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Uveitis occurrence in patients with ankylosing spondylitis according to the type of tumour necrosis factor inhibitor: a cohort study of 175 patients

 Eun Young Choi  ;  Minwoo Lee  ;  Christopher Seungkyu Lee 
 CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, Vol.38(6) : 1132-1137, 2020-11 
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Issue Date
Adalimumab / adverse effects ; Cohort Studies ; Etanercept / adverse effects ; Humans ; Infliximab / adverse effects ; Retrospective Studies ; Spondylitis, Ankylosing* / drug therapy ; Tumor Necrosis Factor Inhibitors / adverse effects* ; Tumor Necrosis Factor-alpha ; Uveitis* / chemically induced
Objectives: To compare the occurrence of non-infectious uveitis based on the type of tumour necrosis factor (TNF) inhibitor used to manage spondyloarthritis in ankylosing spondylitis (AS) patients. Methods: The occurrence (new-onset and recurrence) of uveitis was reviewed retrospectively in AS patients receiving different TNF inhibitor therapies (adalimumab [ADA], infliximab [IFX], etanercept [ETN], and golimumab [GOL]) for the management of spondyloarthritis from 2005 to 2018. Kaplan-Meier analysis was performed to calculate the cumulative occurrence rates of uveitis during TNF inhibitor therapy, and a log-rank test was used to analyse differences between the survival curves. Multivariable Cox proportional-hazards models were used to compute hazard ratios (HRs) of different TNF agents for uveitis occurrence after adjusting for concurrent confounding factors. Results: The three-year cumulative occurrence rates of uveitis were significantly different according to the type of anti-TNFs used (23.1% in IFX, 18.5% in ETN, and 11.9% in ADA+GOL group) (p=0.020). The risk of new-onset uveitis was similar for different drugs. However, the IFX group showed a 5.4 times higher risk of recurrence than the ADA+GOL group (p=0.022). After adjusting for other confounding factors, IFX use was independently associated with a more frequent occurrence of uveitis in AS patients (HR=2.01; p=0.011). Conclusions: A significant number of AS patients who received anti-TNF therapy developed uveitis. Different types of anti-TNF drugs were associated with uveitis recurrence. Particularly, chimeric mouse-human monoclonal antibody (IFX) was found to increase the risk of uveitis occurrence compared to humanised monoclonal antibody (ADA or GOL).
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Christopher Seungkyu(이승규) ORCID logo https://orcid.org/0000-0001-5054-9470
Choi, Eun Young(최은영) ORCID logo https://orcid.org/0000-0002-1668-6452
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