AB1310 JANUS KINASE INHIBITORS IN SEVERE AND REFRACTORY INFLAMMATORY OCULAR PATHOLOGY. CASES REPORTS AND LITERATURE REVIEW

Background Inflammatory ocular pathology (IOP) includes internal and external involvement. IOP may be severe conditions refractory to conventional immunosuppressants even biological therapy. Janus Kinase inhibitors (JAKINIB) had shown efficacy in cases of different immune-mediated inflammatory diseases (IMID). Objectives In patients with treated JAKINIB our aims were a ) assess the Spanish referral centers, b Literature review. Methods Multicenter study 6 JAKINIB. For review search was conducted PubMed, Embase Cochrane library from their inception 1 st January 2022, conference proceedings four major rheumatology conferences. addition, therapeutical approach is proposed. Results We have identified five University Hospitals 11 literature These 17 (14 women/ 3 men) (24 affected eyes), mean age 35.5±23.4 years (uveitis=11; scleritis= 3, PUK= 3). Most associated IMID (n=13, 76.5%). The main underlying juvenile idiopathic arthritis (n=5, 29.4%), rheumatoid (n=2, 11.8%) spondyloarthritis (n=2; (Table ). Table 1. Cases reports Study, year Age/ Sex Underlying Ocular involvement Previous immunosuppressive treatment Improvement (Ref Meadow et al. 2014 59, F RA TOFA PUK MTX, ABA, ivMP Partial (PI) (1) Bauermann 2018 22, JIA A. uveitis, CME ADA, RTX, GOLI, IFX, CsA, TCZ, MMF Complete (CI) (2) Paley 2019 2 1.40, 1.Idiopathic 1.TOFA 1.Scleritis 1.MTX, MMF, AZA, CYP 1.CI (3) 2.45, 2.Idiopathic 2.TOFA 2.A. 2.MTX, LFN, CZP, intravitreal fluocinolone ac. 2.CI Liu J 2020 30, M Behçet dis Scleritis SSZ, THD, COL, GLM PI (4) Majumder 26, Vogt-Koyanagi- Harada P. uveitis CI (5) Miserocchi 4 9, Panuv TCZ. 2. 1, BARI ABA. (6) 3. 2, 4. 10, ETN, RTX. Pyare 45, Idiopathic Necrotizing scleritis (7) Present study, 2022 25, Blau Syndrome TOFA/BARI ANA, ABA 85, iv MP. 41, Relapsing polychondritis ADA. 65, AZA 5. AS UPA ADA 6. 40, SpA ulcerative colitis Uveitis (n=11) followed by surface (n=6) most frequent subtypes IOP. Patterns panuveitis (n=6), anterior (n=4; them Cystoid macular edema) posterior (n=1). due (n=3) (n=3). Besides systemic corticosteroids, before JAKINIB, (n= 16; 94.1%) drugs (n=13; 76.5%) required. widely used tofacitinib 10; 58.8%) baricitinib (n=7; 41.2%). only one patient switched lymphopenia. After starting treatment, all presented clinical improvement, complete (n=15, 88.2%) or partial 2; 11.8%). Based on these data proposed (Figure Figure Therapeutical Conclusion an effective safe therapy References [1]Meadow PB. Case Rep Rheumatol. 2014. [2]Bauermann Ocul Immunol Inflamm. 2019. [3]Paley MA. Am Ophthalmol Reports. [4]Liu J. Ann Rheum Dis. 2020. [5]D Majumder. Indian Ophthalmol. [6]Miserocchi E. Clin [7]Pyare Ophtalmol, Disclosure Interests None declared