Background In ankylosing spondylitis (AS), uveitis is one of serious extra-articular manifestation and the recurrence has known to be reduced by treatment with TNF inhibitor (TNFi). However, new onset or recurrent episode of uveitis has been developed under TNFi in our clinical experience.
Objectives The aim of this study was to find cases of new onset and recurrent of uveitis during TNFi therapy and compare incidence rate of uveitis among three TNFi agents in Korean.
Methods A retrospective evaluation was performed in 316 AS patients who were treated with TNFi therapy in a tertiary care center from June 2003 to June 2011. Among them, patients who documented uveitis were reviewed during follow up and analyzed the incidence rates of uveitis among infliximab, adalimumab, and etanercept. We also analyzed patients who were developed first episode of uveitis after starting TNFi therapy.
Results Among 316 AS patients treated with TNFi, we found 42 (13%) patients of uveitis. The mean age of starting TNFi (35.5±10.3 years), male predominance (86%), and the mean duration of TNFi therapy (31.2±18.3) were not different to non-uveitis patients. Of the 42 patients, fifteen, eight, and three had been treated with etanercept, adalimumb, and infliximab, respectively. Overall incidence rate of uveitis in all TNFi was 45.6 per 1,000 person-years (py) (95% CI: 31.6 – 63.8). The incidence rate for etanercept was 53.7/1,000 py (95% CI: 33.6-81.2); adalimumab, 45.7/1,000 py (95% CI: 20.9-86.7); and infliximab, 21.7/1,000 py (95% CI: 4.5-63.5). Among 42 patients, new onset of uveitis patients during TNFi therapy was 10 (7, etanercept; 2, adalimumab; and 1, infliximab). The incidence rate of new onset-uveitis during all TNF inhibitor agents was 15.2 per 1,000 py (95% CI: 7.3-28.0). The incidence rate for etanercept was 17.9 py (95% CI: 7.2-36.8); adalimumab, 13.9 py (95% CI: 1.7-50.2); and infliximab 8.1 py (95% CI: 2.1-45.7).
Conclusions In Korean, development of uveitis under TNFi treatment was found in 13% and new onset of uveitis during TNFi therapy was 3% of our cohort. Among three TNFi, the new onset and recurrence of uveitis was low relatively in infliximab group.
Disclosure of Interest : None declared