FRI0316 CAN THE MOMENT OF OCCURRENCE OF THE FIRST EPISODE OF UVEITIS PREDICT DIFFERENCES IN THE PROGNOSIS OF SPONDYLOARTHRITIS? DATA FROM THE SPANISH REGISTRY REGISPONSER
Authors: G. G. Ignacio, C. López-Medina, M. Ladehesa Pineda, M. D. C. Castro Villegas, P. S. Laura, M. Á. Puche Larrubia, J. M. Sequí-Sabater, F. U. Pilar, R. Ortega Castro, A. Escudero Contreras, E. Collantes Estevez
Journal: Annals of the Rheumatic Diseases (2020)

Background: Uveitis is one of the most usual extraaxial manifestations of spondyloarthrities (SpA) but the impact of the date of the onset is no well-known. Objectives: a) To assess the prevalence of acute anterior uveitis (AAU) in the Spanish population with SpA; b) To describe the time of appearance of the AAU regarding to the onset of rheumatic symptoms and SpA diagnosis; c) To evaluate the impact of the moment of appearance of the AAU on the treatment and disease activity. Methods: A cross-sectional study with data extracted from REGISPONSER registry. First, the prevalence of AAU was determined. Patients were classified as AAU before/ concomitant/ after the onset of rheumatic symptoms and as AAU before/ concomitant/ after the SpA diagnosis regarding the date of appearance of each symptom and SpA diagnosis. Treatment and disease activity were compared between ‘AAU before or concomitant with rheumatic symptoms’ vs. ‘AAU after rheumatic symptoms’ groups, as well as ‘AAU before or concomitant with SpA diagnosis’ vs. ’AAU after the SpA diagnosis’ groups using Chi-square and T-Student tests. Results: Among the 2346 patients included in REGISPONSER, 379 (16.2%) had at least one episode of AAU. Information concerning the date of occurrence of rheumatic symptoms and SpA diagnosis was available in 280 and 284 patients, respectively. A total of 28 (9.7%), 31 (10.8%) and 229 (79.5%) patients suffered the first episode of AAU before, concomitantly and after the rheumatic symptoms, respectively; while 108 (38.0%), 38 (13.4%) and 138 (48.6%) suffered the episode of AAU before, concomitantly and after the SpA diagnosis, respectively. The comparison of patients with ‘AAU before or concomitant with rheumatic symptoms’ vs ‘AAU after rheumatic symptoms’ (Table 1), showed in the second group a younger age of symptoms onset, a greater diagnosis delay, higher disease activity (CRP and BASDAI), greater structural damage (BASRI). No significant differences were found in the use of biological (27.9% vs. 23.2%) or synthetic DMARDs (14.8% vs. 20.3%). The comparison of ‘AAU before or concomitant with the SpA diagnosis’ vs. ‘AAU after the SpA diagnosis’ groups (Table 1) showed similar results to the previous ones with no significant differences were obtained in the use of biological (28.8% vs 20.4%) or synthetic (17.2% vs 20.4%) DMARDs. Conclusion: These results suggest that patients who presented the first episode of AAU prior to the onset of rheumatic symptoms showed a later start of the disease with a shorter diagnosis delay, lower disease activity and less structural damage. AAU regarding the rheumatic symptoms onset (n=280) AAU regarding the SpA diagnosis (n=284) Before or concomitant N = 61 (%) After N = 229 (%) p Before or concomitant N = 146 (%) After N = 138 (%) p Gender (male) 32/61 (52,5%) 160/229 (69,9%) NS 88/146 (60,3%) 100/138 (72,5%) NS Age of symptoms onset (years), mean (SD) 31,02 (9,12) 24,49 (9,89) &lt;0,001 27,01 (9,77) 24,66 (9,65) 0,042 Diagnosis delay (years), mean (SD) 3,00 (4,98) 9,68 (10,73) &lt;0,001 10,90 (11,76) 5,59 (7,32) &lt;0,001 Clinical classification Axial 40/61 (65,%) 144/228 (62,9%) NS 96 (66,2%) 85 (61,6%) NS Peripheral 4/61 (6,6%) 9/228 (4,0%) NS 7 (4,8%) 4 (2,9%) NS Mixed 17/61 (27,9%) 75/228 (32,9%) NS 42 (29%) 47 (34,1%) NS HLAB27+ 50/57 (87,7%) 195/213 (91,5%) NS 119/135 (88,1%) 121/130 (93,1%) NS ESR (mm/h), mean (SD) 16,47 (12,88) 18,04 (16,34) NS 17,44 (15,57) 18,41 (16,27) NS CRP (mg/l), mean (SD) 5,57 (9,63) 8,96 (11.62) 0,044 6,82 (9,88) 9,86 (12,65) 0,031 BASDAI, mean (SD) 3,57 (2,25) 4,31 (2,33) 0,027 3,92 (2,30) 4,42 (2,37) 0,073 Spinal BASRI, mean (SD) 3,00 (2,63) 6,06 (3,58) &lt;0,001 4,99 (3,31) 5,60 (5,45) NS Disclosure of Interests: Gómez García Ignacio: None declared, Clementina López-Medina: None declared, MLourdes Ladehesa Pineda: None declared, María del Carmen Castro Villegas: None declared, Pérez Sánchez Laura: None declared, María Ángeles Puche Larrubia: None declared, José Miguel Sequí-Sabater: None declared, Font Ugalde Pilar: None declared, Rafaela Ortega Castro: None declared, Alejandro Escudero Contreras Grant/research support from: ROCHE and Pfizer, Speakers bureau: ROCHE, Lilly, Bristol and Celgene., Eduardo Collantes Estevez Grant/research support from: ROCHE and Pfizer, Speakers bureau: ROCHE, Lilly, Bristol and Celgene