Rheumatology, University of Texas McGovern Medical School, Houston, Texas, USA
Cedars-Sinai Medical Center, Los Angeles, California, USA.
RMD Open. 2020 Nov;6(3). doi: 10.1136/rmdopen-2020-001418.
BACKGROUND/PURPOSE: First-degree relatives (FDRs) of patients with ankylosing spondylitis (AS) may be at high risk of spondyloarthritis. We examined the frequency, characteristics of chronic back pain (CBP), associated features, persistence of symptoms, and HLA-B27 allele frequency in FDRs of AS patients, also comparing those FDRs with participants in NHANES 2009-2010 with CBP.
399 FDRs of AS probands were divided into: (1) No CBP (subjects >40 years old at study visit without CBP) (n=162); (2) NICBP (non-inflammatory CBP) (n=82), and (3) CIBP (inflammatory CBP) (n=155). White FDRs with CBP were compared with 772 participants in NHANES 2009-2010 with CBP. FDRs were invited to return for reassessment.
FDRs with CIBP had earlier onset of CBP than those with NICBP (p<0.001) and had higher frequency of heel pain than those without CBP (p=0.002). HLA-B27 occurred in 57% of FDRs with CIBP vs 39.6% of those without CBP (p=0.005, OR=1.9). Of 23 patients with CIBP at baseline re-evaluated 67.04±31.02 months later, 16 (73%) still had CIBP, whereas 4 (31%) of 13 NICBP patients seen 61.23±31.84 months later remained symptomatic.
CIBP in FDRs of AS patients is HLA-B27-associated, has earlier onset and tends to persist compared to NICBP.
背景/目的：强直性脊柱炎（AS）患者的一级亲属（FDRs）可能患脊柱关节炎的风险较高。我们检查了 AS 患者 FDRs 的慢性背痛（CBP）频率、特征、相关特征、症状持续时间以及 HLA-B27 等位基因频率，同时将这些 FDRs 与 2009-2010 年 NHANES 中患有 CBP 的参与者进行了比较。
将 399 名 AS 先证者的 FDRs 分为：（1）无 CBP（研究就诊时年龄>40 岁且无 CBP）（n=162）；（2）非炎症性 CBP（NICBP）（n=82），和（3）炎症性 CBP（CIBP）（n=155）。患有 CBP 的白人 FDRs 与 2009-2010 年 NHANES 中患有 CBP 的 772 名参与者进行了比较。邀请 FDRs 重新评估。
与 NICBP 相比，CIBP 患者的 CBP 发病更早（p<0.001），且足跟痛的发生率高于无 CBP 者（p=0.002）。CIBP 患者的 HLA-B27 发生率为 57%，而无 CBP 患者的 HLA-B27 发生率为 39.6%（p=0.005，OR=1.9）。23 例 CIBP 患者在基线时重新评估，67.04±31.02 个月后，16 例（73%）仍有 CIBP，而 13 例 NICBP 患者中的 4 例（31%）在 61.23±31.84 个月后仍有症状。
与 NICBP 相比，AS 患者 FDRs 的 CIBP 与 HLA-B27 相关，发病更早且趋于持续。
