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Kampman A, Wink F, Paap D, Carbo M, Siderius M, Kieskamp S, Maas F, Spoorenberg A, Arends S. Patients' Perspectives on Axial Pain in Relation to Inflammation and Structural Damage in a Large Cohort of Axial Spondyloarthritis Patients. Arthritis Care Res (Hoboken) 2024; 76:350-358. [PMID: 37781730 DOI: 10.1002/acr.25246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/12/2023] [Accepted: 09/26/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE The objective of this study was to explore to what extent patients with axial spondyloarthritis (axSpA) link experienced pain in the neck, back, and hips to inflammation and/or structural damage. METHODS Patients from the Groningen Leeuwarden Axial Spondyloarthritis (GLAS) cohort visiting the outpatient clinic between 2016 and 2019 filled out two additional questions in relation to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) question 2: (1) "To what extent do you think the pain you experience in your neck, back, and hips is related to inflammation caused by axSpA?" and (2) "To what extent do you think the pain you experience in your neck, back, and hips is related to damage of the spine and joints caused by axSpA?" Answers had to be depicted on a numeric rating scale from 0 (none) to 10 (very much); a difference of ≥2 points between the scores of these questions was considered clinically relevant in favor of the highest scoring question. RESULTS A total of 688 patients with axSpA (24% with nonradiographic axSpA [nr-axSpA]) were included (62% male, mean ± SD age 48 ± 14 years, and mean ± SD Ankylosing Spondylitis Disease Activity Score [ASDAS] 2.3 ± 1.0). Seventy-five percent of patients could not link the origin of their pain, 15% linked axial pain predominantly to inflammation, and 10% linked axial pain predominantly to damage. Patients in the inflammation group were younger, had shorter symptom duration, were more frequently diagnosed with nr-axSpA, had higher ASDASCRP , had more often elevated CRP levels, had fewer comorbidities, had better spinal mobility, and had less spinal radiographic damage. CONCLUSION In our large observational cohort, the majority of patients with axSpA 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 and supporting better patient-centered treatment decisions.
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Affiliation(s)
- Anne Kampman
- Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Freke Wink
- Medical Center Leeuwarden, Leeuwarden, and University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Davy Paap
- University of Groningen, University Medical Center Groningen, Groningen, and Saxion University of Applied Sciences, Enschede, The Netherlands
| | - Marlies Carbo
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mark Siderius
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Stan Kieskamp
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Fiona Maas
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anneke Spoorenberg
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Suzanne Arends
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Cinakli H, Ediboglu ED, Solmaz D, Akar S. Factors associated with acute anterior uveitis history in patients with axial spondyloarthritis: Results of a longitudinal study. Int J Rheum Dis 2024; 27:e15076. [PMID: 38454194 DOI: 10.1111/1756-185x.15076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/13/2024] [Accepted: 01/27/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUNDS Acute anterior uveitis (AAU) is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA). OBJECTIVES The aim of the study is to evaluate the factors associated with AAU attacks in patients with axSpA during a 36-month follow-up period. METHODS In total, 469 patients with axSpA were included in this observational study. Demographic data, clinical characteristics, disease activity measurements, and treatment patterns were compared between patients with and without a history of AAU. The development of AAU and its related factors were investigated using generalized estimating equations, which is a technique for longitudinal data analysis. RESULTS Overall, 99 (21%) out of 469 patients experienced at least one AAU attack, with 77 patients (78%) having a history of AAU and 53 patients (58% of whom had a history of AAU) experiencing AAU attacks during the follow-up period. At baseline, patients with a history of AAU were found to be older (p = .001), be more likely to have peripheral arthritis (p < .001), have higher serum CRP levels (p = .016), have a higher frequency of sulfasalazine (SLZ) and tumor necrosis factor inhibitors (TNFi) use (p < .001 and p < .001, respectively). In the longitudinal analysis, having a history of AAU was identified as the only independent determinant of the development of AAU. CONCLUSIONS AAU history might be a risk factor for the development of AAU attacks in patients with axSpA. Although TNFi and SLZ were prescribed more frequently to patients with a history of AAU, the effectiveness of these agents in preventing further AAU attacks was not demonstrated.
