Ahn Soo Min, Kim Minju, Kim Ye-Jee, Lee Yusun, Kim Yong-Gil
Department of Rheumatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
J Clin Med. 2022 Jan 26;11(3):631. doi: 10.3390/jcm11030631.
We evaluated the risk of acute anterior uveitis (AAU) in patients with ankylosing spondylitis (AS) during treatment with tumor necrosis factor-alpha inhibitors (TNFis).
This study was performed on AS patients using the Korean National Health Insurance claims database. We analyzed the first and total occurrence of AAU during the first 2 years of TNFis use according to the type of TNFis. Additionally, the occurrence of AAU was assessed in subgroups with or without prior AAU before TNFis initiation.
In total, 5938 AS patients initiated TNFis use between 2009 and 2017 and used them for more than 2 years. Among them, 1488 (25.1%) patients had a history of AAU before starting TNFis treatment. Compared to adalimumab, the use of etanercept (hazard ratio [HR] 1.77) increased the risk of AAU. The incidence rate ratio (IRR) of AAU with etanercept was significantly higher than that of adalimumab (IRR 1.78). The IRR of AAU was also higher for etanercept than adalimumab use in patients with (IRR 1.86) and without (IRR 2.92) a history of AAU.
These data suggest that compared to anti-TNF-alpha monoclonal antibodies, etanercept has a higher incidence of AAU regardless of a history of AAU.
我们评估了强直性脊柱炎（AS）患者在接受肿瘤坏死因子-α抑制剂（TNFis）治疗期间发生急性前葡萄膜炎（AAU）的风险。
本研究使用韩国国民健康保险理赔数据库对AS患者进行。我们根据TNFis的类型分析了在使用TNFis的前2年中AAU的首次发生情况和总发生情况。此外，还评估了在开始使用TNFis之前有或无前AAU病史的亚组中AAU的发生情况。
2009年至2017年间，共有5938例AS患者开始使用TNFis并使用超过2年。其中，1488例（25.1%）患者在开始TNFis治疗前有AAU病史。与阿达木单抗相比，使用依那西普（风险比[HR] 1.77）会增加AAU的风险。依那西普导致AAU的发病率比（IRR）显著高于阿达木单抗（IRR 1.78）。在有AAU病史（IRR 1.86）和无AAU病史（IRR 2.92）的患者中，依那西普导致AAU的IRR也高于阿达木单抗。
这些数据表明，与抗TNF-α单克隆抗体相比，无论有无AAU病史，依那西普导致AAU的发生率更高。
