Is the current ASAS expert definition of a positive family history useful in identifying axial spondyloarthritis Results from the SPACE and DESIR cohortsReport as inadecuate




Is the current ASAS expert definition of a positive family history useful in identifying axial spondyloarthritis Results from the SPACE and DESIR cohorts - Download this document for free, or read online. Document in PDF available to download.

1 Leiden University Medical Center LUMC 2 iPLESP - Institut Pierre Louis d-Epidémiologie et de Santé Publique 3 Service de Rhumatologie CHU Pitié-Salpêtrière 4 Diakonhjemmet Hospital 5 AMC - Academic Medical Center Amsterdam 6 Universita degli Studi di Padova 7 CRESS - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité

Abstract : Background: The Assessment of SpondyloArthritis international Society ASAS definition of a positive family history PFH of spondyloarthritis SpA includes the following diseases in first- or second-degree relatives: ankylosing spondylitis AS, acute anterior uveitis AAU, reactive arthritis ReA, inflammatory bowel disease IBD, and psoriasis. However, it is not known if a PFH for each of these diseases contributes to making a diagnosis of axSpA, sacroiliitis on imaging, or fulfilling the ASAS criteria in patients presenting with chronic back pain CBP. Therefore, the aim of this study was to assess which SpA diseases in family members are associated with human leukocyte antigen B27 HLA-B27 and axial spondyloarthritis axSpA in CBP patients.Methods: CBP patients suspected of axSpA from the SPACE n = 438 and the DESIR n = 647 cohort were asked about the presence of SpA diseases in first- or second-degree relatives AS, AAU, ReA, IBD, and psoriasis. The associations between a PFH and HLA-B27, sacroiliitis on imaging magnetic resonance imaging MRI or radiographs, axSpA diagnosis, and ASAS classification in CBP patients were assessed.Results: In the SPACE and the DESIR cohort, a PFH of AS odds ratio OR 5.9 95% confidence interval CI 3.5–9.9, and OR 3.3 95% CI 2.1–5.2 and a PFH of AAU OR 9.8 95% CI 3.3–28.9 and OR 21.6 95% CI 2.9–160.1 were significantly associated with presence of HLA-B27. Furthermore, in both cohorts a PFH of AS and a PFH of AAU were positively associated with fulfilment of the ASAS criteria, but not with sacroiliitis on imaging. In SPACE but not in DESIR a PFH of AAU was positively associated with axSpA diagnosis. In both cohorts a PFH of ReA, IBD, or psoriasis was not positively associated with HLA-B27 positivity, sacroiliitis on imaging, axSpA diagnosis, or meeting the ASAS criteria for axSpA.Conclusions:In our cohorts, a PFH of AS or AAU is useful for case-finding of axSpA as this is correlated with HLA-B27 carriership. However, as a PFH of ReA, IBD, or psoriasis does not contribute to identifying axSpA in CBP patients, these data suggest that the widely used ASAS definition of a PFH of SpA should be updated.





Author: Zineb Ez-Zaitouni - Andrea Hilkens - Laure Gossec - Inger Jorid Berg - Robert Landewé - Roberta Ramonda - Maxime Dougados - Dés

Source: https://hal.archives-ouvertes.fr/



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