This Genetic marker may predict Long-Term Outcomes in Juvenile Idiopathic Arthritis: Study
Researchers have found in a new research that HLA-B27 genetic marker is linked to a higher risk of various arthropathies, including juvenile idiopathic arthritis (JIA), but its prognostic value has been uncertain. The large Scandinavian study further found that juvenile idiopathic arthritis patients carrying HLA-B27, particularly males, had worse long-term outcomes in adulthood, including lower rates of drug-free remission. These findings suggest that HLA-B27 may serve as a key indicator of disease progression and prognosis in juvenile idiopathic arthritis.
Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease with heterogeneous presentations and outcomes. Previously, it was shown that human leukocyte antigen B27 (HLA-B27) was negatively associated with remission status eight years after disease onset.
This study aimed to investigate the associations of HLA-B27 with clinical features and disease outcomes 18 years after the onset of juvenile idiopathic arthritis. A total of 434 patients from the population-based Nordic juvenile idiopathic arthritis cohort were studied, with demographic and clinical data, including remission status, collected consecutively at baseline, eight years after disease onset, and 18 years after disease onset, and analyzed in relation to HLA-B27 status. Among the 434 participants, HLA-B27 status was available for 416 individuals (96%), of whom 93 (22.4%) were HLA-B27 positive, with a higher prevalence in men (P = 0.01).
The sacroiliac, hip, and subtalar joints were more frequently involved in individuals with HLA-B27 positivity compared to those without. Furthermore, in nearly half of the individuals who were both HLA-B27 positive and had uveitis, the uveitis was asymptomatic. Several clinical manifestations, including uveitis, inflammatory back pain, sacroiliitis, arthritis in the hip, tarsal, and subtalar joints, as well as enthesitis during the disease course, were all associated with a lower likelihood of achieving remission off medication. HLA-B27 positivity was significantly linked to an increased risk of not being in remission off medication 18 years after disease onset, with an odds ratio (OR) of 2.6, and this association was particularly strong in men (OR 5.6).
Clinical features consistent with spondylarthropathies were more frequently observed in patients who were HLA-B27 positive and were associated with worse long-term disease outcomes, particularly with an increased likelihood of nonremission 18 years after disease onset, especially in men. These findings highlight the adverse impact of HLA-B27 positivity on the long-term prognosis of individuals with juvenile idiopathic arthritis.
Reference:
Ekelund M, et al "Clinical impact of HLA-B27 on juvenile idiopathic arthritis: Eighteen years of follow-up in the population-based Nordic juvenile idiopathic arthritis cohort" ACR Open Rheumatol 2025; DOI: 10.1002/acr2.70005.
