The following article is a part of conference coverage from the American College of Rheumatology (ACR) Convergence 2021, being held virtually from November 3 to 10, 2021. The team at Rheumatology Advisor will be reporting on the latest news and research conducted by leading experts in rheumatology. Check back for more from the ACR Convergence 2021.
Among patients with psoriatic arthritis (PsA), uveitis was prevalent in 4.9%, with a pattern similar to that of axial spondyloarthritis, according to study results recently presented at the American College of Rheumatology (ACR) Convergence 2021, held virtually from November 3 to 10, 2021.
The current cross-sectional study included participants with PsA from a single hospital. Classification Criteria for Psoriatic Arthritis (CASPAR) was used to classify PsA. Ophthalmologists assessed participants with ocular manifestations for uveitis. The study researchers recorded clinical findings, demographic characteristics, complementary tests, treatment used, and additional extra-articular manifestations.
A total of 406 participants (204 men; mean age, 46.3±12.3 years; mean disease duration, 9.9±8.2 years) were included in the study. Among the total cohort, 4.9% (n=20) presented with uveitis, characterized as recurrent (50%), unilateral (80%), anterior (80%), or acute-onset (100%).
Patients with uveitis had a higher frequency of human leukocyte antigen (HLA) B27 (45%), ocular surface pathology (10%), and sacroiliitis on magnetic resonance imaging (MRI; 25%). Patients with PsA and uveitis had higher scores on both the Bath Ankylosing Spondylitis Functional Index (BASFI; median, 4) and the Psoriatic Arthritis Impact of Disease (median, 5.9).
Uveitis occurred before treatment with etanercept and tumor necrosis factor (TNF) inhibitors at an incidence of 6.03 and 56.3 episodes per 100 patients per year, respectively. After treatment, uveitis incidence among those who received treatment with TNF inhibitors reduced to 9.4 episodes per 100 patients per year, and to 50 and 24.2 episodes per 100 patients per year among those who received treatment with secukinumab and etanercept, respectively.
The study authors concluded that the 4.9% prevalence of uveitis in patients with PsA exhibited a pattern “similar to that observed in [axial spondyloarthritis] with acute onset and anterior and unilateral pattern.” Furthermore, researchers indicated that those developing uveitis “more frequently presented HLA-B27 positivity, sacroiliitis in MRI and ocular surface pathology, in addition to a higher [Psoriatic Arthritis Impact of Disease] score and the BASFI index. The uveitis rate decreased with the monoclonal antibodies TNF [inhibitors], while an increase was recorded with [etanercept] or [secukinumab].”
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
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de Vicente Delmás A, Sánchez-Bilbao L, Calvo-Río V, et al. Uveitis in 406 patients with psoriatic arthritis: epidemiology, clinical characteristics and relationship with biological treatment. Study of a single university center. Presented at: ACR Convergence 2021; November 3-10, 2021. Abstract 1323.