title: New onset of uveitis during anti-tumor necrosis factor treatment for rheumatic diseases.
abstract: Uveitis may be associated with various inflammatory diseases. Previous reports suggested that tumor necrosis factor (TNF) blockers, especially anti-TNF monoclonal antibodies, may reduce the incidence of uveitis flares in some inflammatory diseases. Under these circumstances, de novo occurrence, ie, new onset of the first episode of uveitis under anti-TNF therapy, is uncommon.
  
  
  OBJECTIVE
  The aim of this study was to collect cases of new onset of uveitis under anti-TNF therapy, using a nationwide network, to describe these cases, and to gather with cases reported in the literature.
  
  
  METHODS
  All French rheumatologists, pediatric rheumatologists, and internal medicine practitioners registered on the Club Rhumatismes et Inflammation web site were contacted in an attempt to declare the cases of new onset of uveitis, diagnosed by an ophthalmologist, in patients treated with TNF blockers. The analysis of the literature was performed through PubMed database and manual research.
  
  
  RESULTS
  Thirty-one cases were recorded, 19 men, mean age 43 (5-70) years, occurring in ankylosing spondylitis (19 cases), psoriatic arthritis (4 cases), rheumatoid arthritis (6 cases), juvenile idiopathic arthritis (2 cases). The TNF blocker at the time of uveitis was etanercept 23 times, adalimumab 3 times, infliximab 5 times, with a mean total duration of exposure to anti-TNF agents of 27 (4-96) months at uveitis occurrence. Most of the patients were good responders to TNF blockers at the time of uveitis onset. Analysis of the literature revealed 121 similar cases published in English.
  
  
  CONCLUSIONS
  Uveitis occurs de novo under anti-TNF therapy mainly in spondyloarthropathies, but also in rheumatoid arthritis and juvenile idiopathic arthritis patients and more frequently under etanercept.
authors.affiliation: Department of Rheumatology, Université de Franche-Comté (EA 4266), Centre Hospitalier Universitaire, Besançon, France. dwendling@chu-besancon.fr
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
authors.forename: Julien
authors.initials: J
authors.lastname: Paccou
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Berthelot
authors.forename: René-Marc
authors.initials: RM
authors.lastname: Flipo
authors.forename: Séverine
authors.initials: S
authors.lastname: Guillaume-Czitrom
authors.forename: Clément
authors.initials: C
authors.lastname: Prati
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Dernis
authors.forename: Guillaume
authors.initials: G
authors.lastname: Direz
authors.forename: Véronique
authors.initials: V
authors.lastname: Ferrazzi
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Ristori
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014605:Uveitis / Q000139:chemically induced*
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha