Background/Purpose: Ankylosing spondylitis (AS) is a chronic inflammatory condition primarily affecting the axial spine, commonly associated with extra-articular manifestations such as anterior uveitis (AU). Racial disparities have been observed in the prevalence of AU among AS patients, with African American individuals often experiencing higher frequencies compared to their White counterparts. Moreover, AS is linked with various comorbidities, contributing to increased morbidity and mortality. This study aims to investigate the prevalence of AU and associated comorbidities among AS patients, with a focus on racial differences.

Methods: This retrospective observational study utilized data from the 2020 National Inpatient Sample (NIS) database, identifying adult patients with ankylosing spondylitis admitted to hospitals in the United States. Descriptive statistics were employed to analyze demographic characteristics and comorbidity prevalence. Multivariate analysis assessed the association between anterior uveitis, race, comorbidities, and inpatient outcomes.

Results: Our analysis revealed significant racial disparities in the prevalence of anterior uveitis (AU) among ankylosing spondylitis (AS) patients. Patients with AU tended to be younger, with a mean age of 48 years versus a mean age of 60 in patients with AS without AU. Among patients with AS without AU, 82% were Caucasians and African Americans represented 6%. Among patients with AS with AU, Caucasians represented 71% and African Americans represented 18%.

In terms of outcomes, patients with a history of anterior uveitis exhibited similar inpatient mortality rates (less than 1%) compared to those without (3%). Acute kidney injury (AKI) was more prevalent among patients with anterior uveitis (24%) versus those without (16%) but was not statistically significant. The comorbidities commonly associated with ankylosing spondylitis include hypertension, both complicated (23%) and uncomplicated (40%), along with diabetes presenting with and without chronic complications at rates of 17% and 11%, respectively.

Conclusion: Our study underscores the need for further research to elucidate the relationships between ankylosing spondylitis, anterior uveitis, and comorbidities, particularly in the context of racial disparities. Improved risk assessment and early detection strategies tailored to the African American population are crucial for facilitating timely diagnosis and targeted treatment interventions for AS. Addressing these disparities and advocating for proactive management approaches can help mitigate healthcare inequities and enhance overall health outcomes for African American AS patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-of-comorbidities-and-racial-disparities-in-anterior-uveitis-risk-among-ankylosing-spondylitis-patients/