title: Anti-TNFα Treatment for HLA-B27-Positive Ankylosing Spondylitis-Related Uveitis.
abstract: OBJECTIVE
  To assess the long-term efficacy of the most widely used anti-tumor necrosis factor alpha (TNFα) agents for treatment of HLA-B27-positive ankylosing spondylitis (AS)-related uveitis.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  The medical records of 143 patients with HLA-B27-positive AS who visited Seoul St. Mary's Hospital and were taking an anti-TNFα agent for at least 1 year were studied. Subjects were divided into 3 groups according to anti-TNFα treatment: Group 1 (infliximab, 66), Group 2 (adalimumab, 45), and Group 3 (etanercept, 32).
  
  
  RESULTS
  Mean age was 41.0 ± 13.0 years, and 97 patients (67.8%) were male. Mean follow-up period was 70.6 ± 37.9 months. In cases of active ocular inflammation at the onset of anti-TNFα treatment, patients showed improved activity of uveitis after 24.0 ± 15.0 days (Group 1), 17.9 ± 6.0 days (Group 2), and 25.9 ± 18.0 days (Group 3). After the anti-TNFα treatment, 71 of 94 patients (32 [76.2%] in Group 1, 26 [78.8%] in Group 2, and 13 [68.4%] in Group 3) remained without uveitis relapse. A reduction in the number of systemic medications was achieved in 129 patients (90.2%). Twenty-eight cases of minor side effects were observed, and 4 cases were tuberculosis leading to discontinuation of anti-TNFα treatment.
  
  
  CONCLUSIONS
  Infliximab, adalimumab, and etanercept were effective for treating and reducing the number of uveitis relapses in HLA-B27-positive AS. However, the risk of serious infections was noted, so ophthalmologists should consider the possibility that prolonged use of biologic agents may result in systemic side effects.
authors.affiliation: Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Mirinae
authors.initials: M
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Jae-Yon
authors.initials: JY
authors.lastname: Won
authors.affiliation: Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Seung Yong
authors.initials: SY
authors.lastname: Choi
authors.affiliation: Department of Rheumatology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Ji Hyeon
authors.initials: JH
authors.lastname: Ju
authors.affiliation: Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, South Korea. Electronic address: parkyh@catholic.ac.kr.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Park
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D000068800:Etanercept / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D015796:HLA-B27 Antigen / Q000276:immunology*; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014605:Uveitis / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology
chemical_list: D018501:Antirheumatic Agents; D015796:HLA-B27 Antigen; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept