Thursday, 18 Jan 2018

You are here

TNF Inhibitor Therapy and the Risk of Anterior Uveitis Recurrence

The TNF inhibitor drug development trials have indirectly taught us that monoclonal antibody based TNFi was capable of retarding the recurrence of anterior uveitis (AU) in patients with ankylosing spondylitis (AS).

This issue has been revisited by Swedish investigators who studied the ability of adalimumab (ADA), etanercept (ETN) and infliximab (IFX) on AU recurrence in AS patients using patients from the Swedish Rheumatology Quality Register starting their first TNFi between January 2003 to December 2010. 

The study included 1365 patients with AS.

Compared with pretreatment rates, reduced rates for AU rates were seen with ADA and IFX, while an increased AU rate was seen for ETN.

The adjusted HRs for developing AU were significantly higher for ETN versus ADA (HR: 3.86) and ETN versus IFX (HR: 1.99), while the HR for IFX versus ADA was not statistically significant.

These data confirm earlier observational studies showing the efficacy of ADA and IFX in AU. However, this study suggests little or no protection when using ETN. Suggesting mechanistic differences between antibody and receptor based therapies are clinically important in this particular extraspinal manifestation of AS.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Salt Drives Gut-Brain Connection via IL-17

A study from Nature Neuroscience shows that a high salt diet may mediate neurovascular disease by altering microbiome and the expansion of TH17 cells in the small intestine, thereby increasing plasma interleukin-17 (IL-17) and its subsequent effects on endothelium in the brain.

MEASURE 3 Study - Anti-IL17 Benefits Persist in Spine Disease

Patients with ankylosing spondylitis (AS) have shown rapid and sustained responses to secukinumab (Cosentyx) in a third phase III trial that includes a higher dose of this anti-interleukin-17A monoclonal antibody, researchers reported.

Therapeutic Update: 5 Questions on FDA Hearing for Tofacitinib in PsA (Best of 2017)

In this Therapeutic Update, Drs. Mease, Gibofsky and Cush answer five questions regarding the August 3rd FDA Arthritis Advisory Committee meeting that reviewed the potential approval of tofacitinib (Xeljanz) in patients with active psoriatic arthritis. The panel was nearly unanimous (10-1) in favor of the efficacy and safety profile of of tofacitinib, and similarly voted 10-1 to approve this drug for use in PsA. Final decisions on these recommendations from the AAC panel will be made at a later date by the FDA. 

Cardiac Disturbances Increased in Spondyloarthritis

A prospective Swedish study between 2001–2009 found a higher risk of aortic regurgitation, pacemaker, AV block and atrial fibrillation in SpA, AS, uSpA and PsA patients.

FDA Approves Xeljanz for Use in Psoriatic Arthritis

Pfizer Inc. announced today that the United States Food and Drug Administration (FDA) has approved Xeljanz (tofacitinibi) for the treatment of adult patients with active psoriatic arthritis (PsA) who have had an inadequate response or intolerance to methotrexate or other disease-modifying antirheumatic drugs (DMARDs).