Uveitis-related Factors in Patients With Spondyloarthritis: TReasure Real-Life Results

Bilge, Nazife Şule Yaşar; Kalyoncu, Umut; Atagündüz, Pamir; Dalkılıç, Ediz; Pehlıvan, Yavuz; Küçükşahin, Orhan; Beş, Cemal; Akar, Servet; Çınar, Muhammet; Emmüngil, Hakan; Ersözlü, Duygu; Ateş, Aşkın; Mercan, Rıdvan; Kimyon, Gezmiş; Koca, Süleyman Serdar; Gönüllü, Emel; Yazısız, Veli; Tekgöz, Emre; Alpay-Kanitez, Nilufer; Erden, Abdülsamet; Kiraz, Sedat; Coşkun, Belkıs Nihan; Yağız, Burcu; İlgen, Ufuk; Karadağ, Ömer; Kılıç, Levent; Ertenli, İhsan; Kaşifoğlu, Timuçin

doi:10.1016/j.ajo.2021.03.026

Cited by 11 publications

(11 citation statements)

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“…Such observation may be due to the lower mean age of unmarried patients compared to the mean age of married patients. In the present series, a positive family history of SpA was significantly associated with the occurrence of uveitis which was consistent with a recent study conducted by Yasar et al 10 This may indicate a genetic association of uveitis in SpA patients.…”

Section: Discussionsupporting

confidence: 93%

“…A good number of studies have reported association of several factors in the occurrence of uveitis in SpA patients. The most common factors are positive human leukocyte antigen (HLA)‐B27, 5,6,9,10 disease duration 5,6,11,12 and radiographic sacroiliitis 5,13,14 . Other factors are age, 15 male gender, 13 types of SpA, 9 number of peripheral arthritis, 16 hip joint involvement, 14,16 antistreptolysin O titer, 14,16 circulating immune complex, 16 family history of SpA, 10 inflammatory low back pain, enthesopathy, urethritis, diarrhea, balanitis, and raised C‐reactive protein (CRP) 14…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and risk factors for uveitis in spondyloarthritis

Yasmin

Islam

Pannu³

et al. 2022

Int J of Rheum Dis

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Spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic disorders which include ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis (PsA), arthritis associated with inflammatory bowel disease, and undifferentiated SpA. 1 In the Assessment of Spondyloarthritis International Society (ASAS) consensus 2009, the SpA family was subdivided into axial and peripheral SpA. 2 The disease is usually characterized by extra-articular manifestations (EAMs), such as uveitis, psoriasis, and inflammatory bowel disease. 3 Among those manifestations, uveitis (any inflammation that affects the uveal tract) is the most common. 4 Uveitis may precede the

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors for uveitis in spondyloarthritis

Yasmin

Islam

Pannu³

et al. 2022

Int J of Rheum Dis

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“…9,10 Our results also suggest that HLA-B27 positivity, nonanterior uveitis, cellularity ≥3, poor visual acuity, panuveitis, and a disease evolution of more than 10 years were associated with a higher risk of 12,13 HLA-B27 plays a role in the development of uveitis and SpA and can cause a genetic predisposition in most patients [14][15][16] Several studies have linked HLA-B27 positivity to adverse outcomes in uveitis. 17,18 HLA-B27 was identified in approximately 90% of patients and has been associated with a substantially increased risk (2.6-to 4.2-fold) of developing of uveitis. 19 We found 83.3% of patients were HLA-B27 positive, with associated bilateral or alternating ocular involvement, and had a family history more frequently than HLA-B27-negative patients.…”

Section: Discussionmentioning

confidence: 99%

“…Conventional synthetic DMARDs, including MTX and AZ, were more frequently used in patients who required systemic treatment for uveitis but often had peripheral arthritis or were receiving treatment with nonsteroidal anti-inflammatory drugs for axial manifestations. The introduction of systemic therapies in treating uveitis has considerably improved the prognosis of uveitis associated with SpA 18 . Salazopyrine was the most frequently used csDMARD, followed by MTX, and ADA was the most frequently used bDMARDs in treating patients with uveitis.…”

Section: Discussionmentioning

confidence: 99%

“…The introduction of systemic therapies in treating uveitis has considerably improved the prognosis of uveitis associated with SpA. 18 Salazopyrine was the most frequently used csDMARD, followed by MTX, and ADA was the most frequently used bDMARDs in treating patients with uveitis. The American College of Rheumatology-Spondyloarthritis Research and Treatment Network guidelines published in 2019 emphasize the importance of treating anterior uveitis associated with SpA and conditionally recommend treatment with TNF inhibitor monoclonal antibodies.…”

