Background Retention of biological drugs in inflammatory arthritis may be affected from different obvious and unknown factors. It can be related with patient characteritics or disease features. In ankylosing spondylitis (AS), retention rate of biological drugs may be related with extra-articular presentation of AS such as uveitis, as well.
Objectives The objective of this study was to assess whether uveitis affected retention of adalimumab in AS patients in our single center biological cohort.
Methods Hacettepe University Biological registry is single-center biological registry since 2005. HURBIO had 2165 spondyloarthritis patients of which 1190 patients had AS according to NY criteria. Until now, in 510 of 1190 patients have used adalimumab and 350 of 510 patients had available for uveitis. Patients were assessed for demographic characteristics, disease duration, HLA-B27, DMARD and biological usage, biological switch ratio. Baseline disease activity was assessed with BASDAI, BASFI VAS (pain, fatigue and patients global assessment), ESR and CRP. Patients were compared according to having uveitis or not. Retention rate of adalimumab assessed by Kaplan-Meier survival analysis.
Results Total 350 (59.4% male) AS patients analyzed. Mean age was 43 (12), mean disease duration and symptom duration were 10.5 (7.8) and 14.8 (9.6) years, respectively. 52 patients (14.8%) had uveitis. Median adalimumab survival time according to having uveitis were 71.9 (95% CI 25.4–118.6) months vs 36.4 (95% CI 23.3–49.4) months (log-rank p=0.014) (figure). Patients with uveitis were more frequently male (18.2% vs 9.8%, p=0.03), HLA-B27 positive (75.0% vs 49.5%, p=0.022). Patients with uveitis had more frequently SpA family history, as well (23.1% vs 10.8%, p=0.003). Age (49 (11) vs 41 (11) years, p<0.001), disease duration (14.4 (10.1) vs 9.8 (7.1) years, p<0.001), and symptom duration (22 (12) vs 14 (8) years, p<0.001) were higher in patients with uveitis. Baseline and last visit disease activities were similar regarding to uveitis.
Conclusions Determination of possible risk factors for retention of TNFi drugs is an important clinical problem for routine practise. It is well known that adalimumab is one of the treatment option for uveitis whether uveitis related with SpA or not. Our biological cohort supported that AS patients with uveitis had better adalimumab survival. For routine practise, adalimumab could be considered for AS patients with uveitis.
Disclosure of Interest None declared