TOPLINE:

Patients with multiple sclerosis (MS) prescribed nucleic acid synthesis inhibitors or sphingosine-1-phosphate (S1P) modulators, fumarates, or interferons were less likely to develop noninfectious uveitis than those receiving on glatiramer acetate, whereas those treated with natalizumab or anti-CD20 monoclonal antibodies showed no clear difference in risk.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using data from a US health claims database to compare the risk of developing noninfectious uveitis after starting different disease-modifying therapies for MS.
• The study included adults with at least three diagnosis codes for MS who started any disease-modifying therapy between January 2000 and June 2022, had at least 2 years of prior insurance enrollment, and had no history of uveitis.
• A total of 43,501 patients, including those who switched therapies, contributed 48,221 episodes of treatment.
• The primary outcome was a new diagnosis of noninfectious uveitis confirmed by a second diagnosis code within 120 days. The median follow-up duration ranged from 562 to 703 days.

TAKEAWAY:

• Patients taking nucleic acid synthesis inhibitors or S1P modulators had an 84% lower risk for noninfectious uveitis than those taking glatiramer acetate (the reference group; adjusted hazard ratio [aHR], 0.16; 95% CI, 0.08-0.32).
• Patients taking fumarates had a 49% lower risk for noninfectious uveitis than the reference group (aHR, 0.51; 95% CI, 0.41-0.79), and those taking interferons had a 32% lower risk (aHR, 0.68; 95% CI, 0.51-0.91).
• The use of anti-CD20 monoclonal antibodies or natalizumab was not associated with a statistically significant difference in the risk for noninfectious uveitis.

IN PRACTICE:

“If these findings are confirmed in additional studies of other cohorts (eg, inflammatory bowel disease, for which fumarates and S1P modulators are also prescribed), such medications could eventually have a role in treating MS patients who have a higher risk” for noninfectious uveitis, as well as treating the condition outside the context of MS, the researchers of the study reported.

SOURCE:

The study was led by Anthony J. Cordisco, MD, MA, University of Pennsylvania, Philadelphia. It was published online on May 4 in the American Journal of Ophthalmology.

LIMITATIONS: 

Researchers pooled patients using different drugs owing to small sample size and low event counts, which may have reduced precision and masked true differences. All patients had private insurance and likely higher socioeconomic status, limiting generalizability. The study relied on claims codes and lacked key clinical data.

DISCLOSURES:

The research received support from the National Eye Institute of the National Institutes of Health, Research to Prevent Blindness, and the Paul and Evanina Bell Mackall Foundation Trust. The authors reported having no relevant financial conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.