Comparison of Incidence or Recurrence of Anterior Uveitis in Patients with Ankylosing Spondylitis Treated with Tumor Necrosis Factor Inhibitors
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Selection and Data Collection
2.2. Treatment
2.3. Analyses
3. Results
3.1. Demographic and Clinical Characteristics
3.2. Rates of Uveitis Recurrence and Incidence of New-Onset Uveitis in Patients with Ankylosing Spondylitis Receiving TNFα Inhibitors
3.3. Survival and Multivariate Analysis for Occurrence of Uveitis
3.4. Comparison of Uveitis Recurrence or Occurrence in the Switching Group
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Total (n = 209) |
---|---|
Age, year | 44.6 ± 11.6 |
Sex, male | 160 (76.6%) |
HLA-B27 positivity | 197 (94.3%) |
Extra-articular manifestations | |
History of anterior uveitis before TNFα inhibitor therapy | 105 (50.2%) |
Psoriasis | 30 (14.4%) |
Inflammatory bowel disease | 8 (3.8%) |
Initial TNFα inhibitor used for treatment | |
Etanercept | 99 (47.4%) |
Adalimumab | 68 (32.5%) |
Infliximab | 42 (20.1%) |
Follow-up period following TNFα inhibitor therapy, median (Q1–Q3) months | 89.5 (47.5–135.0) |
Uveitis manifestations of previous episodes | (% among 105 uveitic patients) |
Unilateral/bilateral involvement | 65:40 (61.9%:38.1%) |
Hypopyon | 4 (3.8%) |
Fibrinous exudates | 8 (7.6%) |
Synechiae | 24 (22.9%) |
Characteristics | Etanercept (n = 99) | Adalimumab (n = 68) | Infliximab (n = 42) | p-Value |
---|---|---|---|---|
Sex, male | 77 (77.8%) | 50 (73.5%) | 33 (78.6%) | 0.769 a |
Age, year (range) | 45.2 ± 11.7 (18.0–80.0) | 43.2 ± 12.0 (23.0–75.0) | 45.2 ± 11.0 (28.0–71.0) | 0.319 b |
HLA-B27 positivity | 95 (96.0%) | 63 (92.6%) | 39 (92.9%) | 0.583 c |
Anterior chamber inflammation grade at active uveitis | 1.98 ± 1.08 | 1.67 ± 1.27 | 2.50 ± 1.39 | 0.292 b |
Number of previous episodes of anterior uveitis prior to the use of TNFα inhibitor | 0.65 ± 1.42 (0–10) | 1.05 ± 1.41 (0–6) | 0.84 ± 1.90 (0–10) | 0.079 b |
Frequency of previous episodes of anterior uveitis per year | 0.91 ± 0.82 | 1.03 ± 0.88 | 0.82 ± 0.90 | 0.624 b |
Extra-articular manifestations | ||||
Anterior uveitis prior to TNFα inhibitor therapy | 46 (46.5%) | 36 (52.9%) | 23 (54.8%) | 0.575 a |
Psoriasis | 18 (18.2%) | 8 (11.8%) | 4 (9.5%) | 0.378 c |
Inflammatory bowel disease | 4 (4.0%) | 2 (2.9%) | 2 (4.8%) | 0.900 c |
Uveitis manifestations (n = 105) | ||||
Unilateral/bilateral | 26:20 (56.5%:43.5%) | 25:11 (69.4%:30.6%) | 14:9 (60.9%:39.1%) | 0.487 a |
Hypopyon | 2 (4.3%) | 1 (2.8%) | 1 (4.3%) | 0.999 c |
Fibrinous exudates | 4 (8.7%) | 2 (5.6%) | 2 (8.7%) | 0.806 c |
Synechiae | 12 (26.1%) | 7 (19.4%) | 5 (21.7%) | 0.767 a |
TNFα Inhibitor | Mean Number of Recurrences within 2 Years (per 100 Patient-Years) | Mean Number of Recurrences after 2 Years (per 100 Patient-Years) | p-Value |
---|---|---|---|
Overall | 14.8 | 16.6 | |
Etanercept | 18.5 | 21.1 | 0.702 |
Adalimumab | 9.7 | 6.1 | 0.420 |
Infliximab | 15.2 | 24.5 | 0.327 |
p value among 3 TNFi groups | 0.483 * | <0.001 † |
TNFα Inhibitor | Mean Number of Incidences within 2 Years (per 100 Patient-Years) | Mean Number of Incidences after 2 Years (per 100 Patient-Years) | p-Value |
---|---|---|---|
Overall | 12.5 | 11.7 | |
Etanercept | 17.9 | 14.2 | 0.201 |
Adalimumab | 4.7 | 5.9 | 0.353 |
Infliximab | 10.5 | 14.7 | 0.301 |
p value among 3 TNFi groups * | 0.125 | 0.118 |
Variables | Odds Ratio (95% CI) | p-Value |
---|---|---|
Age | 0.974 (0.947–1.001) | 0.053 |
Initial TNF inhibitor used for treatment | 0.049 | |
Adalimumab vs. Etanercept | 0.404 (0.194–0.841) | 0.015 |
Infliximab vs. Etanercept | 0.797 (0.354–1.794) | 0.583 |
History of anterior uveitis | 2.004 (1.050–3.824) | 0.035 |
Follow-up period | 1.013 (1.005–1.020) | 0.001 |
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Kwon, H.Y.; Kim, Y.J.; Kim, T.-H.; Ahn, S.J. Comparison of Incidence or Recurrence of Anterior Uveitis in Patients with Ankylosing Spondylitis Treated with Tumor Necrosis Factor Inhibitors. J. Clin. Med. 2024, 13, 912. https://doi.org/10.3390/jcm13030912
Kwon HY, Kim YJ, Kim T-H, Ahn SJ. Comparison of Incidence or Recurrence of Anterior Uveitis in Patients with Ankylosing Spondylitis Treated with Tumor Necrosis Factor Inhibitors. Journal of Clinical Medicine. 2024; 13(3):912. https://doi.org/10.3390/jcm13030912
Chicago/Turabian StyleKwon, Hyeon Yoon, Yu Jeong Kim, Tae-Hwan Kim, and Seong Joon Ahn. 2024. "Comparison of Incidence or Recurrence of Anterior Uveitis in Patients with Ankylosing Spondylitis Treated with Tumor Necrosis Factor Inhibitors" Journal of Clinical Medicine 13, no. 3: 912. https://doi.org/10.3390/jcm13030912