Clinical characteristics of psoriatic arthritis and axSpA patients with uveitis

Abstract

Introduction/ObjectiveTo describe the clinical characteristics and risk factors for uveitis flare in our psoriatic arthritis and axSpA patient cohorts and to describe possible associations of the different disease domains and uveitis flares. Methodology and methodsRetrospective analysis of patients followed prospectively in the SpA and PsA clinics at the Toronto western hospital (January 2004–December 2020). ResultsOf the 3306 included, 1724 patients had axSpA and 1582 PsA. 30.2% of the axSpA cohort, and 7.6% of the PsA population were diagnosed with uveitis. The annual rate of flares per person at risk was 12.1% in the axSpA cohort, vs 1.7 in the PsA. In the axSpA patients, 68% were HLA*B27+, compared 16% of the PsA patients. In the axSpA cohort, higher CRP (HR 1.009, p=.004) increased the risk of a uveitis flare, while biologic agents decreased the risk of flare (HR .702, p=.040) in patients with uveitis. In the PsA cohort, being HLA*B27+ (HR 3.084, p=.007) increased the risk of a uveitis flare, while being on a DMARD decreased the risk of a flare in patients with uveitis (HR .262, p=.0088). ConclusionsUveitis is a common complication seen in inflammatory arthritis, with a prevalence of 30% in the SpA vs 7.6% in PsA. Uveitis is more common in the axSpA population than in PsA. Even though HLA-B27 is more common in the axSpA population, it constitutes a risk for uveitis only in the PsA population.