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Prevalence of spondyloarthritis in reference to HLA-B27 in the French population: results of the GAZEL cohort
  1. Félicie Costantino1,2,
  2. Alice Talpin1,2,
  3. Roula Said-Nahal3,
  4. Marcel Goldberg4,5,
  5. Joseph Henny4,5,
  6. Gilles Chiocchia1,2,5,
  7. Henri-Jean Garchon1,2,5,6,
  8. Marie Zins4,5,
  9. Maxime Breban1,2,3,5
  1. 1Institut Cochin, Université Paris Descartes, Paris, France
  2. 2INSERM U1016, Paris, France
  3. 3Rheumatology Division, Ambroise Paré Hospital (AP-HP), Boulogne-Billancourt, France
  4. 4Population-Based Epidemiological Cohorts, Research Platform, UMRS 1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
  5. 5UFR des Sciences de la Santé, Simone Veil, Versailles Saint Quentin en Yvelines University, Montigny-Le-Bretonneux, France
  6. 6Genetics Division, Ambroise Paré Hospital (AP-HP) Boulogne-Billancourt, France
  1. Correspondence to Professor Maxime Breban, Rheumatology Division, Hôpital Ambroise Paré, 9 ave Charles de Gaulle, Boulogne 92100, France; maxime.breban{at}apr.aphp.fr

Abstract

Objective To estimate the prevalence of spondyloarthritis (SpA) in reference to HLA-B27 in the French population.

Methods In 1989, 20 625 employees of the French national gas and electricity company aged 35–50 years were enrolled in the GAZEL cohort. In 2010, 18 757 still active participants were screened by a questionnaire validated for the detection of SpA. Responders with available DNA were retained for further studies. Pelvic radiograph and HLA-B27 typing were performed in all the self-reported cases of SpA or psoriatic arthritis. Self-reported diagnosis was verified by a qualified rheumatologist. HLA-B27 determination was also performed in subjects without any SpA feature.

Results The target population consisted of 6556 responders with available DNA. Their male:female ratio was 3.6 and their mean age was 65.5±3.3 years. A diagnosis of SpA was confirmed in 32 of the 72 self-reported cases, 75% of them being HLA-B27 positive. Estimated SpA prevalence adjusted for sex was 0.43% (95% CI 0.26% to 0.70%). HLA-B27 positivity rate in 2466 healthy controls was 6.9% (95% CI 5.9% to 7.9%). The relative risk of SpA in HLA-B27 positive individuals was 39 (95% CI 17 to 86).

Conclusions We estimated the prevalence of SpA in the French population in 2010 to 0.43%. With an estimated prevalence of 75.0% in SpA and 6.9% in healthy controls, HLA-B27 increased the disease risk 39-fold, as compared with HLA-B27 negative subjects.

  • Ankylosing Spondylitis
  • Spondyloarthritis
  • Epidemiology

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