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HLA-B27, axial spondyloarthritis and survival.
Li, Zhixiu; Khan, Mohammad Kazim; van der Linden, Sjef M; Winkens, Bjorn; Villiger, Peter M; Baumberger, Heinz; van Zandwijk, Hermine; Khan, Muhammad Asim; Brown, Matthew A.
Afiliación
  • Li Z; School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, Guangdong, China.
  • Khan MK; Centre for Genomics and Personalised Health, School of Biomedical Sciences, Faculty of Health, Translational Research Institute, Queensland University of Technology, Woolloongabba, Queensland, Australia.
  • van der Linden SM; Department of Mathematical Sciences, Kent State University, Kent, Ohio, USA.
  • Winkens B; University of Bern, Bern, Switzerland.
  • Villiger PM; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • Baumberger H; Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), University of Maastricht, Maastricht, The Netherlands.
  • van Zandwijk H; University of Bern, Bern, Switzerland.
  • Khan MA; Department of Rheumatology and Clinical Immunology, Medical Center Monbijou, Bern, Switzerland.
  • Brown MA; Former President of Swiss Ankylosing Spondylitis Patient Society, Flims, Switzerland.
Ann Rheum Dis ; 82(12): 1558-1567, 2023 12.
Article en En | MEDLINE | ID: mdl-37679034
INTRODUCTION: Ankylosing 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. METHODS: In 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). RESULTS: AS 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. DISCUSSION: AS 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Espondilitis Anquilosante / Enfermedades Vasculares / Espondiloartritis Tipo de estudio: Observational_studies / Prognostic_studies Límite: Female / Humans / Male Idioma: En Revista: Ann Rheum Dis Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Espondilitis Anquilosante / Enfermedades Vasculares / Espondiloartritis Tipo de estudio: Observational_studies / Prognostic_studies Límite: Female / Humans / Male Idioma: En Revista: Ann Rheum Dis Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido