Background The aim of the ESPeranza program was to provide an early and effective access to rheumatologic care for patients with spondiloarthropaties (SpA). Specific Rheumatologic Units (SRU) for an early evaluation, treatment and follow up of patients with SpA were established in 28 Spanish hospitals. There is little information on the prevalence and incidence of uveitis in early SpA, which it has been reported to be lower compared with advanced SpA (10-50%). These data could be very useful ASAS.
Objectives To estimate the prevalence and incidence of uveitis in early SpA.
Methods Observational prospective study (2008-2011) following usual clinical practice. Patients aged 45 years or below, attended in the SRU, reporting symptoms for 3-24 months (early), meeting the following criteria were included in the ESPeranza database: a) inflammatory back pain, or b) symmetric arthritis, or c) spine pain/articular pain, plus at least one of the following ones: a) psoriasis, b) inflammatory bowel disease (IBD), c) anterior uveitis (AU), d) radiographic sacroiliitis, e) family history of spondylitis, psoriasis, IBD, or AU, f) HLA-B27 positive. For the purpose of this sub-study, we selected patients of whom the rheumatologist, according to their clinical criteria, considered as Spa. We also collected sociodemographic variables (sex, age), Ankylosing Spondylitis Disease Activity Score, Bath AS Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Radiology Index, Ankylosing Spondylitis Quality of Life, MASES index, erythrocyte sedimentation rate, C-reactive protein, HLA-B27, disease modifying antirheumatic drugs (DMARD), and anti-TNF agents. A descriptive analysis was performed. Prevalence was estimated using data from the study entry, and all collected variables were tested in a logistic multivariate analysis searching for associations. The incidence was estimated using follow-up data.
Results We analyzed 603 early SpA from the ESPeranza database (n=1.179) of whom 27 (5%) reported AU at the study entry (59% were male, with a mean age of 33 years ± 7 years, mean follow-up of 8.7 months ± 10.2 months, 26% on DMARD and 7% on anti-TNF). AU was only associated with family history of AU (p=0.010). However, when we analyze associations including all patients from the ESPeranza database, HLAB27 positive and bilateral radiographic sacroiliitis were also significantly associated with UA. The incidence of AU during the observation period was 3 cases (4.8‰, 95% confidence interval 1.5-14.8).
Conclusions The prevalence of AU in our patients with early SpA is lower than the reported in the validation of the new ASAS classification criteria for axial SpA. The incidence seems to be somewhat lower than expected, which would suggest that AU may be a manifestation more linked to the evolution of the disease than in early stages.
Zeboulon N, Dougados M, Gossec L. Prevalence and characteristics of uveitis in the spondyloarthropathies: a systematic literature review. Ann Rheum Dis 2008;67:955-9
Collantes E, Zarco P, Muñoz E, et al. Disease pattern of spondyloarthropathies in Spain: description of the first national registry (REGISPONSER) extended report. Rheumatology 2007;46:1309-15
Disclosure of Interest M. Fernández Prada Grant/Research support from: Esperanza Program has been supported by an unrestricted grant from Pfizer, E. de Miguel Mendieta Grant/Research support from: Esperanza Program has been supported by an unrestricted grant from Pfizer, C. Fernández-Espartero Grant/Research support from: Esperanza Program has been supported by an unrestricted grant from Pfizer, M. Gobbo Grant/Research support from: Esperanza Program has been supported by an unrestricted grant from Pfizer, C. Martínez Grant/Research support from: Esperanza Program has been supported by an unrestricted grant from Pfizer
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