Clinical Expression of Radiographic Axial Spondyloarthritis and Its Association With HLA-B27 in European and Ibero-American Populations
Bibliographic record
Abstract
OBJECTIVE: To compare the clinical and sociodemographic characteristics of Ibero-American patients with radiographic axial spondyloarthritis (r-axSpA) to those of European patients with r-axSpA, with a particular focus on the influence of HLA-B27. METHODS: This was an observational, cross-sectional, and multicenter study of patients who fulfilled the European Spondyloarthropathy Study Group criteria for SpA from the Registry of Spondyloarthritis of Spanish Rheumatology (REGISPONSER) and Ibero-American Registry of Spondyloarthropathies (RESPONDIA). Univariate and multivariate analyses between European and Ibero-American populations stratified by HLA-B27 status were conducted. Race stratification (White, Black American, and American Indian) was also performed to evaluate clinical differences according to HLA-B27. RESULTS: A total of 2592 patients with a clinical diagnosis of r-axSpA were included in the analysis: 1083 (41.8%) Ibero-American patients and 1509 (58.2%) European patients. Among the patients who were HLA-B27 positive, Ibero-American status was independently associated with conventional synthetic disease-modifying antirheumatic drug (csDMARD) intake (odds ratio [OR] 4.21), arthritis (OR 2.33), enthesitis (OR 6.01), dactylitis (OR 6.10), severe structural damage (Bath Ankylosing Spondylitis Radiological Index [BASRI]; OR 1.12), and poor functionality (Bath Ankylosing Spondylitis Functional Index; OR 1.40). Multivariate analysis of patients who were HLA-B27 negative revealed that Ibero-American status was independently associated with enthesitis (OR 11.67), csDMARDs (OR 15.51), and total BASRI (OR 1.34). Clinical manifestations also varied across racial groups, with differences noted in the prevalence of peripheral joint manifestations, such as more arthritis and enthesitis in American Indian patients than in White and Black American patients. CONCLUSION: Ibero-American patients with r-axSpA in our study exhibit more peripheral manifestations, more structural damage, and worse functionality than European patients, regardless of the presence of HLA-B27.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".