Antifibrillarin antibodies are associated with native north American ethnicity and poorer survival in systemic sclerosis
Date
2017
Authors
Otero, C.
Assassi, S.
Hudson, M.
Mayes, M.
Estrada-Y-Martin, R.
Pedroza, C.
Mills, T.
Walker, J.
Baron, M.
Stevens, W.
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Journal Title
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Journal article
Citation
Journal of Rheumatology, 2017; 44(6):799-805
Statement of Responsibility
Carolina Mejia Otero, Shervin Assassi, Marie Hudson, Maureen D. Mayes, Rosa Estrada-Y-Martin, Claudia Pedroza, Tingting W. Mills, Jennifer Walker, Murray Baron, Wendy Stevens, Susanna M. Proudman, Mandana Nikpour, Sonal Mehra, Mianbo Wang, and Marvin J. Fritzler, and the Canadian Scleroderma Research Group, Australian Scleroderma Cohort Study, Genetics versus Environment in Scleroderma Outcome Study
Conference Name
Abstract
Objective: To examine the clinical correlates and survival in patients with antifibrillarin antibodies (AFA) in a large international study population consisting of well-characterized systemic sclerosis (SSc) cohorts from Canada, Australia, and the United States. Methods: Baseline clinical data from the prospective cohorts (Canadian Scleroderma Research Group, the Australian Scleroderma Cohort Study, and the American Genetics versus Environment in Scleroderma Outcome Study) were investigated. Clinical variables were harmonized and sera were tested for AFA using a commercially available SSc profile line immunoassay, regardless of the immunofluorescence staining pattern. Association of demographic and clinical features with AFA was investigated by logistic or linear regression. Further, a survival analysis was performed by Cox regression analysis. Results: A total of 1506 patients with SSc with complete serological profiles were included in the study. Fifty-two patients (3.5%) had antibodies detected against fibrillarin. Patients of African descent and Native North American ethnicity were more likely to be AFA-positive compared with other ethnicities. After adjustment for demographic factors, diffuse involvement, and intestinal bacterial overgrowth requiring antibiotics, gastrointestinal reflux disease showed a trend for association with AFA. Further, AFA positivity was associated with shorter survival independently of demographic factors and disease type (HR 1.76, 95% CI 1.11-2.79, p = 0.016). Conclusion: In this large multinational SSc cohort, AFA was associated with Native American ethnicity and was an independent predictor of mortality.
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The Journal of Rheumatology Copyright © 2017. All rights reserved.