{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:30:05Z","timestamp":1759336205557,"version":"build-2065373602"},"reference-count":31,"publisher":"The Journal of Rheumatology","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"accepted":{"date-parts":[[2025,5,14]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The HLA-B27 allele is strongly associated with spondyloarthritis (SpA). HLA-B27 is included in SpA classification criteria and referral strategies for axial SpA. Investigations of HLA-B27 testing in usual clinical practice are limited.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We identified all adult patients tested for HLA-B27 from January 1, 2022, to December 31, 2022, in the Mass General Brigham healthcare system. We examined patient demographics; ordering provider specialty; testing indication; concurrent testing with antinuclear antibodies (ANA), rheumatoid factor, and\/or anticyclic citrullinated peptide autoantibodies; and rheumatology referral. We compared the rate of rheumatology referral between HLA-B27\u2013positive and HLA-B27\u2013negative patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>HLA-B27 tests were ordered for 1960 patients (62.4% female; average age: 47.4 yrs). The most common specialties testing HLA-B27 were rheumatology (39.7%) and ophthalmology (21.4%). The most common indications for HLA-B27 testing were peripheral arthritis (33%), uveitis (22%), and back pain (16.7%). The majority of HLA-B27 tests (69.3%) were ordered concurrently with other autoantibody tests. A total of 11% of tested patients were HLA-B27 positive. Ophthalmology had the highest positive rate (15.4%), whereas reactive arthritis was the indication with the highest positive test rate (50%). A greater proportion of HLA-B27\u2013positive patients were referred to rheumatology (53% vs 32%; <jats:italic>P<\/jats:italic> = 0.002).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>HLA-B27 testing was frequently performed by rheumatologists and nonrheumatologists for a broad spectrum of indications. Cotesting HLA-B27 with ANA and rheumatoid arthritis autoantibodies was common. Nearly half of HLA-B27\u2013positive patients were not referred to rheumatology. Further efforts are needed to promote judicious use of HLA-B27 testing and optimize referral pathways to rheumatology.<\/jats:p>\n               <\/jats:sec>","DOI":"10.3899\/jrheum.2025-0167","type":"journal-article","created":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T08:25:18Z","timestamp":1748766318000},"page":"1021-1027","source":"Crossref","is-referenced-by-count":0,"title":["HLA-B27 Testing in Clinical Practice: A Retrospective Analysis of Testing Indications and Rheumatology Referral Patterns"],"prefix":"10.3899","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9750-5448","authenticated-orcid":false,"given":"Gregory C.","family":"McDermott","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8748-6034","authenticated-orcid":false,"given":"Mathieu","family":"Choufani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armaan","family":"Monshizadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3836-9404","authenticated-orcid":false,"given":"Joerg","family":"Ermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2262","published-online":{"date-parts":[[2025,6,1]]},"reference":[{"key":"2025100105301407000_52.10.1021.1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000946"},{"key":"2025100105301407000_52.10.1021.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(73)91360-3"},{"key":"2025100105301407000_52.10.1021.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197304052881403"},{"key":"2025100105301407000_52.10.1021.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(73)91090-8"},{"key":"2025100105301407000_52.10.1021.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(73)91091-X"},{"key":"2025100105301407000_52.10.1021.6","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/S0140-6736(74)91262-8","article-title":"HL-A 27 and arthropathies associated with ulcerative colitis and psoriasis","volume":"1","author":"Brewerton","year":"1974","journal-title":"Lancet"},{"key":"2025100105301407000_52.10.1021.7","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.108233"},{"key":"2025100105301407000_52.10.1021.8","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-207151"},{"key":"2025100105301407000_52.10.1021.9","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2012.39"},{"key":"2025100105301407000_52.10.1021.10","doi-asserted-by":"crossref","first-page":"105579","DOI":"10.1016\/j.jbspin.2023.105579","article-title":"What is the best referral strategy for axial spondyloarthritis? 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