Kwon Oh Chan, Lee Hye Sun, Yang Juyeon, Park Min-Chan
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea.
Rheumatology (Oxford). 2025 Feb 1;64(2):588-596. doi: 10.1093/rheumatology/keae003.
To evaluate the comparative risk of incident and recurrent acute anterior uveitis (AAU) across different biological DMARDs (bDMARDs) in patients with AS.
A retrospective nationwide cohort study was conducted on 34 621 patients with AS without a previous history of AAU using a national claims database. Patients were followed-up from 2010 to 2021. The comparative risk of incident and recurrent AAU across different bDMARDs was examined using multivariable time-dependent Cox models and counting process (Anderson-Gill) models, respectively.
The adjusted hazard ratios (aHRs) and 95% CIs for incident AAU (bDMARDs non-exposure as reference) were: adalimumab 0.674 (0.581-0.891), etanercept 1.760 (1.540-2.012), golimumab 0.771 (0.620-0.959), infliximab 0.891 (0.741-1.071) and secukinumab 1.324 (0.794-2.209). Compared with adalimumab exposure, etanercept [aHR 2.553 (2.114-3.083)], infliximab [aHR 1.303 (1.039-1.634)] and secukinumab [aHR 2.173 (1.273-3.710)] exposures showed a higher risk of incident AAU. The aHRs and 95% CIs for recurrent AAU (bDMARDs non-exposure as reference) were: adalimumab 0.798 (0.659-0.968), etanercept 1.416 (1.185-1.693), golimumab 0.874 (0.645-1.185), infliximab 0.926 (0.729-1.177) and secukinumab 1.257 (0.670-2.359). Compared with adalimumab exposure, etanercept exposure [aHR 1.793 (1.403-2.292)] was associated with a higher risk of recurrent AAU.
Our data suggest preference for bDMARDs in the following order: adalimumab/golimumab > infliximab > secukinumab > etanercept (for incident AAU prevention) and adalimumab > golimumab/infliximab/secukinumab > etanercept (for recurrent AAU prevention).
评估强直性脊柱炎（AS）患者使用不同生物性改善病情抗风湿药（bDMARDs）发生急性前葡萄膜炎（AAU）及复发的相对风险。
利用全国索赔数据库对34621例既往无AAU病史的AS患者进行一项全国性回顾性队列研究。对患者从2010年至2021年进行随访。分别使用多变量时间依赖性Cox模型和计数过程（Anderson-Gill）模型检查不同bDMARDs发生AAU及复发的相对风险。
以未暴露于bDMARDs为参照，新发AAU的校正风险比（aHRs）及95%置信区间（CIs）为：阿达木单抗0.674（0.581-0.891），依那西普1.760（1.540-2.012），戈利木单抗0.771（0.620-0.959），英夫利昔单抗0.891（0.741-1.071），司库奇尤单抗1.324（0.794-2.209）。与暴露于阿达木单抗相比，暴露于依那西普[aHR 2.553（2.114-3.083）]、英夫利昔单抗[aHR 1.303（1.039-1.634）]和司库奇尤单抗[aHR 2.173（1.273-3.710）]新发AAU的风险更高。复发AAU的aHRs及95% CIs为：阿达木单抗0.798（0.659-0.968），依那西普1.416（1.185-1.693），戈利木单抗0.874（0.645-1.185），英夫利昔单抗0.926（0.729-1.177），司库奇尤单抗1.257（0.670-2.359）。与暴露于阿达木单抗相比，暴露于依那西普[aHR 1.793（1.403-2.292）]复发AAU的风险更高。
我们的数据表明，bDMARDs的优先选择顺序如下：阿达木单抗/戈利木单抗>英夫利昔单抗>司库奇尤单抗>依那西普（用于预防新发AAU）以及阿达木单抗>戈利木单抗/英夫利昔单抗/司库奇尤单抗>依那西普（用于预防复发AAU）。
