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Prevalence and incidence of uveitis in patients with spondyloarthritis: the impact of the biologics era. Data from International ASAS-COMOSPA Study

Affiliations
  • 1Rheumatology Section, Hospital San Antonio de Padua and Clínica Regional Del Sud, Argentina, Río Cuarto, Córdoba.
  • 2Rheumatology Department, Reina Sofia University Hospital, IMIBIC, University of Cordoba, Cordoba, Spain.
  • 3Rheumatology Section, Hospital de Clínicas Pte. Dr Nicolás Avellaneda, Tucumán, Argentina.
  • 4Rheumatology, Hospital Dr Hector Cura, Olavarría, Argentina.
  • 5School of Medicine, Buenos Aires University, Buenos Aires, Argentina.
  • 6Rheumatology Department, Hôpital Cochin, AP-HP, Paris, France.
  • 7Department of Rheumatology, Hopital Cochin, Paris, France.
  • 8Amsterdam Rheumatology & Clinical Immunology Center, Amsterdam, the Netherlands.
  • 9Zuyderland Medical Center Heerlen, the Netherlands.
  • 10Department of Rheumatic Diseases, Leiden University Medical Center, Leiden, the Netherlands.
  • 11Department of Rheumatology, University of Ghent, Ghent, Belgium.

Published on:

October 3, 2024

Abstract

OBJECTIVES

Uveitis is a common extra-musculoskeletal manifestation in Spondyloarthritis (SpA). The aim of this study was to analyze the prevalence of uveitis in SpA patients, its association with geographical areas and to determine whether its incidence was different before and after the biological era.

METHODS

ASAS-COMOSPA is a retrospective study that includes patients fulfilling ASAS SpA classification criteria from 22 countries. The overall prevalence of uveitis was calculated, and factors associated with the onset of a first episode of uveitis were evaluated using a Cox regression. A Log-Rank test was performed to compare the new onset of uveitis in the no biological era (SpA onset before 2000) vs biological era (SpA onset after 2000).

RESULTS

3984 patients were included. The likelihood of presenting a first uveitis episode increased over time, from a prevalence of 10.5% (95%CI 9.5%-11.4%) at the time of the SpA diagnosis to 46.6% (41.6%-51.5%) after 30 years since the SpA diagnosis. HLA-B27 positivity, family history of uveitis, peripheral enthesitis and IBD were associated with higher risk of uveitis. Patients with SpA disease onset after year 2000 showed a lower prevalence of uveitis compared with disease onset before year 2000 (8.2% vs 25.5%, p< 0.01), as well as a lower incidence (2.8 per 100 PY vs 6.1 per 100 PY, respectively).

CONCLUSION

In our study the risk of having suffered from at least one episode of uveitis ranged from 10% at the time of the diagnosis of axSpA to 47% after 30 years of disease duration. Patients with disease onset after biologic therapy introduction showed a significantly lower prevalence and incidence of first episodes of uveitis.

Keywords:

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