title: Insights into uveitis in association with spondyloarthritis from a large patient survey.
abstract: BACKGROUND
  Uveitis is reported to be the most common extra-articular feature in spondyloarthritis (SpA).
  
  
  OBJECTIVE
  The objective of this study was to investigate the relationship between uveitis and SpA in a cohort identified from a survey.
  
  
  METHODS
  Eight hundred sixty-three respondents completed a survey conducted by the Spondylitis Association of America. Data on baseline demographics, quality of life, medication use, and joint involvement were compared in SpA patients with and without uveitis. Logistic regression analysis was used to identify characteristics associated with the presence of uveitis.
  
  
  RESULTS
  Of the 863 respondents, 168 (19.5%) reported a diagnosis of uveitis. Baseline demographics including sex, age, and ethnicity were similar between the uveitis and no-uveitis groups. The presence of uveitis had a significant positive association with the use of the biologic drug infliximab (adjusted odds ratio [ORadj] = 1.66, P = 0.044), "lower jaw" involvement (ORadj = 1.60, P = 0.015), heel involvement (ORadj = 1.51, P = 0.023), and a diagnosis of arthritis associated with inflammatory bowel disease (ORadj = 1.92, P = 0.005). It had a significant negative association with the use of the biologic drug etanercept (ORadj = 0.49, P = 0.011) or a coexisting diagnosis of diabetes (ORadj = 0.02, P = 0.020).
  
  
  CONCLUSIONS
  The relationship of uveitis to medication presumably reflects the choice of a specific tumor necrosis factor inhibitor in the setting of a history of uveitis. One prior study has also correlated heel pain and uveitis, thus supporting the validity of the association and suggesting potentially a common pathogenesis. Because diabetes has been proposed as a risk factor for uveitis, the negative association is surprising and may distinguish the pathogenesis of uveitis in association with SpA from other forms of uveitis.
authors.affiliation: From the Departments of *Ophthalmology and †Public Health & Preventive Medicine, Oregon Health & Science University, Portland, OR; ‡Spondylitis Association of America, Los Angeles, CA; §Department of Medicine, OregonHealth & Science University, and ∥Devers Eye Institute, Portland, OR.
authors.forename: Katie M
authors.initials: KM
authors.lastname: Keck
authors.forename: Dongseok
authors.initials: D
authors.lastname: Choi
authors.forename: Laurie M
authors.initials: LM
authors.lastname: Savage
authors.forename: James T
authors.initials: JT
authors.lastname: Rosenbaum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects / Q000627:therapeutic use; D000069285:Infliximab; D007596:Joints / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011788:Quality of Life; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012307:Risk Factors; D025241:Spondylarthritis / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014605:Uveitis / Q000139:chemically induced* / Q000453:epidemiology*
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept