Uveitis in 406 patients with psoriatic arthritis: Epidemiology, clinical characteristics and relationship with biological treatment. Study of a single university center.
Authors: Ana de Vicente Delmás al.
Uveitis may complicate the course of PsA and tends to be insidious, chronic and with often bilateral onset. Monoclonal antibodies targeting TNF are effective in the prevention and treatment of refractory uveitis. This study is a cross sectional study of 406 PsA patients all fulfilling the CASPAR criteria. Patients with ocular manifestations were evaluated by an expert ophthalmologist. Uveitis was observed in 4.9% (20/406) of patients, 60% of them were female. Acute onset was noted in all and recurrent disease in 50% of the patients. Patients with uveitis (compared to those without uveitis) were significantly more often HLA B27 positive (45 versus 7.5%) and had higher disease activity scores such as BASFI and PsAID compared to patients without uveitis. In addition, patients with uveitis had sacroiliitis at MRI more frequently than patients without uveitis (25 versus 8.3%), p = 0.021. The uveitis rate decreased with the use of monoclonal antibodies to TNF but increased with etanercept or secukinumab.
This cross-sectional study revealed that the overall frequency of uveitis with 4.9% is low in patients with PsA. Of note, an association of uveitis with HLA B27, MRI sacroiliitis and higher disease activity scores was observed. As the uveitis rate decreased with the use of monoclonal antibodies to TNF but increased in patients who received secukinumab or etanercept, these findings may be helpful to individualize treatment strategies.