Efficacy of tumour necrosis factor blockers in reducing uveitis flares in patients with spondylarthropathy: a retrospective study
- René-Descartes University, Medicine Faculty, APHP, Cochin Hospital, Rheumatology B Department, Paris, France
- Correspondence to:
Cochin Hospital, Rheumatology B, 82 quai de la loire, Paris 72019, France;
- Accepted 4 August 2006
- Published Online First 10 August 2006
Objective: To evaluate the efficacy of anti-tumour necrosis factor (TNF) treatments (given for rheumatological manifestations) in reducing uveitis flares in patients with spondylarthropathy in daily practice.
Methods: A retrospective observational study of all patients with spondylarthropathy with at least one uveitis flare treated with anti-TNF in one centre (December 1997–December 2004). The number of uveitis flares per 100 patient-years was compared before and during anti-TNF treatment; each patient was his or her own control. The relative risk (RR) and the number needed to treat (NNT) were calculated.
Results: 46 patients with spondylarthropathy treated with anti-TNF drugs had at least one uveitis flare (33 treated with anti-TNF antibodies, infliximab or adalimumab, and 13 with soluble TNF receptor, etanercept). The mean age at first symptoms was 26 years, 71% were men. Patients were followed for 15.2 years (mean) before anti-TNF versus 1.2 years during anti-TNF treatment. The number of uveitis flares per 100 patient-years before and during anti-TNF were, respectively: for all anti-TNF treatments,—51.8 v 21.4 (p = 0.03), RR = 2.4, NNT = 3 (95% confidence interval (CI) 2 to 5); for soluble TNF receptor—54.6 v 58.5 (p = 0.92), RR = 0.9; and for anti-TNF antibodies—50.6 v 6.8 (p = 0.001), RR = 7.4, NNT = 2 (95% CI 2 to 5).
Conclusion: Anti-TNF treatments were efficacious in decreasing the number of uveitis flares in patients with spondylarthropathy. Anti-TNF antibodies decreased the rate of uveitis flares, whereas soluble TNF receptor did not seem to decrease this rate. These results could have consequences for the choice of anti-TNF treatment in certain patients.
- DMARD, disease-modifying anti-rheumatic drug
- NNT, number needed to treat
- TNF, tumour necrosis factor
Published Online First 10 August 2006
↵* These two authors contributed equally in the design, analysis, interpretation and monitoring of this study.