Purchase this article with an account.
Lyndell L Lim, Helmut Butzkueven, Tiffany Ching Shen Lo, Cecily Whitford, Shannon Ritter, Diego G Silva, Anthony John Hall; The impact of Uveitis on the course of Multiple Sclerosis (MS) in a Large MS Cohort from the Fingolimod Trials. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2189.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Uveitis and multiple sclerosis (MS) share similar immunopathology, where it has been postulated that the two diseases may have a shared antigen. Numerous studies have reported an association between uveitis and MS. However, no prospective study has described the effect a concurrent diagnosis of uveitis may have on the disease course of MS of a patient with both conditions. The purpose of this study is to describe the disease course of patients with MS and uveitis, in comparison to those without uveitis, who were all enrolled in prospective fingolimod trials.
All patients who received ≥1fingolimod dose in any of the fingolimod trials for relapsing or primary progressive MS were included in the analyses. Patients excluded due to protocol deviation in any trial were not included. All patients had mandated ophthalmic reviews as part of their follow up throughout the clinical trials.
Overall, 24,785 patients were included in the analysis: mean age, 39.8 years; women, 70%; Caucasian, 70%. History of uveitis was reported in 153/24691 patients (prevalence rate: 0.62). At baseline, there were no significant differences in MS disease characteristics between the groups of patients with/without a history of uveitis, except for T2 lesion number (31.3 vs 21.2, p=0.03). Patients with uveitis (first/recurrent event) had a higher increase in Expanded Disability Status Scale (EDSS) from baseline to Year 8 (first event, 0.63; recurrent event, 0.39 versus 0.1 for patients with no history of uveitis and no episodes of uveitis throughout follow up). Patients with a history of uveitis and/or recurrent uveitis during follow up had a numerically higher annualized relapse rate during the observation period versus those who did not have an event (0.6 vs 0.3, respectively, p=0.05).
This is the first report on the effect of uveitis on MS disease course in a large prospective MS cohort. Patients with uveitis showed a trend to increased MS disease activity and future disability over the observation period.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
This PDF is available to Subscribers Only