Recurrence of axial spondyloarthritis among first-degree relatives in a prospective 35-year-follow-up family study

Autor: Sjef M van der Linden, Muhammad Asim Khan, Zhixiu Li, Heinz Baumberger, Hermine van Zandwijk, Mohammad Kazim Khan, Peter M Villiger, Matthew A Brown
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: van der Linden, Sjef M; Khan, Muhammad Asim; Li, Zhixiu; Baumberger, Heinz; Zandwijk, Hermine van; Khan, Mohammad Kazim; Villiger, Peter M; Brown, Matthew A (2022). Recurrence of axial spondyloarthritis among first-degree relatives in a prospective 35-year-follow-up family study. RMD open, 8(2) BMJ Publishing Group 10.1136/rmdopen-2022-002208
DOI: 10.1136/rmdopen-2022-002208
Popis: ObjectiveThe lifetime recurrence rate (RR) of axial spondyloarthritis (axSpA) among first-degree relatives (FDR) and the effect of proband’s gender, HLA-B27 and radiographic status is unclear. Our 35-year-follow-up family study has enabled these issues to be addressed.MethodsIn 1985, 363 ankylosing spondylitis (AS) probands (members of the Swiss AS Patient Society) and 806 FDR recruited into the study, completed questionnaires regarding axSpA manifestations, underwent a physical examination and most also underwent pelvic radiography and HLA-B27 typing. At follow-up in 2018–2019, of the former participants whose current addresses could be retrieved, 162 had died and 485 (125 patients with AS plus 360 FDR) completed a postal questionnaire.ResultsAt follow-up, 48 of 177 HLA-B27(+) FDR had developed axSpA, an RR of 27.1% (95% CI 20.6% to 33.7%). 27/148 (18.2%) children of AS probands (modified New York (mNY) criteria) were affected versus 2/50 (4.0%) children of non-radiographic axSpA probands (p=0.0138, OR=5.36; 95% CI 1.23 to 23.40). Children of female probands were more often affected (12/22; 54.5%) than of male probands (15/78; 19.2%) (p=0.0003; OR=4.89; 95% CI 1.96 to 12.23). This increased risk applies equally to sons and daughters.ConclusionThe lifetime RR of axSpA for HLA-B27(+) FDR is substantial (27.1%), and disease severity (as defined by radiographic sacroiliitis by the mNY criteria) is an additional risk factor. Affected mothers pass on the disease significantly more often to their offspring than do affected fathers. These findings may lead to better assessment of lifetime risk for axSpA in the offspring. Moreover, investigation of this gender effect may uncover additional putative disease susceptibility factors.
Databáze: OpenAIRE