1. Association of (Q)R/KRAA positive HLA-DRB1 alleles with disease progression in early active and severe rheumatoid arthritis
- Author
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Seidl C, Koch U, Buhleier T, Burkhard Möller, Wigand R, Markert E, Koller-Wagner G, Seifried E, and Jp, Kaltwasser
- Subjects
Adult ,Male ,Histocompatibility Testing ,HLA-DR Antigens ,Middle Aged ,Severity of Illness Index ,Arthritis, Rheumatoid ,Haplotypes ,Antirheumatic Agents ,Disease Progression ,Humans ,Female ,Joints ,Arthrography ,Alleles ,Aged ,Follow-Up Studies ,HLA-DRB1 Chains - Abstract
We have shown that HLA-DRB1 alleles influence inflammatory activity in patients with early active and severe rheumatoid arthritis (RA). Therefore, we analyzed the effect of HLA-DRB1 alleles on disease progression in patients with early RA during a clinical followup period of 18 months.Disease progression was defined by the Larsen Score, the Ritchie Index (RI), and the Health Assessment Questionnaire (HAQ) score.Patients carrying arthritogenic HLA-DRB1 alleles on one or both haplotypes are characterized by increased radiological joint destruction (Larsen Score). Further, (Q)R/KRAA homozygous patients were characterized by worse overall disease course (higher RI and HAQ). However, analysis of changes in joint effects (delta-RI) and personal disability (delta-HAQ) did not reveal significant differences between patients with or without disease associated HLA-DRB1 alleles.The predisposing genetic pattern with disease associated HLA-DRB1 alleles did not profoundly influence the therapeutic outcome. Our data support the role of the HLA-DRB1 gene locus in disease modulation of RA. The genetic predisposition due to HLA-DRB1, however, may have only a limited influence on the therapeutic outcome in clinically severe cases of RA.