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. 2015 Aug;74(8):1522-9.
doi: 10.1136/annrheumdis-2013-205009. Epub 2014 Mar 31.

Improved performance of epidemiologic and genetic risk models for rheumatoid arthritis serologic phenotypes using family history

Jeffrey A Sparks  1 , Chia-Yen Chen  2 , Xia Jiang  3 , Johan Askling  4 , Linda T Hiraki  5 , Susan Malspeis  1 , Lars Klareskog  4 , Lars Alfredsson  6 , Karen H Costenbader  1 , Elizabeth W Karlson  1
Affiliations

Improved performance of epidemiologic and genetic risk models for rheumatoid arthritis serologic phenotypes using family history

Jeffrey A Sparks et al. Ann Rheum Dis. 2015 Aug.

Erratum in

  • Ann Rheum Dis. 2015 Aug;74(8):1528

Abstract

Objective: To develop and validate rheumatoid arthritis (RA) risk models based on family history, epidemiologic factors and known genetic risk factors.

Methods: We developed and validated models for RA based on known RA risk factors, among women in two cohorts: the Nurses' Health Study (NHS, 381 RA cases and 410 controls) and the Epidemiological Investigation of RA (EIRA, 1244 RA cases and 971 controls). Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC) in logistic regression models for the study population and for those with positive family history. The joint effect of family history with genetics, smoking and body mass index (BMI) was evaluated using logistic regression models to estimate ORs for RA.

Results: The complete model including family history, epidemiologic risk factors and genetics demonstrated AUCs of 0.74 for seropositive RA in NHS and 0.77 for anti-citrullinated protein antibody (ACPA)-positive RA in EIRA. Among women with positive family history, discrimination was excellent for complete models for seropositive RA in NHS (AUC 0.82) and ACPA-positive RA in EIRA (AUC 0.83). Positive family history, high genetic susceptibility, smoking and increased BMI had an OR of 21.73 for ACPA-positive RA.

Conclusions: We developed models for seropositive and seronegative RA phenotypes based on family history, epidemiological and genetic factors. Among those with positive family history, models using epidemiologic and genetic factors were highly discriminatory for seropositive and seronegative RA. Assessing epidemiological and genetic factors among those with positive family history may identify individuals suitable for RA prevention strategies.

Keywords: Epidemiology; Gene Polymorphism; Rheumatoid Arthritis.

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Figures

Figure 1
Figure 1
Receiver operating characteristic curves for (A) seropositive rheumatoid arthritis (RA) for women in Nurses’ Health Study (NHS), (B) ACPA-positive RA for women in the Epidemiologic Investigation of RA (EIRA), (C) ACPA-positive RA for men in EIRA, (D) seropositive RA among women with positive family history in NHS (E) ACPA-positive RA among women with positive family history in EIRA, and (F) ACPA-positive RA among men with positive family history in EIRA.
See this image and copyright information in PMC

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