Incidence of anterior uveitis in patients with axial spondyloarthritis treated with anti-TNF or anti-IL17A: a systematic review, a pairwise and network meta-analysis of randomized controlled trials

Abstract Background Anterior uveitis (AU) is the most frequent extra-articular feature of axial spondyloarthritis (axSpA). We aimed to assess and compare incidence AU in axSpA patients treated with anti-TNF or anti-IL17A. Methods systematically reviewed PubMed, EMBase, Cochrane from inception May 3, 2020, searched for placebo-controlled head-to-head randomized controlled trials (RCTs) assessing monoclonal antibodies (mAb) soluble receptor fusion protein anti-IL17A according ASAS criteria reporting safety data on AU. Data were extracted following a predefined protocol. did pairwise network meta-analyses primary outcome flares (relapse de novo) estimated summary odds ratios (ORs). assessed quality evidence using risk-of-bias 2.0 tool. ranked treatments their effectiveness preventing flare P-score. Results identified 752 citations included 33 RCTs, comprising 4544 (anti-TNF mAb 2101, etanercept [ETN] 699, 1744) 2497 placebo-receiving patients. Incidence was lower versus placebo (OR = 0.46; CI 95% [0.24; 0.90]) 0.34; [0.12; 0.92]. According P-score, ranking least preventive treatment as follows: mAb, ETN, placebo, Conclusion In RCTs axSpA, incident are rare events. However, this meta-analysis demonstrates that associated compared