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Tumour necrosis factor inhibitor treatment and occurrence of anterior uveitis in ankylosing spondylitis: results from the Swedish biologics register.

Lie, Elisabeth; Lindström, Ulf; Zverkova-Sandström, Tatiana; Olsen, Inge C.; D'Elia, Helena Forsblad; Askling, Johan; C Kapetanovic, Meliha LU ; Kristensen, Lars Erik LU and Jacobsson, Lennart T H (2017) In Annals of the Rheumatic Diseases 3. p.1-7
Abstract
OBJECTIVES:
Tumour necrosis factor-α inhibitor (TNFi) treatment has been shown to reduce the rates of anterior uveitis (AU) in patients with ankylosing spondylitis (AS). Our objective was to compare the effect of adalimumab (ADA), etanercept (ETN) and infliximab (IFX) on AU occurrence in AS, using real-world data.
METHODS:
Patients with AS starting ADA, ETN or IFX as their first TNFi from January 2003 to December 2010 were extracted from the Swedish Rheumatology Quality Register. AU rates, based on visits to an ophthalmologist with International Classification of Diseases 10 codes for AU, were obtained by linkage to the Swedish National Patient Register. For each TNFi, AU rates 2 years before TNFi start and for the first 2... (More)
OBJECTIVES:
Tumour necrosis factor-α inhibitor (TNFi) treatment has been shown to reduce the rates of anterior uveitis (AU) in patients with ankylosing spondylitis (AS). Our objective was to compare the effect of adalimumab (ADA), etanercept (ETN) and infliximab (IFX) on AU occurrence in AS, using real-world data.
METHODS:
Patients with AS starting ADA, ETN or IFX as their first TNFi from January 2003 to December 2010 were extracted from the Swedish Rheumatology Quality Register. AU rates, based on visits to an ophthalmologist with International Classification of Diseases 10 codes for AU, were obtained by linkage to the Swedish National Patient Register. For each TNFi, AU rates 2 years before TNFi start and for the first 2 years on TNFi treatment were compared. In the subgroup of patients who were AU-free during the 2 years before TNFi start, we also compared the risk of a first AU event.
RESULTS:
1365 patients with AS were included (406 ADA, 354 ETN, 605 IFX). Compared with pretreatment rates, we noted a reduction in overall AU rates for ADA and IFX, and an increase for ETN. The adjusted HRs for AU in 1127 patients who were free of AU in the last 2 years before TNFi start were significantly higher for ETN versus ADA (HR: 3.86 95% CI 1.85 to 8.06) and ETN versus IFX (HR: 1.99, 95% CI 1.23 to 3.22), while the HR for IFX versus ADA was not statistically significant.
CONCLUSIONS:
The results suggest differences in effect on AU risk between ADA, ETN and IFX, with a clear advantage for ADA/IFX over ETN.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
anterior uveitis, TNF blockade
in
Annals of the Rheumatic Diseases
volume
3
pages
7 pages
publisher
British Medical Association
external identifiers
  • pmid: 28254789
ISSN
1468-2060
language
English
LU publication?
yes
id
a2417326-7682-4b9f-8ae9-bbbcd9d61375
alternative location
http://ard.bmj.com/content/early/2017/03/02/annrheumdis-2016-210931.long
date added to LUP
2017-06-19 09:50:16
date last changed
2017-06-26 09:34:19
@article{a2417326-7682-4b9f-8ae9-bbbcd9d61375,
  abstract     = {OBJECTIVES: <br/>Tumour necrosis factor-α inhibitor (TNFi) treatment has been shown to reduce the rates of anterior uveitis (AU) in patients with ankylosing spondylitis (AS). Our objective was to compare the effect of adalimumab (ADA), etanercept (ETN) and infliximab (IFX) on AU occurrence in AS, using real-world data.<br/>METHODS: <br/>Patients with AS starting ADA, ETN or IFX as their first TNFi from January 2003 to December 2010 were extracted from the Swedish Rheumatology Quality Register. AU rates, based on visits to an ophthalmologist with International Classification of Diseases 10 codes for AU, were obtained by linkage to the Swedish National Patient Register. For each TNFi, AU rates 2 years before TNFi start and for the first 2 years on TNFi treatment were compared. In the subgroup of patients who were AU-free during the 2 years before TNFi start, we also compared the risk of a first AU event.<br/>RESULTS: <br/>1365 patients with AS were included (406 ADA, 354 ETN, 605 IFX). Compared with pretreatment rates, we noted a reduction in overall AU rates for ADA and IFX, and an increase for ETN. The adjusted HRs for AU in 1127 patients who were free of AU in the last 2 years before TNFi start were significantly higher for ETN versus ADA (HR: 3.86 95% CI 1.85 to 8.06) and ETN versus IFX (HR: 1.99, 95% CI 1.23 to 3.22), while the HR for IFX versus ADA was not statistically significant.<br/>CONCLUSIONS: <br/>The results suggest differences in effect on AU risk between ADA, ETN and IFX, with a clear advantage for ADA/IFX over ETN.<br/><br/>},
  author       = {Lie, Elisabeth and Lindström, Ulf and Zverkova-Sandström, Tatiana and Olsen, Inge C. and D'Elia, Helena Forsblad and Askling, Johan and C Kapetanovic, Meliha and Kristensen, Lars Erik and Jacobsson, Lennart T H},
  issn         = {1468-2060},
  keyword      = {anterior uveitis,TNF blockade},
  language     = {eng},
  month        = {03},
  pages        = {1--7},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Tumour necrosis factor inhibitor treatment and occurrence of anterior uveitis in ankylosing spondylitis: results from the Swedish biologics register.},
  volume       = {3},
  year         = {2017},
}