OBJECTIVE: There are conflicting data concerning the role of HLA-DRB1 alleles in disease outcome in early rheumatoid arthritis. The exact role of these alleles in short-term outcome is determined in this large, prospective, population-based study. METHODS: We recruited 532 patients with inflammatory polyarthritis from the Norfolk Arthritis Register and typed their sera for HLA-DRB1 alleles using polymerase chain reaction-based methods. Disease outcome was assessed at 2 years in terms of persistent joint inflammation, functional disability, and radiologic erosions. Results are expressed as risk ratios (RR) with 95% confidence intervals (95% CI). RESULTS: There was no influence of HLA-DRB1 alleles, in any combination, on the likelihood of disease persistence, and only a modest effect on functional disability (Health Assessment Questionnaire score > or = 1). The most obvious effect was on the development of erosions (RR 1.9, 95% CI 1.4-2.6 for those who carried at least 1 DRB1 shared epitope [SE] allele), with slightly greater effects for those who were homozygous for SE-bearing alleles (RR 2.5, 95% CI 1.8-3.6). This effect of HLA-DRB1 was restricted to patients whose sera were negative for rheumatoid factor. Among patients with erosions, HLA-DRB1 had no influence on the severity of radiologic damage (defined as the number of eroded joints, or total Larsen score). CONCLUSION: These data do not support routine HLA-DRB1 screening of patients with early arthritis to identify those at risk for subsequent severe disease.
OBJECTIVE: There are conflicting data concerning the role of HLA-DRB1 alleles in disease outcome in early rheumatoid arthritis. The exact role of these alleles in short-term outcome is determined in this large, prospective, population-based study. METHODS: We recruited 532 patients with inflammatory polyarthritis from the Norfolk Arthritis Register and typed their sera for HLA-DRB1 alleles using polymerase chain reaction-based methods. Disease outcome was assessed at 2 years in terms of persistent joint inflammation, functional disability, and radiologic erosions. Results are expressed as risk ratios (RR) with 95% confidence intervals (95% CI). RESULTS: There was no influence of HLA-DRB1 alleles, in any combination, on the likelihood of disease persistence, and only a modest effect on functional disability (Health Assessment Questionnaire score > or = 1). The most obvious effect was on the development of erosions (RR 1.9, 95% CI 1.4-2.6 for those who carried at least 1 DRB1 shared epitope [SE] allele), with slightly greater effects for those who were homozygous for SE-bearing alleles (RR 2.5, 95% CI 1.8-3.6). This effect of HLA-DRB1 was restricted to patients whose sera were negative for rheumatoid factor. Among patients with erosions, HLA-DRB1 had no influence on the severity of radiologic damage (defined as the number of eroded joints, or total Larsen score). CONCLUSION: These data do not support routine HLA-DRB1 screening of patients with early arthritis to identify those at risk for subsequent severe disease.
Authors: A Stockman; B D Tait; R Wolfe; C A Brand; M J Rowley; M D Varney; R Buchbinder; K D Muirden Journal: Rheumatol Int Date: 2005-09-07 Impact factor: 2.631
Authors: H Marotte; B Pallot-Prades; L Grange; J Tebib; P Gaudin; C Alexandre; J L Blond; M A Cazalis; B Mougin; P Miossec Journal: Ann Rheum Dis Date: 2005-08-11 Impact factor: 19.103
Authors: Hiba Mahdi; Benjamin A Fisher; Henrik Källberg; Darren Plant; Vivianne Malmström; Johan Rönnelid; Peter Charles; Bo Ding; Lars Alfredsson; Leonid Padyukov; Deborah P M Symmons; Patrick J Venables; Lars Klareskog; Karin Lundberg Journal: Nat Genet Date: 2009-11-08 Impact factor: 38.330
Authors: L De Rycke; I Peene; I E A Hoffman; E Kruithof; A Union; L Meheus; K Lebeer; B Wyns; C Vincent; H Mielants; L Boullart; G Serre; E M Veys; F De Keyser Journal: Ann Rheum Dis Date: 2004-12 Impact factor: 19.103