Félicie Costantino1, Alice Talpin1, Roula Said-Nahal2, Marcel Goldberg3, Joseph Henny3, Gilles Chiocchia4, Henri-Jean Garchon5, Marie Zins3, Maxime Breban6. 1. Institut Cochin, Université Paris Descartes, Paris, France INSERM U1016, Paris, France. 2. Rheumatology Division, Ambroise Paré Hospital (AP-HP), Boulogne-Billancourt, France. 3. Population-Based Epidemiological Cohorts, Research Platform, UMRS 1018, Centre for Research in Epidemiology and Population Health, Villejuif, France UFR des Sciences de la Santé, Simone Veil, Versailles Saint Quentin en Yvelines University, Montigny-Le-Bretonneux, France. 4. Institut Cochin, Université Paris Descartes, Paris, France INSERM U1016, Paris, France UFR des Sciences de la Santé, Simone Veil, Versailles Saint Quentin en Yvelines University, Montigny-Le-Bretonneux, France. 5. Institut Cochin, Université Paris Descartes, Paris, France INSERM U1016, Paris, France UFR des Sciences de la Santé, Simone Veil, Versailles Saint Quentin en Yvelines University, Montigny-Le-Bretonneux, France Genetics Division, Ambroise Paré Hospital (AP-HP) Boulogne-Billancourt, France. 6. Institut Cochin, Université Paris Descartes, Paris, France INSERM U1016, Paris, France Rheumatology Division, Ambroise Paré Hospital (AP-HP), Boulogne-Billancourt, France UFR des Sciences de la Santé, Simone Veil, Versailles Saint Quentin en Yvelines University, Montigny-Le-Bretonneux, France.
Abstract
OBJECTIVE: To estimate the prevalence of spondyloarthritis (SpA) in reference to HLA-B27 in the French population. METHODS: In 1989, 20 625 employees of the French national gas and electricity company aged 35-50 years were enrolled in the GAZEL cohort. In 2010, 18 757 still active participants were screened by a questionnaire validated for the detection of SpA. Responders with available DNA were retained for further studies. Pelvic radiograph and HLA-B27 typing were performed in all the self-reported cases of SpA or psoriatic arthritis. Self-reported diagnosis was verified by a qualified rheumatologist. HLA-B27 determination was also performed in subjects without any SpA feature. RESULTS: The target population consisted of 6556 responders with available DNA. Their male:female ratio was 3.6 and their mean age was 65.5±3.3 years. A diagnosis of SpA was confirmed in 32 of the 72 self-reported cases, 75% of them being HLA-B27 positive. Estimated SpA prevalence adjusted for sex was 0.43% (95% CI 0.26% to 0.70%). HLA-B27 positivity rate in 2466 healthy controls was 6.9% (95% CI 5.9% to 7.9%). The relative risk of SpA in HLA-B27 positive individuals was 39 (95% CI 17 to 86). CONCLUSIONS: We estimated the prevalence of SpA in the French population in 2010 to 0.43%. With an estimated prevalence of 75.0% in SpA and 6.9% in healthy controls, HLA-B27 increased the disease risk 39-fold, as compared with HLA-B27 negative subjects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE: To estimate the prevalence of spondyloarthritis (SpA) in reference to HLA-B27 in the French population. METHODS: In 1989, 20 625 employees of the French national gas and electricity company aged 35-50 years were enrolled in the GAZEL cohort. In 2010, 18 757 still active participants were screened by a questionnaire validated for the detection of SpA. Responders with available DNA were retained for further studies. Pelvic radiograph and HLA-B27 typing were performed in all the self-reported cases of SpA or psoriatic arthritis. Self-reported diagnosis was verified by a qualified rheumatologist. HLA-B27 determination was also performed in subjects without any SpA feature. RESULTS: The target population consisted of 6556 responders with available DNA. Their male:female ratio was 3.6 and their mean age was 65.5±3.3 years. A diagnosis of SpA was confirmed in 32 of the 72 self-reported cases, 75% of them being HLA-B27 positive. Estimated SpA prevalence adjusted for sex was 0.43% (95% CI 0.26% to 0.70%). HLA-B27 positivity rate in 2466 healthy controls was 6.9% (95% CI 5.9% to 7.9%). The relative risk of SpA in HLA-B27 positive individuals was 39 (95% CI 17 to 86). CONCLUSIONS: We estimated the prevalence of SpA in the French population in 2010 to 0.43%. With an estimated prevalence of 75.0% in SpA and 6.9% in healthy controls, HLA-B27 increased the disease risk 39-fold, as compared with HLA-B27 negative subjects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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