Abstract
Objective: The aim of our study was to assess the influence of the HLA-B27 status on axial spondyloarthritis (axSpA) in the largest cohort in China.Methods: An observational, cross-sectional, and analytic study of axSpA patients from the China axSpA database was performed. Demographic and clinical data were compared in terms of the HLA-B27 status. Univariate and multivariate analyses were performed to identify variables related to HLA-B27 presence.Results: We enrolled 4,131 patients in this study; of those, 36,95 (89.4%) were HLA-B27 positive. In the multivariate analysis, male gender (p < 0.001), younger age (p < 0.001), a disease duration of more than 3 years (p < 0.001), a family history of SpA (p < 0.001), uveitis (p < 0.001), ASDAS-CRP (p < 0.001), and biologic treatment (p < 0.001) were the main variables that were independently related to HLA-B27 presence, whereas a diagnosis delay time >36 months (p < 0.001) and psoriasis (p < 0.001) were independently related to HLA-B27 absence.Conclusion: In Chinese axial SpA patients, presence of HLA-B27 is associated with the male sex, younger age, longer disease duration, greater family aggregation, and higher frequency of uveitis; absence of HLA-B27 is associated with longer diagnosis delay time and higher frequency of psoriasis.
Highlights
Axial spondyloarthritis (SpA) describes a heterogeneous group of rheumatic diseases characterized by axial skeleton involvement
Patients with HLA-B27 showed a greater prevalence of family history than patients without HLA-B27 (24.3 vs. 11.5%, p < 0.001) (Table 1)
This study found a higher prevalence of male axSpA patients with HLAB27, which is in accordance with that previously published in another Chinese research on radiographic SpA, and similar in a DESIR cohort conducted in patients representing early forms of the whole spectrum of axial SpA [20, 21]
Summary
Axial spondyloarthritis (SpA) describes a heterogeneous group of rheumatic diseases characterized by axial skeleton involvement. It can involve other sites such as peripheral arthritis, enthesitis, dactylitis, and extra-articular manifestations as uveitis, psoriasis, and inflammatory bowel disease (IBD). The term axial spondyloarthritis affects patients with both non-radiographic and radiographic axial spondyloarthritis, which is termed ankylosing spondylitis (AS) [1]. HLA-B27 is found in 74–89% of patients with either non-radiographic axial spondyloarthritis or ankylosing spondylitis by GESPIC [3] and Herne cohort [4]. Previous studies suggest a relationship between HLAB27 and clinical manifestations. Since previous studies focused mainly on its association with AS, the exact role of HLA-B27 in axial SpA remains unknown in China.
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