Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, and University of Oxford, Oxford, UK.
Rheumazentrum Ruhrgebiet, Ruhr-Universität, Bochum, Germany.
Arthritis Care Res (Hoboken). 2021 Jun;73(6):856-860. doi: 10.1002/acr.24174.
To describe the radiographic phenotype of axial spondyloarthritis (SpA) according to the presence of HLA-B27.
An international collaboration compared the radiographic phenotype of axial SpA according to HLA-B27 status. Patients with ankylosing spondylitis (AS) and axial psoriatic arthritis (PsA) were collected. Radiographs were read centrally, blinded to clinical details. The symmetry of the sacroiliac joints and lumbar syndesmophytes and the morphology of syndesmophytes (typical marginal versus atypical chunky), together with the modified Stoke Ankylosing Spondylitis Spine Score and the Psoriatic Arthritis Spondylitis Radiographic Index, were recorded.
A total of 244 patients with PsA and 198 patients with AS were included. In PsA, 60 patients (25%) were HLA-B27 positive while in AS, 148 patients (75%) were HLA-B27 positive. Patients with HLA-B27 were younger and more often male and had a longer duration of disease. In multivariable logistic regression, HLA-B27 was significantly associated with syndesmophyte symmetry (odds ratio [OR] 3.02 [95% confidence interval (95% CI) 1.38, 6.61]) and marginal syndesmophytes (OR 1.97 [95% CI 1.16, 3.36]) but not with sacroiliac symmetry. Mean radiographic scores were higher for patients with HLA-B27.
Patients with axial SpA who are positive for HLA-B27 have more severe radiographic damage, more marginal syndesmophytes, and more frequent syndesmophyte symmetry compared to patients who are negative for HLA-B27.
根据 HLA-B27 阳性与否，描述中轴型脊柱关节炎（SpA）的放射学表型。
国际合作比较了 HLA-B27 状态下中轴型 SpA 的放射学表型。收集强直性脊柱炎（AS）和中轴型银屑病关节炎（PsA）患者。放射学图像由中心阅片，不了解临床细节。记录骶髂关节和腰椎骨桥的对称性以及骨桥的形态（典型的边缘型与非典型的块状型），同时记录改良的 Stoke 强直性脊柱炎脊柱评分和银屑病关节炎脊柱放射学指数。
共纳入 244 例 PsA 患者和 198 例 AS 患者。在 PsA 中，60 例（25%）患者 HLA-B27 阳性，而在 AS 中，148 例（75%）患者 HLA-B27 阳性。HLA-B27 阳性患者更年轻，更常为男性，且疾病病程更长。多变量逻辑回归分析显示，HLA-B27 与骨桥对称性（比值比 [OR] 3.02 [95%置信区间 95%CI 1.38，6.61]）和边缘型骨桥（OR 1.97 [95%CI 1.16，3.36]）显著相关，但与骶髂关节对称性无关。HLA-B27 阳性患者的放射学评分平均值更高。
与 HLA-B27 阴性患者相比，HLA-B27 阳性的中轴型 SpA 患者的放射学损害更严重，更常出现边缘型骨桥，且骨桥对称性更常见。
