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The Influence of the HLA-DRB1 Rheumatoid Arthritis Shared Epitope on the Clinical Characteristics and Radiological Outcome of Psoriatic Arthritis
ELEANOR KORENDOWYCH, JONATHAN DIXEY, BEVERLY COX, SHARON JONES, and NEIL McHUGH
ABSTRACT.
Methods. One hundred fifty-eight patients with well documented PsA and 250 controls were typed for HLA-DRB1 alleles including the SE by polymerase chain reaction. Clinical data collected on the patient group included disease subset, swollen and tender joint counts, the psoriasis area severity index (PASI), and the presence of radiological erosions. Clinical and radiological associations with HLA-DRB1 and SE alleles were determined. Results. There was an increased frequency of HLA-DR7 (41 vs 25%; puncorr = 0.001, OR 2.02, pcorr = 0.01) and a decreased frequency of HLA-DR2 (19 vs 28%; puncorr = 0.03, OR 0.59, pcorr = 0.3) in the patient population compared with controls. There was no significant difference in the frequency of HLA-DR1 and HLA-DR4 between patient and control populations. There was no significant difference in the prevalence of SE alleles between the patient and control populations (48 vs 54%). There was no increase in the prevalence of the SE in the polyarthritis subgroup, but there was a marginal decrease in those who remained in the oligoarthritis subgroup. There were no differences with respect to sex, age of onset of disease, family history, Health Assessment Questionnaire score, joint score, skin score, or nail score between those patients who were SE positive and those who were SE negative. However, significantly more patients who were SE positive developed radiological erosions (60 vs 43%; p = 0.03, OR 2.11). Conclusion. Overall, the prevalence of the SE in patients with PsA did not differ from our control population. However, it was overrepresented in those who developed radiological erosions. It is possible that the SE does have a role in the clinical severity of PsA. (J Rheumatol 2003;30:96-101) Key Indexing Terms:
PSORIATIC ARTHRITIS
From the Royal National Hospital for Rheumatic Diseases and Bath Institute for Rheumatic Diseases, Bath, England. Supported by the Psoriasis Association UK, Remedi, and the Bath Area Medical Research Trust. E. Korendowych, MA, BM, BCh, Research Fellow, Royal National Hospital for Rheumatic Diseases; J. Dixey, BSc Hons, Scientist; B. Cox , BSc Hons, Scientist, Bath Institute for Rheumatic Diseases; S.M. Jones, MD, Consultant Rheumatologist, University Hospital, Cardiff, UK; N.J. McHugh, MD, Consultant Rheumatologist, Royal National Hospital for Rheumatic Diseases. Address reprint requests to Dr. N.J. McHugh, Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath, England, BA1 1RL. E-mail: n.j.mchugh@bath.ac.uk Submitted October 4, 2001; revision accepted July 16, 2002. |