Genotyping for disease associated HLA DR beta 1 alleles and the need for early joint surgery in rheumatoid arthritis: a quantitative evaluation

Anne Crilly, Nicola Maiden, Hilary A. Capell, Rajan Madhok

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

OBJECTIVE: To determine the value of HLA DR beta 1 disease associated epitope (DAE) and erythrocyte sedimentation (ESR) in predicting the need for major joint replacement in rheumatoid arthritis (RA).

METHODS: Sixty five RA patients who had undergone hip, knee or shoulder arthroplasty within 15 years of disease onset and 65 who had not. HLA DR beta 1 genotype was determined by polymerase chain reaction. ESR at first hospital visit was noted.

RESULTS: Significantly more patients with two DAE required surgery, (32% v 9%), chi 2 = 13.9, p = 0.001, odds ratio = 5.4 (95% CI: 1.8, 16). Sensitivity was poor, 32%, specificity high, 91%. Presentation ESR was higher in surgery patients compared with non-surgery patients, 52 mm 1st h v 25 mm 1st h, p < 0.001, but was independent of DAE status. Sensitivity of an ESR of 30 mm 1st h was 75%, specificity 53%.

CONCLUSION: The presence of two DAE is a risk factor for major joint surgery in RA and is independent of ESR, whereas in those with one or no DAE, a high ESR is an important predictor.

Original languageEnglish
Pages (from-to)114-7
Number of pages4
JournalAnnals of the Rheumatic Diseases
Volume58
Issue number2
Publication statusPublished - Feb 1999
Externally publishedYes

Keywords

  • Aged
  • Alleles
  • Arthritis, Rheumatoid
  • Arthroplasty
  • Blood Sedimentation
  • Case-Control Studies
  • Epitopes
  • Female
  • Genotype
  • HLA-DR Antigens
  • HLA-DRB1 Chains
  • Humans
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Predictive Value of Tests
  • Risk Factors
  • Sensitivity and Specificity

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