Clinical and Imaging Signs of Spondyloarthritis in First‐Degree Relatives of HLA–B27–Positive Ankylosing Spondylitis Patients: The Pre‐Spondyloarthritis (Pre‐SpA) Cohort Study. Issue 10 (28th September 2016)

• Record Type: Journal Article
• Authors: Turina, Maureen C.; de Winter, Janneke J.; Paramarta, Jacky E.; Gamala, Mihaela; Yeremenko, Nataliya; Nabibux, Marita N.; Landewé, Robert; Baeten, Dominique L.
• Is Part Of: Arthritis & rheumatology. Volume 68:Issue 10(2016)
• Page Start: 2444
• Page End: 2455
• Publication Date: 2016-09-28
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/art.39766
• Languages: English
• ISSNs: 2326-5191

Abstract

Abstract : Objective: To investigate whether seemingly healthy first‐degree relatives of patients with ankylosing spondylitis (AS) have clinical, laboratory, or imaging features of spondyloarthritis (SpA). Methods: First‐degree relatives (ages 18–40 years) of HLA–B27–positive AS patients were included in the pre‐spondyloarthritis (Pre‐SpA) cohort, a prospective inception cohort study. Clinical, biologic, and imaging features were recorded. First‐degree relatives were classified according to several sets of SpA classification criteria. Results: We report baseline features of 51 first‐degree relatives included in this study. Twenty‐nine (57%) had back pain, 2 (4%) had psoriasis, 1 (2%) had inflammatory bowel disease, and 1 (2%) had uveitis. Three (6%) had low‐grade sacroiliitis, 1 (2%) had cervical syndesmophytes on radiography, and 10 (20%) had bone marrow edema on magnetic resonance imaging of the sacroiliiac joints. Seventeen of 51 first‐degree relatives (33%) fulfilled SpA classification criteria: 7 (14%) fulfilled both Assessment of SpondyloArthritis international Society (ASAS) axial SpA and European Spondylarthropathy Study Group (ESSG) classification criteria, 6 (12%) fulfilled only ASAS axial SpA classification criteria, and 4 (8%) fulfilled only ESSG classification criteria; 3 (6%) also fulfilled the Amor criteria. None fulfilled other SpA classification criteria. First‐degree relatives fulfilling the ASAS axial SpA and/or ESSG classification criteria had more frequent inflammatory back pain, had a higher level of disease activity, and had more psoriasis. No differences were found in parameters of inflammation, peripheral and extraarticular disease other than psoriasis, and HLA–B27 positivity between those who did and those who did not fulfill the ASAS axial SpA and/or ESSG classification criteria. Four first‐degree relatives (12%) who did not fulfill the ASAS axial SpA and/or ESSG classification criteria had imaging abnormalities suggestive of SpA. Conclusion: A substantial proportion of seemingly healthy first‐degree relatives of HLA–B27–positive AS patients have clinical and/or imaging abnormalities suggestive of SpA. Thirty‐three percent could be classified as having SpA. Further follow‐up will show which first‐degree relatives will develop clinically manifest SpA.