RESEARCH - The value of HLA-DRB1 SE, -308 TNF gene promoter polymorphism, RF, anti-CCP, and early erosions for predicting radiologic outcome in RA

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J Rheumatol. 2009 May 1.

The Value of HLA-DRB1 Shared Epitope, -308 Tumor Necrosis

Factor-{alpha} Gene Promoter Polymorphism, Rheumatoid Factor,

Anti-Citrullinated Peptide Antibodies, and Early Erosions for

Predicting Radiological Outcome in Recent-Onset Rheumatoid Arthritis.

Reneses S, González-Escribano MF, Fernández-Suárez A, Pestana L,

Davila B, Wichmann I, García A.

From the Department of Rheumatology and Department of Immunology,

Virgen del Rocío University Hospital, Seville, Spain; Biotechnology

Area, Alto Guadalquivir Hospital, Andújar, Spain; and Language

Services, World Health Organization, Geneva, Switzerland.

OBJECTIVE: To study the value of HLA-DRB1 shared epitope (SE), -308

tumor necrosis factor-alpha (TNF-alpha) gene promoter polymorphism,

rheumatoid factor (RF), anti-citrullinated peptide antibodies

(anti-CCP), and baseline erosions for predicting radiological outcome

at 1 year in patients with recent-onset rheumatoid arthritis (RA).

METHODS: Radiological damage was assessed by radiographs at baseline

and at 1 year in an inception cohort of 134 RA patients with disease

duration </= 1 year at study entry. Radiographs were scored with the

modified Sharp/van der Heijde (SvdH) erosion score for hands, wrists,

and feet. The predictive value of the variables was studied by

multiple linear regression analysis, using immunogenetic factors,

baseline SvdH erosion score, and type of treatment during the followup

period as independent variables, and SvdH erosion score at 1 year as

the dependent variable.

RESULTS: The SvdH erosion score increased from the baseline visit to

the 1-year visit in 49 patients (36.6%). In multiple linear regression

analysis, radiological outcome was significantly predicted by SE

homozygosity (ss coefficient 1.75; 95% CI 1.54, 2.96; p = 0.005) and

baseline SvdH erosion score (ss coefficient 1.56; 95% CI 1.4, 1.71; p

< 0.001). This model explained 78% of the variability of the dependent

variable (R2 = 0.779).

CONCLUSION: Erosive damage at 1 year in patients with recent-onset RA

is significantly influenced by SE homozygosity and the presence of

baseline erosions, but not by RF status, anti-CCP status, or -308

TNF-alpha genotype.

PMID: 19411391

http://www.ncbi.nlm.nih.gov/pubmed/19411391

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