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HLA B27 allele types in homogeneous groups of juvenile idiopathic arthritis patients in Latvia
Juvenile idiopathic arthritis (JIA) is a heterogeneous condition and therapeutic strategies vary in different JIA types. The routinely accepted practice to start with Sulphasalazine (SS) as the first line treatment in patients with HLA B27 positive JIA proves to be ineffective in a large proportion...
Autores principales: | , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964715/ https://www.ncbi.nlm.nih.gov/pubmed/20946671 http://dx.doi.org/10.1186/1546-0096-8-26 |
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author | Stanevicha, Valda Eglite, Jelena Zavadska, Dace Sochnevs, Arturs Lazareva, Arina Guseinova, Dinara Shantere, Ruta Gardovska, Dace |
author_facet | Stanevicha, Valda Eglite, Jelena Zavadska, Dace Sochnevs, Arturs Lazareva, Arina Guseinova, Dinara Shantere, Ruta Gardovska, Dace |
author_sort | Stanevicha, Valda |
collection | PubMed |
description | Juvenile idiopathic arthritis (JIA) is a heterogeneous condition and therapeutic strategies vary in different JIA types. The routinely accepted practice to start with Sulphasalazine (SS) as the first line treatment in patients with HLA B27 positive JIA proves to be ineffective in a large proportion of children. OBJECTIVE: to investigate HLA B27 positive JIA patients clinical characteristics, determined HLA B27 allele types and their connection with antirheumatic treatment in homogenous patient groups. MATERIALS AND METHODS: 56 patients diagnosed with JIA and observed over the period 2006 to 2009 included in the study. HLAB27 allele types were determined using PCR method. RESULTS: In HLA B27 positive JIA patients mean disease onset was 12.34 ± 3.3 years. Most common (44%) JIA type was enthesitis related arthritis. Positive response to the treatment with SS was found in 32% of patients, Methotrexate (MTX) - in 43%, combined treatment - SS with MTX was effective in 12.5%. 12.5% of patients required combination MTX with Enbrel. Eight HLA B27 allele types were found in JIA patients in Latvia: *2702, *2703, *2704, *2705, *2710, *2715, *2717, *2728. The most common was *2705 - in 55% of cases. Among all the patients enthesitis related arthritis most commonly occurred in patients with HLAB*2705 allele (OR = 2.01, p < 0.02), oligoarthritis in patients with *2710 allele (OR = 3.0, p < 0.04) and polyarthritis with *2717 allele (OR = 3.0, p < 0.05). In patients with *2705 allele effective treatment was MTX (OR = 1.13, p < 0.03) and MTX with SS (OR = 2.02, p < 0.05), but in patients having *2703 allele - MTX with Enbrel (OR = 2.94, p < 0.02). CONCLUSIONS: There are 8 different HLA B27 alleles in JIA patients in Latvia and the most common is *2705, but in order to assert them to be disease associated alleles, more extensive studies are needed, including control group of HLA B27 positive healthy individuals. Standard treatment approach with SS proves to be unsatisfactory in the majority of JIA patients. To improve children's quality of life achieving rapid disease control, the first line treatment in HLA B27 positive patients should be MTX. In order to start with the most appropriate drug it is necessary to determine HLAB 27 type at the onset of disease. |
format | Text |
id | pubmed-2964715 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-29647152010-10-28 HLA B27 allele types in homogeneous groups of juvenile idiopathic arthritis patients in Latvia Stanevicha, Valda Eglite, Jelena Zavadska, Dace Sochnevs, Arturs Lazareva, Arina Guseinova, Dinara Shantere, Ruta Gardovska, Dace Pediatr Rheumatol Online J Research Juvenile idiopathic arthritis (JIA) is a heterogeneous condition and therapeutic strategies vary in different JIA types. The routinely accepted practice to start with Sulphasalazine (SS) as the first line treatment in patients with HLA B27 positive JIA proves to be ineffective in a large proportion of children. OBJECTIVE: to investigate HLA B27 positive JIA patients clinical characteristics, determined HLA B27 allele types and their connection with antirheumatic treatment in homogenous patient groups. MATERIALS AND METHODS: 56 patients diagnosed with JIA and observed over the period 2006 to 2009 included in the study. HLAB27 allele types were determined using PCR method. RESULTS: In HLA B27 positive JIA patients mean disease onset was 12.34 ± 3.3 years. Most common (44%) JIA type was enthesitis related arthritis. Positive response to the treatment with SS was found in 32% of patients, Methotrexate (MTX) - in 43%, combined treatment - SS with MTX was effective in 12.5%. 12.5% of patients required combination MTX with Enbrel. Eight HLA B27 allele types were found in JIA patients in Latvia: *2702, *2703, *2704, *2705, *2710, *2715, *2717, *2728. The most common was *2705 - in 55% of cases. Among all the patients enthesitis related arthritis most commonly occurred in patients with HLAB*2705 allele (OR = 2.01, p < 0.02), oligoarthritis in patients with *2710 allele (OR = 3.0, p < 0.04) and polyarthritis with *2717 allele (OR = 3.0, p < 0.05). In patients with *2705 allele effective treatment was MTX (OR = 1.13, p < 0.03) and MTX with SS (OR = 2.02, p < 0.05), but in patients having *2703 allele - MTX with Enbrel (OR = 2.94, p < 0.02). CONCLUSIONS: There are 8 different HLA B27 alleles in JIA patients in Latvia and the most common is *2705, but in order to assert them to be disease associated alleles, more extensive studies are needed, including control group of HLA B27 positive healthy individuals. Standard treatment approach with SS proves to be unsatisfactory in the majority of JIA patients. To improve children's quality of life achieving rapid disease control, the first line treatment in HLA B27 positive patients should be MTX. In order to start with the most appropriate drug it is necessary to determine HLAB 27 type at the onset of disease. BioMed Central 2010-10-14 /pmc/articles/PMC2964715/ /pubmed/20946671 http://dx.doi.org/10.1186/1546-0096-8-26 Text en Copyright ©2010 Stanevicha et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Stanevicha, Valda Eglite, Jelena Zavadska, Dace Sochnevs, Arturs Lazareva, Arina Guseinova, Dinara Shantere, Ruta Gardovska, Dace HLA B27 allele types in homogeneous groups of juvenile idiopathic arthritis patients in Latvia |
title | HLA B27 allele types in homogeneous groups of juvenile idiopathic arthritis patients in Latvia |
title_full | HLA B27 allele types in homogeneous groups of juvenile idiopathic arthritis patients in Latvia |
title_fullStr | HLA B27 allele types in homogeneous groups of juvenile idiopathic arthritis patients in Latvia |
title_full_unstemmed | HLA B27 allele types in homogeneous groups of juvenile idiopathic arthritis patients in Latvia |
title_short | HLA B27 allele types in homogeneous groups of juvenile idiopathic arthritis patients in Latvia |
title_sort | hla b27 allele types in homogeneous groups of juvenile idiopathic arthritis patients in latvia |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964715/ https://www.ncbi.nlm.nih.gov/pubmed/20946671 http://dx.doi.org/10.1186/1546-0096-8-26 |
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