HLA-B27 Status Influences Axial Spondyloarthritis Inflammation Profile

NEW data from a Saudi MRI-based cohort show HLA-B27 status shapes the clinical phenotype of axial spondyloarthritis (axSpA), particularly influencing systemic inflammation and extra-musculoskeletal manifestations.

Researchers analyzed 84 patients with MRI-confirmed axSpA. Of them, 32 were HLA-B27 positive, 52 negative. Positive cases were more often male, had higher C-reactive protein levels, and showed increased rates of uveitis and family history of spondyloarthritis.

Spinal inflammation on MRI was more common in HLA-B27-positive patients, though not statistically significant. Diagnostic delay remained substantial across both groups, with no difference in biologic therapy use.

Findings suggest HLA-B27 defines a more inflammatory phenotype but does not alter diagnosis timing or treatment decisions. MRI confirmation remains critical, especially in non-Western populations with varying HLA-B27 expression.