Clinical and immunogenetic prognostic factors for radiographic severity in ankylosing spondylitis

Abstract

Objective. To improve prognostic ability in ankylosing spondylitis (AS), we sought to identify demographic, clinical, and immunogenetic characteristics associated with radiographic severity in a large cohort of patients. Methods. Patients with AS for >20 years were enrolled in a cross-sectional study (n ‫؍‬ 398). Pelvic and spinal radiographs were scored using the Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s), and radiographic severity was measured as the BASRI-s/duration of AS. Clinical factors and HLA-B, DR, DQ, and DP alleles associated with the highest quartile of the distribution of radiographic severity were identified by first using random forests and then using multivariable logistic regression modeling. Similar procedures were used to identify factors associated with the lowest quartile of radiographic severity. Conclusion. The accuracy of the prognosis of radiographic severity in AS is improved by knowing the age at disease onset, sex, smoking history, and the presence of HLA-B*4100, DRB1*0804, DQA1*0401, DQB1*0603, DRB1*0801, and DPB1*0202 alleles. Results. Radiographic severity (being in the top quartile of BASRI-s/duration of AS) was associated with older age at onset of AS (odds ratio

The Correlation between Pack-Years of Smoking and Disease Activity, Quality of Life, Spinal Mobility, and Sacroiliitis Grading in Patients with Ankylosing Spondylitis

“…[7,[13][14][15][16][17] However, the relationship between smoking and radiographic severity has not been consistent in the literature. [3][4][5][6][7][8][9][10][11][12][13][14][15]18] To our knowledge, the first survey which exposed the connection between smoking and AS patient outcomes was by Averns et al [15] in 1996. This investigation was included AS patients with a median duration of 20 years, and the authors found significant differences between smokers and non-smokers with regard to the finger-floor distance, Schober's test, total spinal involvement, occiput-to-wall distance, functional status, stiffness, and spinal radiographic damage.…”

“…In addition, Ward et al [3] revealed that radiographic severity is predicted by a history of smoking as well as age at disease onset, male gender, and some HLA alleles.…”

“…), a family history of AS, and age at disease onset have been reported to affect the clinical manifestations or severity of AS. [3][4][5][6][7] Smoking is one of the modifiable lifestyle factors that has been proposed as being responsible for the more severe form of AS in recent years. [5] Conversely, to the best of our knowledge, only a few studies have focused on the relationship between the quantity of smoking (pack-years) and severity markers in AS.…”

“…[5] Conversely, to the best of our knowledge, only a few studies have focused on the relationship between the quantity of smoking (pack-years) and severity markers in AS. [3,5] Furthermore, a variety of environmental factors can affect disease activity, quality of life (QoL), and disease progression in communities and geographic regions with heterogeneous genetic patterns. Therefore, we sought to determine the correlation between pack-years of smoking on disease activity, QoL, and spinal mobility in a group of Iranian patients with ankylosing spondylitis (AS).…”

Ankylosing Spondylitis: Patterns of Radiographic Involvement—A Re-examination of Accepted Principles in a Cohort of 769 Patients

“…Patients examined for this study were part of a large cohort enrolled at fi ve institutions to characterize the genetic risk for susceptibility and severity of AS. Patients were recruited from the clinics of the investigators, local rheumatologists, from patient support and advocacy groups, and from the community by advertisements (2)(3)(4). Enrollment occurred between February 2002 and January 2009.…”