Citera G*, Schneeberger EE, Cavalieri M, Campusano RR, Orozco MC, Sommerfleck FA, Zamora N and Capelusnik D
Department of Rheumatology, Institute of Psychophysical Rehabilitation, ArgentinaFulltext PDF
Introduction: The objective of this study was to determine the prevalence of AAU in a cohort of patients with axSpA and to describe their clinical characteristics, frequency of episodes, response to treatment and long-term prognosis, as well as, their association with general disease characteristics. Material and Methods: A longitudinal study was carried out. We included patients that fulfilled the ASAS criteria for axSpA (ASAS 2009 criteria) from ESPAXIA (Estudio de eSPondiloartritis Axial Irep Argentina) cohort. Sociodemographic data, type of axSpA, extra-articular manifestations, comorbidities, disease duration and treatments received numbers of episodes of uveitis, incidence date, and its characteristics, treatment and complications were consigned. Morning stiffness, night pain, global pain and patient’s and physician's global assessment (NVS), number of swollen joints (44), axial mobility (BASMI), enthesitis (MASES), ESR, CRP and HLA-B27 were registered. BASDAI, BASFI and ASQoL self-questionnaires were administered. Results: Two hundred and thirty one patients with axSpA were included, 174 male (75.3%) with a median age of 46 years (IQR 36 to 57) and median disease duration of 20.5 years (IQR 10.5 to 30.5). Sixty patients (26%) had at least one episode of uveitis, being the first manifestation of the disease in 22 of them (37.9%). Acute anterior uveitis was the most frequent form, and it was observed in 59 patients (98.3%). The mean number of episodes was 4.78 (SD 5.64). Recurrences were unilateral in 48.8% of cases. The treatment received was local in 42 (79.2%) of the patients. Twenty patients (33.33%) where in treatment with Tumor Necrosis Factor α inhibitors (TNFi) by the time of the data collection: 17 patients with monoclonal antibodies and 3 with Etanercept (ETN). Patients with axSpA and UAA received monoclonal agents more frequently (85% vs. 15%, p=0.018). The presence of UAA was associated with a lower survival of biological medication, with a median of 91.42 months (SD 19.74) vs. 109.44 months (SD 12.34). Twelve patients (22.2%) presented a complication after the first episode, being the decrease in visual acuity and cataracts, the most frequent ones (16.7% and 5.6%, respectively). The presence of uveitis was significantly associated with longer disease duration (x̄ 24.9 years vs. x̄ 20.7 years, p=0.038) and with the presence of HLA-B27, (69% vs. 47.4%, p=0.006) and these associations were maintained in the multivariate analysis, after adjusting for other variables.
Uveitis; Spondyloarthritis; Axial spa; HLA-B27
Citera G, Schneeberger EE, Cavalieri M, Campusano RR, Orozco MC, Sommerfleck FA, et al. Uveitis, the Most Faithful Partner of Axial Spondyloarthritis. Ann Arthritis Clin Rheumatol. 2020; 3(1): 1016.