DENVER – Anterior uveitis occurred in 13% of military veterans with spondyloarthritis followed longitudinally in the PULSAR registry, Dr. Maureen Dubreuil reported at the annual meeting of the Spondyloarthritis Research and Treatment Network.
One factor proved to be independently associated with the risk of developing uveitis in a multivariate logistic regression analysis: being positive for HLA-B27. This conferred an 11.3-fold increased risk of developing the serious ophthalmologic complication, according to Dr. Dubreuil of Boston University.
PULSAR (the Program to Understand Long-Term Outcomes in Spondyloarthritis) is an eight-site longitudinal registry funded by the Department of Veterans Affairs since 2007.
Dr. Maureen Dubreuil
Thirty-five of 268 men (13.1%) with spondyloarthritis (SpA) were diagnosed with anterior uveitis a mean of 10.3 years following diagnosis of SpA. The diagnosis of uveitis was made by a participating PULSAR rheumatologist and confirmed by an ophthalmologist.
Sixty-two percent of subjects with uveitis experienced a mean of 5.7 recurrences, while the remainder had encountered a solitary episode at the time of the study. Two-thirds of the time, uveitis episodes occurred concurrently with periods of SpA activity. The uveitis occurred in an alternating unilateral pattern in nearly half of cases.
One-quarter of subjects with uveitis experienced complications, including cataracts, glaucoma, and blindness in two patients.
Uveitis is recognized as one of the most common extra-articular manifestations of radiographic axial SpA; however, the picture in patients with non-axial SpA has been far less clear. In the PULSAR analysis, the prevalence of uveitis was 24% among the 95 subjects with axial SpA. In a univariate analysis, this translated to a 2.45-fold increased likelihood of uveitis in individuals with axial SpA, compared with patients with non-axial SpA. Nonetheless, in a multivariate logistic regression analysis, axial SpA wasn’t associated with a significantly increased risk of uveitis. Neither were demographic variables, smoking status, SpA duration, or inflammatory markers, Dr. Dubreuil said.
She reported having no financial conflicts regarding the study, which was funded by the Department of Veterans Affairs.