Around 25 to 40% of SpA patients are expected to suffer from least one acute anterior uveitis episode. A non-significant reduced risk of developing uveitis with soluble-receptor ETA versus mAb treatment was found in this study on comparing qualitative and quantitative analyses of the incidence of uveitis in a year after  TNFi was used. Also, the TNFi should be seletced based on the history of extra-articular symptoms of the patient.

The risk of anterior uveitis in patients with spondyloarthritis (SpA) or psoriatic arthritis (PsA) when treated with the soluble-receptor etanercept (ETA) or monoclonal antibodies (mAbs) has been investigated in this observational, retrolective study.

Between 2000- 2014, the patients with SpA who were recommended anti-TNF agents were considered. The risk of uveitis was interpreted qualitatively  as number of subjects with at least one uveitis and quantitatively  as number of uveitis flares for each individual. Adjustment of propensity score was done with respect to ETA or mAbs.

A total of 499 patients were included (302 had SpA and 127 had PsA). Out of these patients, 203 received a mAb and 226 ETA as a 1st TNF-α inhibitor. Likelihood of uveitis occurring during the an year of treatment decreased with ETA as compared to with mAbs however was not significant following the adjustment for the propensity score. ETA had a numerically higher over-time risk of uveitis as compared to with mAbs, but was not statistically significant.

Uveitis risk in SpA patients does not appear to be more with ETA than with mAb treatment. The occurrence of uveitis in patients receiving an anti-TNF-α agent seems to be associated more with the history of uveitis as compared to the treatment used.