Dr. Weisman has received research grants from Abbott, Amgen, Array BioPharma, Aspreva, Bio-Rad, Bristol-Myers Squibb, Centocor, Genentech, Human Genome Sciences, MedImmune, PDL BioPharma, Regeneron, Rigel, Wyeth, XDx, Inc., and UCB, and has received consulting fees (less than $10,000 each) for serving on the advisory/data safety monitoring boards of Abbott, Amgen/Wyeth, Array BioPharma, Biogen, CombinatoRx, Crescendo Bioscience, Cypress Bioscience, Centocor, Elan, Genentech, Human Genome Sciences, Lilly, Merck & Co., Inc., Novartis, Ortelius, Rigel, TAP, Targegen, and UCB.
Clinical and immunogenetic prognostic factors for radiographic severity in ankylosing spondylitis
Article first published online: 29 JUN 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 7, pages 859–866, 15 July 2009
How to Cite
Ward, M. M., Hendrey, M. R., Malley, J. D., Learch, T. J., Davis, J. C., Reveille, J. D. and Weisman, M. H. (2009), Clinical and immunogenetic prognostic factors for radiographic severity in ankylosing spondylitis. Arthritis & Rheumatism, 61: 859–866. doi: 10.1002/art.24585
- Issue published online: 29 JUN 2009
- Article first published online: 29 JUN 2009
- Manuscript Accepted: 27 MAR 2009
- Manuscript Received: 11 DEC 2008
- Intramural Research Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases
- NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: R01-AR048465
- Cedars-Sinai General Clinical Research Center. Grant Number: M01-RR00425
- University of Texas at Houston General Clinical Research Center. Grant Number: M01-RR02558
- The Rosalind Russell Center for Arthritis Research at the University of California, San Francisco
To improve prognostic ability in ankylosing spondylitis (AS), we sought to identify demographic, clinical, and immunogenetic characteristics associated with radiographic severity in a large cohort of patients.
Patients with AS for ≥20 years were enrolled in a cross-sectional study (n = 398). Pelvic and spinal radiographs were scored using the Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s), and radiographic severity was measured as the BASRI-s/duration of AS. Clinical factors and HLA–B, DR, DQ, and DP alleles associated with the highest quartile of the distribution of radiographic severity were identified by first using random forests and then using multivariable logistic regression modeling. Similar procedures were used to identify factors associated with the lowest quartile of radiographic severity.
Radiographic severity (being in the top quartile of BASRI-s/duration of AS) was associated with older age at onset of AS (odds ratio [OR] 1.10 per year), male sex (OR 1.90), current smoker (OR 4.72), and the presence of HLA–B*4100 (OR 11.73), DRB1*0804 (OR 12.32), DQA1*0401 (OR 5.24), DQB1*0603 (OR 3.42), and DPB1*0202 (OR 23.36), whereas the presence of DRB1*0801 was strongly negatively associated (OR 0.03). Being in the lowest quartile of BASRI-s/duration of AS was also less likely among those with an older age at onset of AS (OR 0.94 per year), men (OR 0.28), and current smokers (OR 0.29).
The accuracy of the prognosis of radiographic severity in AS is improved by knowing the age at disease onset, sex, smoking history, and the presence of HLA–B*4100, DRB1*0804, DQA1*0401, DQB1*0603, DRB1*0801, and DPB1*0202 alleles.