Acute anterior uveitis in spondyloarthritis: a monocentric study of 301 patients.

Abstract

OBJECTIVES:

To assess the cumulative incidence of uveitis in spondyloarthritis (SpA) and its associated factors and to evaluate the effect of DMARD treatment on uveitis in a real-life setting.

METHODS:

A cross-sectional monocentric observational study (COSPA) was conducted. Patients with definite SpA underwent a face-to-face interview. General data and specific data concerning uveitis were collected. Cumulative incidence of uveitis flares was estimated by Kaplan-Meier survival curves. Factors associated with uveitis were determined by Cox analysis. Treatment effectiveness was evaluated by comparing the number of uveitis flares before/after treatment using Wilcoxon test.

RESULTS:

In total, 301 patients were included, 186 (61.8%) were men, with mean age and disease duration of 44.8 (±13.6) and 16.8 (±11.9) years, respectively. Among them, 82 (27.2%) had at least one uveitis flare. Prevalence of uveitis at the time of SpA diagnosis was 11.5 % (±1.9%) and increased over time to reach 39.3% (±4.1%) 20 years after diagnosis. HLA B27 positivity and heel pain were independently associated with uveitis (HR [IC 95%] = 4.5 [1.3-15.2] and 1.8 [1.1-2.9], respectively). A significant reduction in the number of uveitis before/after treatment was observed in patients treated with anti TNF monoclonal antibodies (n=27), (1.83 (±4.03) vs. 0.41 (±1.22), p=0.002), whereas it was not with etanercept (n=19), (0.44 (±0.70) and 0.79 (±1.36), p=NS).

CONCLUSIONS:

Prevalence of uveitis in SpA seems to increase with disease duration and seems more likely to appear with HLA B27 positivity and heel pain. Anti-TNF monoclonal antibodies seemed to be more effective in the reduction of uveitis flares.

• Authors: Camelia Frantz, Agnes Portier, Adrien Etcheto, Dominique Monnet, Antoine Brezin, Fanny Roure, Muriel Elhai, Vincent Burki, Isabelle Fabreguet, Eugenie Koumakis, Judith Payet, Laure Gossec, Maxime Dougados, Anna Molto
• Journal: Clinical and experimental rheumatology (Clin Exp Rheumatol) 2019 Jan-Feb Vol. 37 Issue 1 Pg. 26-31 ISSN: 0392-856X [Print] Italy
• PMID: 30620268 (Publication Type: Journal Article, Observational Study)

Chemical References

• HLA-B27 Antigen
• Tumor Necrosis Factor-alpha

Topics

• Adult
• Cross-Sectional Studies
• Female
• HLA-B27 Antigen
• Humans
• Male
• Spondylarthritis (epidemiology)
• Tumor Necrosis Factor-alpha
• Uveitis, Anterior (epidemiology)