Mortality Among Patients With AS and nr-axSpA

Life expectancy is shorter in patients with ankylosing spondylitis (AS), but not nonradiographic axial spondyloarthritis (nr-axSpA), compared with the general population, according to study findings published online ahead of print in Annals of the Rheumatic Diseases.

“Increased mortality is particularly significant among women with HLA-B27-positive AS,” wrote corresponding author Matthew A. Brown, MBBS, MD, of Genomics England Ltd, London, United Kingdom, and study coauthors.

The study investigated whether mortality was higher in people with AS, as well as with HLA-B27 gene carriage. Researchers analyzed data from a 35-year AS follow-up study and UK Biobank data for the general population.

In the AS study, the standardized mortality rate (SMR) was 1.37 for patients with AS and 1.38 for patients with HLA-B27-positive AS compared with the general population, according to the study. Among patients with AS, HLA-B27-positivity was associated with shortened life expectancy in both sexes: SMRs were 1.77 for female patients and 1.31 for male patients. However, the SMR in patients with nr-axSpA was a significantly lower 0.44 compared with the general population.

In the UK Biobank cohort, HLA-B27 carriage was not significantly associated with any mortality differences in either men or women, the study found.

“HLA-B27 carriage in the European-ancestry general population does not influence survival, or the risk of death due to vascular disease,” researchers wrote.

Reference:
Li Z, Khan MK, van der Linden SM, et al. HLA-B27, axial spondyloarthritis and survival. Ann Rheum Dis. Published online September 7, 2023. doi:10.1136/ard-2023-224434