HLA-B27 as a predictor of effectiveness of treatment with TNF inhibitors in axial spondyloarthritis : data from the Swiss Clinical Quality Management Registry

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

doi:10.1007/s10067-022-06490-8

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-30335

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	HLA-B27 as a predictor of effectiveness of treatment with TNF inhibitors in axial spondyloarthritis : data from the Swiss Clinical Quality Management Registry
Authors:	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
et. al:	No
DOI:	10.1007/s10067-022-06490-8 10.21256/zhaw-30335
Published in:	Clinical Rheumatology
Volume(Issue):	42
Issue:	5
Page(s):	1267
Pages to:	1274
Issue Date:	May-2023
Publisher / Ed. Institution:	Springer
ISSN:	0770-3198 1434-9949
Language:	English
Subjects:	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
Subject (DDC):	616.7: Diseases of musculoskeletal system and orthopaedics
Abstract:	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 better defined by sex and objective markers of disease activity, such as C-reactive protein.
Further description:	Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch)
URI:	https://digitalcollection.zhaw.ch/handle/11475/30335
Fulltext version:	Published version
License (according to publishing contract):	CC BY 4.0: Attribution 4.0 International
Departement:	School of Health Sciences
Organisational Unit:	Institute of Physiotherapy (IPT)
Appears in collections:	Publikationen Gesundheit

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Fröhlich, F., Micheroli, R., Hebeisen, M., Kissling, S., Bürki, K., Exer, P., Bräm, R., Niedermann, K., Möller, B., Nissen, M. J., Kyburz, D., Andor, M., Distler, O., Scherer, A., & Ciurea, A. (2023). HLA-B27 as a predictor of effectiveness of treatment with TNF inhibitors in axial spondyloarthritis : data from the Swiss Clinical Quality Management Registry. Clinical Rheumatology, 42(5), 1267–1274. https://doi.org/10.1007/s10067-022-06490-8

Fröhlich, F. et al. (2023) ‘HLA-B27 as a predictor of effectiveness of treatment with TNF inhibitors in axial spondyloarthritis : data from the Swiss Clinical Quality Management Registry’, Clinical Rheumatology, 42(5), pp. 1267–1274. Available at: https://doi.org/10.1007/s10067-022-06490-8.

F. Fröhlich et al., “HLA-B27 as a predictor of effectiveness of treatment with TNF inhibitors in axial spondyloarthritis : data from the Swiss Clinical Quality Management Registry,” Clinical Rheumatology, vol. 42, no. 5, pp. 1267–1274, May 2023, doi: 10.1007/s10067-022-06490-8.

FRÖHLICH, Fabienne, Raphael MICHEROLI, Monika HEBEISEN, Seraphina KISSLING, Kristina BÜRKI, Pascale EXER, René BRÄM, Karin NIEDERMANN, Burkhard MÖLLER, Michael J. NISSEN, Diego KYBURZ, Michael ANDOR, Oliver DISTLER, Almut SCHERER und Adrian CIUREA, 2023. HLA-B27 as a predictor of effectiveness of treatment with TNF inhibitors in axial spondyloarthritis : data from the Swiss Clinical Quality Management Registry. Clinical Rheumatology. Mai 2023. Bd. 42, Nr. 5, S. 1267–1274. DOI 10.1007/s10067-022-06490-8

Fröhlich, Fabienne, Raphael Micheroli, Monika Hebeisen, Seraphina Kissling, Kristina Bürki, Pascale Exer, René Bräm, et al. 2023. “HLA-B27 as a Predictor of Effectiveness of Treatment with TNF Inhibitors in Axial Spondyloarthritis : Data from the Swiss Clinical Quality Management Registry.” Clinical Rheumatology 42 (5): 1267–74. https://doi.org/10.1007/s10067-022-06490-8.

Fröhlich, Fabienne, et al. “HLA-B27 as a Predictor of Effectiveness of Treatment with TNF Inhibitors in Axial Spondyloarthritis : Data from the Swiss Clinical Quality Management Registry.” Clinical Rheumatology, vol. 42, no. 5, May 2023, pp. 1267–74, https://doi.org/10.1007/s10067-022-06490-8.