A nine years prospective study was performed on 82 Spanish rheumatoid arthr
itis patients with a disease duration of less than two years at the study e
ntry, in order to evaluate the role of HLA markers in the susceptibility an
d progression of rheumatoid arthritis. Radiological evaluation of disease s
everity was performed at the time of diagnosis and 9 years later. High reso
lution HLA-DR typing demonstrated chat the presence of the shared epitope (
SE) was more frequent among patients (61% vs. 31% in controls; P = 0.00003;
OR = 3.48). Fourteen patients carried two SE+ HLA-DRB1 alleles (Si +/+); 3
6, one single allele (SE +/-) and 32 were SE negative(SE -/-). HLA-DR4 (par
ticularly DRB1*0401 and DRB1*0405) and HLA-DR10 were increased among patien
ts. Ar study entry, the frequencies of locally severe (hands and feet) RA w
ere more frequent among SE +/+ patients (79%) than among SE +/- (47%) and S
E -/- (44%) patients (p = 0.05; RR = 1.80). After 3 years of disease these
differences disappeared, where as differences in the extent of the disease
arise: 79%, 50% and 32% of SE +/+, SE +/- and SE -/- patients respectively
showed large joints involvement (shoulders, elbows, hips and knees) (p = 0.
01; RR = 2.44 for SE+/+ vs. SE -/-; and p = 0.04; RR = 1.81 for SE+ vs. SE-
). These results suggest that the presence of the shared epitope is associa
ted with the extent and progression of radiological joint damage in rheumat
oid arthritis. Human Immunology 60, 250-254 (1999). (C) American Society fo
r Histocompatibility and Immunogenetics, 1999. Published by Elsevier Scienc
e Inc.