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Beitragstitel | Intermediate uveitis in a HLA-B27 positive patient treated with upadacitinib |
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Beitragscode | P89 |
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Präsentationsform | ePoster |
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Abstract-Text |
Purpose Upadacitinib is a specific Janus kinase inhibitor (Jack-1) recently approved for the treatment of psoriatic arthritis and ankylosing spondylitis. Method We report the case of a 33-year-old woman, who was referred with severe HLA-B27 related uveitis and macular edema, unresponsive to a treatment of oral steroids and adalimumab 40mg/week, the latter having also provoked a paradoxical tumor necrosis factor inhibitor-induced psoriasis. Results Fundus examination revealed the presence of bilateral intermediate uveitis, associated with a peripheral retinal vaso-proliferative tumor. Optical coherence tomography confirmed the persistence of macular edema in both eyes. A rheumatological work-up revealed the presence of knee arthritis and right sacroiliitis due to axial spondyloarthropathy. Following a therapy switch to upadacitinib 15 mg/day and oral prednisone 20 mg/day with progressive tapering, the psoriatic lesions disappeared. One month later, visual acuity had improved from 1.0 to 1.25 in the right eye and from 0.63 to 1.25 in the left eye. The central foveal thickness, initially 297 um in the RE and 410 um in the LE, had decreased respectively to 281 and 294 um. Conclusion Upadacitinib could represent a promising second-line therapy in uveitis patients simultaneously affected by axial spondyloarthropathy. |