Responses

HLA-B27, axial spondyloarthritis and survival
Free
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests

PLEASE NOTE:

  • A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses.
  • We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
  • Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
  • By submitting this rapid response you are agreeing to our terms and conditions for rapid responses and understand that your personal data will be processed in accordance with those terms and our privacy notice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    Response to HLA-B27, axial spondyloarthritis and survival by Zhixiu Li et al.
    • Hasan Yazici, Professor of rheumatology Academic Hospital. Istanbul, Turkey
    • Other Contributors:
      • Becemhan Sulu, Rheumatology fellow
      • Sinem Nihal Esatoglu, Rheumatologist

    The authors report that AS is associated with an increased mortality, more so among the females (1). Their observations further strengthen the recent understanding that women are not so lucky (2) after all, when they acquire AS. However, we would like to point out to a neglected point in the current report, an issue related to the proposed sex differences in the risk of death.
    The mean age of entry of AS patients into this work was 44 years. On the other hand, we know that AS usually starts well before age 30 and according to one study, at a median age of 25 for males and 28 for females (3). Thus, most of the patients in the current report had AS years before entering this study. Therefore, the current report really concerns the fate of AS patients after quite a number of years of disease duration. A previous study about mortality in AS had shown that males and females had a similar survival after disease onset for about a decade after which the decrease in male survival became apparent. On the other hand, it took 35 years from disease onset when the female survival began to decrease (4). It follows that the design of the current work does not allow us to assess the survival of AS from the time of disease onset.
    Finally, we surely agree with the authors that more work is needed to assess the proposed increased mortality among women with AS.

    Conflict of Interest:
    None declared.
  • Published on:
    Correspondence on 'HLA-B27, Axial Spondyloarthritis, and Survival'
    • Sung Huang Laurent Tsai, MD, MPH, Orthopedic Surgeon Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung 204, and School of Medicine, Chang Gung
    • Other Contributors:
      • James Cheng-Chung Wei, MD, PhD., Physician

    We were intrigued by the recently published paper in the Annals of Rheumatic Diseases titled "HLA-B27, Axial Spondyloarthritis, and Survival" by Li et al.[1] This study explores the association between HLA-B27 carriage, axial spondyloarthritis (axSpA), and survival, offering valuable insights. By combining data from a 35-year follow-up study of Ankylosing Spondylitis (AS) and axSpA patients with the extensive UK Biobank dataset, the study significantly enhances our understanding of mortality patterns in AS/axSpA and the potential impact of HLA-B27 in the general population. We consider this study's implications important and look forward to critically examining its key findings and broader implications. However, there are some concerns that would better be clarified.

    First and foremost, the observed gender-based differences in AS mortality are intriguing, with women generally exhibiting less severe sacroiliac joint damage.[2] However, an important consideration is the potential influence of HPV infection.[3] Surprisingly, the original study did not account for this factor, despite previous research linking HPV infection to autoimmune diseases, including AS, and suggesting a significantly elevated risk for AS development in HPV-infected individuals.[4] These findings underscore the complex interplay between infectious agents and autoimmune conditions. Additionally, prior research has indicated higher mortality in HPV-infected patients, emphasizing the...

    Show More
    Conflict of Interest:
    None declared.