Prevalence of Axial SpA and Inflammatory Back Pain in anterior uveitis
Research type
Research Study
Full title
A study to investigate the prevalence of axial spondyloarthropaty (axial SpA) and inflammatory back pain (IBP) in patients presenting with acute anterior uveitis (AAU)
IRAS ID
125652
Contact name
Mark Sykes
Contact email
Sponsor organisation
Norfolk & Norwich University Hospitals NHS Foundation Trust
Research summary
The objective of the study is to determine the prevalence of axial spondyloarthropathy (axial SpA) and inflammatory back pain (IBP) in patients presenting with acute anterior uveitis (AAU).\n\nAxial SpA—including ankylosing spondylitis (AS)—is a chronic inflammatory disease that mainly affects the sacroiliac joints and spine. The pathophysiological hallmarks of AS are spinal inflammation and new bone formation.\n\nAcute anterior uveitis is the most common manifestation outside the spine and joints with the prevalence varying from 13 to 48% in AS populations. When the conditions co-exist, they are strongly linked with HLA-B27. Quite often the diagnosis of uveitis is made before the diagnosis of AS, even though the spinal symptoms are commonly present before the first episode of uveitis.\n\nThe prevalence of AS has been studied in several uveitis populations; however data on the prevalence of IBP and axial SpA in patients with AAU is limited.\n\nTraditionally the diagnosis of AS was based on x-rays, but x-ray changes can take several years to develop, often resulting in a delayed or missed diagnosis. Newer criteria for the diagnosis of axial SpA are based on MRI findings. This may enable an earlier diagnosis to be made and will hopefully result in earlier treatment, potentially preventing longer term complications and disability.\n\nThe study population will be patients presenting to the ophthalmology department of the Norfolk & Norwich Hospital with acute anterior uveitis over a 12-month period. All those with a history of back pain will be invited to undertake an assessment in the rheumatology department, involving an interview, a questionnaire and an examination. Those who have had back pain for >3 months, which started before the age of 45 years, will undergo routine blood tests and an MRI scan in order to answer the study objectives.
REC name
East of England - Cambridgeshire and Hertfordshire Research Ethics Committee
REC reference
13/EE/0442
Date of REC Opinion
6 Jan 2014
REC opinion
Further Information Favourable Opinion