Factors That May be Associated with Uveitis in Patients with Spondyloarthritis

Timucin Kasifoglu¹, Nazife Sule Yasar Bilge², Sedat Kiraz³, Ihsan Ertenli⁴, Orhan Kucuksahin⁵, Ediz Dalkiliç⁶, Cemal Bes⁷, Nilufer Alpay Kanitez⁸, Pamir Atagunduz⁹, Belkıs Nihan Coşkun¹⁰, Burcu Yagız¹¹, Suleyman Serdar Koca¹², Muhammed Cinar¹³, Aşkın Ateş¹⁴, Servet Akar¹⁵, Onay Gercik¹⁶, Duygu Ersozlu Bakirli¹⁷, Veli Yazisiz¹⁸, Gezmis Kimyon¹⁹, Muge Aydin Tufan²⁰, Hakan Emmungil²¹, Rıdvan Mercan²², Erdal Bodakci²³, Burak Oz²⁴, Zeynel Abidin Akar²⁵, Omer Karadag³, Bahar Kelesoglu²⁶, Sedat Yılmaz²⁷, Ufuk Ilgen²⁸, Yavuz Pehlivan²⁹, Ender Terzioglu³⁰, Levent Kilic⁴, Sukran Erten³¹, Koray Tascilar³² and Umut Kalyoncu³³, ¹Department of Internal Medicine, Division of Rheumatology, Eskisehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey, ²Rheumatology, Eskisehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey, ³Rheumatology, Hacettepe University, Faculty of Medicine, Ankara, Turkey, ⁴Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey, ⁵Rheumatology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey, ⁶Department of Internal Medicine, Division of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey, ⁷Department of Rheumatology, Health Sciences University Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey, ⁸Rheumatology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey, ⁹Department of Internal Medicine, Division of Rheumatology, Marmara University Faculty of Medicine, Istanbul, Turkey, ¹⁰Rheumatology, Uludag University Faculty of Medicine, Bursa, Turkey, ¹¹Uludag University, Medical Faculty, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey, ¹²Rheumatology, Firat University Faculty of Medicine, Elazığ, Turkey, ¹³GATA, Ankara, Turkey, ¹⁴Department of Internal Medicine, Division of Rheumatology, Ankara University School of Medicine, Ankara, Turkey, ¹⁵Department of Internal Medicine, Division of Rheumatology,, Izmir Katip Çelebi University Faculty of Medicine, Izmir, Turkey, ¹⁶Rheumatology, Izmir Katip Celebi University School of Medicine, Izmir, Turkey, ¹⁷PsART study group, Adana, Turkey, ¹⁸Rheumatology, Akdeniz University Faculty of Medicine, Antalya, Turkey, ¹⁹Rheumatology, Hatay Mustafa Kemal University Faculty of Medicine, Hatay, Turkey, ²⁰Rheumatology, Cukurova University School of Medicine, Adana, Turkey, ²¹Department of Internal Medicine, Division of Rheumatology, Trakya University Faculty of Medicine, Edirne, Turkey, ²²PsART study group, Tekirdag, Turkey, ²³Eskisehir Osmangazi University, Eskisehir, Turkey, ²⁴Fırat University, Elazıg, Turkey, ²⁵Frat University, Elazıg, Turkey, ²⁶Rheumatology, Ankara University, Ankara, Turkey, ²⁷Rheumatology Division, Gülhane Training and Research Hospital, Ankara, Turkey, ²⁸Rheumatology, Trakya University, Edirne, Turkey, ²⁹Bursa Uludag University, Bursa, Turkey, ³⁰Rheumatology, Akdeniz University, Antalya, Turkey, ³¹PsART study group, Ankara, Turkey, ³²Numune Research and Teaching Hospital, Ankara, Turkey, ³³Department of Internal Medicine, Divison of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: spondylarthritis and uveitis

Session Information

Date: Monday, October 22, 2018

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster II: Clinical/Epidemiology Studies

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Factors That May Be Associated With Uveitis In Patients With Spondyloarthritis

Background/Purpose: It is known that uveitis is present in the extra-articular findings of spondyloarthritis (SPA) patients. Sufficient information is available in the literature on the frequency and characteristics of uveitis in SpA patients. The factors associated with uveitis in SPA patients are not clear. In this study, uveitis-related factors were analyzed in SPA patients in a large cohort.

Methods: In patients with and without uveitis, age, gender, duration of illness, delayed onset, body mass index, educational status, smoking habit, SPA subgroup, SPA clinical findings as well as co-morbid diseases, HLA B27 and acute phase responses, VAS pain, VAS patient global, VAS fatigue, BASDAI and BASFI values, swollen and painful joint counts, and direct X-ray findings were evaluated retrospectively. The history of uveitis was accepted only if diagnosed by ophthalmologists.