Section: Discussionmentioning

confidence: 99%

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Factors Associated With Adverse Outcomes in Uveitis Related to Spondyloarthritis

et al. 2023

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BackgroundEvaluating the efficacy and refractoriness to treatment and determining factors associated with adverse outcomes in uveitis associated with spondylarthritis (SpA) are complicated by the lack of validated outcome measures.ObjectivesThe aims of this study were to develop an outcome score SpA-U in patients with uveitis associated with SpA and to determine factors associated with adverse outcomes in patients with uveitis under systemic treatment.MethodsThe outcome score SpA-U was defined by best-corrected visual acuity, anterior chamber inflammation, macular edema and inflammation of posterior chamber, global assessment, and refractoriness to treatment. Factors associated with adverse outcomes in uveitis were studied using linear regression. For categorical factors, marginal averages and their SEs are displayed together with linear regression coefficients with 95% confidence intervals. For continuous factors, averages and SDs are reported in addition to linear regression coefficients with 95% confidence interval. Two regression coefficients are reported for each variable: unadjusted and adjusted for age at diagnosis and sex.ResultsOne hundred ninety-seven uveitis outbreaks were included. Sixty-two uveitis outbreaks (31%) were classified as severe, 42 as moderate (21%), and 93 as mild (47%) based on the definition and construction of outcome score. The results of the linear regression model revealed that the uveitis activity was more severe in patients with smoking history (β = 0.34), axial and peripheral involvement (β = 0.43), Ankylosing Spondylitis Disease Activity Score >2.1 (β = 0.45), positive HLA-B27 (β = 0.29), female sex (β = 0.19), patients with C-reactive protein elevation (β = 0.002), and bilateral ocular involvement (β = 0.32). At the same time, shorter disease evolution (β = −0.02) was associated with less severe uveitis activity.ConclusionWe have determined factors associated with adverse outcomes in patients with uveitis associated with SpA by developing an outcome score SpA-U that integrates ocular inflammatory activity, visual acuity, global assessment, and refractoriness to treatment.

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Patients’ Perspectives on Axial Pain in Relation to Inflammation and Structural Damage in a Large Cohort of Axial Spondyloarthritis Patients

Kampman,

Wink,

Paap

et al. 2024

Arthritis Care & Research

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ObjectiveTo explore to what extent axSpA patients link experienced pain in neck, back and hips to inflammation and/or structural damage.MethodsPatients from the GLAS cohort visiting the outpatient clinic between 2016 and 2019 filled out two additional questions in relation to BASDAI Q2: ‘To what extent do you think the pain you experience in your neck, back and hips is related to: 1. inflammation caused by axSpA?, 2. damage of the spine and joints caused by axSpA?’ Answers had to be depicted on a NRS from 0 (none) to 10 (very much); a difference of ≥2 points between the scores of these questions was considered as clinically relevant in favor of the highest scoring question.Results688 axSpA patients (24% nr‐axSpA) were included, 62% male, mean age 48±14 years and mean ASDASCRP 2.3±1.0. 75% of patients could not link the origin of their pain, 15% linked axial pain predominantly to inflammation and 10% to damage. Patients in the inflammation group were younger, had shorter symptom duration, were more frequently diagnosed as nr‐axSpA, had higher ASDASCRP, more often elevated CRP, less comorbidities, better spinal mobility and less spinal radiographic damage.ConclusionIn our large observational cohort, the majority of axSpA patients could not differentiate the origin of experienced axial pain. If patients were able to link axial pain to clinical inflammation or damage, it was in concordance with clinical assessments and radiographic outcome, which may be helpful in establishing the origin of pain supporting better patient centered treatment decisions.This article is protected by copyright. All rights reserved.

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Uveitis-related Factors in Patients With Spondyloarthritis: TReasure Real-Life Results

Cited by 11 publications

References 10 publications

Prevalence and risk factors for uveitis in spondyloarthritis

Prevalence and risk factors for uveitis in spondyloarthritis

Factors Associated With Adverse Outcomes in Uveitis Related to Spondyloarthritis

Patients’ Perspectives on Axial Pain in Relation to Inflammation and Structural Damage in a Large Cohort of Axial Spondyloarthritis Patients

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