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Affiliation(s)
- Haluk Cinakli
- Division of Rheumatology, Kırklareli Education and Research Hospital, Kırklareli, Turkey
| | - Elif Durak Ediboglu
- Division of Rheumatology, Hatay Education and Research Hospital, Hatay, Turkey
| | - Dilek Solmaz
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Servet Akar
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
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Jacquot R, Kodjikian L, Chapurlat R, Sève P. Targeted therapies for uveitis in spondyloarthritis: A narrative review. Joint Bone Spine 2024; 91:105697. [PMID: 38309516 DOI: 10.1016/j.jbspin.2024.105697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/01/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
Spondyloarthritis (SpA) encompasses a group of chronic inflammatory disorders of the joints frequently associated with uveitis in almost a quarter of cases. SpA-related uveitis typically affects the eye anterior chamber with sudden onset, causing pain, redness, photophobia, and blurred vision. Ophthalmologists will describe an acute anterior unilateral uveitis. Most patients present with episodic acute anterior non-granulomatous uveitis and retain excellent visual acuity. However, systemic treatments are recommended in the event of frequent relapses (2-3/year) or in rare cases of sight-threatening with ocular complications. The improved understanding of the pathogenesis of SpA has led to the management of this disease by biologics. Here, we review the main data regarding the opportunity to target specific components in inflammatory pathways for the treatment of SpA-related uveitis. These therapies are recommended for long-term control when uveitis relapses occur too frequently despite conventional systemic treatments. Significant benefits have been obtained with the tumor necrosis factor-α inhibitors (TNFis), particularly infliximab and adalimumab. Paradoxically, a high number of uveitis occurrences have been shown on etanercept. Mixed results have been demonstrated with interleukin-17 antagonists (secukinumab) and interleukin-12/interleukin-23 antagonists (ustekinumab) in cases of failure of TNFis. JAK inhibitors seem to be a valuable class of medications for these patients in the future. Although SpA-related uveitis is typically managed with conventional local and/or systemic treatments, these biological/targeted therapies may provide avenues to control both the underlying SpA and uveitis manifestations. Thus, a close collaboration between patients, rheumatologists, internists, and ophthalmologists is needed to optimally manage ocular inflammation in SpA.
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Affiliation(s)
- Robin Jacquot
- Department of Internal Medicine, Hospices Civils de Lyon, Hôpital Universitaire de la Croix-Rousse, University Claude-Bernard Lyon 1, Lyon, France; Inserm U1290, Research on Healthcare Performance (RESHAPE), University Claude-Bernard Lyon 1, Lyon, France.
| | - Laurent Kodjikian
- Department of Ophthalmology, Hospices Civils de Lyon, Hôpital Universitaire de la Croix-Rousse, University Claude-Bernard Lyon 1, Lyon, France; UMR5510 MATEIS, CNRS, INSA Lyon, University Claude-Bernard Lyon 1, Villeurbanne, France
| | - Roland Chapurlat
- Department of Rheumatology, Hospices Civils de Lyon, Hôpital Universitaire Édouard-Herriot, University Claude-Bernard Lyon 1, Lyon, France
| | - Pascal Sève
- Department of Internal Medicine, Hospices Civils de Lyon, Hôpital Universitaire de la Croix-Rousse, University Claude-Bernard Lyon 1, Lyon, France; Inserm U1290, Research on Healthcare Performance (RESHAPE), University Claude-Bernard Lyon 1, Lyon, France
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Michelena X, Zhao SS, Marco-Pascual C, Almirall M, Collantes-Estevez E, Font-Ugalde P, López-Medina C, Wei JCC, Morgan AW, Rodríguez J, Juanola X, Vázquez-Mellado J, Marzo-Ortega H. Diagnostic delay is associated with uveitis and inflammatory bowel disease in AS: a study of extra-musculoskeletal manifestations in SpA. Rheumatology (Oxford) 2024; 63:430-435. [PMID: 37184889 PMCID: PMC10836992 DOI: 10.1093/rheumatology/kead225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/27/2023] [Accepted: 05/06/2023] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVES To examine the prevalence of extra-musculoskeletal manifestations (EMM) and the association between diagnostic delay and their incidence in AS and PsA. METHODS This was a retrospective, cohort study comprising two single centre cohorts in Europe and one multicentre cohort in Latin America (RESPONDIA). Crude prevalence of EMMs (uveitis, IBD and psoriasis) was calculated across geographic area and adjusted by direct standardization. Cox proportional