Impact of genetic predisposition of de novo uveitis with etanercept in ankylosing spondylitis

We read with interest the paper by Sieper et al 1 reporting acute anterior uveitis (AAU) during etanercept or sulfasalazine therapies for axial spondyloarthritis (AxSpA). AAU is a well-known symptom in AxSpA without therapy and is itself a good indication for tumour necrosis factor (TNF) blockers.2 However during the last years, new onsets of AAU were reported with TNF blockers,3 as a paradoxical effect of this therapy, similarly to paradoxical psoriasis. New onset of AAU occurred mainly in AxSpA (19 cases) compared with other rheumatic conditions (12 cases) according to data from the French nationwide network.4 The real mechanism of this type of AAU is …