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42. Kongress der Deutschen Gesellschaft für Rheumatologie, 28. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 24. Wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

17.-20. September 2014, Düsseldorf

Calprotectin serum level independently predicts radiographic spinal progression in axial spondyloarthritis

Meeting Abstract

  • Maureen Turina - Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
  • Joachim Sieper - Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektologie, Rheumatologie, Berlin
  • Nataliya Yeremenko - Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
  • Kristina Conrad - Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektologie, Rheumatologie, Berlin
  • Hildrun Haibel - Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektologie, Rheumatologie, Berlin
  • Martin Rudwaleit - Endokrinologikum Berlin, Berlin
  • Dominique Baeten - Academic Medical Center/University of Amsterdam, Clinical Immunology and Rheumatology, Amsterdam, The Netherlands
  • Denis Poddubnyy - Charité - Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektologie, Rheumatologie, Berlin

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 42. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 28. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 24. wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Düsseldorf, 17.-20.09.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocSP.02

doi: 10.3205/14dgrh235, urn:nbn:de:0183-14dgrh2350

Published: September 12, 2014

© 2014 Turina et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Background: It has been shown previously that markers of systemic inflammation (i.e., elevated C-reactive protein – CRP) are independently associated with radiographic spinal progression over two years in patients with axial spondyloarthritis (axSpA) in the German Spondyloarthritis Inception Cohort (GESPIC). Calprotectin, a heterodimer of the calcium binding proteins S100A8 and S100A9, is secreted during monocyte infiltration into inflamed tissues and thus directly reflects a potentially important pathophysiological mechanism in SpA. The aim of this study was to determine the predictive value of serum calprotectin for radiographic spinal progression in axSpA.

Methods: Seventy six patients with definite axSpA from GESPIC were selected for this analysis. Radiographic spinal progression after 2 years of follow up was defined as 1) worsening of the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) by ≥2 units, and 2) development of a new syndesmophyte or progression of existing syndesmophytes (formation of a bridging syndesmophyte). Levels of serum calprotectin were determined by ELISA at baseline.

Results: Baseline calprotectin serum values were higher in patients with mSASSS worsening by ≥2 units after 2 years (n=15) versus those without progression (0.68±0.21 vs. 0.48±0.26 μg/ml, respectively, p=0.005) and in patients with syndesmophyte formation (n=18) versus those without new bone formation (0.64±0.27 vs. 0.48±0.25 μg/ml, respectively, p = 0.035). A receiver operating characteristic (ROC)-analysis showed a good performance of calprotectin in prediction of mSASSS worsening, as well as in prediction of syndesmophyte formation/progression-figure. Calprotectin serum level >0.5 μg/ml had a sensitivity of 80% and specificity of 62% as predictor of mSASSS worsening with an odds ratio (OR)=6.2 (95% CI 1.6-24.2). As predictor of syndesmophytes formation, calprotectin serum level >0.5 μg/ml demonstrated a sensitivity of 72%, a specificity of 60%, and an OR=4.1 (95% CI 1.2-32.0). These associations remained significant after adjustment for other known risk factors for radiographic spinal progression including syndesmophytes, CRP and smoking (Figure 1 [Fig. 1]).

Conclusion: Calprotectin is a biomarker with an independent predictive value for radiographic spinal progression in axSpA.