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HLA-B27 is associated with reduced disease activity in axial spondyloarthritis

HLA-B27 is associated with increased susceptibility and disease activity of ankylosing spondylitis, but the effect of HLA-B27 on the activity of the broader category now called axial spondyloarthritis (AxSpA) is apparently the opposite. A modified Bath Ankylosing Spondylitis Disease Activity Index (...

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Autores principales: Rosenbaum, James T., Weisman, Michael H., Hamilton, Hedley, Shafer, Cassie, Aslanyan, Elin, Howard, Richard A., Ogle, Kimberly, Reveille, John D., Winthrop, Kevin L., Choi, Dongseok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192504/
https://www.ncbi.nlm.nih.gov/pubmed/34112886
http://dx.doi.org/10.1038/s41598-021-91829-5
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author Rosenbaum, James T.
Weisman, Michael H.
Hamilton, Hedley
Shafer, Cassie
Aslanyan, Elin
Howard, Richard A.
Ogle, Kimberly
Reveille, John D.
Winthrop, Kevin L.
Choi, Dongseok
author_facet Rosenbaum, James T.
Weisman, Michael H.
Hamilton, Hedley
Shafer, Cassie
Aslanyan, Elin
Howard, Richard A.
Ogle, Kimberly
Reveille, John D.
Winthrop, Kevin L.
Choi, Dongseok
author_sort Rosenbaum, James T.
collection PubMed
description HLA-B27 is associated with increased susceptibility and disease activity of ankylosing spondylitis, but the effect of HLA-B27 on the activity of the broader category now called axial spondyloarthritis (AxSpA) is apparently the opposite. A modified Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to assess disease activity among 3435 patients with spondyloarthritis (SpA) who participated in a survey designed to assess the effect of their disease and its treatment on the susceptibility and severity of Covid-19. Chi square testing was used to compare BASDAI scores between HLA-B27 positive and negative subjects. 2836 survey respondents were HLA B27 positive. The average BASDAI for the HLA-B27 negative cohort was 4.92 compared to 4.34 for the HLA-B27 positive subjects. Based on linear regression, a subject’s sex could not fully account for the differing BASDAI score in HLA-B27 negative subjects compared to those who are HLA-B27 positive. The difference between B27 positive and negative subjects was skewed by those with a BASDAI score of one or two. HLA-B27 positive subjects were more than twice as likely to have a BASDAI score of 1 compared to HLA B27 negative subjects and about 60% more likely to have a BASDAI score of 2 (p < 0.0001). HLA-B27 positive subjects have less active spondyloarthritis compared to HLA-B27 negative subjects as measured by a BASDAI score. Our data indicate that patients with mild back pain and a diagnosis of AxSpA are disproportionately HLA-B27 positive. The HLA-B27 test facilitates the diagnosis of axial spondyloarthritis such that patients from a community survey with mild back pain may be disproportionately diagnosed as having AxSpA if they are HLA-B27 positive. The test result likely introduces a cognitive bias into medical decision making and could explain our observations.
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spelling pubmed-81925042021-06-14 HLA-B27 is associated with reduced disease activity in axial spondyloarthritis Rosenbaum, James T. Weisman, Michael H. Hamilton, Hedley Shafer, Cassie Aslanyan, Elin Howard, Richard A. Ogle, Kimberly Reveille, John D. Winthrop, Kevin L. Choi, Dongseok Sci Rep Article HLA-B27 is associated with increased susceptibility and disease activity of ankylosing spondylitis, but the effect of HLA-B27 on the activity of the broader category now called axial spondyloarthritis (AxSpA) is apparently the opposite. A modified Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to assess disease activity among 3435 patients with spondyloarthritis (SpA) who participated in a survey designed to assess the effect of their disease and its treatment on the susceptibility and severity of Covid-19. Chi square testing was used to compare BASDAI scores between HLA-B27 positive and negative subjects. 2836 survey respondents were HLA B27 positive. The average BASDAI for the HLA-B27 negative cohort was 4.92 compared to 4.34 for the HLA-B27 positive subjects. Based on linear regression, a subject’s sex could not fully account for the differing BASDAI score in HLA-B27 negative subjects compared to those who are HLA-B27 positive. The difference between B27 positive and negative subjects was skewed by those with a BASDAI score of one or two. HLA-B27 positive subjects were more than twice as likely to have a BASDAI score of 1 compared to HLA B27 negative subjects and about 60% more likely to have a BASDAI score of 2 (p < 0.0001). HLA-B27 positive subjects have less active spondyloarthritis compared to HLA-B27 negative subjects as measured by a BASDAI score. Our data indicate that patients with mild back pain and a diagnosis of AxSpA are disproportionately HLA-B27 positive. The HLA-B27 test facilitates the diagnosis of axial spondyloarthritis such that patients from a community survey with mild back pain may be disproportionately diagnosed as having AxSpA if they are HLA-B27 positive. The test result likely introduces a cognitive bias into medical decision making and could explain our observations. Nature Publishing Group UK 2021-06-10 /pmc/articles/PMC8192504/ /pubmed/34112886 http://dx.doi.org/10.1038/s41598-021-91829-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Rosenbaum, James T.
Weisman, Michael H.
Hamilton, Hedley
Shafer, Cassie
Aslanyan, Elin
Howard, Richard A.
Ogle, Kimberly
Reveille, John D.
Winthrop, Kevin L.
Choi, Dongseok
HLA-B27 is associated with reduced disease activity in axial spondyloarthritis
title HLA-B27 is associated with reduced disease activity in axial spondyloarthritis
title_full HLA-B27 is associated with reduced disease activity in axial spondyloarthritis
title_fullStr HLA-B27 is associated with reduced disease activity in axial spondyloarthritis
title_full_unstemmed HLA-B27 is associated with reduced disease activity in axial spondyloarthritis
title_short HLA-B27 is associated with reduced disease activity in axial spondyloarthritis
title_sort hla-b27 is associated with reduced disease activity in axial spondyloarthritis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192504/
https://www.ncbi.nlm.nih.gov/pubmed/34112886
http://dx.doi.org/10.1038/s41598-021-91829-5
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