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AB1055 (2020)
CERTOLIZUMAB PEGOL: A SAFE AND EFFICIENT TREATMENT IN PATIENTS WITH UVEITIS DURING PREGNANCY.
D. Prieto-Peña1, M. Calderón-Goercke1, A. Adan2, L. Chamorro-López2, O. Maiz3, J. De Dios-Jiménez Aberásturi4, R. Veroz Gonzalez5, S. Blanco6, J. M. Santos7, F. Navarro8, A. Gallego9, S. González-Suárez10, A. Conesa11, A. García-Valle12, M. Cordero-Coma13, N. Pardiñas-Barón14, R. Demetrio-Pablo1, V. Calvo-Río1, V. M. Mora-Cuesta1, S. Castañeda15, J. L. Hernández1, M. A. González-Gay1, R. Blanco1
1Marqués de Valdecilla University Hospital, Santander, Spain
2Hospital Clinic, Barcelona, Spain
3Donostia, San Sebastián, Spain
4Txagorritxu, Vitoria-Gasteiz, Spain
5Mérida, Mérida, Spain
6Galdakano, Vizcaya, Spain
7Río Hortega, Valladolid, Spain
8Elche, Alicante, Spain
9Badajoz, Badajoz, Spain
10Cabueñes, Gijón, Spain
11Castellón, Castellón, Spain
12Río Carrión, Palencia, Spain
13León, León, Spain
14Miguel Servet, Zaragoza, Spain
15La Princesa, Madrid, Spain

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).

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


Citation: Ann Rheum Dis, volume 79, supplement 1, year 2020, page 1813
Session: Other orphan diseases (Abstracts Accepted for Publication)