{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T21:48:14Z","timestamp":1771364894889,"version":"3.50.1"},"reference-count":31,"publisher":"The Journal of Rheumatology","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the prevalence and 4-year incidence of acute anterior uveitis (AAU), inflammatory bowel disease (IBD) and psoriasis (PsO), and to explore associations of newly developed extraskeletal manifestations (ESMs) with clinical disease outcome in a large cohort of patients with axial spondyloarthritis (axSpA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All consecutive patients included in the Groningen Leeuwarden Axial Spondyloarthritis (GLAS) cohort between 2004 and 2011 were analyzed. History of ESMs at baseline and newly developed ESMs during 4-year follow-up were only recorded when diagnosis by an ophthalmologist, gastroenterologist, or dermatologist was present.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 414 included patients with axSpA, 31.4% had a positive history of \u2265 1 ESMs: 24.9% AAU, 9.4% IBD, and 4.3% PsO. History of PsO was significantly associated with more radiographic damage, especially of the cervical spine. Of the 362 patients with 4-year follow-up data, 15.7% patients developed an ESM: 13.3% patients had AAU (of which 3.6% had a first episode and 9.7% had recurrent AAU), 1.9% developed IBD, and 0.8% developed PsO. Patients with newly developed ESMs (without history of ESMs) had worse Ankylosing Spondylitis Quality of Life scores (mean 10.0 vs. 5.8, <jats:italic>P<\/jats:italic> = 0.001), larger occiput-wall distance (median 6.3 vs. 2.0, <jats:italic>P<\/jats:italic> = 0.02) and more limited modified Schober test (mean 12.6 vs. 13.6, <jats:italic>P<\/jats:italic> = 0.01) after 4 years of follow-up. The majority of patients developing an ESM used anti\u2013tumor necrosis factor therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>History of ESMs was present at baseline in one-third of patients with axSpA. The 4-year incidence of ESMs was relatively low, but patients who developed a new ESM reported worse quality of life.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.210308","type":"journal-article","created":{"date-parts":[[2021,8,15]],"date-time":"2021-08-15T13:05:10Z","timestamp":1629032710000},"page":"157-164","source":"Crossref","is-referenced-by-count":11,"title":["Extraskeletal Manifestations in Axial Spondyloarthritis Are Associated With Worse Clinical Outcomes Despite the Use of Tumor Necrosis Factor Inhibitor Therapy"],"prefix":"10.3899","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4604-911X","authenticated-orcid":false,"given":"Rienk","family":"van der 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