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Beitragstitel Intermediate uveitis in a HLA-B27 positive patient treated with upadacitinib
Beitragscode P89
Autor:innen
  1. Julie Schneider Jules Gonin Eye Hospital - University of Lausanne
  2. Ann Schalenbourg Hôpital ophtalmique Jules-Gonin
  3. Jean Dudler HFR Fribourg, Hôpital Cantonal, University of Fribourg, Switzerland
  4. Yan Guex-Crosier Hôpital ophtalmique Jules-Gonin, Fondation Asile des Aveugles Präsentierende:r
Präsentationsform ePoster
Themengebiete
  • Uveitis / Intraocular Inflammation
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.