uveitis due to Behçet’s disease: results of a multicentre open-label study. Clin Exp Rheumatol. 2016. Sep-Oct;34(6 Suppl 102): S34-S40 [5]Calvo-Río V et al. Golimumab in refractory uveitis related to spondyloarthritis. Multicenter study of 15 patients.Semin Arthritis Rheum. 2016 Aug;46(1):95-101. doi: 10.1016/j.semarthrit.2016.03.002 Disclosure of Interests: D. Prieto-Peña: None declared, Monica Calderón-Goercke: None declared, Alfredo Adan: None declared, Lillian Chamorro-López: None declared, Olga Maiz: None declared, JR De Dios-Jiménez Aberásturi: None declared, Raul Veroz Gonzalez: None declared, Soledad Blanco: None declared, José M Santos: None declared, Francisco Navarro: None declared, Adela Gallego: None declared, Senen González-Suárez: None declared, Arantxa Conesa: None declared, Andrea García-Valle: None declared, Miguel Cordero-Coma: None declared, Nieves Pardiñas-Barón: None declared, Rosalía Demetrio-Pablo: None declared, Vanesa Calvo-Río Grant/research support from: MSD and Roche, Speakers bureau: AbbVie, Lilly, Celgene, Grünenthal, UCB Pharma, Victor Manuel Mora-Cuesta: None declared, Santos Castañeda: None declared, J. Luis Hernández: None declared, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD, Ricardo Blanco Grant/research support from: AbbVie, MSD, Roche, Consultant of: Abbvie, Eli Lilly, Pfizer, Roche, Bristol-Myers, Janssen, UCB Pharma and MSD, Speakers bureau: Abbvie, Eli Lilly, Pfizer, Roche, Bristol-Myers, Janssen, UCB Pharma. MSD