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

Abstract 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 Activit...

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Autores principales:	James T. Rosenbaum, Michael H. Weisman, Hedley Hamilton, Cassie Shafer, Elin Aslanyan, Richard A. Howard, Kimberly Ogle, John D. Reveille, Kevin L. Winthrop, Dongseok Choi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/08013669b00b492da5ace5e27d25234c
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spelling	oai:doaj.org-article:08013669b00b492da5ace5e27d25234c2021-12-02T17:47:37ZHLA-B27 is associated with reduced disease activity in axial spondyloarthritis10.1038/s41598-021-91829-52045-2322https://doaj.org/article/08013669b00b492da5ace5e27d25234c2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91829-5https://doaj.org/toc/2045-2322Abstract 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.James T. RosenbaumMichael H. WeismanHedley HamiltonCassie ShaferElin AslanyanRichard A. HowardKimberly OgleJohn D. ReveilleKevin L. WinthropDongseok ChoiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-5 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q James T. Rosenbaum Michael H. Weisman Hedley Hamilton Cassie Shafer Elin Aslanyan Richard A. Howard Kimberly Ogle John D. Reveille Kevin L. Winthrop Dongseok Choi HLA-B27 is associated with reduced disease activity in axial spondyloarthritis
description	Abstract 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.
format	article
author	James T. Rosenbaum Michael H. Weisman Hedley Hamilton Cassie Shafer Elin Aslanyan Richard A. Howard Kimberly Ogle John D. Reveille Kevin L. Winthrop Dongseok Choi
author_facet	James T. Rosenbaum Michael H. Weisman Hedley Hamilton Cassie Shafer Elin Aslanyan Richard A. Howard Kimberly Ogle John D. Reveille Kevin L. Winthrop Dongseok Choi
author_sort	James T. Rosenbaum
title	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_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_sort	hla-b27 is associated with reduced disease activity in axial spondyloarthritis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/08013669b00b492da5ace5e27d25234c
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HLA-B27 is associated with reduced disease activity in axial spondyloarthritis

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