Document Detail


HLA DRB1*01 and DRB1*04 phenotyping does not predict the need for joint surgery in rheumatoid arthritis. A retrospective quantitative evaluation of 300 French patients.
MedLine Citation:
PMID:  15301244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine if the presence of HLA-DR disease-associated epitopes predicts the need for total joint arthroplasty or joint fusion in rheumatoid arthritis (RA). METHODS: Tertiary-referral, monocenter study. Three hundred RA patients (1987 ACR criteria) were retrospectively evaluated; outcome measure was recourse to total joint arthroplasty, joint fusion or bone resection. HLA-DR1 and DR4 were considered as the disease-associated epitopes (subtypes were not available for analysis). Analysis was performed using the lifetable method (Kaplan-Meyer technique). RESULTS: Of the 300 patients included, 78% were women, mean age: 56+/-14 years, mean RA follow-up: 12+/-9 years. Phenotyping: 73% of patients carried one (52%) or two (21%) disease-associated epitopes. Surgery was performed on 24% of the patients during follow-up. The most frequent surgery was total hip arthroplasty (13% of patients). According to lifetable analysis, 13% of patients had surgery (total joint arthroplasty or joint fusion) after 10 years of follow-up, 34% after 20 years. years of follow-up, There was no statistically significant difference in recourse to surgery according to absence or presence (single or double-dose) of disease-associated epitopes. Similar results were observed if the event was the second surgical procedure on a given patient. CONCLUSION: This study failed to demonstrate a relation between HLA phenotyping and the severity of RA defined by the requirement for surgery.
Authors:
L Gossec; I Bettembourg-Brault; T Pham; M Dougados
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and experimental rheumatology     Volume:  22     ISSN:  0392-856X     ISO Abbreviation:  Clin. Exp. Rheumatol.     Publication Date:    2004 Jul-Aug
Date Detail:
Created Date:  2004-08-10     Completed Date:  2004-09-07     Revised Date:  2005-05-14    
Medline Journal Info:
Nlm Unique ID:  8308521     Medline TA:  Clin Exp Rheumatol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  462-4     Citation Subset:  IM    
Affiliation:
Service de Rhumatologie B, Université René Descartes, Centre Hospitalier Universitaire Cochin, Paris, France. laure.gossec@cch.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Arthritis, Rheumatoid* / genetics,  immunology,  physiopathology,  surgery
Female
Genetic Predisposition to Disease*
HLA-DR Antigens / genetics*
Humans
Male
Middle Aged
Orthopedic Procedures* / statistics & numerical data
Outpatients
Predictive Value of Tests
Retrospective Studies
Chemical
Reg. No./Substance:
0/HLA-DR Antigens; 128338-86-3/HLA-DRB1 antigen

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