Uveitis in PsA Associated With Quality of Life, Disability

The prevalence of uveitis in patients with psoriatic arthritis (PsA) at a single university hospital was about 5%, with patients demonstrating clinical features similar to those in patients with uveitis and axial spondyloarthritis, according to a study published online in RMD Open.

“[I]n our study, uveitis related to PsA occurs less frequently than in spondyloarthritis, but with a similar pattern of anterior and unilateral involvement, as well as an acute and often recurrent course of the disease,” wrote corresponding author Ricardo Blanco, MD, PhD, of Hospital Universitario Marqués de Valdecilla in Santander, Spain, and study coauthors.

The retrospective study included 406 patients diagnosed with PsA over 30 years from a single referral university hospital.

Some 4.9% of patients had ophthalmologist-diagnosed uveitis, according to the study. In all affected patients, uveitis was acute. The location of uveitis was anterior in 80% of affected patients and posterior in 20%; the pattern was unilateral in 80% and bilateral in 20%. Uveitis recurrence affected 50% of patients.

Compared with patients with PsA without uveitis, those with uveitis had a higher prevalence of human leucocyte antigen B27, sacroiliitis on magnetic resonance imaging, and ocular surface pathology, the study found. They also had a worse quality of life per the PsA Impact of Disease Score and greater functional disability per the Bath Ankylosing Spondylitis Functional Index.

“Therefore, uveitis may be a poor prognostic marker in PsA patients and could influence the choice of the therapeutic scheme,” the authors wrote. “In this regard, we found a decrease in exposure-adjusted incidence rate with TNFi [tumor necrosis factor inhibitor] monoclonal antibodies but, although the number of cases of uveitis was small, it seems not to occur with etanercept or secukinumab.”

In fact, the uveitis exposure-adjusted incidence rate actually increased with etanercept and secukinumab treatment. Researchers pointed out, however, the study included only a single patient treated with etanercept and a single patient treated with secukinumab, “which,” they wrote, “is an important limitation.”

Reference:
De Vicente Delmás A, Sanchez-Bilbao L, Calvo-Río V, et al. Uveitis in psoriatic arthritis: study of 406 patients in a single university center and literature review. RMD Open. 2023;9(1):e002781. doi: 10.1136/rmdopen-2022-002781