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*For medical professionals to read and refer to clinical information, 1s touches▎Clinical question: Is there any concern about the occurrence and development of axial spondyloarthritis (axSpA) in first-degree relatives (FDRs) of patients with ankylosing spondylitis (AS) Predictive factors? For FDRs in AS patients, the factors that predict axSpA are unknown
.
A study from Annals of Rheumatology followed up for 35 years and analyzed HLA-B27 levels, radiographic sacroiliitis status, clinical history including chronic inflammatory back pain (CIBP), acute anterior uveitis (AAU) and many other factors to predict its value for the development of axSpA
.
Screenshot of the literature▎Research plan: This study established a follow-up cohort in 1985 (AS=363, FDR=806) and improved clinical diagnosis, imaging, blood sample retention and other work, and followed up again in 2018-2019 (AS=125, FDR=360) and returned the questionnaire
.
▎Main findings: In HLA-B27(+) FDR, a total of 25.
4%-26.
3% developed axSpA, and the occurrence of axSpA was not related to the radiographic sacroiliitis status of relatives
.
AAU occurred in 13 of 34 FDRs with axSpA (38.
2%) and 29 of 251 FDR without axSpA (11.
6%) (P=0.
00004, OR=4.
74, 95%CI 2.
15-10.
47)
.
The presence of CIBP at baseline did not predict axSpA
.
However, at the 2018-2019 follow-up assessment, combining CIBP with a history of previous pain/discomfort in the thoracic spine and anterior chest wall (ventral) had 83.
1% sensitivity and 87.
2% specificity for predicting axSpA
.
▎Deficiencies and prospects: The results of this study suggest that further screening for axSpA is required for the first-degree relatives of probands with axSpA if AAU occurs
.
Combining AAU, CIBP, and pain/discomfort in the thoracic spine and anterior chest wall into a three-phase questionnaire was helpful in the clinical suspicion of axSpA in these DFRs
.
.
A study from Annals of Rheumatology followed up for 35 years and analyzed HLA-B27 levels, radiographic sacroiliitis status, clinical history including chronic inflammatory back pain (CIBP), acute anterior uveitis (AAU) and many other factors to predict its value for the development of axSpA
.
Screenshot of the literature▎Research plan: This study established a follow-up cohort in 1985 (AS=363, FDR=806) and improved clinical diagnosis, imaging, blood sample retention and other work, and followed up again in 2018-2019 (AS=125, FDR=360) and returned the questionnaire
.
▎Main findings: In HLA-B27(+) FDR, a total of 25.
4%-26.
3% developed axSpA, and the occurrence of axSpA was not related to the radiographic sacroiliitis status of relatives
.
AAU occurred in 13 of 34 FDRs with axSpA (38.
2%) and 29 of 251 FDR without axSpA (11.
6%) (P=0.
00004, OR=4.
74, 95%CI 2.
15-10.
47)
.
The presence of CIBP at baseline did not predict axSpA
.
However, at the 2018-2019 follow-up assessment, combining CIBP with a history of previous pain/discomfort in the thoracic spine and anterior chest wall (ventral) had 83.
1% sensitivity and 87.
2% specificity for predicting axSpA
.
▎Deficiencies and prospects: The results of this study suggest that further screening for axSpA is required for the first-degree relatives of probands with axSpA if AAU occurs
.
Combining AAU, CIBP, and pain/discomfort in the thoracic spine and anterior chest wall into a three-phase questionnaire was helpful in the clinical suspicion of axSpA in these DFRs
.
