Psoriatic spondyloarthropathy: A comparative study between HLA-B27 positive and HLA-B27 negative disease*
Section snippets
Patients and methods
This retrospective cross-sectional study included 70 consecutive patients diagnosed as having PsSpA on the basis of radiological criteria who were recruited at a single university hospital in northern Spain. The majority of them had been included in a previous study, in which the main clinical and epidemiological features of our PsA population were investigated (6). The presence of clear radiographic SI of grade 2 or more according to the New York criteria was mandatory (7). If patients
Results
Of the 70 patients (mean age 48 ± 14.5 years), 44 were men and 26 women (male-to-female [M/F] ratio 7:1). The mean duration of psoriasis was 17 ± 8.6 years, and the duration of arthritis was 12 ± 7 years. The average age at onset of psoriasis was 28 ± 14 years, and of arthritis 35 ± 12 years. The mean latency period between the onset of psoriasis and the first sign of arthritis was 7 ± 6.8 years. A positive family history of dermopathy-arthropathy was recorded in 14 patients (20%). Psoriasis
Discussion
In their initial studies, Moll and Wright identified SpA as a specific pattern of PsA (11). In later years, it became evident that isolated spondylitis in PsA was unusual and that in most cases, it was accompanied by peripheral arthritis 12, 13, 14. Therefore, it is difficult to provide a universally accepted definition of PsSpA, especially because overlap between the different articular subtypes of PsA is common over time 12, 13, 14. Additionally, psoriatic spondylitis may not be noted
References (32)
- et al.
The spondyloarthropathies
Baillieres Clin Rheumatol
(1995) - et al.
HLA-B27 alone rather than B27-related class I haplotypes contributes to ankylosing spondylitis susceptibility
Hum Immunol
(2000) Genetics and HLA antigens
Baillieres Clin Rheumatol
(1994)- et al.
Psoriatic arthritis
Semin Arthritis Rheum
(1973) Natural history of psoriatic arthritis
Baillieres Clin Rheumatol
(1994)B27+ disease versus B27− disease
Scand J Rheumatol (Suppl)
(1990)- et al.
Prevalence of spondyloarthropathies in HLA-B27 positive and negative blood donors
Arthritis Rheum
(1998) - et al.
Psoriatic arthritis (PA): a clinical, immunological and radiological study of 180 patients
Br J Rheumatol
(1991) - et al.
New York symposium on population studies in the rheumatic diseases. New diagnostic criteria
Bull Rheum Dis
(1967) - et al.
Ankylosing spondylitis
A modification of the Health Assessment Questionnaire for the spondyloarthropathies
J Rheumatol
On estimating the relation between blood groups and disease
Ann Hum Genet
Classification of clinical subsets in psoriatic arthritis
Br J Rheumatol
A re-evaluation of the osteoarticular manifestations of psoriasis
Br J Rheumatol
Clinical, radiographic and HLA associations as markers for the different patterns of psoriatic arthritis
Rheumatology
Clinical and immunogenetic subsets of psoriatic arthritis
Clin Exp Rheumatol
Cited by (76)
Efficacy of guselkumab on axial involvement in patients with active psoriatic arthritis and sacroiliitis: a post-hoc analysis of the phase 3 DISCOVER-1 and DISCOVER-2 studies
2021, The Lancet RheumatologyCitation Excerpt :Current treatment recommendations from the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis,23 the American College of Rheumatology/National Psoriasis Foundation,24 and the European Alliance of Associations for Rheumatology (known as EULAR)25 focus on choosing the optimal treatment to address the individual patient's symptoms across the multiple domains of psoriatic arthritis, including axial disease. HLA-B27 has been associated with axial inflammation and more severe disease in patients with psoriatic arthritis.7 Our exploratory analyses of efficacy suggested that guselkumab-treated patients had greater improvements in axial symptoms at week 24 versus placebo regardless of HLA-B27 status.
Axial psoriatic arthritis: An update for dermatologists
2021, Journal of the American Academy of DermatologyCitation Excerpt :Given these observations, whether HLA-B27–positive patients with psoriasis have AS or axial PsA remains a matter of debate. Interestingly, some studies have suggested that HLA-B0801 is the predominant genetic marker associated with axial PsA.32,43 Additional studies are needed, but testing for HLA-B27 and/or HLA-B0801 may identify patients with axial PsA.
What Does Human Leukocyte Antigen B27 Have to Do with Spondyloarthritis?
2020, Rheumatic Disease Clinics of North AmericaCitation Excerpt :In a multivariate analysis of an early SpA cohort, psoriasis data showed a negative association with HLA-B27 (odds ratio, 0.59; 95% confidence interval, 0.39, 0.90; P = .01),58 which suggests a 22% to 58% reduction in the odds of having psoriasis when HLA-B27 is positive in patients with axSpA. However, a contradictory trend is found in some other studies, with an increasing prevalence of HLA-B27 in psoriasis, psoriatic arthritis (PsA), and axial PsA/psoriatic SpA at 5%, 20%,66 and 23.4% to 34.5%,83,84 respectively. The recent review by Queiro and colleagues66 also suggested that HLA-B27 is a genetic biomarker of joint disease in patients with psoriasis, and a marker for disease expression in PsA.
Axial Psoriatic Arthritis: A Distinct Clinical Entity in Search of a Definition
2020, Rheumatic Disease Clinics of North AmericaCitation Excerpt :In the same line, a recent study showed that HLA-B0801 had the strongest association with radiographic sacroiliitis; however, when dividing the cohort HLA-B0801 was associated with unilateral sacroiliitis, whereas HLA-B27 was associated with bilateral sacroiliitis,19 corroborating the possible distinct clinical phenotypes of axial PsA and radiographic axial SpA, traditionally known as ankylosing spondylitis (AS). These data are consistent with results from clinical observational studies where a variable prevalence of HLA-B27 was reported in subjects with axPsA.14,17–20 Data from these cohorts also suggest that the smaller subset of axPsA in which the diagnosis has been substantiated by imaging, and which is HLA-B27-positive, seems to be the subset with more radiographic, bilateral SIJ damage,18 and/or MRI findings of acute inflammatory lesions32 similar to those seen in HLA-B27-positive axSpA.33
Comorbidities associated with psoriatic arthritis: Review and update
2020, Clinical ImmunologyGenetic and inflammatory factors associated with psoriatic arthritis: Relevance to diagnosis and management
2019, Clinical ImmunologyCitation Excerpt :Specifically, HLA-B*27, initially described in 90% of patients with AS, occurs as a genetic marker for PsA but not for PsC [19,32]. Patients who have positive test findings for the HLA-B*27 allele are significantly more likely to develop bilateral axial sacroiliitis even before PsC, while those who have HLA-C*06 are more likely to develop PsC several years before PsA [30,33]. Furthermore, other HLA-B alleles such as HLA-B*38 and HLA-B*8 alleles are reported with more prominent musculoskeletal features in patients with PsC [18].
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Address reprint requests to R. Queiro, MD, Rheumatology Unit, Hospital San Agustin, Camino de Heros 4, 33400, Avilés-Asturias, Spain. E-mail: [email protected]