Impact of uveitis on the phenotype of patients with recent inflammatory back pain: data from a prospective multicenter French cohort

Arthritis Care Res (Hoboken). 2012 Jul;64(7):1089-93. doi: 10.1002/acr.21648.

Abstract

Objective: To determine the prevalence of uveitis in patients with recent inflammatory back pain (IBP) suggestive of spondylarthritis (SpA), and to investigate the impact of uveitis on the overall features of these patients.

Methods: The Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR; Outcome of Recent Undifferentiated Spondylarthropathies) cohort is a prospective multicenter French cohort of 708 patients with early IBP suggestive of SpA. Uveitis was defined by an ophthalmologic episode diagnosed as uveitis by an ophthalmologist, or history of a medical diagnosis of uveitis given to the patient. Data on the baseline demographic characteristics, functional status and quality of life, imaging features, bone mineral density (BMD), and blood tests were compared in patients with and without uveitis. Factors associated with the presence of uveitis were identified both by univariate and multivariate analysis (logistic regression).

Results: The prevalence of uveitis at inclusion in the DESIR cohort was 8.5%. Uveitis occurred after the first symptoms of IBP in 45% of patients. The presence of uveitis was significantly associated (univariate) with pain in the cervical spine, infection preceding inflammatory disease, a previous diagnosis of inflammatory bowel disease (IBD), the Short Form 36 (SF-36; mental and physical health and social relationship subscales), Achilles enthesitis, elevated leukocyte count, and radiologic hip involvement, but not with fulfillment of classification criteria, HLA-B27, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Disease Activity Score, and BMD. Stepwise multivariate analysis found an association between uveitis and pain in the cervical spine, infection preceding inflammatory disease, a previous diagnosis of IBD, and the physical health limitation of the SF-36 (P < 0.05).

Conclusion: In recent IBP suggestive of SpA, uveitis is associated with IBD and infection. This might suggest a role of environmental factors in the incidence of uveitis in SpA.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Back Pain / epidemiology*
  • Back Pain / physiopathology
  • Bone Density / physiology
  • Cohort Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Inflammatory Bowel Diseases / epidemiology*
  • Inflammatory Bowel Diseases / physiopathology
  • Male
  • Multivariate Analysis
  • Phenotype*
  • Prevalence
  • Prospective Studies
  • Quality of Life
  • Severity of Illness Index
  • Spine / diagnostic imaging
  • Spondylarthritis / epidemiology*
  • Spondylarthritis / physiopathology
  • Ultrasonography
  • Uveitis / epidemiology*
  • Uveitis / physiopathology