AB0574 UVEITIS IN 406 PATIENTS WITH PSORIATIC ARTHRITIS. STUDY FROM A SINGLE UNIVERSITARY CENTER
Authors: A. De Vicente-Delmás, L. Sanchez-Bilbao, D. Martínez-López, I. González-Mazón, V. Calvo-Río, N. Barroso García, N. Palmou-Fontana, M. A. González-Gay, R. Blanco
Journal: Annals of the Rheumatic Diseases (2021)

Background: Uveitis is an extraarticular manifestation of psoriatic arthritis (PsA) and it has been described as the most frequent ocular manifestation in PsA. Uveitis in PsA has been described to be more likely insidious in onset, continuous, posterior, and active bilaterally compared with uveitis in patients with Spondyloarthritis (Paiva ES, et al. Ann Rheum Dis. 2000;59: 67-7 ). Anti-TNF agents, especially monoclonal antibodies have been effective in prevention and treatment of refractory non-infectious uveitis. Objectives: Our aim was to assess a ) epidemiology and clinical features of uveitis associated to PsA, b ) to compare patients who developed uveitis and those who did not and c ) its relationship with biological treatment used in PsA. Methods: We conducted a cross-sectional study of 406 patients with PsA from a single reference University Hospital with: a ) PsA classified by CASPAR criteria and, b ) diagnosis of uveitis by expert ophthalmologists. Demographic features, clinical findings, complementary tests, occurrence of other extraarticular manifestations and treatment were recorded. Results: We studied 406 (202 women/204 men) patients with PsA, mean age of 46.3±12.3 years. Uveitis was observed in 20 (12 women/8 men) of 406 patients (prevalence 4.9%); mean age of 43.1±14.5 years. Uveitis was most frequently anterior (80%), unilateral (80%), of acute onset (100%), and recurrent (50%). In the comparative study between patients who developed uveitis and who did not (Table 1), in patients with uveitis was more frequent the presence of HLA-B27 positive (45%), sacroiliitis in MRI (25%), ocular surface pathology (10%), and higher mean PsAID score (4.8±2.5). Ten (50%) patients with PsA related uveitis received biological therapy, 12 (60%) of the treatments were anti-TNF monoclonal antibodies and 1 (5%) was etanercept. The 2 (10%) remaining therapies were other biological therapy non anti-TNF (Figure 1). Figure 1. Biologic immunosuppressive drugs in PsA patients related uveitis. Conclusion: Uveitis was observed in 4.9% of patients with PsA.Most of the PsA related uveitis had an acute onset with anterior and unilateral pattern. HLA-B27 positive, presence of sacroiliitis on MRI and ocular surface pathology were more frequent in patients who developed uveitis. PsAID score is higher in patients with uveitis. Table 1. General features of 406 patients with PsA. Comparison between with and without uveitis. Overall (n= 406 ) Uveitis (n= 20 ) Non uveitis (n= 386 ) p Main general features Age, years, mean±SD 46.3±12.3 43.1±14.5 46.5±12.2 0.225 Sex, women/men, N (% of women) 202/204(49.8) 12/8 (60) 218/168 (56.5) 0.757 HLAB-27 positive, N (%) 38(9.4) 9 (45) 29 (7.5) 0.000* PsA pattern Axial pattern, N (%) 48 (11.8) 4 (20) 44 (11.4) 0.277 Peripheral pattern, N (%) 236 (58.1) 12 (60) 224 (58) 0.862 Mixed pattern, N (%) 122 (30.1) 4 (20) 118 (30.6) 0.315 PsA Scores PsAID, mean±SD 3±2.4 4.8±2.5 2±2.6 0.003* Radiological features Sacroiliitis on MRI, N (%) 37 (9.1) 5 (25) 32 (8.3) 0.027* Other extraarticular manifestations Inflammatory bowel disease, N (%) 21 (5.2) 2 (10) 19 (4.9) 0.277 Ocular surface pathology, N (%) 5 (1.2) 2 (10) 3 (0.8) 0.021* Biologic treatments bDMARDs, N (%) 280 (68.9) 15 (75) 265 (68.7) 0.550 Etanercept 31 (7.6) 1 (5) 30 (7.8) 0.999 TNFi monoclonal antibodies 160 (39.4) 12 (60) 148 (38.3) 0.053 Disclosure of Interests: A. De Vicente-Delmás: None declared., Lara Sanchez-Bilbao: None declared., David Martínez-López: None declared., Iñigo González-Mazón: None declared., Vanesa Calvo-Río Speakers bureau: AbbVie, Lilly, Celgene, Grünenthal and UCB Pharma, Grant/research support from: MSD and Roche, Nuria Barroso García: None declared., Natalia Palmou-Fontana Speakers bureau: Celgene, AbbVie, Lilly, Miguel A González-Gay Speakers bureau: Pfizer, Abbvie, MSD, Grant/research support from: Pfizer, Abbvie, MSD, Ricardo Blanco Speakers bureau: AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, and MSD, Grant/research support from: AbbVie, MSD, and Roche.