Cordero-Coma Miguel, Calvo-Río Vanesa, Adán Alfredo, Blanco Ricardo, Álvarez-Castro Carolina, Mesquida Marina, Calleja Sara, González-Gay Miguel A, Ruíz de Morales José G
Department of Ophthalmology, University Hospital of León, 24071 León, Spain ; Uveitis Unit, University Hospital of León, 24071 León, Spain ; Institute of Biomedicine (INBIOMED), University of León, León, Spain.
Department of Rheumatology, University Hospital "Marques de Valdecilla", IFIMAV, 39008 Santander, Spain.
Mediators Inflamm. 2014;2014:717598. doi: 10.1155/2014/717598. Epub 2014 May 28.
To evaluate, in three Spanish tertiary referral centres, the short-term safety and efficacy of golimumab (GLM) for treatment of immune-mediated uveitis resistant to previous immunosuppressive therapy.
Nonrandomized retrospective interventional case series. Thirteen patients with different types of uveitis that were resistant to treatment with at least 2 previous immunosuppressors were included in this study. All included patients were treated with GLM (50 mg every four weeks) during at least 6 months. Clinical evaluation and treatment-related side effects were assessed at least four times in all included patients.
Eight men and 5 women (22 affected eyes) with a median age of 30 years (range 20-38) and active immune-mediated uveitides were studied. GLM was used in combination with conventional immunosuppressors in 7 patients (53.8%). GLM therapy achieved complete control of inflammation in 12/13 patients (92.3%) after six months of treatment. There was a statistically significant improvement in mean BCVA (0.60 versus 0.68, P = 0.009) and mean 1 mm central retinal thickness (317 versus 261.2 μ, P = 0.05) at the six-month endpoint when compared to basal values. No major systemic adverse effects associated with GLM therapy were observed.
GLM is a new and promising therapeutic option for patients with severe and refractory uveitis.
在三个西班牙三级转诊中心评估戈利木单抗（GLM）治疗对先前免疫抑制治疗耐药的免疫介导性葡萄膜炎的短期安全性和有效性。
非随机回顾性干预病例系列。本研究纳入了13例对至少两种先前免疫抑制剂治疗耐药的不同类型葡萄膜炎患者。所有纳入患者均接受GLM治疗（每四周50毫克）至少6个月。对所有纳入患者至少进行四次临床评估和治疗相关副作用评估。
研究了8名男性和5名女性（22只患眼），中位年龄30岁（范围20 - 38岁），患有活动性免疫介导性葡萄膜炎。7例患者（53.8%）将GLM与传统免疫抑制剂联合使用。治疗六个月后，GLM疗法使13例患者中的12例（92.3%）炎症得到完全控制。与基线值相比，六个月终点时平均最佳矫正视力（BCVA）（0.60对0.68，P = 0.009）和平均1毫米中心视网膜厚度（317对261.2 μ，P = 0.05）有统计学显著改善。未观察到与GLM治疗相关的重大全身不良反应。
对于严重难治性葡萄膜炎患者，GLM是一种新的且有前景的治疗选择。
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