PMID- 31674159
OWN - NLM
STAT- MEDLINE
DCOM- 20200407
LR  - 20200408
IS  - 1598-6357 (Electronic)
IS  - 1011-8934 (Print)
IS  - 1011-8934 (Linking)
VI  - 34
IP  - 42
DP  - 2019 Nov 4
TI  - The Effect of Tumor Necrosis Factor-Alpha Inhibitors on Uveitis in Patients with 
      Ankylosing Spondylitis.
PG  - e278
LID - 10.3346/jkms.2019.34.e278 [doi]
LID - e278
AB  - BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha) inhibitors (TNFis), which are the 
      main treatment for ankylosing spondylitis (AS), have been reported not only to 
      reduce the incidence of anterior uveitis (AU) but also to induce it, and these 
      effects differ among the various types of TNFis in clinical use. The present 
      study investigated the effect of TNFis on uveitis by analyzing the long-term 
      clinical course of AU in AS patients treated with TNFi therapy. METHODS: Patients 
      treated with at least one TNFi between January 2007 and July 2017 were reviewed, 
      and 54 patients with at least one episode of AU were included in this study. The 
      TNFis included anti-TNF-alpha antibodies (adalimumab, infliximab, and golimumab), and 
      a soluble TNF receptor molecule (etanercept). The effect of prevention of AU, the 
      likelihood of new-onset uveitis after the initiation of TNFi therapy, and the 
      effects of drug switching and dose escalation were assessed. RESULTS: The first 
      uveitis flare was observed before TNFi therapy in 39 patients and after TNFi 
      therapy in 15 patients. Anti-TNF-alpha antibodies were more efficacious in decreasing 
      the recurrence of AU than etanercept. Among patients in which uveitis first 
      occurred after beginning TNFi therapy, patients on etanercept tended to first 
      develop AU less than 1 year after starting the drug, and their AS tended to be 
      well-controlled at the time of uveitis flares. Patients with a uveitis flare 
      before their medication was switched did not recur afterwards, and five of eight 
      patients showed no relapse after dose escalation. CONCLUSION: TNFis have various 
      effects on AU. TNFis, particularly anti-TNF-alpha antibodies, should be considered in 
      patients with AS and frequent AU relapse. Additionally, clinicians should 
      consider whether AU is due to an absence of a therapeutic response of AS to TNFi 
      treatment or to TNFi treatment itself, and appropriate treatment changes should 
      be made accordingly.
CI  - (c) 2019 The Korean Academy of Medical Sciences.
FAU - Lee, Suhwan
AU  - Lee S
AUID- ORCID: 0000-0002-7065-8735
AD  - Department of Ophthalmology, Kangwon National University Hospital, Kangwon 
      National University Graduate School of Medicine, Chuncheon, Korea.
FAU - Park, Yu Jeong
AU  - Park YJ
AUID- ORCID: 0000-0002-0609-8614
AD  - Department of Ophthalmology, Asan Medical Center, University of Ulsan College of 
      Medicine, Seoul, Korea.
FAU - Lee, Joo Yong
AU  - Lee JY
AUID- ORCID: 0000-0002-2187-196X
AD  - Department of Ophthalmology, Asan Medical Center, University of Ulsan College of 
      Medicine, Seoul, Korea. ophthalmo@amc.seoul.kr.
LA  - eng
GR  - NRF2018R1D1A1A02045583/NRF/National Research Foundation of Korea/Korea
GR  - 16-484/Asan Institute for Life Sciences, Asan Medical Center/Korea
PT  - Journal Article
DEP - 20191104
PL  - Korea (South)
TA  - J Korean Med Sci
JT  - Journal of Korean medical science
JID - 8703518
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (TNF protein, human)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 91X1KLU43E (golimumab)
RN  - B72HH48FLU (Infliximab)
RN  - FYS6T7F842 (Adalimumab)
RN  - OP401G7OJC (Etanercept)
SB  - IM
MH  - Adalimumab/therapeutic use
MH  - Adult
MH  - Aged
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Etanercept/therapeutic use
MH  - Female
MH  - Humans
MH  - Infliximab/therapeutic use
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Retrospective Studies
MH  - Spondylitis, Ankylosing/complications/*drug therapy
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors
MH  - Uveitis/complications/*drug therapy
MH  - Young Adult
PMC - PMC6823519
OTO - NOTNLM
OT  - Adalimumab
OT  - Ankylosing Spondylitis
OT  - Anterior Uveitis
OT  - Etanercept
OT  - Infliximab
OT  - Tumor Necrosis Factor-Alpha
COIS- The authors have no potential conflicts of interest to disclose.
EDAT- 2019/11/02 06:00
MHDA- 2020/04/09 06:00
PMCR- 2019/11/04
CRDT- 2019/11/02 06:00
PHST- 2019/05/29 00:00 [received]
PHST- 2019/09/23 00:00 [accepted]
PHST- 2019/11/02 06:00 [entrez]
PHST- 2019/11/02 06:00 [pubmed]
PHST- 2020/04/09 06:00 [medline]
PHST- 2019/11/04 00:00 [pmc-release]
AID - 34.e278 [pii]
AID - 10.3346/jkms.2019.34.e278 [doi]
PST - epublish
SO  - J Korean Med Sci. 2019 Nov 4;34(42):e278. doi: 10.3346/jkms.2019.34.e278.