Human leukocyte antigen and demographic characteristics in Chinese patients with active peripheral type psoriatic arthritis who had inadequate response to conventional disease-modifying antirheumatic drugs in a single dermatologic clinic

• Published in: PloS one Vol. 14; no. 1; p. e0210076
• Main Authors: Sin, Chi-Zai, Wang, Ting-Shun, Chiu, Hsien-Yi, Tsai, Tsen-Fang
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 16.01.2019; Public Library of Science (PLoS)
• Subjects: Adult; Alleles; Antigens; Antirheumatic agents; Antirheumatic Agents - therapeutic use; Arthritis; Arthritis, Psoriatic - drug therapy; Arthritis, Psoriatic - ethnology; Arthritis, Psoriatic - genetics; Asian Continental Ancestry Group - genetics; Biological treatment; Biology and Life Sciences; Cases (containers); Demographics; Dermatology; Drb1 protein; Drugs; Female; Gene Frequency; Genetic polymorphisms; Genetic Predisposition to Disease - ethnology; Genetic Predisposition to Disease - genetics; Genotype; Genotyping; Haplotypes; Histocompatibility antigen HLA; HLA Antigens - genetics; Hospitals; Humans; Joint diseases; Leukocytes; Male; Medicine; Medicine and Health Sciences; Middle Aged; Nonsteroidal anti-inflammatory drugs; Patients; People and Places; Polymorphism; Polymorphism, Genetic; Population; Population genetics; Population studies; Psoriasis; Psoriasis - drug therapy; Psoriasis - ethnology; Psoriasis - genetics; Psoriatic arthritis; Research and Analysis Methods; Rheumatology; Risk factors; Skin - drug effects; Skin - metabolism; Skin - pathology; Skin diseases; Studies; Taiwan; Taiwan; China; Asia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0210076

Correlation between severity of psoriasis and psoriatic arthritis (PsA) is inconsistent. Also, human leukocyte antigen (HLA)-Cw6 was found to be underrepresented in severe psoriasis who failed conventional systemic therapies, but the effect of HLA polymorphism on PsA severity needs to be confirmed. To describe the severity of psoriasis, demographic features and HLA polymorphism among Chinese patients with active peripheral type PsA who had inadequate response to conventional disease-modifying antirheumatic drugs. We included all patients with PsA who had at least 3 tender and swollen peripheral joints despite at least two conventional non-biologic treatments in our clinic. Demographic results were compared with global pivotal studies of biologics for PsA. HLA-Cw and HLA-DRB1 genotyping was also analyzed. We identified 60 patients who met our inclusion criteria. The male to female ratio was 1.31:1. The majority of patients presented with psoriasis first (81.7%). The mean interval between psoriasis and PsA was 7.2 ± 8.1 years (mean ± SD). The baseline number of tender and swollen joints was 14.9 ± 10.7 and 11.3 ±10.2, respectively. In total, 41.7% subjects had more than 3% body surface area involvement of psoriasis. Genotyping of HLA-Cw and HLA-DRB1 was performed in 47 subjects. HLA-Cw*0702 was the most frequent allele (29.8%), followed by HLA-Cw*01 (26.6%). The frequency of HLA-Cw*0602 allele was similar to normal population. The most frequent HLA-DRB1 allele was HLA-DRB1*04 (20.2%), followed by HLA-DRB1*08 (16.0%). No cases carrying HLA-DRB1*13 were detected. Compared with Western population, our patients had less psoriasis and PsA burden. The frequencies of HLA-Cw*06, HLA-Cw*12, and HLA-DRB1*07 were not increased. In contrast, HLA-Cw*0702 and HLA-DRB1*08 allele frequencies were increased compared with psoriasis patients and normal population in Taiwan. Future studies are still needed to characterize the demographic and genetic features of high need PsA patients.