THU0365 THE IMPACT OF UVEITIS, PSORIASIS AND INFLAMMATORY BOWEL DISEASE ON MUSCULOSKELETAL DISEASE ACTIVITY AND FUNCTION IN AXIAL SPONDYLOARTHRITIS: A POPULATION-BASED ANALYSIS OF INSURANCE CLAIMS LINKED TO PATIENT SURVEY DATA
Authors: Imke Redeker, Johanna Callhoff, Falk Hoffmann, Hildrun Haibel, Joachim Sieper, Angela Zink, Denis Poddubnyy
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Uveitis, psoriasis and inflammatory bowel disease (IBD) are common in axial spondyloarthritis (axSpA) but data on their impact on activity of musculoskeletal manifestations and functional status in general are contradictory. <h3>Objectives:</h3> The aim of this study was to assess the impact of uveitis, psoriasis and IBD on disease activity and functional status in a population-based cohort of patients with axSpA. <h3>Methods:</h3> A stratified random sample of subjects with a diagnosis of axSpA (ICD-10 M45) was drawn from health insurance data in Germany. These patients received a questionnaire on disease-related, demographic and socioeconomic parameters. Age, sex, drug prescriptions and non-pharmacological treatment were retrieved from claims data and linked to the questionnaire data. Information on recent/current occurrence of uveitis, psoriasis and IBD (within one year) was obtained from claims data; in addition, information on history of uveitis, psoriasis and IBD was obtained from survey data. Patients with uveitis, psoriasis or IBD were compared to those without uveitis, psoriasis or IBD. Separate multivariable linear regression models were calculated to determine the effect of uveitis, psoriasis and IBD on disease activity and functional status after adjustment for other relevant parameters including treatment. <h3>Results:</h3> A total of 1,729 patients with axSpA were included in the analyses; mean age was 55.9 years and 46.1% were female. The prevalence was 9% (27%) for recent (ever) uveitis, 10% (15%) for recent (ever) psoriasis, and 6% (9%) for recent (ever) IBD. In 1.6% (6.9%) of the patients two of these conditions were recently (ever) present, and in 0% (0.5%) of the patients, all three conditions were recently (ever) present. The multivariable linear regression analyses revealed that history of psoriasis was significantly associated with both higher level of disease activity and higher level of functional impairment. History of IBD was also associated with higher disease activity, whereas recent psoriasis or IBD showed no strong association with disease activity and functional status (Table). In contrast, history of uveitis showed no strong association with disease activity and functional status while recent uveitis was significantly associated with lower disease activity according to the BASDAI even after adjustment for treatment. <h3>Conclusion:</h3> Disease activity and functional impairment are higher in axSpA patients with a history of psoriasis or IBD, whereas history of uveitis does not have a major impact on activity of musculoskeletal manifestations and functional status in axSpA. However, recent uveitis showed a somewhat unexpected association with lower disease activity. The latter might be related to a higher likelihood of being treated with TNF inhibitors in the presence of uveitis. <h3>Acknowledgement:</h3> This work was supported by the Federal Ministry of Education and Research within the research network PROCLAIR (01EC1405). <h3>Disclosure of Interests:</h3> Imke Redeker: None declared, Johanna Callhoff: None declared, Falk Hoffmann: None declared, Hildrun Haibel: None declared, Joachim Sieper Consultant for: Abbvie, Böhringer Ingelheim, Janssen, Lilly, Merck, Mylan, Novartis, Pfizer, UCB., Speakers bureau: Abbvie, Böhringer Ingelheim, Janssen, Lilly, Merck, Mylan, Novartis, Pfizer, UCB., Angela Zink Speakers bureau: Speakers fees from AbbVie, Janssen, Pfizer, Roche, Sanofi, Denis Poddubnyy Grant/research support from: AbbVie, Merck Sharp &amp; Dohme, Novartis, Consultant for: AbbVie, Bristol-Myers Squibb, Janssen, Merck Sharp &amp; Dohme, Novartis, Pfizer, UCB Pharma, Speakers bureau: AbbVie, Bristol-Myers Squibb, Janssen, Merck Sharp &amp; Dohme, Novartis, Pfizer, Roche, UCB Pharma