Comparison of Clinical Features in HLA-B27 Positive and Negative Patients With Axial Spondyloarthritis: Results From a Cohort of 4,131 Patients

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.