HLA-B27, axial spondyloarthritis and survival

Li, Zhixiu1,2; Khan, Mohammad Kazim3; van der Linden, Sjef M.4,5; Winkens, Bjorn6; Villiger, Peter M.4,7; Baumberger, Heinz8; van Zandwijk, Hermine9; Khan, Muhammad Asim10; Brown, Matthew A.11,12

2023-09-01

10.1136/ard-2023-224434

ANNALS OF THE RHEUMATIC DISEASES   Impact Factor & Quartile

0003-4967

1468-2060

IntroductionAnkylosing spondylitis (AS), and carriage of HLA-B27 gene in otherwise healthy individuals, are reportedly associated with increased mortality. We evaluated this hypothesis, using data from both a 35-year AS follow-up study and UK Biobank data.MethodsIn 1985, 363 members of the Swiss AS Patient Society and 806 relatives were screened clinically and then radiographically for AS/axial spondyloarthritis (axSpA). Life expectancy was analysed in 377 axSpA patients having available pelvic radiographs and HLA-B27 status, comparing with matched Swiss population data. Survival in relation to HLA-B27 status in the general population was studied in UK Biobank European-ancestry participants (n=407 480, n=30 419 deaths).ResultsAS patients have increased standardised mortality rate (SMR) compared with the general population (1.37, 95% CI 1.11 to 1.62). This increase was significant for HLA-B27-positive AS (SMR 1.38, 95% CI 1.11 to 1.65). Shortened life expectancy was observed among both HLA-B27-positive AS women (SMR 1.77, 95% CI 1.09 to 2.70) and men (SMR 1.31, 95% CI 1.02 to 1.59). Patients with non-radiographic axSpA (nr-axSpA) had significantly lower SMR: 0.44 (95% CI 0.23 to 0.77), compared with the general population. In the UK Biobank European-ancestry population cohort, HLA-B27 carriage was not significantly associated with any change in mortality (HR 1, 95% CI 0.97 to 1.1, p=0.349, adjusted by sex), in either males (HR 1, 95% CI 0.98 to 1.1, p=0.281) or females (HR 0.96, 95% CI 0.9 to 1, p=0.232), and no increase in vascular disease mortality was observed.DiscussionAS patients, but not nr-axSpA patients, have a significantly shortened life expectancy. Increased mortality is particularly significant among women with HLA-B27-positive AS. HLA-B27 carriage in the European-ancestry general population does not influence survival, or the risk of death due to vascular disease.

Spondylitis, Ankylosing Epidemiology Arthritis

SCI

English

First

Rheumatology

Rheumatology

WOS:001064620000001

BMJ PUBLISHING GROUP

CLINICAL MEDICINE

Web of Science

1.Southern Univ Sci & Technol, Sch Publ Hlth & Emergency Management, Shenzhen, Guangdong, Peoples R China
2.Queensland Univ Technol, Translat Res Inst, Fac Hlth, Ctr Genom & Personalised Hlth,Sch Biomed Sci, Woolloongabba, Qld, Australia
3.Kent State Univ, Dept Math Sci, Kent, OH USA
4.Univ Bern, Bern, Switzerland
5.Maastricht Univ, Dept Internal Med, Div Rheumatol, Med Ctr, Maastricht, Netherlands
6.Maastricht Univ, Care & Publ Hlth Res Inst CAPHRI, Dept Methodol & Stat, Maastricht, Netherlands
7.Med Ctr Monbijou, Dept Rheumatol & Clin Immunol, Bern, Switzerland
8.Swiss Ankylosing Spondylitis Patient Soc, Flims, Switzerland
9.Rheumatol Res, Mortroux, Belgium
10.Case Western Reserve Univ, Dept Med, Cleveland, OH USA
11.Genom England Ltd, London EC1M 6BQ, England
12.Kings Coll London, Dept Med & Mol Genet, London, England

Li, Zhixiu,Khan, Mohammad Kazim,van der Linden, Sjef M.,et al. HLA-B27, axial spondyloarthritis and survival[J]. ANNALS OF THE RHEUMATIC DISEASES,2023.

Li, Zhixiu.,Khan, Mohammad Kazim.,van der Linden, Sjef M..,Winkens, Bjorn.,Villiger, Peter M..,...&Brown, Matthew A..(2023).HLA-B27, axial spondyloarthritis and survival.ANNALS OF THE RHEUMATIC DISEASES.

Li, Zhixiu,et al."HLA-B27, axial spondyloarthritis and survival".ANNALS OF THE RHEUMATIC DISEASES (2023).