Clinical Expression of Radiographic Axial Spondyloarthritis and Its Association with HLA-B27 in European and Ibero-American Populations: Data from the REGISPONSER and RESPONDIA Registries

Maria Angeles Puche-Larrubia¹, María Lourdes Ladehesa-Pineda², Pilar Font³, Rubén Burgos Vargas⁴, Percival Sampaio-Barros⁵, José Maldonado Cocco⁶, Anabela Barcelos⁷, Jordi Gratacos Masmitja⁸, Xavier Juanola⁹, Alejandro Escudero-Contreras³, Janitzia Vázquez Mellado⁴, Iván Arias-de la Rosa¹⁰, Eduardo Collantes-Estevez¹¹ and Clementina López Medina¹², ¹Reina Sofía University Hospital, Cordoba, Spain, ²IMIBIC/Reina Sofia Hospital/University of Cordoba, Cordoba, Andalucia, Spain, ³IMIBIC/Reina Sofia Hospital/University of Cordoba, Cordoba, Spain, ⁴Department of Rheumatology, Hospital General de México and Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico, Mexico, ⁵Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil, ⁶Rheumatology, Buenos Aires University School of Medicine, Buenos Aires, Argentina, ⁷Rheumatology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal, ⁸University Hospital Parc Taulí, Sabadell, Spain, ⁹Department of Rheumatology, Hospital Universitari de Bellvitge, Barcelona, Spain, ¹⁰Rheumatology Service, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain, ¹¹Rheumatology Service, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba 14012, Spain, ¹²Reina Sofia University Hospital, Cordoba, Spain

Meeting: ACR Convergence 2024

Keywords: spondyloarthritis

Session Information

Date: Saturday, November 16, 2024

Title: SpA Including PsA – Diagnosis, Manifestations, & Outcomes Poster I

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: To date, few comparative studies have explored how ethnic and geographical differences impact the clinical presentation and management of Spondyloarthritis (SpA). Moreover, no studies have evaluated these differences according to the presence of HLA-B27 which could confirm or refute whether differences in phenotypes between European and Latin American patients are due to the unbalanced distribution of this antigen.

The objective of this study is to compare the sociodemographic and clinical characteristics of Ibero-American patients with radiographic axial SpA (r-axSpA) to those of European patients, with a particular focus on the influence of HLA-B27.

Methods: This was an observational, cross-sectional, and multicentre study of patients who fulfilled the European Spondyloarthropathy Study Group (ESSG) criteria for SpA from the REGISPONSER (Registry of Spondyloarthritis of Spanish Rheumatology) and RESPONDIA (Ibero-American Registry of Spondyloarthropathies) registries. Univariate and multivariate analyses between European and Ibero-American populations stratified by HLA-B27 status were conducted. Race stratification (White, Black American, and Indian American) was also performed to evaluate clinical differences according to HLA-B27.

Results: A total of 2592 patients with a clinical diagnosis of r-axSpA were included in the analysis: 1083 (41.8%) Ibero-American and 1509 (58.2%) European. Among the HLA-B27-positive patients, factors independently associated with Ibero-American patients were the higher use of conventional synthetic disease-modifying antirheumatic drugs (csDMARD) (OR: 4.21), arthritis (OR: 2.36), enthesitis (OR: 6.01), dactylitis (OR: 6.10), severe structural damage (BASRI) (OR: 1.12) and poor functionality (BASFI) (OR: 1.40). Multivariate analysis in HLAB27-negative patients revealed that Ibero-American status was independently associated with enthesitis (OR: 11.67), csDMARDs (OR: 15.51) and total BASRI (OR: 1.34) (Figure 1). Clinical manifestations also varied across racial groups, with differences noted in the prevalence of peripheral joint manifestations such as more arthritis and enthesitis in American Indian patients than in White and Black American patients (Table 1).

Conclusion: Compared with patients from Europe, the Ibero-American r-axSpA patients exhibited more peripheral manifestations, more structural damage, and worse functionality, regardless of the presence of HLA-B27. Along with American Indian patients, Black American patients had a greater prevalence of peripheral manifestations and a greater loss of functionality regardless of HLA-B27 positivity.

Figure 1. Factors associated with Ibero-American countries versus European countries

Disclosures: M. Puche-Larrubia: None; M. Ladehesa-Pineda: None; P. Font: None; R. Burgos Vargas: None; P. Sampaio-Barros: None; J. Maldonado Cocco: None; A. Barcelos: None; J. Gratacos Masmitja: None; X. Juanola: None; A. Escudero-Contreras: None; J. Vázquez Mellado: None; I. Arias-de la Rosa: None; E. Collantes-Estevez: None; C. López Medina: AbbVie, 2, 5, 6, Eli Lilly, 2, 5, 6, Janssen, 6, MSD, 6, Novartis, 2, 5, 6, UCB Pharma, 2, 5, 6.

To cite this abstract in AMA style:

Puche-Larrubia M, Ladehesa-Pineda M, Font P, Burgos Vargas R, Sampaio-Barros P, Maldonado Cocco J, Barcelos A, Gratacos Masmitja J, Juanola X, Escudero-Contreras A, Vázquez Mellado J, Arias-de la Rosa I, Collantes-Estevez E, López Medina C. Clinical Expression of Radiographic Axial Spondyloarthritis and Its Association with HLA-B27 in European and Ibero-American Populations: Data from the REGISPONSER and RESPONDIA Registries [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/clinical-expression-of-radiographic-axial-spondyloarthritis-and-its-association-with-hla-b27-in-european-and-ibero-american-populations-data-from-the-regisponser-and-respondia-registries/. Accessed .

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