Rheumatology, Vol 38, 415-422, Copyright © 1999 by British Society for Rheumatology
P Barrera, TR Radstake, JM Albers, PL van Riel and LB van de Putte
OBJECTIVES: To study the familial aggregation of rheumatoid arthritis (RA)
in The Netherlands and to analyse the effect of proband characteristics on
the concordance rates for RA. Secondary aims were to compare the
characteristics of patients in an early RA inception cohort with those of
regular patients and to select Dutch families for the genome-wide scan
carried out by the European Consortium on RA families (ECRAF). METHODS: A
cross-sectional, hospital-based survey aimed to identify affected sibpair
(ASP) families among our whole RA population. Familial RA, or an ASP
family, was defined by the presence of at least two siblings fulfilling the
1987 ACR criteria for RA. RESULTS: The estimated prevalence for familial RA
was 9.8% and similar to that found in previous hospital series. The
true-positive reporting rate for RA in sibs was 60%. Sibship size in ASP
families (mean +/- S.D. = 7.8+/-3.3) was significantly larger than in the
Dutch population. Probands with familial RA were more often rheumatoid
factor positive and had a longer follow-up. Male gender and history of
joint replacements were associated with higher concordance rates for RA.
However, regression analysis showed that, correcting for sibship size, the
concordance rate for RA was largely not explained by proband
characteristics. Compared to regular RA patients, our inception cohort
encompassed more male and/or rheumatoid factor-negative patients, but had
similar performance in the study and rate of familial aggregation.
CONCLUSIONS: The familial aggregation of RA in The Netherlands is not
increased and occurs preferentially in large sibships. Among proband
characteristics, sibship size is most clearly related to the recurrence of
RA in particular families. Patients' recognition of RA manifestations in
relatives is not optimal.
ORIGINAL PAPERS
Familial aggregation of rheumatoid arthritis in The Netherlands: a cross-sectional hospital-based survey. European Consortium on Rheumatoid Arthritis families (ECRAF)
Department of Rheumatology, University Hospital, Nijmegen, The Netherlands.
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