Gene Linked to Early Death in Inflammatory Arthritis

HLA-DRB1 genotype, smoking and anti-CCP antibodies associated with highest risk

TUESDAY, Feb. 5 (HealthDay News) -- Individuals with inflammatory polyarthritis with shared epitope (SE) alleles of the HLA-DRB1 gene are at increased risk of premature death, according to an article published in Arthritis & Rheumatism in February.

Tracey M. Farragher, Ph.D., of the University of Manchester in the United Kingdom, and colleagues prospectively followed a cohort of 1,022 patients with inflammatory polyarthritis in order to investigate the association between the HLA-DRB1 (including SE) and PTPN22 genes, and the risk of death from cardiovascular disease and other causes.

During the follow-up period, 751 patients (74 percent) met criteria for rheumatoid arthritis. In total, 242 patients (24 percent) died. Carrying two copies of SE alleles was associated with an increased risk of death from all causes (hazard ratio, 1.57) and from cardiovascular disease (HR, 1.68). Risk of death was greatest in patients who smoked, carried SE alleles and had anti-cyclic citrullinated peptide (anti-CCP) antibodies (HR, 7.81). The PTPN22 gene was not associated with an increased risk of mortality.

"In conclusion, we found that HLA-DRB1 genotypes previously associated with vasculitis and extraarticular disease in rheumatoid arthritis were associated with premature death in patients with inflammatory polyarthritis," write the authors. "This knowledge could facilitate a targeted prevention program for cardiovascular disease in patients with inflammatory polyarthritis and rheumatoid arthritis."

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