{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T08:06:43Z","timestamp":1790496403331,"version":"4.1.0"},"reference-count":35,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Schweizer R\u00fcck Insurance","award":["Not known"],"award-info":[{"award-number":["Not known"]}]},{"name":"Ciba-Geigy","award":["Not known"],"award-info":[{"award-number":["Not known"]}]},{"name":"NIHR Clinical Research Facility","award":["Not known"],"award-info":[{"award-number":["Not known"]}]},{"DOI":"10.13039\/501100000764","name":"King's College London","doi-asserted-by":"publisher","award":["not known"],"award-info":[{"award-number":["not known"]}],"id":[{"id":"10.13039\/501100000764","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004941","name":"Guy's and St Thomas' NHS Foundation Trust","doi-asserted-by":"publisher","award":["Not known"],"award-info":[{"award-number":["Not known"]}],"id":[{"id":"10.13039\/501100004941","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Biomedical Research Centre"},{"name":"Swiss National Fund","award":["Not known"],"award-info":[{"award-number":["Not known"]}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","award":["Not known"],"award-info":[{"award-number":["Not known"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2022,4,11]]},"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The lifetime recurrence rate (RR) of axial spondyloarthritis (axSpA) among first-degree relatives (FDR) and the effect of proband\u2019s gender, HLA-B27 and radiographic status is unclear. Our 35-year-follow-up family study has enabled these issues to be addressed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In 1985, 363 ankylosing spondylitis (AS) probands (members of the Swiss AS Patient Society) and 806 FDR recruited into the study, completed questionnaires regarding axSpA manifestations, underwent a physical examination and most also underwent pelvic radiography and HLA-B27 typing. At follow-up in 2018\u20132019, of the former participants whose current addresses could be retrieved, 162 had died and 485 (125 patients with AS plus 360 FDR) completed a postal questionnaire.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At follow-up, 48 of 177 HLA-B27(+) FDR had developed axSpA, an RR of 27.1% (95% CI 20.6% to 33.7%). 27\/148 (18.2%) children of AS probands (modified New York (mNY) criteria) were affected versus 2\/50 (4.0%) children of non-radiographic axSpA probands (p=0.0138, OR=5.36; 95%\u2009CI 1.23 to 23.40). Children of female probands were more often affected (12\/22; 54.5%) than of male probands (15\/78; 19.2%) (p=0.0003; OR=4.89; 95%\u2009CI 1.96 to 12.23). This increased risk applies equally to sons and daughters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The lifetime RR of axSpA for HLA-B27(+) FDR is substantial (27.1%), and disease severity (as defined by radiographic sacroiliitis by the mNY criteria) is an additional risk factor. Affected mothers pass on the disease significantly more often to their offspring than do affected fathers. These findings may lead to better assessment of lifetime risk for axSpA in the offspring. Moreover, investigation of this gender effect may uncover additional putative disease susceptibility factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2022-002208","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T11:26:56Z","timestamp":1658489216000},"page":"e002208","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Recurrence of axial spondyloarthritis among first-degree relatives in a prospective 35-year-follow-up family study"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0087-0351","authenticated-orcid":false,"given":"Sjef M","family":"van der Linden","sequence":"first","affiliation":[{"name":"University of Bern, Bern, Switzerland"},{"name":"Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4704-8311","authenticated-orcid":false,"given":"Muhammad Asim","family":"Khan","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2924-9120","authenticated-orcid":false,"given":"Zhixiu","family":"Li","sequence":"additional","affiliation":[{"name":"Centre for Genomics and Personalised Health, Brisbane, Queensland, Australia"},{"name":"Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz","family":"Baumberger","sequence":"additional","affiliation":[{"name":"Former President of the Swiss Ankylosing Spondylitis Patient Society, Flims, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermine van","family":"Zandwijk","sequence":"additional","affiliation":[{"name":"Rheumatology Research, Mortroux, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9857-0578","authenticated-orcid":false,"given":"Mohammad Kazim","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Mathematical Sciences, Kent State University, Kent, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8859-9964","authenticated-orcid":false,"given":"Peter M","family":"Villiger","sequence":"additional","affiliation":[{"name":"University of Bern, Bern, Switzerland"},{"name":"Department of Rheumatology and Clinical Immunology, Medical Center Monbijou, Bern, 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