Article Title: The Role of Biologic Agents in Reducing Uveitis Risk in Axial Spondyloarthritis Patients
Revised Article:
Understanding the potential benefits of specific immunomodulatory treatments could be crucial in mitigating the occurrence of anterior uveitis (inflammation of the eye’s middle layer) in individuals diagnosed with axial spondyloarthritis, a type of inflammatory arthritis.
The Study’s Focus:
This comprehensive review scrutinized the incidence of anterior uveitis in axial spondyloarthritis patients undergoing treatment with three particular categories of drugs: anti-tumor necrosis factor (TNF) inhibitors, anti-interleukin (IL)-17A inhibitors, and Janus kinase (JAK) inhibitors. Forty-four clinical trials, both phase 2 and 3, met the criteria for inclusion in this review. These randomized, placebo-controlled trials were published between 2020 and 2023, with a total of 5910 participants.
Findings:
Out of the 44 clinical trials, 26 discussed anterior uveitis events. Following a breakdown, nine patients on anti-TNF monoclonal antibodies, four on etanercept, forty on anti-IL-17 inhibitors, and five on JAK inhibitors experienced anterior uveitis. This amounted to 58 patients in total. Simultaneously, the same number of patients taking a placebo also developed anterior uveitis. The incidence rates of anterior uveitis varied between 1.5-5.4 per 100 patient-years in those receiving the studied drugs, compared to 10.8 per 100 patient-years in those on placebo.
Limitations:
Importantly, 18 of the studies did not mention anterior uveitis events. This review assumed no such events occurred in these studies, which could potentially influence the analysis when comparing different treatment methods. Furthermore, there was a notable difference in exposure time, with the placebo group having significantly less compared to the group receiving treatment drugs.
What This Means Clinically:
For individuals with axial spondyloarthritis, biologic agents or targeted therapies seem to lower the risk of anterior uveitis episodes when compared to placebo, especially treatments involving anti-IL-17 inhibitors. Nevertheless, the risk of anterior uveitis did not vary significantly between the different treatment methods. This implies that any one of the three classes of medication examined in this review could potentially be prescribed.
Financial Disclosures: Dr. Ashleigh Levison has disclosed financial relationships with AbbVie, serving as a Consultant/Advisor.
Published In: Arthritis and Rheumatology, May 2024
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