hazard analysis was performed to assess the association between diagnostic delay and EMM incidence. RESULTS Of 3553 patients, 2097 had AS and 1456 had PsA. The overall prevalence of uveitis was 22.9% (95% CI: 21.1, 24.8) in AS and 3.8% (95% CI: 2.9, 5.0) in PsA; 8.1% (95% CI: 7.0, 9.4) and 2.1% (1.3, 2.9), respectively, for IBD; and 11.0% (95% CI: 9.7, 12.4) and 94.6% (93.0, 95.9), respectively, for psoriasis. The EMM often presented before the arthritis (uveitis 45.1% and 33.3%, and IBD 37.4% and 70%, in AS and PsA, respectively). In the multivariable model, longer diagnostic delay (≥5 years) associated with more uveitis (hazard ratio [HR] 4.01; 95% CI: 3.23, 4.07) and IBD events (HR 1.85; 95% CI: 1.28, 2.67) in AS. Diagnostic delay was not significantly associated with uveitis (HR 1.57; 95% CI: 0.69, 3.59) or IBD events (HR 1.59; 95% CI: 0.39, 6.37) in PsA. CONCLUSION EMMs are more prevalent in AS than PsA and often present before the onset of the articular disease. A longer diagnostic delay is associated with the 'de novo' appearance of uveitis and IBD in AS, highlighting the need to enhance diagnostic strategies to shorten the time from first symptom to diagnosis in SpA.
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Affiliation(s)
- Xabier Michelena
- Rheumatology Unit, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
- NIHR Leeds BRC, Leeds Teaching Hospitals NHS Trust and School of Medicine, University of Leeds, Leeds, UK
| | - Sizheng Steven Zhao
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Science, The University of Manchester, Manchester, UK
| | - Carla Marco-Pascual
- Rheumatology Unit, Hospital Dos de Maig—Consorci Sanitari Integral, Barcelona, Spain
- Rheumatology Unit, Bellvitge University Hospital, L’Hospitalet de Llobregat, Spain
| | - Miriam Almirall
- NIHR Leeds BRC, Leeds Teaching Hospitals NHS Trust and School of Medicine, University of Leeds, Leeds, UK
| | - Eduardo Collantes-Estevez
- Rheumatology Unit, Reina Sofia University Hospital and Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Pilar Font-Ugalde
- Rheumatology Unit, Reina Sofia University Hospital and Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Clementina López-Medina
- Rheumatology Unit, Reina Sofia University Hospital and Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ann W Morgan
- NIHR Leeds BRC, Leeds Teaching Hospitals NHS Trust and School of Medicine, University of Leeds, Leeds, UK
| | - Jesús Rodríguez
- Rheumatology Unit, Bellvitge University Hospital, L’Hospitalet de Llobregat, Spain
| | - Xavier Juanola
- Rheumatology Unit, Bellvitge University Hospital, L’Hospitalet de Llobregat, Spain
| | | | - Helena Marzo-Ortega
- NIHR Leeds BRC, Leeds Teaching Hospitals NHS Trust and School of Medicine, University of Leeds, Leeds, UK
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Li H, Xu Y, Guo Q, Zhang T, Zhou S, Wu M, Cheng Y, Guo C. Ankylosing spondylitis: acute/subacute vs. chronic iridocyclitis - a bidirectional two-sample Mendelian randomization study. Front Immunol 2024; 14:1295118. [PMID: 38274819 PMCID: PMC10808375 DOI: 10.3389/fimmu.2023.1295118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/13/2023] [Indexed: 01/27/2024] Open
Abstract
Background Observational studies found associations between ankylosing spondylitis (AS) and iridocyclitis (IC), but the causality remained unconfirmed. Methods We employed two-sample Mendelian randomization (MR) to investigate the bidirectional causal relationships between AS and IC. Single-nucleotide polymorphisms (SNPs) were chosen from the FinnGen database's genome-wide association studies (GWAS) following a rigorous evaluation of the studies' quality. Sensitivity analysis was performed to assess the potential influence of pleiotropy and heterogeneity on the MR findings. Results Elevated genetic risk for AS showed positive causal effects on IC and its subtypes (IC, OR = 1.094, 95% CI = 1.035-1.157, P = 0.00156; Acute/Subacute IC, OR = 1.327, 95% CI = 1.266-1.392, P = 8.73×10-32; Chronic IC, OR = 1.454, 95% CI = 1.308-1.618, P = 5.19×10-12). Significant causal association was specifically observed between Acute/Subacute IC and AS (OR = 1.944, 95% CI = 1.316-2.873, P = 8.38×10-4). Sensitivity analysis suggested that horizontal pleiotropy was unlikely to influence the causality, and the leave-one-out analysis confirmed that a single SNP did not drive the observed associations. Conclusion Our findings provide new proof of a positive causal relationship between AS and IC in the European population. Notably, it is Acute/Subacute IC, rather than IC as a whole or Chronic IC, that is associated with an elevated risk of AS. These results emphasize the significance of considering AS characteristics in the diagnosis of Acute/Subacute IC.
