Assessment of the effectivness of various methods of treatment of uveitis associated with ankylosing spondylitis

    Abstract

    Assessment of the effectivness of various methods of treatment of uveitis associated with ankylosing spondylitis

    I.YU. Razumova, A.A. Godzenko

    Research institute of Eye Disease, Moscow

    Purpose: to use retrospective analysis to compare the effect of combination therapy of Sulfasalazine (SS) and non-steroidal anti-inflammatory drugs (NSAIDs) to NSAIDs mono-therapy and inhibitors of tumor necrosis factor-alpha (TNF-α) on exacerbation rate of uveitis associated with ankylosing spondylitis (AS).

    Material and methods. 159 patients with uveitis associated with AS were iincluded in the retrospective analysis. During the disease duration, all patients had at least one exacerbation event per year. Among them, 49 were receiving combination therapy of SS and NSAIDs, the average duration of treatment was 3,9±2,28 years. 62 – NSAIDs mono-therapy, the average duration of treatment was 7,2±6,4 years, and 48 – TNF-α inhibitors at least 1 year.

    Results. 43 patients of the 49 that were receiving SS and NSAIDs combination therapy had 3 or less acute uveitis episodes per year, 6 patients – more than 3 episodes. 62 patients were receiving only NSAIDs during the observation period; among them 9 had on the average more than 3 acute uveitis episodes per year, 53 – 3 or less episodes. Among the 48 patients who had more than one acute uveitis episode per year and were treated with TNF-α inhibitors for at least one year, 25 were receiving infliximab, 15 – adalimumab, 11 – etanercept.

    Conclusion. Combination therapy of SS and NSAIDs does not significantly affect the exacerbation rate of uveitis in patients with AS who have frequent acute episodes (more than 3 times a year), but significantly reduces the exacerbation rate in patients with mild uveitis (3 or less acute episodes a year). TNF-α inhibitors can be recommended for cases with severe uveitis with high exacerbation rate.

    Key words: uveitis, Sulfasalazine, NSAIDs, TNF-α inhibitors, ankylosing spondylitis.