Lack of Correlation Between Clinical Disease Activity and Erythrocyte Sedimentation Rate, Acute Phase Proteins or Protease Inhibitors in Ankylosing Spondylitis

Sheehan, N. J.; Slavin, B; Donovan, Michael P.; Mount, J N; Mathews, John

doi:10.1093/rheumatology/25.2.171

Cited by 51 publications

(24 citation statements)

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“…Several studies have evaluated the activity of AS with MRI [6,7,[9][10][11][24][25][26][27]. The outcomes of those studies suggest that tissue perfusion and diffusion can be considered important biological parameters that might be used for the detection of disease or treatment response [28].…”

Section: Discussionmentioning

confidence: 99%

“…Sacroiliitis is considered to be an important criterion for the diagnosis of AS and is the most important factor in different AS stages [4]. Conventional magnetic resonance imaging (MRI) is believed to be a sensitive, noninvasive imaging method that can detect the activity in sacroiliitis with AS, which cannot be assessed by clinical means such as erythrocyte sedimentation rate (ESR) and Creactive protein (CRP) [5,6]. In addition, a study has shown that up to 40 % of patients with AS in the active stage never have elevated CRP or ESR [7].…”

Section: Snrmentioning

confidence: 99%

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Detection of Active Sacroiliitis with Ankylosing Spondylitis through Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging

Zhao

Liu

et al. 2015

Eur Radiol

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Objective To confirm feasibility and assess intravoxel incoherent motion (IVIM) to differentiate active sacroiliitis and ankylosing spondylitis.. Methods Forty-one patients were divided into two groups, an active group (n=20) and a chronic group (n=21), according to the Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI) and laboratory parameters. In addition, 21 healthy volunteers were chosen as the control group. Tissue diffusivity (D slow ), perfusion fraction (f), and pseudo-diffusion coefficient (D fast ) values were obtained for all three groups. Oneway analysis of variance and receiver operating characteristic analysis were performed for all parameters. Results There was good interobserver agreement on the measurements between the two observers. The optimal cutoff values (with respective AUC, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio) between active and chronic groups were D slow =0.53×10 −3 mm 2 /s (0.976, 90 %, 95.2 %, 18.9, 0.10) and f= 0. 09 (0.545, 20 %, 95.5 %, 4.2, 0.84), and between chronic and control groups were D slow = 0.22 × 10 −3 mm 2 /s (0.517, 9.52 %, 100 %, no number, 0.9) and f = 0.09 (0.935, 95.24 %, 80.95 %, 5, 0.059).Conclusion D slow and f of IVIM diffusion-weighted (DW)-MRI in AS show a significant difference in the values of diffusion of water molecules and fractional perfusion-related volume among the three groups. Key Points• D slow can be used to differentiate the activity of AS.• With perfusion fraction, the sensitivity of differentiating the AS activity is improved. • IVIM DWI plays an important role in detecting the activity in patients with AS.

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Section: Discussionmentioning

confidence: 99%

Section: Snrmentioning

confidence: 99%

Detection of Active Sacroiliitis with Ankylosing Spondylitis through Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging

Zhao

Liu

et al. 2015

Eur Radiol

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“…CRP and ESR are the most common laboratory methods for evaluating AS disease activity in clinical practice. 21,22 An elevated ESR or CRP level is present in only 30e40% of patients with AS, and normal values do not rule out the presence of inflammation. 22,23 In this study, the correlation of ESR or CRP to BASDAI is quite poor.…”

Section: Discussionmentioning

confidence: 99%

Association of serum interleukin-17 and interleukin-23 levels with disease activity in Chinese patients with ankylosing spondylitis

Chen¹,

Chang²,

Lin³

et al. 2012

Journal of the Chinese Medical Association

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“…In AS only 50-70% of patients with active disease have an increased level of CRP and a raised ESR, and measurement of the levels of these APR has been suggested to have limited value in determining disease activity [30,31].…”

Section: Discussionmentioning

confidence: 99%

“…Since disease activity in AS patients is not well reXected by ESR and CRP levels, these markers cannot be used as the only parameters for evaluating AS disease activity [31,33]. In this study, serum level of the recently studied biomarker MMP-3 was measured in AS patients and in healthy controls.…”

Section: Discussionmentioning

confidence: 99%

Role of matrix metalloproteinase-3 (MMP-3) and magnetic resonance imaging of sacroiliitis in assessing disease activity in ankylosing spondylitis

et al. 2011

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The objective of this study is to evaluate the role of MMP-3 and MRI in assessing disease activity in sacroiliac joints of AS patients in comparison to the conventional measures Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Serum MMP-3 was measured in 30 patients who fulfilled the modified New York criteria for AS and in ten healthy volunteers. AS patients were categorized into those having high or low MMP-3 according to a cut-off value = 7.1 ng/ml. MRI of the sacroiliac joints (SIJs) was performed on all patients. SIJs were evaluated for enhancement and subchondral bone marrow edema. Results of MMP-3 and findings on MRI were correlated with multiple clinical parameters including BASDAI, ESR and CRP. Serum MMP-3 was significantly elevated in AS patients with active disease. Elevated MMP-3 levels were significantly associated with high BASDAI (P = 0.046), but not with ESR or CRP. MRI showed bone marrow edema and enhancement of SIJs in 19/30 patients with one patient showing enhancement only. These MRI findings were not correlated with MMP-3, BASDAI, CRP or ESR. In conclusion, serum MMP-3 is an objective measure reflecting clinical disease activity in AS. Bone marrow edema and enhancement detected by MRI of SIJs is another objective measure of disease activity, but are not correlated with MMP-3 or the conventional parameters as BASDAI, ESR, or CRP. Although both MMP-3 and MRI can reflect disease activity in AS they seem to be unrelated, perhaps each is reflecting a different aspect of disease activity. MMP-3 and MRI should be considered together with BASDAI in assessing disease activity and in guiding the available recommendations for initiation of biologics in AS.

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Lack of Correlation Between Clinical Disease Activity and Erythrocyte Sedimentation Rate, Acute Phase Proteins or Protease Inhibitors in Ankylosing Spondylitis

Cited by 51 publications

References 0 publications

Detection of Active Sacroiliitis with Ankylosing Spondylitis through Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging

Detection of Active Sacroiliitis with Ankylosing Spondylitis through Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging

Association of serum interleukin-17 and interleukin-23 levels with disease activity in Chinese patients with ankylosing spondylitis

Role of matrix metalloproteinase-3 (MMP-3) and magnetic resonance imaging of sacroiliitis in assessing disease activity in ankylosing spondylitis

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