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Abstract
Uveitis is the most common extra-articular manifestation of ankylosing spondylitis, and this occurs in 30∼50% of the patients with ankylosing spondylitis. The main symptoms of ankylosing spondylitis are usually highly responsive to TNF inhibitors, but the effects of TNF inhibitors on uveitis are inconsistent. We report here on sixteen cases of new onset uveitis during etanercept therapy in patients with ankylosing spondylitis and they had no histories of uveitis. The symptoms of ankylosing spondyltiis, other than the uveitis, were well controlled during etanercept therapy. Six patients had histories of infliximab therapy before undergoing etanercept therapy, and uveitis did not develop during this infliximab therapy. Uveitis can develop during the course of ankylosing spondylitis, yet there is a possibility of a temporal relationship between etanercept therapy and uveitis.
References
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Table 1.
The prevalence of uveitis in TNF inhibitor-users with ankylosing spondylitis (AS)
| TNF∗ inhibitor | TNF inhibitor-users with AS (No†) | Prevalence of uveitis (No) | New onset uveitis after TNF inhibitors (No) |
|---|---|---|---|
| Etanercept | 279 (63.6%) | 37.9% (88/232) | 16 |
| Infliximab | 113 (25.7%) | 23.8% (20/84) | 0 |
| Adalimumab | 47 (10.7%) | 36.2% (17/47) | 0 |
| Total | 439 | 34.4% (125/363) | 16 |
Table 2.
New-onset uveitis after etanercept therapy in patients with ankylosing spondylitis
| Patient (Pt) | Age (years) | Sex | HLA B27 | D.D∗ (years) | Recurrent uveitis | E.D† (months) | History of infiximab | Duration of infliximab | Change to other TNFi‡ |
|---|---|---|---|---|---|---|---|---|---|
| Pt.1 | 18 | M | ＋ | 1.0 | Yes | 8.6 | No | No | |
| Pt.2 | 27 | F | ＋ | 6.1 | Yes | 20.1 | Yes | 15 months | No |
| Pt.3 | 46 | M | ＋ | 7.1 | No | 7.1 | Yes | 4 months | No |
| Pt.4 | 23 | M | ＋ | 3.5 | No | 31.5 | No | No | |
| Pt.5 | 35 | M | ＋ | 6.2 | No | 5.6 | No | No | |
| Pt.6 | 32 | M | ＋ | 9.0 | No | 14.0 | No | No | |
| Pt.7 | 34 | F | ＋ | 6.1 | No | 3.1 | Yes | 3 months | No |
| Pt.8 | 28 | F | ＋ | 7.2 | Yes | 6.8 | No | No | |
| Pt.9 | 21 | M | ＋ | 4.6 | Yes | 9.6 | No | Adalimumab | |
| Pt.10 | 39 | M | ＋ | 4.3 | Yes | 16.8 | No | No | |
| Pt.11 | 31 | F | ＋ | 4.3 | Yes | 12.5 | Yes | 32 months | No |
| Pt.12 | 55 | M | ＋ | 1.3 | Yes | 5.7 | No | No | |
| Pt.13 | 48 | M | ＋ | 4.8 | Yes | 6.1 | Yes | 16 months | No |
| Pt.14 | 35 | M | ＋ | 14.1 | No | 19.0 | Yes | 3 months | No |
| Pt.15 | 48 | F | ＋ | 6.6 | Yes | 24.9 | No | No | |
| Pt.16 | 30 | M | ＋ | 3.2 | No | 2.6 | No | No |
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