Leiden University Scholarly Publications

Persistent URL of this record https://hdl.handle.net/1887/3515289

In Collections

This item can be found in the following collections:

Jong, H.M.Y. de; Winter, J.J.H. de; Horst-Bruinsma, I.E. van der; Schaardenburg, D.J. van; Gaalen, F.A. van; Tubergen, A.M. van; ... ; Sande, M.G.H. van de (2022)

Progression from subclinical inflammation to overt spondyloarthritis (SpA) in first-degree relatives of SpA patients in association with HLA-B27: the Pre-SpA cohort

Article / Letter to editor
Objective As first-degree relatives (FDRs) of HLA-B27-positive patients with axial spondyloarthritis (SpA) have an increased risk of developing axial SpA, the objectives were 1) to evaluate the presence of highly specific imaging features as well as clinical signs of SpA at baseline and after 1 year of follow-up, and 2) to describe the evolution toward clinical disease within 1 year of follow-up in a cohort of seemingly healthy FDRs of HLA-B27-positive axial SpA patients. Methods The Pre-SpA cohort is a 5-year prospective inception cohort of seemingly healthy FDRs of HLA-B27-positive axial SpA patients. Clinical and imaging features were collected and recorded. Results At baseline, 19% of the FDRs reported inflammatory back pain, 32% current arthralgia, 3% arthritis (ever), 5% enthesitis (ever), and 1% dactylitis (ever), and 3% had an extraarticular manifestation. C-reactive protein level was elevated in 16%, and erythrocyte sedimentation rate was elevated in 7%. On magnetic...Show moreObjective As first-degree relatives (FDRs) of HLA-B27-positive patients with axial spondyloarthritis (SpA) have an increased risk of developing axial SpA, the objectives were 1) to evaluate the presence of highly specific imaging features as well as clinical signs of SpA at baseline and after 1 year of follow-up, and 2) to describe the evolution toward clinical disease within 1 year of follow-up in a cohort of seemingly healthy FDRs of HLA-B27-positive axial SpA patients. Methods The Pre-SpA cohort is a 5-year prospective inception cohort of seemingly healthy FDRs of HLA-B27-positive axial SpA patients. Clinical and imaging features were collected and recorded. Results At baseline, 19% of the FDRs reported inflammatory back pain, 32% current arthralgia, 3% arthritis (ever), 5% enthesitis (ever), and 1% dactylitis (ever), and 3% had an extraarticular manifestation. C-reactive protein level was elevated in 16%, and erythrocyte sedimentation rate was elevated in 7%. On magnetic resonance imaging (MRI) views of sacroiliac joints, 10% had a Spondyloarthritis Research Consortium of Canada score of >= 2, 4% had a score of >= 5, and 4% had deep lesions. In total, 1% fulfilled the modified New York criteria for radiographic sacroiliitis. Clinical, MRI, and acute phase findings were equally distributed between HLA-B27-positive and -negative FDRs. After 1 year of follow-up, clinical parameters did not change on the group level, but 6% of the FDRs were clinically diagnosed with axial SpA, of whom 86% were HLA-B27-positive. Conclusion Features associated with SpA or imaging abnormalities were found in up to 32% of seemingly healthy FDRs, with an equal distribution between HLA-B27-positive and -negative FDRs. Progression to clinical axial SpA within 1 year of follow-up was mainly observed in HLA-B27-positive FDRs.Show less
All authors
Jong, H.M.Y. de; Winter, J.J.H. de; Horst-Bruinsma, I.E. van der; Schaardenburg, D.J. van; Gaalen, F.A. van; Tubergen, A.M. van; Weel, A.E.A.M.; Landewe, R.B.M.; Baeten, D.L.P.; Sande, M.G.H. van de
Date
2022-09-07
Journal
Arthritis Care & Research
Volume
74
Issue
12
Pages
2076 - 2084
DOI
doi:10.1002/acr.24743
Link
https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/acr.24743