Uveitis in psoriatic arthritis: study of 406 patients in a single university center and literature review.

BACKGROUND/PURPOSE

The manifestations of uveitis are well established in axial spondyloarthritis (ax-SpA), but not in psoriatic arthritis (PsA). We aimed to assess, in a large unselected series of PsA: (A) the frequency and clinical features of uveitis; (B) its association with PsA activity, the impact of disease and functional disability, and (C) its relationship with the biological treatment. In addition, a literature review was performed.

METHODS

Retrospective longitudinal study of PsA patients from a single referral hospital. PsA was classified according to the CASPAR criteria, and uveitis was diagnosed by experienced ophthalmologists.

RESULTS

We studied 406 patients with PsA (46.3±12.3 years). Uveitis was observed in 20 (4.9%). Uveitis was acute in all cases, anterior (80%), unilateral (80%) and recurrent (50%). Patients with uveitis had a higher prevalence of HLA-B27 (45% vs 7.5%, p<0.0001), sacroiliitis on MRI (25% vs 8.3% p=0.027), ocular surface pathology (10% vs 0.8%, p=0.021), and median PsA impact of Disease Score (5.9 (2.1-6.8) vs 1.25 (0.0-3.0), p=0.001) and Bath Ankylosing Spondylitis Functional Index (4 (1.6-5) vs 1.0 (0.0-3.5), p=0.01) than patients without uveitis.The exposure adjusted incidence rate (episodes/100 patients-year) of uveitis before versus after biological treatment decreased with anti-TNFα monoclonal antibodies (56.3 vs 9.4) and increased with etanercept (ETN) (6.03 vs 24.2) and secukinumab (SECU) (0 vs 50) (including only one patient treated in the last two cases).

CONCLUSION

The prevalence of uveitis in patients with PsA was about 5%. The pattern was similar to that observed in ax-SpA. Uveitis was associated with a worse quality of life and greater functional disability. The uveitis exposure adjusted incidence rate decreased with anti-TNFα monoclonal antibodies and increased with ETN and SECU.

Informations de copyright

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: Dr. MA González-Gay received grants/research support from Abbvie, MSD, and Roche, and had consultation fees/participation in company-sponsored speaker's bureau from Pfizer, Celgene, Novartis, Roche, Sanofi, and Lilly. Dr. R Blanco received grants/research support from Abbvie, MSD, and Roche, and had consultation fees/participation in company-sponsored speaker's bureau from Abbvie, Pfizer, Roche, BMS, Janssen, Lilly, and MSD. Dr. JL Hernández received grants/research support from Amgen and had participation in company-sponsored speaker's bureau from Amgen, and MSD. Vanesa Calvo-Río received grants/research supports from AbbVie, Lilly, MSD and UCB Pharma. Natalia Palmou-Fontana received grants/research supports from Novartis, GSK, Amgen and Sanofi. No financial disclosures declared: Ana de Vicente-Delmás, Lara Sánchez-Bilbao, David Martínez-López, Alba Herrero- Morant, Iñigo González-Mazón, Nuria Barroso-García and Eva Galíndez-Agirregoikoa.