Background/Purpose: Psoriatic arthritis (PsA) belongs to the group of spondyloarthropathies in which uveitis is an associated disease . The prevalence of uveitis among PsA patients especially in the era of biologic treatment is not well established.

Methods: A retrospective database study was conducted on 6,147 adult PsA patients who were newly diagnosed with PsA between January 1, 2005 (start date) and 31 December 2020 (end date) with date of diagnosis considered the index date compared to 23,999 randomly selected control subjects matched for age, sex, ethnicity, and index date. Both groups were followed from the index date until the first episode of uveitis, death, or end of follow-up, whichever came first. Demographic variables, smoking status, socioeconomic status (SES), body mass index (BMI), presence of selected chronic comorbidities, and medication use including conventional and biologic disease-modifying anti-rheumatic drugs (c/b DMARD) were extracted in both groups.

Descriptive statistics was applied as appropriate. Marginal model with robust covariant estimate counting for the matching was used to estimate the crude and adjusted hazard ratio (HR) for the association between PsA and uveitis. Within the group of PsA patients, Cox proportional hazard regression time dependent models were used to calculate the risk of uveitis given demographic variables, SES, smoking, selected comorbidities, and c/bDMARD. All tests were 2-sided; p values of ≤ 0.05 were considered statistically significant.

Results: PsA cohort consisted of 53.1% females with mean age of 51.75±15.39. In the PsA group, 107 patients (1.7%) were diagnosed with uveitis, compared to 187 patients (0.8%) in the control group (p< 0.0001, HR 2.25, CI 1.78-2.86). Compared to the control group with uveitis, patients with PsA and uveitis were more often female (64.5% vs 51.9% p=0.036), of a younger age (54.49±16.2 vs 58.89±14.8, p=0.02).

Within the PsA group, patients with uveitis had a previous history of uveitis (HR 33.56 CI 20.76- 54.25), and were more often treated with cDMARDS (83.2% vs 67.1%, p< 0.0001), monoclonal anti-Tumor Necrosis Factor-a (anti-TNF-a) agents (68.2% vs 38.6%, p< 0.0001) and etanercept (37.4% vs 20.8%, p< 0.0001). No difference in uveitis occurrence was noted regarding treatment with anti-IL-17 or anti IL12/23 agents or with regards to demographic characteristics and comorbidities.

No difference in uveitis occurrence was noted regarding treatment with anti-IL-17 or anti IL12/23 agents or with regards to demographic characteristics and comorbidities.

Conclusion: The hazard ratio for uveitis was significantly higher in the PsA group relative to the general population. A high index of suspicion for uveitis is warranted in PsA patients with previous episode of uveitis. Uveitis was reported in patients treated with TNFα blockers irrespective of their mode of action.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/uveitis-in-patients-with-psoriatic-arthritis-a-database-analysis/