Drs. Wendling and Prati contributed equally to this work.
Impact of uveitis on the phenotype of patients with recent inflammatory back pain: Data from a prospective multicenter French cohort†
Article first published online: 26 JUN 2012
Copyright © 2012 by the American College of Rheumatology
Arthritis Care & Research
Volume 64, Issue 7, pages 1089–1093, July 2012
How to Cite
Wendling, D., Prati, C., Demattei, C., Miceli-Richard, C., Daures, J.-P. and Dougados, M. (2012), Impact of uveitis on the phenotype of patients with recent inflammatory back pain: Data from a prospective multicenter French cohort. Arthritis Care Res, 64: 1089–1093. doi: 10.1002/acr.21648
The Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR; Outcome of Recent Undifferentiated Spondylarthropathies) cohort was supported by an unrestricted grant from Pfizer France. The DESIR study was conducted as a PHRC (Programme Hospitalier de Recherche Clinique) with AP-HP as the sponsor. The DESIR study is also under the umbrella of the French Society of Rheumatology, which also financially supported the cohort.
- Issue published online: 26 JUN 2012
- Article first published online: 26 JUN 2012
- Accepted manuscript online: 21 FEB 2012 03:39PM EST
- Manuscript Accepted: 13 FEB 2012
- Manuscript Received: 15 OCT 2011
- Pfizer France
- French Society of Rheumatology
To determine the prevalence of uveitis in patients with recent inflammatory back pain (IBP) suggestive of spondylarthritis (SpA), and to investigate the impact of uveitis on the overall features of these patients.
The Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR; Outcome of Recent Undifferentiated Spondylarthropathies) cohort is a prospective multicenter French cohort of 708 patients with early IBP suggestive of SpA. Uveitis was defined by an ophthalmologic episode diagnosed as uveitis by an ophthalmologist, or history of a medical diagnosis of uveitis given to the patient. Data on the baseline demographic characteristics, functional status and quality of life, imaging features, bone mineral density (BMD), and blood tests were compared in patients with and without uveitis. Factors associated with the presence of uveitis were identified both by univariate and multivariate analysis (logistic regression).
The prevalence of uveitis at inclusion in the DESIR cohort was 8.5%. Uveitis occurred after the first symptoms of IBP in 45% of patients. The presence of uveitis was significantly associated (univariate) with pain in the cervical spine, infection preceding inflammatory disease, a previous diagnosis of inflammatory bowel disease (IBD), the Short Form 36 (SF-36; mental and physical health and social relationship subscales), Achilles enthesitis, elevated leukocyte count, and radiologic hip involvement, but not with fulfillment of classification criteria, HLA–B27, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Disease Activity Score, and BMD. Stepwise multivariate analysis found an association between uveitis and pain in the cervical spine, infection preceding inflammatory disease, a previous diagnosis of IBD, and the physical health limitation of the SF-36 (P < 0.05).
In recent IBP suggestive of SpA, uveitis is associated with IBD and infection. This might suggest a role of environmental factors in the incidence of uveitis in SpA.