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

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14

 

  1. Rheumatology B Department, Cochin Hospital, Paris Descartes University, Paris, France.
  2. Rheumatology Department, Saint-Joseph Hospital, Paris, France.
  3. INSERM (U1153): Clinical Epidemiology and Biostatistics-PRES Sorbonne Paris-Cité, France.
  4. Ophthalmology Department, Cochin Hospital, Paris Descartes University, Paris, France.
  5. Ophthalmology Department, Cochin Hospital, Paris Descartes University, Paris, France.
  6. Rheumatology B Department, Cochin Hospital, Paris Descartes University, Paris, France.
  7. Rheumatology B Department, Cochin Hospital, Paris Descartes University, Paris, France.
  8. Rheumatology B Department, Cochin Hospital, Paris Descartes University, Paris, France.
  9. Rheumatology B Department, Cochin Hospital, Paris Descartes University, Paris, France.
  10. Rheumatology B Department, Cochin Hospital, Paris Descartes University, Paris, France.
  11. Rheumatology B Department, Cochin Hospital, Paris Descartes University, Paris, France.
  12. Department of Rheumatology, Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Paris, France.
  13. Rheumatology B Department, Cochin Hospital, Paris Descartes University, Paris, and INSERM (U1153): Clinical Epidemiology and Biostatistics-PRES Sorbonne Paris-Cité, France.
  14. Rheumatology B Department, Cochin Hospital, Paris Descartes University, Paris, and INSERM (U1153): Clinical Epidemiology and Biostatistics-PRES Sorbonne Paris-Cité, France. anna.molto@aphp.fr

CER10899
2019 Vol.37, N°1
PI 0026, PF 0031
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PMID: 30620268 [PubMed]

Received: 19/10/2017
Accepted : 26/02/2018
In Press: 19/12/2018
Published: 18/01/2019

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.

Rheumatology Article