The risk factors for uveitis among psoriatic arthritis patients: a population-based cohort study

Nizar Hijazi, Tal Gazitt, Amir Haddad, Muna Elias, Sameer Kassem, Ilan Feldhamer, Arnon Dov Cohen, Shaul Sar, Oren Tomkins-Netzer, Walid Saliba, Devy Zisman

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objective: To assess the frequency of uveitis in patients with psoriatic arthritis (PsA) in the era of biologics and to identify risk factors associated with uveitis. Methods: A retrospective matched cohort study was conducted within the database of a large healthcare provider. Newly diagnosed 6147 adult PsA patients between 2005 and 2020 were matched by the index date of PsA diagnosis, age, sex, and ethnicity to 23,999 randomly selected controls. This cohort was used to examine the association between PsA and uveitis. An additional analysis was conducted within the PsA group to identify uveitis risk factors, using two analytic approaches: a retrospective cohort study and a nested case-control study. Results: Uveitis was diagnosed in 107 patients in the PsA group (1.7%) vs 187 (0.8%) patients in the control group (adjusted HR, 2.38, 95% CI 1.80–3.15, p<0.005) and was similar when the analysis was confined to patients without past uveitis. Uveitis was diagnosed more in females (2.1% vs 1.3%, HR 1.61, 95% CI 1.09–2.40, p<0.05), and was acute in all cases. Anterior uveitis was documented in 41.1% of the cases, 64.5% unilateral, and 9.3% bilateral. In the PsA group, using nested case control approach, only past uveitis [adjusted OR 136.4 (95% CI 27.38–679.88), p<0.005] and treatment with etanercept [adjusted OR 2.57 (95% CI 1.45–4.57), p=0.001] were independently associated with uveitis. Only one PsA patient with uveitis (out of 107) required systemic oral treatment with prednisone, while the rest of the patients were treated with topical glucocorticosteroids only. Conclusion: PsA is associated with increased risk of uveitis. Past uveitis and treatment with etanercept were associated with higher risk of uveitis. (Table presented.).s

    Original languageEnglish
    Pages (from-to)1053-1061
    Number of pages9
    JournalClinical Rheumatology
    Volume43
    Issue number3
    DOIs
    StatePublished - 1 Mar 2024

    Keywords

    • Biologics
    • Psoriatic arthritis
    • Risk factors
    • Uveitis

    ASJC Scopus subject areas

    • Rheumatology

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