Journal
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
Volume 61, Issue 7, Pages 859-866Publisher
WILEY-LISS
DOI: 10.1002/art.24585
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Funding
- Intramural Research Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH [R01-AR048465]
- Cedars-Sinai General Clinical Research Center [M01-RR00425]
- University of Texas at Houston General Clinical Research Center [M01-RR02558]
- Rosalind Russell Center for Arthritis Research at the University of California, San Francisco
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Objective. To improve prognostic ability in ankylosing spondylitis (AS), we sought to identify demographic, clinical, and immunogenetic characteristics associated with radiographic severity in a large cohort of patients. Methods. Patients with AS for >= 20 years were enrolled in a cross-sectional study (n = 398). Pelvic and spinal radiographs were scored using the Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s), and radiographic severity was measured as the BASRI-s/duration of AS. Clinical factors and HLA-B, DR, DQ, and DP alleles associated with the highest quartile of the distribution of radiographic severity were identified by first using random forests and then using multivariable logistic regression modeling. Similar procedures were used to identify factors associated with the lowest quartile of radiographic severity. Results. Radiographic severity (being in the top quartile of BASRI-s/duration of AS) was associated with older age at onset of AS (odds ratio [OR] 1.10 per year), male sex (OR 1.90), current smoker (OR 4.72), and the presence of HLA-B*4100 (OR 11.73), DRB1*0804 (OR 12.32), DQA1*0401 (OR 5.24), DQB1*0603 (OR 3.42), and DPB1*0202 (OR 23.36), whereas the presence of DRB1*0801 was strongly negatively associated (OR 0.03). Being in the lowest quartile of BASRI-s/duration of AS was also less likely among those with an older age at onset of AS (OR 0.94 per year), men (OR 0.281, and current smokers (OR 0.29). Conclusion. The accuracy of the prognosis of radiographic severity in AS is improved by knowing the age at disease onset, sex, smoking history, and the presence of HLA-B*4100, DRB1*0804, DQA1*0401, DQB1*0603, DRB1*0801, and DPB1*0202 alleles.
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