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Affiliation(s)
- Hui Li
- The Third Affiliated Hospital, The Third School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Rheumatology and Immunology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Yingying Xu
- Department of Intensive Care Medicine, Qingyuan People’s Hospital, Qingyuan, China
- Department of Respiratory and Critical Care Medicine, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Qin Guo
- Department of Rheumatology and Immunology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Tiantian Zhang
- Department of Rheumatology and Immunology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Shufen Zhou
- Department of Rheumatology and Immunology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Meimei Wu
- Department of Rheumatology and Immunology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Yuanxiong Cheng
- Department of Respiratory and Critical Care Medicine, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Chengshan Guo
- Department of Rheumatology and Immunology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
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Lee SC, Yang CH, Tsai YC, Yu KH. The effect of uveitis and undiagnosed spondyloarthritis: a systematic review and meta-analysis. Sci Rep 2023; 13:14779. [PMID: 37679498 PMCID: PMC10484908 DOI: 10.1038/s41598-023-41971-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/04/2023] [Indexed: 09/09/2023] Open
Abstract
Delay diagnosis of spondyloarthritis (SpA) is associated with poor functional ability and quality of life. Uveitis is the most frequent extraarticular manifestation in SpA, and its prevalence increases with longer disease duration. This study examines the effect of uveitis on the disease activity and functional outcome of undiagnosed SpA. We reviewed published and unpublished studies. Data were pooled using the random-effects model; pooled means, and mean differences (MDs) were calculated. In the included 14 studies, disease activity, functional index, and inflammatory markers were measured in 2581 patients with SpA with uveitis and 13,972 without. The pooled mean delay in diagnosis of SpA with uveitis (6.08 years; 95% CI 4.77 to 7.38) was longer than those without (5.41 years; 95% CI 3.94 to 6.89). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score was the highest for a delay of 2-5 years (5.60, 95% CI 5.47 to 5.73) and the Bath Ankylosing Spondylitis Functional Index (BASFI) score was the lowest for a delay of < 2 years (2.92, 95% CI 2.48 to 3.37) and gradually increased to delay of > 10 years (4.17, 95% CI 2.93 to 5.41). Patients with SpA with uveitis had higher trend of Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP and BASDAI. The delay to diagnosis was longer in SpA with uveitis, and disease activity was often higher than those without uveitis. Early diagnosis of SpA with timely initiation of an appropriate management plan may reduce the adverse effects of the disease and improve functional ability.
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Affiliation(s)
- Shih-Ching Lee
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, No. 5, Fu-Shin St., Kuei-Shan, 333, Tao-Yuan, Taiwan
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Chung-Han Yang
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, No. 5, Fu-Shin St., Kuei-Shan, 333, Tao-Yuan, Taiwan
| | - Yun-Chen Tsai
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, No. 5, Fu-Shin St., Kuei-Shan, 333, Tao-Yuan, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan
| | - Kuang-Hui Yu
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, No. 5, Fu-Shin St., Kuei-Shan, 333, Tao-Yuan, Taiwan.
- Chang Gung University, Tao-Yuan, Taiwan.
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Sieiro Santos C, Sendino-Tenorio I, Álvarez Castro C, Moriano Morales C, Cordero Coma M, Díez Álvarez E. Factors Associated With Adverse Outcomes in Uveitis Related to Spondyloarthritis: Development of an Outcome Score (SpA-U). J Clin Rheumatol 2023; 29:132-138. [PMID: 36728382 DOI: 10.1097/rhu.0000000000001921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Evaluating 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. OBJECTIVES The 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. METHODS The 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. RESULTS One 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. CONCLUSION We 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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Affiliation(s)
| | | | | | | | - Miguel Cordero Coma
- Ophthalmology Department, Complejo Asistencial Universitario de León, León, Spain
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Abstract
Spondyloarthropathies, also known as spondyloarthritis, encompasses a spectrum of diseases classified by it's axial and peripheral musculoskeletal manifestations. Extra-articular features are common in SpA making these systemic rheumatologic diseases involve the skin, eye, gut, and other organ systems.Research has identified risk factors for the development of spondyloarthritis, particularly regarding genetic susceptibility and the strong association with HLA-B27. Multiple studies have elucidated clinical risk factors associated with SpA disease activity and severity. In this review, we aim to explore the environmental risk factors for spondyloarthritis.
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Affiliation(s)
- Yvette Farran
- Division of Rheumatology, Department of Internal Medicine, John P. and Kathrine G. McGovern School of Medicine at The University of Texas Health Science Center at Houston, 6431 Fannin MSB 5.270, Houston, TX 77030, USA
| | - John Reveille
- Division of Rheumatology, Department of Internal Medicine, John P. and Kathrine G. McGovern School of Medicine at The University of Texas Health Science Center at Houston, 6431 Fannin MSB 5.270, Houston, TX 77030, USA
| | - Mark Hwang
- Division of Rheumatology, Department of Internal Medicine, John P. and Kathrine G. McGovern School of Medicine at The University of Texas Health Science Center at Houston, 6431 Fannin MSB 5.270, Houston, TX 77030, USA.
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Yasmin MR, Islam MN, Pannu ZR, Azad MAK, Uddin MSG. Prevalence and risk factors for uveitis in spondyloarthritis. Int J Rheum Dis 2022; 25:517-522. [PMID: 35170215 DOI: 10.1111/1756-185x.14303] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/24/2022] [Accepted: 01/30/2022] [Indexed: 01/20/2023]
Abstract
AIM To determine the prevalence and risk factors for uveitis in spondyloarthritis (SpA) patients. METHODS A total of 225 patients who fulfilled Assessment of Spondyloarthritis International Society classification criteria for axial and peripheral SpA were enrolled. The diagnosis of uveitis was confirmed by an ophthalmologist. From medical records and from clinical evaluation associated information like disease duration, and human leukocyte antigen B27 was collected. Relevant laboratory tests were done and disease severity was assessed using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score - erythrocyte sedimentation rate and C-reactive protein. Characteristics of uveitis positive and uveitis negative groups were compared. Multivariate logistic regression analysis was done for the risk factors, and P values <.05 were considered significant. RESULTS Prevalence of uveitis was 18.7%. The disease duration was 9.3 ± 7 years and 5.4 ± 4.5 years in uveitis and no uveitis groups respectively (P ≤ .001). Family history of SpA was positive in 45.2% in the uveitis group (P ≤ .001). The frequency of axial SpA was 92.9% and 73.8% in the uveitis and no uveitis groups respectively (P ≤ .008). The mean BASDAI was 2.4 ± 1.9 and 3.3 ± 2.8 in uveitis and no uveitis groups respectively (P = .050). In multivariate logistic regression analysis, among the selected variables, family history of SpA (odds ratio [OR] =3.697; 95% CI =1.616-8.457; P = .002) and duration of disease (OR =1.089; 95% CI =1.004-1.181; P = .039) were independently associated with the occurrence of uveitis. CONCLUSIONS The prevalence of uveitis was 18.7%. The family history and the disease duration of SpA were independently associated with uveitis.
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Affiliation(s)
- Mst Rupali Yasmin
- Department of Rheumatology, BSMMU, Dhaka, Bangladesh.,Mugda Medical College Hospital, Dhaka, Bangladesh
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