Prevalence and risk factors for uveitis in spondyloarthritis

Yasmin, Mst Rupali; Islam, Md. Nazrul; Pannu, Zahedur Rahman; Azad, Mohammad Abul Kalam; Uddin, Mudassir

doi:10.1111/1756-185x.14303

Cited by 6 publications

(7 citation statements)

References 21 publications

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“…This finding is important because it underlines that uveitis may be the first symptom of SpA 8 . The mean age at uveitis onset in our study was 36.6 years, which coincides with the age reported in literature 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 complications.…”

Section: Discussionsupporting

confidence: 86%

“…8 The mean age at uveitis onset in our study was 36.6 years, which coincides with the age reported in literature. 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.…”

Section: Discussionsupporting

confidence: 57%

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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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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 57%

Factors Associated With Adverse Outcomes in Uveitis Related to Spondyloarthritis

et al. 2023

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“…Finally, the definition of International Uveitis Research Group (IUSG), the subtypes of uveitis included anterior uveitis, middle uveitis, posterior uveitis, and panuveitis (28). All the types of inflammation of uveitis can be divided into infectious and noninfectious (29)(30)(31)(32). Our study focuses on non-infectious uveitis and the diagnosis of AAU is acceptable and stable, depending on our selection criteria.…”

Section: Discussionmentioning

confidence: 99%

The Risk of Major Adverse Cardiovascular Events in Ankylosing Spondylitis Patients With a History of Acute Anterior Uveitis: A Nationwide, Population Based Cohort Study

et al. 2022

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BackgroundTo investigate the association between a history of acute anterior uveitis (AAU) and the risk of major adverse cardiovascular events (MACE) among patients with ankylosing spondylitis (AS).MethodsWe identified 38,691 newly diagnosed AS patients between 2003 and 2013 from the Taiwan National Health Insurance Research Database. The exposure group was defined as people with uveitis diagnosis by ophthalmologist before AS diagnosis date. The incidence of MACE in patients with AS according to the International Classification of Diseases, Ninth Revision. We randomly selected a comparison group without a history of AAU at a 1:4 ratio matched by age, sex, and index year in relation to the risk of developing MACE. We used cox proportional hazard regression model to compare the risk of MACE between groups, shown as adjusted hazard ratios (aHRs) with 95% confidence intervals (CI). Further subgroup analysis and sensitivity tests were also performed.ResultsThere were 3,544 patients in the AAU group and 14,176 patients in the non-AAU group. The aHR of MACE for the AAU group was 0.79 (95% CI = 0.57–1.10) at a 1:4 ratio for age, sex and index year. Sensitivity analyses using various adjustment variables showed consistent results. Cox proportional hazard regression model demonstrated that use of non-steroidal anti-inflammatory drugs (NSAIDs) was associated with an increased risk of MACE in this cohort (HR = 3.44; 95% CI = 2.25–5.25).ConclusionThis cohort study showed that subjects with AAU was not associated with the risk of MACE among AS patients, compared to non-AAU controls.

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“…The incidence of uveitis in patients with AS in our study was 4.2% (828/19706 = 4.2%). The occurrence of uveitis in patients with AS varies across studies, ranging from 0% to 40% (22)(23)(24)(25)(26)(27)(28)(29). According to previous studies, AS is typically diagnosed in the second to fourth decade of life (30,31).…”

Section: Discussionmentioning

confidence: 99%

Uveitis increases the risk of stroke among patients with ankylosing spondylitis: A nationwide population-based longitudinal study

Tsung

Huang²,

Chien³

et al. 2022

Front. Immunol.

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Ankylosing spondylitis (AS) is known to increase the risk of stroke. Among patients with AS, uveitis is the most common extra-articular manifestation. However, no previous investigations have discussed the association between uveitis and the risk for developing stroke in patients with AS. This retrospective cohort study aimed to explore the relationship between uveitis and the incidence of stroke in patients with AS by obtaining medical records from January 1, 2000, to December 31, 2015, from the National Health Insurance Research Database, according to the International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes. The primary outcome was the incidence of stroke. Pearson’s chi-square test and Fisher’s exact test were used to analyze variables. Kaplan–Meier survival curves and univariate and multivariate Cox proportional hazard regression models with and without Fine and Gray’s competing risk model were used to analyze data. Total 828 AS patients with uveitis and 3,312 AS patients without uveitis were identified. During the follow-up period, 137 patients in the uveitis group and 344 in the non-uveitis group developed stroke. Uveitis is a significant risk factor for stroke development in patients with AS (adjusted hazard ratio = 1.846, p < 0.001). Age, diabetes mellitus, hyperlipidemia, hypertension, congestive heart failure, chronic obstructive pulmonary disease, asthma, coronary artery disease, and atrial fibrillation were associated with a higher risk of stroke. After subgroup analysis, both anterior uveitis and posterior segment involvement were found to increase the risk of stroke in patients with AS. Uveitis is associated with an increased risk in both ischemic and hemorrhagic strokes in patients with AS. Therefore, when uveitis is identified, clinicians should pay more attention to the cerebrovascular risk in patients with AS, especially in those with underlying comorbidities.

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Prevalence and risk factors for uveitis in spondyloarthritis

Cited by 6 publications

References 21 publications

Factors Associated With Adverse Outcomes in Uveitis Related to Spondyloarthritis

Factors Associated With Adverse Outcomes in Uveitis Related to Spondyloarthritis

The Risk of Major Adverse Cardiovascular Events in Ankylosing Spondylitis Patients With a History of Acute Anterior Uveitis: A Nationwide, Population Based Cohort Study

Uveitis increases the risk of stroke among patients with ankylosing spondylitis: A nationwide population-based longitudinal study

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