{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T19:52:10Z","timestamp":1769629930816,"version":"3.49.0"},"reference-count":20,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T00:00:00Z","timestamp":1690243200000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","award":["IIS-2018-125369"],"award-info":[{"award-number":["IIS-2018-125369"]}],"id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Novartis, Abbvie, Pfizer, Janssen, Eli Lilly, UCB Pharma","award":["IIS-2018-125369"],"award-info":[{"award-number":["IIS-2018-125369"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,6,22]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We aimed to characterize differences of clinical features, extra-musculoskeletal manifestations and treatment utilizations based on the patients\u2019 HLA-B*27 status in a global axSpA cohort and identify predictors of HLA-B*27 negativity in these patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methodology<\/jats:title>\n                  <jats:p>In post-hoc analysis of the ASAS-PerSpA study, patients fulfilling the 2009 ASAS classification criteria for axSpA and typed for HLA-B*27 were included. The patient characteristics cwere compared between the HLA-B*27(+) and HLA-B*27(-) subgroups. Multivariablete logistic regression was conducted to identify predictors of HLA-B*27 negativity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 2910 patients with axSpA from 24 countries, 2269 were tested for HLA-B*27 [1753 HLA-B*27(+) and 516 HLA-B*27(-)]. The proportion of males was higher in the HLA-B*27 (+) compared to the HLA-B*27 (-) subgroup (72.1 vs 54.3%). Patient population with HLA-B*27 (+) more often had positive family history for axSpA (29.8 vs 15.3%), and younger age at diagnosis, 31.6 years (SD 10.9) vs 37.7 years (SD 12.1). HLA-B*27 (-) patients had significantly higher peripheral arthritis (47.5 vs 42.1%, p&lt;0.05), psoriasis (19.4 vs 10.2), enthesitis (56.6 vs 49.8%) and IBD (12.8 vs 3.4) (p&lt;0.001). The exposure to csDMARDS in HLA-B*27 (-) patients was higher (61.2 vs 55.0%, p&lt; 0.05). On multivariable analysis, HLA-B*27 (-) status was positively associated with enthesitis, psoriasis and IBD with an OR 1.27 (1.02-1.57), 1.84 (1.36-2.48) and 4.84 (3.23-7.30) respectively, and inversely associated with uveitis, OR 0.37 (0.27-0.50).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>HLA-B*27 (-) axSpA patients had a longer delay in diagnosis, more frequently had peripheral arthritis, enthesitis, IBD, psoriasis, and were more often treated with csDMARDs compared to HLA-B*27 (+) subgroup.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003179","type":"journal-article","created":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T12:59:07Z","timestamp":1690289947000},"page":"e003179","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Clinical profile and treatment utilisation based on HLA-B*27 status in axial spondyloarthritis: results from ASAS-PerSpA study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6722-0372","authenticated-orcid":false,"given":"Haseeb","family":"Chaudhary","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Case Western Reserve University, University Hospitals, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2309-5837","authenticated-orcid":false,"given":"Clementina","family":"L\u00f3pez-Medina","sequence":"additional","affiliation":[{"name":"Rheumatology, Reina Sofia University Hospital, IMIBIC, Univerisity of Cordoba, Cordoba, Spain"},{"name":"Department of Rheumatology, H\u00f4pital Cochin. Assistance Publique - H\u00f4pitaux de ParisINSERM (U1153): Clinical epidemiology and biostatistics PRES Sorbonne Paris-Cit\u00e9, Universit\u00e9 de Paris, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4704-8311","authenticated-orcid":false,"given":"Muhammad Asim","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3009-6229","authenticated-orcid":false,"given":"Maxime","family":"Dougados","sequence":"additional","affiliation":[{"name":"Hopital Cochin, Rheumatology, Universit\u00e9 Paris Descartes Facult\u00e9 de M\u00e9decine, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Magrey","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Case Western Reserve University, University Hospitals, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,7,25]]},"reference":[{"key":"2025090313350946000_9.3.e003179.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31591-4"},{"key":"2025090313350946000_9.3.e003179.2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.108233"},{"key":"2025090313350946000_9.3.e003179.3","doi-asserted-by":"crossref","DOI":"10.1111\/eci.12913","article-title":"Pathophysiology of axial Spondyloarthritis: consensus and controversies","volume":"48","author":"de Koning","year":"2018","journal-title":"Eur J Clin Invest"},{"key":"2025090313350946000_9.3.e003179.