title: Bilateral Retrobulbar Optic Neuropathy Associated With Golimumab.
abstract: We report the first documented case of retrobulbar optic neuropathy associated with golimumab. A 48-year-old man was admitted with a 3-week history of progressive visual loss of his left eye. He had received a second infusion of golimumab for ankylosing spondylitis 10 days before admission. A magnetic resonance imaging scan showed enhancement of both optic nerves and visual evoked potentials were consistent with demyelinating bilateral optic neuropathy, although visual acuity drop in the right eye could not be determined because of deep amblyopia. No improvement was observed after golimumab dechallenge or corticosteroid treatment. Demyelinating complications related to treatment with tumor necrosis factor alpha inhibitors (TNFAI) have been previously described. Golimumab, a fully human monoclonal antibody, is the most recently developed TNFAI and thus, fewer adverse effects have been reported. Further studies should be developed to elucidate if variability in golimumab's pharmacokinetics or TNF receptor binding affinity could explain different safety profiles compared with other TNFAI.
authors.affiliation: Departments of *Ophthalmology, †Neurology, and ‡Rheumatology, Donostia University Hospital, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: de Frutos-Lezaun
authors.forename: Aritz
authors.initials: A
authors.lastname: Bidaguren
authors.forename: Patricia
authors.initials: P
authors.lastname: de la Riva
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Meneses
authors.forename: Javier
authors.initials: J
authors.lastname: Olascoaga
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D018450:Disease Progression; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009186:Myelin Sheath / Q000187:drug effects / Q000276:immunology; D020258:Neurotoxicity Syndromes / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D009900:Optic Nerve / Q000000981:diagnostic imaging / Q000187:drug effects / Q000276:immunology / Q000503:physiopathology; D009902:Optic Neuritis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D013167:Spondylitis, Ankylosing / Q000188:drug therapy; D016896:Treatment Outcome; D015354:Vision, Low / Q000209:etiology* / Q000517:prevention & control
chemical_list: D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C529000:golimumab