HLA-B27 and Axial Involvement as Independent Risk Factors for Uveitis in Spondyloarthritis: New Insights from a 15-Year Real-Life Study

Kent LE¹, Hervé LOCRELLE¹, Myriam NORMAND¹, Irina COMAN¹, Louis DELENTE¹, Tiphany NEEL¹, Adamah AMOUZOUGAN¹, Thierry THOMAS¹ and Hubert Marotte², ¹Service Rhumatologie Hôpital Nord, Saint-Etienne, France, ²INSERM ¹⁰⁵⁹/University of Saint-Etienne, Saint-Etienne, France

Meeting: ACR Convergence 2025

Keywords: Anti-TNF Drugs, Eye Disorders, Interleukins, risk factors, spondyloarthritis

Session Information

Date: Sunday, October 26, 2025

Title: (0522–0553) Spondyloarthritis Including Psoriatic Arthritis – Diagnosis, Manifestations, & Outcomes Poster I

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: To assess the prevalence, risk factors and treatment-related outcomes of uveitis in patients with spondyloarthritis (SpA), using data from a 15-year real-life cohort.

Methods: We conducted a retrospective study including all patients treated for SpA at the Rheumatology Department of Saint-Etienne University Hospital, between January 2008 and July 2022. Demographic, clinical, biological, radiographic, and treatment data were collected. Patients were classified according to uveitis history and timing relative to treatment initiation (absent, recurrent, de novo). Multivariate analysis identified factors associated with uveitis and treatment outcomes.

Results: Among the 1,571 patients included (mean age 50.6 ± 14.7 years; 52.7% male; mean disease duration 13.6 ± 10.6 years), 46% were diagnosed with ankylosing spondylitis, 33.9% with non-radiographic axial SpA, and 20.1% with peripheral SpA. HLA-B27 was positive in 59.5% of patients. Uveitis prevalence was 12.3% (95% CI: 10–14%), rising to 20.7% (95% CI: 17.7–24%) among HLA-B27 positive patients. Independent risk factors for acute anterior uveitis (AAU) included axial involvement (OR = 3.34; 95% CI: 1.46–7.65; p = 0.004), HLA-B27 positivity (OR = 3.65; 95% CI: 2.30–5.82; p < 0.01), and longer disease duration (OR = 1.03/year; 95% CI: 1.01–1.05; p < 0.001). Uveitis recurrence occurred in 33.3% of patients treated with IL-17 inhibitors vs. 10.4% with anti-TNF agents (p = 0.02).

Conclusion: In this extensive cohort, our study confirmed the independent association of HLA-B27, axial phenotype, and disease duration as the key predictors of uveitis in SpA. Among bDMARDs, monoclonal anti-TNF agents were the most effective in preventing uveitis, while recurrence was significantly higher under anti-IL17 therapy. Notably, this study is the first to demonstrate the independent association between HLAB27 positivity and axial involvement, offering new insights for personalized treatment strategies.

Disclosures: K. LE: None; H. LOCRELLE: None; M. NORMAND: None; I. COMAN: None; L. DELENTE: None; T. NEEL: None; A. AMOUZOUGAN: None; T. THOMAS: None; H. Marotte: None.

To cite this abstract in AMA style:

LE K, LOCRELLE H, NORMAND M, COMAN I, DELENTE L, NEEL T, AMOUZOUGAN A, THOMAS T, Marotte H. HLA-B27 and Axial Involvement as Independent Risk Factors for Uveitis in Spondyloarthritis: New Insights from a 15-Year Real-Life Study [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/hla-b27-and-axial-involvement-as-independent-risk-factors-for-uveitis-in-spondyloarthritis-new-insights-from-a-15-year-real-life-study/. Accessed .

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