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197304052881403"},{"key":"2025090313350946000_9.3.e003179.5","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1093\/rheumatology\/kex345","article-title":"The clinical utility of human Leucocyte antigen B27 in axial Spondyloarthritis","volume":"57","author":"Lim","year":"2018","journal-title":"Rheumatology (Oxford)"},{"key":"2025090313350946000_9.3.e003179.6","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.152975"},{"key":"2025090313350946000_9.3.e003179.7","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-002-0237-4"},{"key":"2025090313350946000_9.3.e003179.8","doi-asserted-by":"crossref","unstructured":"Lorenzin M , Cozzi G , Scagnellato L , et al . Relationship between sex and clinical and imaging features of early axial Spondyloarthritis: results from a 48 month follow-up (Italian arm of the Spondyloarthritis caught early (SPACE) study). Scand J Rheumatol 2023:1\u201311. doi:10.1080\/03009742.2023.2169990","DOI":"10.1080\/03009742.2023.2169990"},{"key":"2025090313350946000_9.3.e003179.9","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2020-001450","article-title":"Prevalence and distribution of peripheral musculoskeletal manifestations in Spondyloarthritis including Psoriatic arthritis: results of the worldwide, cross-sectional ASAS-Perspa study","volume":"7","author":"L\u00f3pez-Medina","year":"2021","journal-title":"RMD Open"},{"key":"2025090313350946000_9.3.e003179.10","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1186\/s12891-017-1639-5","article-title":"HLA B27 antigen in middle Eastern and Arab countries: systematic review of the strength of association with axial Spondyloarthritis and methodological gaps","volume":"18","author":"Ziade","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"key":"2025090313350946000_9.3.e003179.11","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203582"},{"key":"2025090313350946000_9.3.e003179.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2009.11.015"},{"key":"2025090313350946000_9.3.e003179.13","doi-asserted-by":"publisher","DOI":"10.1002\/art.24483"},{"key":"2025090313350946000_9.3.e003179.14","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1186\/s13075-018-1724-7","article-title":"Influence of HLA-B27 on the Ankylosing Spondylitis phenotype: results from the REGISPONSER database","volume":"20","author":"Ar\u00e9valo","year":"2018","journal-title":"Arthritis Res Ther"},{"key":"2025090313350946000_9.3.e003179.15","first-page":"574","article-title":"Hla-B27 homozygosity has no influence on clinical manifestations and functional disability in ankylosing spondylitis","volume":"27","author":"Kim","year":"2009","journal-title":"Clin Exp Rheumatol"},{"key":"2025090313350946000_9.3.e003179.16","doi-asserted-by":"crossref","first-page":"609562","DOI":"10.3389\/fmed.2020.609562","article-title":"Comparison of clinical features in HLA-B27 positive and negative patients with axial spondyloarthritis: results from a cohort of 4,131 patients","volume":"7","author":"Zhang","year":"2020","journal-title":"Front Med"},{"key":"2025090313350946000_9.3.e003179.17","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1002\/acr.24174","article-title":"The phenotype of axial Spondyloarthritis: is it dependent on HLA-B27 status?","volume":"73","author":"Coates","year":"2021","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025090313350946000_9.3.e003179.18","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2022-002696","article-title":"Moreno M, et alAssociation between HLA-B27 and peripheral Spondyloarthritis phenotype: results from the ASAS perSpA study RMD","volume":"8","author":"Arevalo Salaet","year":"2022","journal-title":"RMD Open"},{"key":"2025090313350946000_9.3.e003179.19","first-page":"560","article-title":"Primary ankylosing spondylitis: patterns of disease in a Brazilian population of 147 patients","volume":"28","author":"Sampaio-Barros","year":"2001","journal-title":"J Rheumatol"},{"key":"2025090313350946000_9.3.e003179.20","doi-asserted-by":"crossref","unstructured":"Lorenzin M , Ometto F , Ortolan A , et al . An update on serum biomarkers to assess axial Spondyloarthritis and to guide treatment decision. Ther Adv Musculoskelet Dis 2020;12. doi:10.1177\/1759720X20934277","DOI":"10.1177\/1759720X20934277"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2023-003179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T20:35:20Z","timestamp":1756931720000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2023-003179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":20,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,7,25]]},"published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1136\/rmdopen-2023-003179"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2023-003179","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]}}}