Session Type: Abstract Submissions (ACR)
Background/Purpose: The search for biomarkers in spondyloarthritis (SpA) is of great interest because of their diagnostic and prognostic role in the treatment of these diseases. In recent years cartilage has been shown to be a major target organ in spondyloarthritis. In other diseases of the joints, elevated levels of urinary CTX-II (C-telopeptide fragments of type II collagen) and Glc-Gal-PYD (glucosyl-galactosyl-pyridinoline) have been associated with progression of radiological damage. Objectives: 1. To compare the level of urinary CTX-II and Glc-Gal-PYD in patients with early-stage SpA with urinary levels in healthy people of similar age and gender. 2. To analyze the association between the level of urinary CTX-II and Glc-Gal-PYD with patient variables and diagnosis at 3 years of follow up.
Methods: We included 68 patients aged <45 years who came to the service with some of the suggestive information of ESP of the table and who later completed three years of follow-up and they fulfill nowadays criteria for the Classification of Spondyloartropathy of The European Spondyloarthropathy Study Group (ESSG):
|– inflammatory back pain,|
|– asymmetrical arthritis especially in lower limbs, dactylitis,|
|– raquialgia or arthralgia, plus one of the following; psoriasis, enthesitis, IBD, anterior uveitis, family history of spondyloarthritis, radiographic sacroiliitis, HLA-B27+, cervicitis/urethritis/diarrehea in the previous month.|
Urine samples were taken from all patients attending for the first time with suspected early SpA. Urinary excretion of CTX-II was determined by immunoassay (ELISA). Urinary excretion of Glc-Gal-PYD was determined by High performance liquid chromatography. We also determined CTX-II and Glc-Gal-PYD urinary excretion in a healthy control group (n = 25) of similar age and sex.
Association analysis was performed with the following variables at 3 years: final diagnosis, HLA-B27, SpA axial / peripheral ASAS, early involvement of large joints (hips/knees), presence of extra-articular manifestations (anterior uveitis , psoriasis or IBD) and anti-TNF therapy.
Results: Urinary excretion of CTX-II and Glc-Gal-PYD in patients presenting for the first time with suspected early SpA was significantly higher than in the healthy control group matched for age and sex (p <0.001).
The levels of urinary excretion of CTX-II and Glc-Gal-PYD in patients presenting for the first time with suspected early SpA were significantly higher in those who had predominantly peripheral involvement (SpA peripheral ASAS) versus axial involvement and in those due to high clinical activity and functional deficits (BASDAI and BASFI) required biological treatment at 3 years follow up. Urinary excretion of CTX-II was also significantly higher in patients developed early large joint involvement at 3 years follow up.
Conclusion: Urinary excretion of CTX-II and Glc-Gal-PYD in patients with early SpA may be a prognostic biomarker since in our series it was associated with peripheral involvement and early large joint involvement, and the need for biological treatment in the first three years of follow-up.
M. D. M. Trujillo,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/urinary-excretion-of-type-ii-collagen-c-telopeptide-and-glucosyl-galactosyl-pyridinoline-as-prognostic-biomarkers-in-early-spondyloarthritis/