Human leukocyte antigen-B27 status is not suggestive of treatment response in psoriatic arthritis axial disease

A study published in the American college of rheumatology Open Rheumatology has concluded that the human leukocyte antigen-B27(HLA-B27) status is not predictive of biologic disease-modifying antirheumatic drugs (bDMARDs) or targeted synthetic DMARDs (tsDMARDs) response in patients with psoriatic arthritis (PsA) axial disease.

The observational study was conducted by Philip J Mease and co-researchers by collecting the patient data from CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry between April 1, 2013, to March 26, 2020. The researchers selected patients fulfilling Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of ≥4 at baseline, Classification Criteria for Psoriatic Arthritis (CASPAR), and known HLA-B27 status. Out of 173 patients considered, 54 patients were with positive HLA-B27 status and 119 with negative HLA-B27 status. The 6 months of bDMARD or tsDMARD therapy did not yield clinically meaningful results, as the decrease in BASDAI total and component scores noted were only ≤0.84. The corresponding mean change in BASDAI score and ASDAS-CRP noted from baseline to 6 months in HLA-B27-positive and HLA-B27-negative groups were −0.80 (1.75) and −0.36 (1.11), − 0.84 (2.24), and − 0.73 (1.16). Researchers noted no significant association between HLA-B27 status and disease measures change from baseline to 6 months after treatment initiation. Axial-related disease activity remained high even after 6 months of treatment with bDMARD or tsDMARD therapies with 5.8 to 6.9 scores for all BASDAI-related measures, and these values were above the threshold for active, moderate, and severe diseases (defined as scores ≥4)

The present study reported that there is no role for HLA-B27 positivity in predicting bDMARD or tsDMARD treatment response in patients with axial PsA and post 6 months of treatment mild improvements were noted for axial disease-related outcomes. The study highlights the need for safe and effective therapies for psoriatic axial disease and attention on the axial domain of PSA. Further advanced research is also warranted to furnish a validated, consensus definition of axial PsA.

Reference: Mease PJ, Chakravarty SD, McLean RR, Blachley T, Kawashima T, Lin I, Kavanaugh A, Ogdie A. Treatment Responses in Patients With Psoriatic Arthritis Axial Disease According to Human Leukocyte Antigen-B27 Status: An Analysis From the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry. ACR Open Rheumatol. 2022 Feb 26 DOI: 10.1002/acr2.11416.