AB1470 Janus Kinase Inhibitors in Severe Inflammatory Ocular Pathology. Multicenter Study and Literature Review

  1. Sanchez-Bilbao, L. 2
  2. Martín-Varillas, J. L. 3
  3. Calvo-Río, V. 2
  4. Álvarez Vega, J. L. 5
  5. Beltrán, E. 4
  6. Esteban-Ortega, M. D. M. 1
  7. Muñoz Fernandez, S. 1
  8. Maiz, O. 6
  9. Torre-Salaberri, I. 7
  10. Urruticoechea-Arana, A. 8
  11. Valls-Pascual, E. 9
  12. Álvarez-Reguera, C. 2
  13. Demetrio-Pablo, R. 2
  14. Blanco, R. 2
  1. 1 Hospital Infanta Sofia
    info

    Hospital Infanta Sofia

    Madrid, España

    ROR https://ror.org/05dfzd836

  2. 2 Hospital Universitario Marqués de Valdecilla
    info

    Hospital Universitario Marqués de Valdecilla

    Santander, España

    ROR https://ror.org/01w4yqf75

  3. 3 Hospital de Laredo
    info

    Hospital de Laredo

    Laredo, España

  4. 4 Hospital del Mar
    info

    Hospital del Mar

    Barcelona, España

    ROR https://ror.org/03a8gac78

  5. 5 Hospital Universitario de Badajoz
    info

    Hospital Universitario de Badajoz

    Badajoz, España

  6. 6 Hospital Universitario de Donostia
    info

    Hospital Universitario de Donostia

    San Sebastián, España

    ROR https://ror.org/04fkwzm96

  7. 7 Hospital Universitario de Basurto
    info

    Hospital Universitario de Basurto

    Bilbao, España

    ROR https://ror.org/00j4pze04

  8. 8 Hospital Can Misses
    info

    Hospital Can Misses

    Ibiza, España

    ROR https://ror.org/03q0mrg27

  9. 9 Hospital Universitario Doctor Peset
    info

    Hospital Universitario Doctor Peset

    Valencia, España

    ROR https://ror.org/03971n288

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Revue:
Annals of the Rheumatic Diseases

ISSN: 0003-4967,  1468-2060

Année de publication: 2023

Volumen: 82

Número: Suppl 1

Pages: 1963.2-1964

Type: Article

DOI: 10.1136/ANNRHEUMDIS-2023-EULAR.5948 GOOGLE SCHOLAR lock_openAccès ouvert editor

D'autres publications dans: Annals of the Rheumatic Diseases

Objectifs de Développement Durable

Résumé

Background Inflammatory ocular pathology (IOP) includes internal (uveitis) and external (mainly ocular surface pathology) involvement. IOP may be severe ocular conditions refractory to conventional and biological immunosuppressants. Janus Kinase inhibitors (JAKINIB) had shown efficacy in refractory cases of different immune-mediated diseases (IMID).Objectives In patients with refractory IOP treated with JAKINIB our aims were a) to assess the patients of Spanish referral centers, b) Literature review.Methods Multicenter study of 11 patients with refractory IOP treated with JAKINIB. For Literature review a search was conducted in PubMed, Embase and the Cochrane library from their inception to 1st January 2023. In addition, a therapeutical approach of refractory IOP is proposed.Results We have identified 11 cases in eight University Hospitals and 13 cases in the literature review. These 24 patients (17 women/ 7 men) (35 affected eyes), mean age 38.9±21.9 years, had different refractory IOP (uveitis=14; scleritis=5, PUK=5).Most of IOP were associated with IMID (n=19, 79.2%). The main underlying IMID were rheumatoid arthritis (n=6, 25%) and juvenile idiopathic arthritis (n=5, 20.8%) (TABLE 1).In addition to systemic corticosteroids, before JAKINIB, conventional (n= 23; 95.8%) and biological immunosuppressive drugs (n=18; 75%) were required. The JAKINIB most widely used was tofacitinib (n= 11; 45.8%). In one patient with Blau Syndrome and uveitis, tofacitinib was switched to baricitinib due to severe lymphopenia. In two other patients, UPA was discontinued due to anemia and skin adverse reaction. Finally, only in one patient baricitinib was withdrawn due to lack of improvement.After starting JAKINIB, 23 patients presented clinical improvement, complete (n=21, 87.5%) or partial (n= 2; 8.3%).Based on these data a therapeutical approach of refractory IOP was proposed (FIGURE 1).Conclusion JAKINIB may be an effective and safe therapy in IOP refractory to conventional or even biological immunosuppressive therapy.