SAT0353 HIGH PREVALENCE OF NEWLY DIAGNOSED AXIAL SPONDYLOARTHRITIS IN PATIENTS WITH ACUTE ANTERIOR UVEITISAND CHRONIC BACK PAIN – PRELIMINARY RESULTS OF THE SP-EYE STUDY
Authors: Rianne van Bentum, Frank Verbraak, Sanne Wolf, Jenny Ongkosuwito, Stevie Tan, Irene van der Horst-Bruinsma
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> One third of the axial spondyloarthritis (axSpA) patients suffers from acute anterior uveitis (AAU). Correspondently, AAU can be the first sign of axSpA and previous studies described undetected axSpA in up to 40% of the patients with noninfectious AAU. <h3>Objectives</h3> To study whether referral of all patients with AAU and chronic back pain results in a high prevalence of newly diagnosed axSpA patients. <h3>Methods</h3> A prospective ongoing observational study was started in April 2017, including all patients with noninfectious AAU and a history of back pain (≥3 months, started &lt; age of 45 years), referred from six Ophthalmology clinics to the Rheumatology Outpatient Clinic of the VU medical center. Patients with a known systemic disease associated with AAU were excluded. Patient characteristics, laboratory (HLA-B27, C-reactive protein) and patient reported parameters (e.g. BASDAI, ASDAS) were collected. X-rays were evaluated according to the modified New York (mNY) criteria for sacroiliitis. The clinical axSpA diagnosis was made by the rheumatologist. Patients were either diagnosed with 'definite SpA', 'suspicion of SpA' or 'no suspicion of SpA', based on the clinical assessment. Patients with 'definite SpA' were classified into radiographic or non-radiographic axSpA according to the ASAS criteria. Patients were treated according to standard care guidelines. <h3>Results</h3> Between April 2017 and October 2018, 65 patients were referred to the Rheumatology clinic, of whom 50 (mean age 42 years; 48% female; median back pain duration 15 years) met all inclusion criteria. AxSpA was diagnosed in 13 patients (26%), of whom seven fulfilled the criteria for radiographic and six for non-radiographic axSpA (table 1). Another 21 patients (42%) were considered clinically suspicious for early axSpA, of whom four had SI joint abnormalities and two even fulfilled the mNY criteria for sacroiliitis. Forty-two% of all patients had a high disease activity score (ASDAS≥2.1). Patients diagnosed with axSpA were significantly more often male and HLA-B27 positive, had more SpA features and a higher BASMI score. In 25 patients treatment was started, mostly with nonsteroidal anti-inflammatory drugs. Two patients received a tumor necrosis factor inhibitor shortly after diagnosis. <h3>Conclusion</h3> In this study, 26% of the patients referred with noninfectious AAU and chronic back pain (≥3 months, started &lt; age of 45 years) were newly diagnosed with axSpA. Furthermore, another 40% required further follow up because of a suspicion for beginning axSpA. These results stress the importance of systematic referral of AAU patients with chronic back pain from the ophthalmologist to the rheumatologist, to improve early recognition of axSpA. <h3>Disclosure of Interests</h3> Rianne van Bentum: None declared, Frank Verbraak: None declared, Sanne Wolf: None declared, Jenny Ongkosuwito: None declared, Stevie Tan: None declared, Irene van der Horst-Bruinsma Grant/research support from: MSD, Pfizer, AbbVie, Consultant for: Abbvie, UCB, MSD, Novartis, Speakers bureau: BMS, AbbVie, Pfizer, MSD