Uveitis occurrence in early inflammatory back pain. Five years data from the prospective French nationwide DESIR cohort

Joint Bone Spine. 2021 Mar;88(2):105100. doi: 10.1016/j.jbspin.2020.105100. Epub 2020 Nov 6.

Abstract

Objective: Uveitis is a frequent extra rheumatological manifestation in axial Spondyloarthritis (SpA). The aim of study was to evaluate the prevalence and incidence of uveitis over the first five years of a prospective nationwide cohort of patients with high suspicion of early axial SpA, and to evaluate its associated factors.

Methods: DESIR is a prospective observational cohort of patients with recent onset inflammatory back pain (more than 3 months, less than 3 years), suggestive of axial SpA, All available factors in the database were compared between patients with and without uveitis at 5 years, by uni and then multivariate analysis. Baseline factors associated with new cases of uveitis occurrence over the 5 years were also analyzed.

Significance: P less than 0.05.

Results: After 5 years, 91 patients (out of 480 with complete follow-up) had at least one uveitis episode, giving an estimated prevalence of 18.9% [95% CI: 15.4-22.4]. In multivariate analysis, uveitis was significantly associated with dactylitis, and elevated ESR. New incident uveitis occurred in 31 cases over 5 years, giving an estimated incidence rate of 1.29 [0.84-1.74]/100 patient-years. Incidence of new uveitis was associated in multivariate analysis with baseline factors: diagnosis of SpA, sacro iliac MRI inflammatory SPARCC score, dactylitis, syndesmophyte score. No significant association was found with HLA-B27, DMARDs, BASDAI, ASDAS, BASFI.

Conclusion: Five-years data of the DESIR cohort allowed an estimation of incidence rate of uveitis of 1.3/100p-y; over five years, uveitis was associated with dactylitis, biologic and sacro iliac MRI inflammation.

Keywords: Cohort; Dactylitis; Spondyloarthritis; Uveitis.

Publication types

  • Observational Study

MeSH terms

  • Back Pain / diagnosis
  • Back Pain / epidemiology
  • Back Pain / etiology
  • Humans
  • Prospective Studies
  • Sacroiliitis*
  • Spondylarthritis* / diagnostic imaging
  • Spondylarthritis* / epidemiology
  • Uveitis* / diagnosis
  • Uveitis* / epidemiology
  • Uveitis* / etiology