TY - JOUR
T1 - Progression from subclinical inflammation to overt SpA in first degree relatives of SpA patients is associated with HLA-B27
T2 - the Pre-SpA cohort
AU - de Jong, Henriëtte M Y
AU - de Winter, Janneke J H
AU - van der Horst-Bruinsma, Irene E
AU - van Schaardenburg, Dirk-Jan
AU - van Gaalen, Floris A
AU - van Tubergen, Astrid M
AU - Weel, Angelique E A M
AU - Landewé, Robert B M
AU - Baeten, Dominique L P
AU - van de Sande, Marleen G H
N1 - This article is protected by copyright. All rights reserved.
PY - 2021/7/5
Y1 - 2021/7/5
N2 - OBJECTIVES: As first-degree relatives (FDRs) of HLA-B27-positive axial spondyloarthritis (axSpA) patients have an increased risk of developing axSpA, the objectives were 1) to evaluate presence of highly specific imaging features as well as clinical signs of SpA at baseline and after one year of follow-up, and 2) describe the evolution towards clinical disease within one year of follow-up in a cohort of seemingly healthy FDRs of HLA-B27 positive axSpA patients.METHODS: The Pre-SpA cohort is a 5-year prospective inception cohort of seemingly healthy FDRs of HLA-B27 positive axSpA patients. Clinical and imaging features were collected and recorded.RESULTS: At baseline 19% of the FDRs reported inflammatory back pain. Thirty-two percent reported current arthralgia, 3% arthritis (ever), 5% enthesitis (ever) and 1% dactylitis (ever). Three percent had an extra-articular manifestation. CRP was elevated in 16%, ESR in 7%. On MRI-SIJ, 10% had a SPARCC score ≥2, 4% ≥5, and 4% deep lesions. One percent fulfilled the mNY criteria for radiographic sacroiliitis. Clinical, MRI and acute phase findings were equally distributed between HLA-B27 positive and negative FDRs. After 1 year of follow-up, clinical parameters did not change on the group level but 6% of the FDRs were clinically diagnosed with axSpA, of whom 86% were HLA-B27 positive.CONCLUSION: Features associated with spondyloarthritis or imaging abnormalities were found in up to 32% of seemingly healthy FDRs, with an equal distribution between HLA-B27 positive and negative FDRs. Progression to clinical axSpA within 1 year of follow-up was mainly observed in HLA-B27 positive FDRs.
AB - OBJECTIVES: As first-degree relatives (FDRs) of HLA-B27-positive axial spondyloarthritis (axSpA) patients have an increased risk of developing axSpA, the objectives were 1) to evaluate presence of highly specific imaging features as well as clinical signs of SpA at baseline and after one year of follow-up, and 2) describe the evolution towards clinical disease within one year of follow-up in a cohort of seemingly healthy FDRs of HLA-B27 positive axSpA patients.METHODS: The Pre-SpA cohort is a 5-year prospective inception cohort of seemingly healthy FDRs of HLA-B27 positive axSpA patients. Clinical and imaging features were collected and recorded.RESULTS: At baseline 19% of the FDRs reported inflammatory back pain. Thirty-two percent reported current arthralgia, 3% arthritis (ever), 5% enthesitis (ever) and 1% dactylitis (ever). Three percent had an extra-articular manifestation. CRP was elevated in 16%, ESR in 7%. On MRI-SIJ, 10% had a SPARCC score ≥2, 4% ≥5, and 4% deep lesions. One percent fulfilled the mNY criteria for radiographic sacroiliitis. Clinical, MRI and acute phase findings were equally distributed between HLA-B27 positive and negative FDRs. After 1 year of follow-up, clinical parameters did not change on the group level but 6% of the FDRs were clinically diagnosed with axSpA, of whom 86% were HLA-B27 positive.CONCLUSION: Features associated with spondyloarthritis or imaging abnormalities were found in up to 32% of seemingly healthy FDRs, with an equal distribution between HLA-B27 positive and negative FDRs. Progression to clinical axSpA within 1 year of follow-up was mainly observed in HLA-B27 positive FDRs.
U2 - https://doi.org/10.1002/acr.24743
DO - https://doi.org/10.1002/acr.24743
M3 - Article
C2 - 34219406
SN - 2151-464X
JO - Arthritis care & research
JF - Arthritis care & research
ER -