J Rheum Dis.  2015 Oct;22(5):288-292. 10.4078/jrd.2015.22.5.288.

The Incidence of Uveitis in Ankylosing Spondylitis Patients Undergoing Tumor Necrosis Factor Inhibiting Therapy in Korea

• Koo BS
• Hong S
• Kim YJ
• Lee CK
• Yoo B
• Kim YG

• KMID: 2222840
• DOI: http://doi.org/10.4078/jrd.2015.22.5.288

Abstract

OBJECTIVE
The purpose of this study is to evaluate the outcome of uveitis in ankylosing spondylitis (AS) during tumor necrosis factor (TNF)-inhibiting therapy and to compare the incidence rate of uveitis in infliximab, adalimumab, and etanercept.
METHODS
A retrospective evaluation was performed in AS patients who had started TNF-inhibiting therapy from June 2003 to June 2011. The clinical characteristics of patients with documented uveitis were evaluated.
RESULTS
Among 316 patients treated with TNF inhibitor, 26 patients (8%) had experienced uveitis during TNF-inhibiting therapy. Among them, 15 patients were treated with etanercept, eight with adalimumab, and three with infliximab. The overall incidence rate of uveitis flare during therapy with TNF inhibitor was 46 per 1,000 person-years (pys) (95% confidence interval [CI], 32 to 64). The incidence rate did not differ between TNF inhibitors, with 54/1,000 pys (95% CI, 34 to 81) for etanercept, 46/1,000 pys (95% CI, 21 to 87) for adalimumab, and 22/1,000 pys (95% CI, 5 to 64) for infliximab. Fourteen patients experienced a first episode of uveitis. The overall incidence rate of new onset-uveitis after therapy with TNF inhibitor was 19 per 1,000 pys (95% CI, 10 to 31). The incidence rate for etanercept was 24/1,000 pys (95% CI, 12 to 45); adalimumab, 15/1,000 pys (95% CI, 3 to 45); and infliximab, 7/1,000 pys (95% CI, 0 to 40). There was no statistical difference in the incidence of uveitis flare or the cumulative uveitis-free rate among the three TNF inhibitors.
CONCLUSION
The relative rate of uveitis, including the first episode, was determined using the TNF inhibitor. However, there was no difference in the incidence rate of uveitis among the three TNF inhibitors.

Keyword

Tumor necrosis factor; Ankylosing spondylitis; Uveitis

MeSH Terms

Humans
Incidence*
Korea*
Retrospective Studies
Spondylitis, Ankylosing*
Tumor Necrosis Factor-alpha*
Uveitis*
Adalimumab
Infliximab
Etanercept
Tumor Necrosis Factor-alpha

Figure

• 

  Figure 1. Cumulative uveitis-free survival rate after tumor necrosis fator (TNF) inhibitors (A) in all patients and (B) in patients who had never experienced uveitis before TNF-inhibiting therapy.

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