Identification of the First Signs or Symptoms in Different Spondyloarthritis Subtypes and Their Association with HLA-B27: Data from REGISPONSER and RESPONDIA Registries

Overview

Journal RMD Open

Publisher BMJ Publishing Group

Specialty Rheumatology

Date 2023 Sep 21

PMID 37734875

Authors

Maria Angeles Puche-Larrubia

Lourdes Ladehesa-Pineda

Janitzia Vazquez-Mellado

Alejandro Escudero-Contreras

Jordi Gratacos

Xavier Juanola

Eduardo Collantes-Estevez

Pilar Font-Ugalde

Clementina Lopez-Medina

Affiliations

Soon will be listed here.

Abstract

Objective: To describe and analyse the initial symptoms attributable to patients with spondyloarthritis (SpA) and their association with HLA-B27 status.

Methods: This was an observational, cross-sectional and multicentre study with patients who fulfilled the European Spondyloarthropathy Study Group criteria for SpA from the Registry of Spondyloarthritis of Spanish Rheumatology (REGISPONSER) and Ibero-American Registry of Spondyloarthropathies (RESPONDIA) united registries. Differences in the first sign(s) or symptom(s) were compared across diagnoses and between HLA-B27 status. The diagnostic delay between patients who start the disease with musculoskeletal manifestations (MMs) and extra-MMs (EMMs) was compared.

Results: A total of 4067 patients were included (2208 from REGISPONSER and 1859 from RESPONDIA) (ankylosing spondylitis (AS): 68.3%, psoriatic arthritis (PsA): 19.9%, undifferentiated SpA: 11.8%). Overall, 3624 (89.1%) patients initiated the disease with MMs and 443 (10.9%) with EMMs. Low back pain (61.7%) and lower-limb arthritis (38.5%) were the most frequent initial symptoms. In AS patients, the absence of HLA-B27 seems to be related to an increase in the probability of starting the disease with cervical pain and peripheral manifestations. In PsA, the onset of arthritis and psoriasis was more prevalent in HLA-B27-negative patients, while initiation with axial manifestations was more predominant in HLA-B27-positive patients. The diagnostic delay was longer in patients with initial MMs than in those with EMMs (7.2 (34.8) vs 4.5 (7.6) years, respectively).

Conclusion: In this SpA population, MMs were the most prevalent initial symptoms, with differences across diagnoses and depending on the presence of the HLA-B27 antigen.

Citing Articles

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.

Resende G, Saad C, Lopes Marques C, Ribeiro S, de Oliveira Gavi M, Yazbek M Adv Rheumatol. 2024; 64(1):33.

PMID: 38671475 DOI: 10.1186/s42358-024-00372-0.

Different Therapeutic Response to Anti-TNF Drugs in Patients with Axial Spondyloarthritis Depending on Their Clinical Profile: An Unsupervised Cluster Analysis.

Priego-Perez C, Puche-Larrubia M, Ladehesa-Pineda L, Calvo-Guiterrez J, Ortega-Castro R, Escudero-Contreras A J Clin Med. 2024; 13(7).

PMID: 38610620 PMC: 11012734. DOI: 10.3390/jcm13071855.

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