September 23, 2013
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Anterior uveitis present in 18.5% of Ibero-American SpA patients

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Anterior uveitis was present in nearly 20% of a large cohort of patients with spondylarthritis in Ibero-American countries and was positively associated with axial involvement and HLA-B27, according to study results.

Researchers investigated clinical and demographic variables and disease indices of 2,012 patients with spondylarthritis (SpA) from 85 centers across 10 Ibero-American countries. Fisher’s exact and chi-squared tests were used to compare categorical variables, while ANOVA and Kruskal-Wallis tests compared continuous variables.

Patients presented with the following diagnoses: ankylosing spondylitis (AS; 62.9%), psoriatic arthritis (19.9%), undifferentiated SpA (9.5%), reactive arthritis (3.5%), juvenile SpA (3.2%) and enteropathic arthritis (1.1%). Anterior uveitis (AU) was present in 18.5% of all patients.

A positive association was found between patients with AU, AS and reactive arthritis (P<.001), while a negative association existed with psoriatic arthritis (P<.001) in comparing patients with (n=372) and without AU (n=1,640). Age at disease onset (26.62 ± 11.09 years vs. 31.89 ± 14.60 years; P<.001) and at diagnosis (34.49 ± 12.97 years vs. 37.44 ± 14.72 years; P=.002) occurred earlier in AU patients.

Inflammatory low back pain (P<.001), radiographic sacroiliitis (P<.001), enthesopathies (P=.004), urethritis/acute diarrhea (P<.001), balanitis (P=.002), hip involvement (P=.002), HLA-B27 (P=.003) and higher C-reactive protein (P=.001) were associated with AU. Negative associations existed between AU and the number of painful (P=.03) and swollen (P=.005) peripheral joints, psoriatic arthritis (P<.001), psoriasis (P<.001), nail involvement (P<.001) and dactilitis (P=.062; trend). AS (P=.001) and HLA-B27 (P=.083; trend) were associated, based on logistic regression, while there was a negative association with extra-articular manifestations (primarily psoriasis; P=.016).

“It is important to consider that AU in Ibero-American SpA patients occurs especially in the subgroup with positive HLA-B27 and predominant axial involvement where it can occur as a minimal manifestation or initial symptom of SpA,” the researchers concluded. “All patients with AU should be submitted to a rheumatologic evaluation since undiagnosed SpA may be present in a significant percentage of cases.”

Disclosure: The researchers report no relevant financial disclosures.