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Value of high-sensitivity C-reactive protein for classification of early axial spondyloarthritis: results from the DESIR cohort
  1. Victoria Navarro-Compán1,
  2. Désirée van der Heijde1,
  3. Bernard Combe2,
  4. Claudine Cosson3,
  5. Floris A van Gaalen1
  1. 1Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2Department of Rheumatology, Hôpital Lapeyronie, Montpellier, France
  3. 3Department of Biochemistry, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Paris, France
  1. Correspondence to Dr Victoria Navarro-Compán, Department of Rheumatology, Leiden University Medical Center, PO Box 9600, Leiden 2333 RC, The Netherlands; m.v.navarro{at}

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The average delay in axial spondyloarthritis (axSpA) diagnosis after symptom onset is one of the longest among inflammatory rheumatic diseases.1 New tools, such as magnetic resonance imaging,2 have been developed to reduce this delay. Elevated C-reactive protein (CRP) has been incorporated as one of the features for Assessment of SpondyloArthritis international Society (ASAS) SpA criteria,3 and in the Berlin diagnostic algorithm.4 However, CRP levels are elevated in only a minority of early SpA patients.5 More sensitive tests, so-called high-sensitivity CRP (hsCRP), have been developed and can detect lower concentrations of CRP compared with traditional methods.6 HsCRP levels are increased in other rheumatic chronic inflammatory diseases,7 and show a better correlation with disease activity parameters compared with routine CRP in patients with axSpA.8 Therefore, hsCRP could be more sensitive than traditional CRP in diagnosing axial SpA. The aim of this study was to assess the contribution of hsCRP versus CRP to classification of early axSpA using the ASAS criteria.

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  • Contributors VNC and FvG performed the statistical analysis. FvG and DvdH participated in the design of the study and interpreted the results. VNC, DvdH, BC, CC and FvG drafted the manuscript. All authors read and approved the final manuscript.

  • Funding VNC was partially supported by a grant from the Fundación Andaluza de Reumatología.

  • Competing interests None.

  • Ethics approval French Departmental Directorate of Health and Social Affairs.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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