Certolizumab pegol shows dual role for axSpA and acute anterior uveitis
medwireNews: Certolizumab pegol significantly reduces the risk for acute anterior uveitis (AAU) flare in patients with axial spondyloarthritis (axSpA), show 48-week interim results from the C-VIEW trial.
The phase IV open-label study shows that certolizumab pegol targets both axSpA symptoms and AAU, said Irene van der Horst-Bruinsma, from Amsterdam University Medical Center, the Netherlands, who presented the findings at the 2019 ACR/ARP Annual Meeting in Atlanta, Georgia, USA.
Among 85 patients with axSPA and a history of recurrent AAU there was a significant 87% reduction in the incidence of flare during 48 weeks of certolizumab pegol treatment, compared with the 48 weeks before treatment, giving an on-treatment incidence of 18.7 per 100 patient–years versus a pretreatment incidence of 146.6 per 100 patient–years.
Most of the patients had radiographic axSpA, at 84.3%, and all were HLA-B27 positive. They were eligible for tumor necrosis factor (TNF) inhibitor treatment due to having active axSpA and failing to respond to at least two NSAIDs. Patients were excluded if they had previous exposure to more than one TNF inhibitor and primary failure or hypersensitivity to any TNF inhibitor.
The patients had a documented history of at least two AAU flares with at least one occurring in the 12 months prior to treatment. They were given certolizumab pegol 400 mg every 2 weeks for 4 weeks, followed by 200 mg every 2 weeks for the duration of the trial.
During treatment, 12.4% of patients experienced one flare, compared with 64.0% prior to treatment, while the corresponding rates for two flares and three or more flares were 2.2% versus 24.7% and 0.0% versus 6.7%.
The findings were similar for the patients with radiographic and nonradiographic axSpA, van der Horst-Bruinsma noted.
She pointed out that the patients’ disease activity improved significantly over the course of treatment, with ASDAS scores decreasing from an average of 3.5 to 2.2 and BASDAI scores from an average of 6.5 to 3.3. ASDAS clinical improvement was achieved by 94.2% of patients at 48 weeks.
ASAS20 and 40 responses were seen in 75.8% and 54.7% of patients, respectively, and 31.4% achieved ASAS partial remission.
The safety profile “was comparable with other studies and in line with previous reports,” said van der Horst-Bruinsma.
She concluded: “These results indicate that certolizumab is a suitable treatment option for patients with axSpA and a history of recurrent acute anterior uveitis.”
By Lucy Piper
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