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The prevalence of uveitis was found to be approximately 5% in patients with psoriatic arthritis (PsA); however, uveitis is associated with worse health-related quality of life (HRQOL) and greater functional disability, according to study data published in RMD Open.
Researchers conducted a retrospective longitudinal study including patients with PsA at a university hospital in Madrid, Spain. The presence of PsA was confirmed using the Classification for Psoriatic Arthritis (CASPAR) criteria. Patients were assessed by an expert ophthalmologist for uveitis. Severity of PsA was evaluated using multiple indices. Additional clinical and laboratory data were collected, including human leucocyte antigen (HLA)-B27 status, uveitis features, the presence of sacroiliitis, and the use of disease-modifying antirheumatic drugs (DMARDs).
The study cohort included 406 patients with PsA, among whom 202 were women. Mean age was 46.3±12.3 years at enrollment; mean disease duration was 9.9±8.2 years. Uveitis was observed in 20 (4.9%) patients, with an incidence rate of 0.5 per 100 patients-year. The most common pattern of uveitis was anterior and unilateral (80%). Onset was acute in all cases and 10 patients (50%) experienced recurrence. All cases of uveitis were treated with topical ophthalmic agents.
Compared with those without uveitis, patients who developed uveitis had a greater frequency of positive HLA-B27 status (7.5% vs 45%; P <.0001), sacroiliitis on imaging (8.3% vs 25%; P =.027), and ocular surface pathology (0.8% vs 10%; P =.021). Median Bath Ankylosing Spondylitis Functional Index (BASFI; 4.0 vs 1.0; P =.01) and PsA impact of Disease score (5.9 vs 1.25; P =.001) were greater in patients with vs without uveitis.
The uveitis exposure adjusted incidence rate decreased after treatment with antitumor necrosis factor (TNF) α monoclonal antibodies (56.3 vs 9.4 per 100 patients-year) but increased with exposure to etanercept (6.03 vs 24.2 per 100 patients-year) and secukinumab (0 vs 50 per 100 patients-year).
Study limitations included possible selection bias given the nature of the study, as some patients may have been included in more than 1 study resulting in overlap.
“[I]n our study, uveitis related to PsA occurs less frequently than in SpA, but with a similar pattern of anterior and unilateral involvement, as well as an acute and often recurrent course of the disease,” the study authors wrote. “The presence of uveitis is associated with axial activity, impaired quality of life and increased functional disability. Therefore, uveitis may be a poor prognostic marker in PsA patients and could influence the choice of the therapeutic scheme,” they added.
Disclosure: Several study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
This article originally appeared on Rheumatology Advisor
