Reina Sofia University Hospital from Córdoba/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC), 14004 Córdoba, Spain.
Reina Sofia University Hospital from Córdoba/Maimonides Research Institute of Biomedical Medicine from Cordoba (IMIBIC), 14004 Córdoba, Spain.
Joint Bone Spine. 2021 May;88(3):105136. doi: 10.1016/j.jbspin.2021.105136. Epub 2021 Jan 21.
To describe the time of onset of acute anterior uveitis (AAU) relative to the appearance of rheumatic symptoms and to determine its association with the evolution of the spondyloarthritis (SpA) in terms of activity, structural damage, functional ability and treatment.
This was a cross-sectional study with data extracted from the REGISPONSER (SpA Registry of the Spanish Rheumatology Society). Thirty-one centres participated, and patients with SpA according to the ESSG criteria were included from 2004 to 2007. Patients were classified according to the time of uveitis appearance with regard to rheumatic symptom onset (before, concomitant with, or after rheumatic symptom onset). We compared the clinical characteristics, disease activity, radiographic damage and functional ability between "AAU before or concomitant with rheumatic symptoms" and "AAU after rheumatic symptoms onset". Finally, we compared whether the time of appearance of AAU had an impact on the use of conventional and biological disease-modifying antirheumatic drugs (csDMARDs and bDMARDs, respectively).
A total of 2367 patients were included in REGISPONSER, with an AAU prevalence of 16.2% (379 patients). Patients with AAU before/concomitant with rheumatic symptom onset (n=59) exhibited better functional ability (BASFI, OR 0.85 [0.73-0.99]) and less structural damage (spinal BASRI, OR 0.88 [0.79-0.99]). Additionally, this group of patients was older at SpA symptom onset (OR 1.05 [1.02-1.09]) and had a shorter diagnosis delay (OR 0.90 [0.84-0.96]) compared patients with AAU after rheumatic symptom onset (n=229). No statistically significant differences in the use of DMARDs were noted (27.9% vs 23.2% for csDMARD use and 15.3% vs 20.3% for bDMARD use in patients with AAU before or concomitant with rheumatic symptom onset vs after rheumatic symptom onset, respectively).
Patients presenting with a first episode of AAU before/concomitant with the onset of rheumatic symptoms had less severe disease (better functional ability and less structural damage) and a shorter diagnosis delay; however, the time of AAU onset did not impact the treatments received.
描述急性前葡萄膜炎 (AAU) 的发病时间与风湿症状出现的时间关系，并确定其与脊柱关节炎 (SpA) 的活动度、结构损伤、功能能力和治疗方面的相关性。
这是一项横断面研究，数据取自于西班牙风湿病学会的 REGISPONSER（SpA 登记处）。有 31 个中心参与，纳入了 2004 年至 2007 年符合 ESSG 标准的 SpA 患者。根据葡萄膜炎出现的时间与风湿症状出现的时间关系，将患者分为风湿症状出现前、同时出现和之后出现 AAU 三种情况。我们比较了“风湿症状出现前或同时出现 AAU”和“风湿症状出现后出现 AAU”两组患者的临床特征、疾病活动度、放射学损伤和功能能力。最后，我们比较了 AAU 出现时间是否会影响传统和生物疾病修饰抗风湿药物（csDMARDs 和 bDMARDs）的使用。
在 REGISPONSER 登记处共纳入 2367 例患者，AAU 的患病率为 16.2%（379 例）。与风湿症状出现后出现 AAU 的患者（n=229）相比，风湿症状出现前或同时出现 AAU 的患者（n=59）具有更好的功能能力（BASFI，OR 0.85 [0.73-0.99]）和较少的结构损伤（脊柱 BASRI，OR 0.88 [0.79-0.99]）。此外，这组患者的 SpA 症状起始年龄更大（OR 1.05 [1.02-1.09]），诊断延迟更短（OR 0.90 [0.84-0.96]）。在 DMARDs 的使用方面，两组间无统计学差异（出现 AAU 前或同时出现风湿症状的患者中，csDMARD 使用率为 27.9%，bDMARD 使用率为 15.3%；出现 AAU 后出现风湿症状的患者中，csDMARD 使用率为 23.2%，bDMARD 使用率为 20.3%）。
首次出现 AAU 与风湿症状同时出现或在风湿症状出现前的患者疾病程度较轻（功能能力更好，结构损伤较少，且诊断延迟较短），但 AAU 发病时间并未影响所接受的治疗。
