Advances in Rheumatology (Apr 2024)

To be or not to B27 positive: implications for the phenotypes of axial spondyloarthritis outcomes. Data from a large multiracial cohort from the Brazilian Registry of Spondyloarthritis

  • Gustavo Gomes Resende,
  • Carla Goncalves Schahin Saad,
  • Claudia Diniz Lopes Marques,
  • Sandra Lúcia Euzébio Ribeiro,
  • Maria Bernadete Renoldi de Oliveira Gavi,
  • Michel Alexandre Yazbek,
  • Adriana de Oliveira Marinho,
  • Rita de Cássia Menin,
  • Manuella Lima Gomes Ochtrop,
  • Andressa Miozzo Soares,
  • Nara Gualberto Cavalcanti,
  • Jamille Nascimento Carneiro,
  • Glaucio Ricardo Werner de Castro,
  • José Mauro Carneiro Fernandes,
  • Elziane da Cruz Ribeiro E Souza,
  • Corina Quental de Menezes Alvarenga,
  • Rejane Maria Rodrigues de Abreu Vieira,
  • Natalia Pereira Machado,
  • Antônio Carlos Ximenes,
  • Morgana Ohira Gazzeta,
  • Cleandro Pires de Albuquerque,
  • Thelma Larocca Skare,
  • Mauro Waldemar Keiserman,
  • Charles Lubianca Kohem,
  • Gabriel Sarkis Benacon,
  • Vítor Florêncio Santos Rocha,
  • Ricardo da Cruz Lage,
  • Olivio Brito Malheiro,
  • Rywka Tenenbaum Medeiros Golebiovski,
  • Thauana Luiza Oliveira,
  • Ruben Horst Duque,
  • Ana Carolina Londe,
  • Marcelo de Medeiros Pinheiro,
  • Percival Degrava Sampaio-Barros

DOI
https://doi.org/10.1186/s42358-024-00372-0
Journal volume & issue
Vol. 64, no. 1
pp. 1 – 8

Abstract

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Abstract Background There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE). Methods The RBE is a multicenter, observational, prospective cohort that enrolled patients with SpA from 46 centers representing all five geographic regions of Brazil. The inclusion criteria were as follow: (1) diagnosis of axSpA by an expert rheumatologist; (2) age ≥18 years; (3) classification according to ASAS axial. The following data were collected via a standardized protocol: demographic data, disease parameters and treatment historical. Results A total of 1096 patients were included, with 73.4% HLA-B27 positivity and a mean age of 44.4 (±13.2) years. Positive HLA-B27 was significantly associated with male sex, earlier age at disease onset and diagnosis, uveitis, and family history of SpA. Conversely, negative HLA-B27 was associated with psoriasis, higher peripheral involvement and disease activity, worse quality of life and mobility. Conclusions Our data showed that HLA-B27 positivity was associated with a classic axSpA pattern quite similar to that of Caucasian axSpA patients around the world. Furthermore, its absence was associated with peripheral manifestations and worse outcomes, suggesting a relevant phenotypic difference in a highly miscegenated population.

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