Serum inflammatory biomarkers fail to identify early axial spondyloarthritis: results from the SpondyloArthritis Caught Early (SPACE) cohort

IntroductionDecreasing the diagnostic delay in axial spondyloarthritis (axSpA) remains a major challenge. Here, we assessed the value of serum inflammatory biomarkers to distinguish early axSpA from other pathologies in a large cohort of patients referred with early back pain.MethodsSerum c reactive...

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Published in:Rheumatic & musculoskeletal diseases open 2017-01, Vol.3 (1), p.e000319-e000319
Main Authors: Turina, Maureen C, Yeremenko, Nataliya, van Gaalen, Floris, van Oosterhout, Maikel, Berg, Inger J, Ramonda, Ramona, Lebre, Cristina (M C), Landewé, Robert, Baeten, Dominique
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Language:English
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Spondyloarthritis
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Summary:IntroductionDecreasing the diagnostic delay in axial spondyloarthritis (axSpA) remains a major challenge. Here, we assessed the value of serum inflammatory biomarkers to distinguish early axSpA from other pathologies in a large cohort of patients referred with early back pain.MethodsSerum c reactive protein (CRP), erythrocyte sedimentation rate (ESR) and calprotectin were determined in the SPondyloArthritis Caught Early (SPACE) cohort (n=310), an early back pain inception cohort. Additionally, explorative serum biomarkers derived from the literature (interleukin-27 (IL-27), human β-defensin-2 (hBD-2) and lipcolin-2 (LCN-2)) were determined by ELISA in full-blown patients with ankylosing spondylitis (AS) (n=21) and healthy controls (n=20).ResultsSerum CRP and ESR levels were not elevated in early axSpA versus ‘control’ back pain patients. Serum calprotectin was elevated in early axSpA versus controls (p=0.01) but failed to identify early axSpA at the individual level (positive predictive value of 38.7%). As to explorative biomarkers, serum levels of IL-27 were not detectable, and hBD-2 and LCN-2 serum levels were not elevated in full-blown AS versus healthy controls (p=0.572, p=0.562, respectively). Therefore, these markers were not further determined in the SPACE cohort.ConclusionsNone of the candidate serum inflammatory markers were useful as diagnostic markers in the early phase of axSpA.
ISSN:2056-5933
2056-5933
DOI:10.1136/rmdopen-2016-000319