Background/Purpose:

The objectives of this study were: a) to assess the prevalence of uveitis in patients with Spondyloarthritis (SpA) in the Spanish registry REGISPONSER; b) to describe the moment of appearance of the uveitis regarding other SpA symptoms and the date of SpA diagnosis; c) to evaluate the impact of the moment of appearance of uveitis on the use of bDMARDS.

Methods:

Data form the Spanish registry REGISPOSER were analysed. The prevalence of uveitis was assessed regarding the time of occurrence of other SpA symptoms (before/ at the same time/ after) and the date of SpA diagnosis. Among patients who had suffered uveitis before SpA diagnosis, we evaluated whether this group presented other SpA features, in order to determine potential diagnostic delay of SpA. Finally, we compared the use of bDMARDS regarding the time of appearance of uveitis through Chi-square test.

Results:

From the 2367 patients included in REGISPONSER, 410 (17.5%) patients reported uveitis at any time of the course of disease. Among these, the date of first uveitis episode was available in 321 patients. Among patients with uveitis, a total of 9.0%, 11.2% and 79.8% had suffered the first episode of uveitis before, at the same time and after other SpA symptoms, respectively (Figure 1). Among patients who had suffered the first episode of uveitis before other SpA symptoms (i.e., uveitis as first SpA manifestation), the median time passed between this episode and the appearance of a second SpA manifestation was 3.0 years. However, considering the date of SpA diagnosis, a total of 36.8%, 13.3% and 49.8% of patients had suffered the first episode of uveitis before, at the same time and after SpA diagnosis, respectively (Figure 2). Among patients who had suffered the first episode of uveitis before SpA diagnosis, the median time passed between this episode and the date of SpA diagnosis was 5.0 years and, among these, 80.2% were HLA-B27 positive.

We did not find statistically significative differences (p=0.827) in the use of bDMARDS regarding the moment of appearance of uveitis (17.4% vs. 16.7% vs. 19.1% for patients with uveitis before, at the same time and after SpA diagnosis).

Conclusion:

Among patients with history of uveitis from REGISPONSER, 36.6% suffered a gap time between the first episode of uveitis and the date of SpA diagnosis (around 5 years) and, among these, 80% were HLA-B27 positive, suggesting a diagnostic delay in these patients. However, this diagnostic delay did not have an impact on the use of bDMARDS.