Results: As of May 2018, there are 2359 registered SPA patients. Among the total number of patients, 2096 patients had axial spondyloarthropathy (axSPA) (1249 ankylosing spondylitis, 100 non-radiographic aSPA), 179 psoriatic arthritis, 50 peripheral SPA and 51 enteropathic arthritis. Overall, 269 (11.4%) patients had experienced one or more episodes of uveitis. Median (Q1-Q3) uveitis beginning age was 36 (27-43) years. Duration between SpA symptom beginning age and first uveitis attack were 6.8 (2.6-12.8) years. Median (Q1-Q3) uveitis attacks number was 2 (1-4). Uveitis was usually unilateral (78.9%). 19/184 (10.3%) patients had permanent damage in the eye. Patients with permanent eye damage had more frequent uveitis attack (4 (2-10) vs 2 (1-3), p=0.018), and had tendency of bilateral uveitis attack (37.5% vs 16.6%, p=0.082). Demographic and clinical feature of patients were given in table 1. In multivariate analysis, only disease duration was related with uveitis OR 1.069 (1.05-1.09).

Conclusion: In our cohort, genetic background, radiographic severity, enthesis, and particularly disease duration may be related with uveitis. Although uveitis is usually self-limited, however almost 10% of SpA patients may have permanent eye damage.

Table 1: Comparison of demographic, clinical and laboratory findings of patients with and without uveitis

	Uveitis (-) n=2359	Uveitis (+) n=269	p
Gender (Male/Female, %)	56.4/43.6	60.2/39.8	0,233*
Age	41 (34-49)	44 (37-52)	0,001*
Delay time of diagnosis	2 (0-6)	3 (1-8)	0,005*
Duration of illness	6 (3-11)	10 (6-16)	<0,001*
Arthritis n (%)	34 (64.2)	3 (100)	0,202**
Enthesitis n (%)	293 (25.1)	53 (42.1)	<0,001**
Dactylitis n (%)	88 (6.8)	11 (7.5)	0,743**
Psoriasis n (%)	361 (15.5)	12 (4.5)	<0,001**
HLA B27 (+)n (%)	688 (49.5)	117 (69.2)	<0,001**
Family history for SPA n (%)	635 (29.5)	102 (41.5)	<0,001**
Syndesmophitis n (%)	219 (24.7)	52 (43.0)	<0,001**
Bamboo spine n (%)	117 (12.1)	32 (23.7)	<0,001**
BASDAI	5.9 (4.2-7.1)	5.8 (4.0-7.0)	0,183*
BASFI	4.4 (2.4-6.1)	3.7 (1.9-5.2)	0,007*
Sedimentation (mm/h)	23 (11-40)	28 (11-48)	0,063*
CRP (mg/L)	12.1 (4.6-27.6)	13.5 (6.1-34)	0,042*

* Mann Whitney U, ** Ki-Kare, data was given as median (Q1-Q3)

Disclosure: T. Kasifoglu, None; N. S. Yasar Bilge, None; S. Kiraz, None; I. Ertenli, None; O. Kucuksahin, None; E. Dalkiliç, None; C. Bes, None; N. Alpay Kanitez, None; P. Atagunduz, None; B. N. Coşkun, None; B. Yagız, None; S. S. Koca, None; M. Cinar, None; A. Ateş, None; S. Akar, None; O. Gercik, None; D. Ersozlu Bakirli, None; V. Yazisiz, None; G. Kimyon, None; M. Aydin Tufan, None; H. Emmungil, None; R. Mercan, None; E. Bodakci, None; B. Oz, None; Z. A. Akar, None; O. Karadag, None; B. Kelesoglu, None; S. Yılmaz, None; U. Ilgen, None; Y. Pehlivan, None; E. Terzioglu, None; L. Kilic, None; S. Erten, None; K. Tascilar, None; U. Kalyoncu, None.

To cite this abstract in AMA style:

Kasifoglu T, Yasar Bilge NS, Kiraz S, Ertenli I, Kucuksahin O, Dalkiliç E, Bes C, Alpay Kanitez N, Atagunduz P, Coşkun BN, Yagız B, Koca SS, Cinar M, Ateş A, Akar S, Gercik O, Ersozlu Bakirli D, Yazisiz V, Kimyon G, Aydin Tufan M, Emmungil H, Mercan R, Bodakci E, Oz B, Akar ZA, Karadag O, Kelesoglu B, Yılmaz S, Ilgen U, Pehlivan Y, Terzioglu E, Kilic L, Erten S, Tascilar K, Kalyoncu U. Factors That May be Associated with Uveitis in Patients with Spondyloarthritis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/factors-that-may-be-associated-with-uveitis-in-patients-with-spondyloarthritis/. Accessed .

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