Academic Journal
HLA-B27 as a predictor of effectiveness of treatment with TNF inhibitors in axial spondyloarthritis : data from the Swiss Clinical Quality Management Registry
| العنوان: | HLA-B27 as a predictor of effectiveness of treatment with TNF inhibitors in axial spondyloarthritis : data from the Swiss Clinical Quality Management Registry |
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| المؤلفون: | Fröhlich, Fabienne, Micheroli, Raphael, Hebeisen, Monika, Kissling, Seraphina, Bürki, Kristina, Exer, Pascale, Bräm, René, Niedermann, Karin, Möller, Burkhard, Nissen, Michael J., Kyburz, Diego, Andor, Michael, Distler, Oliver, Scherer, Almut, Ciurea, Adrian |
| المصدر: | ISSN:0770-3198 ; ISSN:1434-9949 ; Clinical Rheumatology. |
| بيانات النشر: | Springer |
| سنة النشر: | 2023 |
| المجموعة: | ZHAW digitalcollection (Repository of the Zurich University of Applied Sciences) |
| مصطلحات موضوعية: | Axial spondyloarthritis, HLA-B27, TNF inhibition, Treatment response, Humans, Male, Tumor necrosis factor inhibitor, HLA-B27 antigen, C-reactive protein, Switzerland, Prospective study, Registry, Spondylitis, ankylosing, Spondylarthritis, info:eu-repo/classification/ddc/616.7 |
| الوصف: | Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch) ; Objective: To explore the impact of the human leucocyte antigen (HLA)-B27 on the effectiveness of tumor necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA). Methods: A total of 1109 patients with available HLA-B27 status (831 B27+ patients and 278 B27− patients) fulfilling the Assessment of Spondyloarthritis international Society classification criteria for axSpA from the prospective Swiss Clinical Quality Management Registry initiating a first TNFi were included. Drug retention was investigated with multiple adjusted Cox proportional hazard models with imputation of missing values. Multiple-adjusted logistic regression analyses were used to assess the proportion of patients reaching 50% reduction in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI50) at 1 year. Results: B27+ and B27− patients differed with regard to age, sex, BASDAI, C-reactive protein (CRP), body mass index, enthesitis, uveitis, and classification status. After adjustment for potential confounders for the relationship between HLA-B27 and drug effectiveness (sex and family history of spondyloarthritis), a higher risk of drug discontinuation was found in B27− patients (HR 1.53, 95% CI 1.27–1.83). This difference decreased after additional adjustment for parameters which may act as mediators (HR 1.30, 95% CI 1.30–1.55). Male sex and elevated C-reactive protein (CRP) levels were consistently associated with longer retention. Comparable results were obtained for BASDAI50 responses. Conclusion: The HLA-B27 genotype is an important predictor of treatment effectiveness. Male sex and CRP seem, however, to better describe variability of response in individual patients. This data may help avoiding potential discrimination of B27− individuals with regard to TNFi initiation. Key Points: • HLA-B27 is a predictor of effectiveness of TNF inhibitors in axial spondyloarthritis. • Variability of response in individual patients is ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| Relation: | https://doi.org/10.1007/s10067-022-06490-8; https://doi.org/10.21256/zhaw-30335; https://hdl.handle.net/11475/30335; https://digitalcollection.zhaw.ch/handle/11475/30335 |
| DOI: | 10.1007/s10067-022-06490-8 |
| DOI: | 10.21256/zhaw-30335 |
| الاتاحة: | https://hdl.handle.net/11475/30335 https://doi.org/10.1007/s10067-022-06490-8 https://doi.org/10.21256/zhaw-30335 https://digitalcollection.zhaw.ch/handle/11475/30335 |
| Rights: | info:eu-repo/semantics/openAccess ; https://creativecommons.org/licenses/by/4.0/ |
| رقم الانضمام: | edsbas.AE50E908 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1007/s10067-022-06490-8 |
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