Background Anterior uveitis is an extra-articular manifestation of spondyloarthritis (SpA)
Objectives To analyze patients data and compare the main musculoskeletal problems as well as clinical characteristics (sacroilitis, enthesitis, psoriasis, night pain, well being), disease activity and function on uveitis vs non uveitis in HLAB27 positive SpA cohort aiming to establish the axial SpA uveitis cohort characteristics.
Methods SpA patients were asked to complete a questionnaire assessing their disease type, age at diagnosis, clinical presentation, disease-activity (BASDAI score) and functional-indices (BASFI score). Only HLA-B27 positive patients' responses were analysed, with those reporting an ophthalmological anterior uveitis diagnosis (current or past) compared to those without uveitis. Means and standard errors were calculated. Statistical significance was determined using unpaired t-tests or Pearson's chi-squared tests.
Results Of 67 HLA-B27 positive patients, 24 (35.8%) had a history of uveitis (M:F =9:15; mean age, 46.1 ± 3.2 years) and 43 (64.2%) (M:F =20:23; 42.7 ± 2.0 years) did not. All had axial disease. 7/24 (29.1%) uveitis and 11/43 (25.5%) non-uveitis patients also had peripheral SpA (ASAS criteria; p>0.05). No significant differences in the proportions of patients with undifferentiated SpA (6/24 versus 7/43; ESSG criteria), Ankylosing Spondylitis (AS) (13/24 versus 18/43; AS mod. New York Criteria) or psoriatic arthritis (PsA) (5/24 versus 12/43; CASPAR), or of patients with arthritis (5/24 versus 10/43), enthesitis (4/24 versus 6/43), radiographic sacroiliitis (9/24 versus 14/43), or psoriasis (3/24 versus 12/43) were found between the two groups. There were also no differences in night pain (5.54 ± 0.63 versus 5.20 ± 0.46), well-being over the past week (4.7 ± 0.6 versus 4.8 ± 0.4), disease activity (BASDAI, 5.92 ± 0.43 versus 5.80 ± 0.30) or functional limitation (BASFI, 4.51±0.57 versus 4.50 ± 0.43). Mean age at diagnosis was lower (31.7 ± 2.3 versus 36.3 ± 1.9) and the mean disease duration was longer in the uveitis group (15.5 ± 2.3 versus 11.3 ± 1.4) but this was also not significant (p>0.05).
Lower back pain and stiffness (n=15 for both; representing 65.2%) was the predominant MSK manifestations of the uveitis positive group, followed by neck pain (13; 56.5%) joint pains (n=12; 52.2%), fatigue (n=10; 43.5%) upper back pain and enthesitis (n=8; 34.2% for both). In the non-uveitis HLAB27+ group lower back pain was also the predominant manifestation (28; 66.7%) followed by fatigue (n=24; 56.1), stiffness (n=23; 54.8%), joint pains (n=23; 54.8%), neck pain (n=19; 45.2) upper back pain (n=18;42.9) and enthesitis (n=17; 40.5%). There was no statistically significant difference between the uveitis and the non uveitis group with regards to their predominant musculoskeletal manifestations.
Conclusions Uveitis SpA patients are younger at disease presentation and have the diagnosis earlier than the non uveitis ax-SpA group. No other differences have been identified.
Disclosure of Interest : None declared