ARD Online First, published on January 7, 2013 as 10.1136/annrheumdis-2012-202504
Serum levels of hs-CRP in patients with normal CRP values (<5 mg/l) ASAS, Assessment of SpondyloArthritis international Society; CRP, C-reactive protein.
The average delay in axial spondyloarthri-tis (axSpA) diagnosis after symptom onsetis one of the longest among inflammatory patients without SpA had sacroiliitis, so Bichat, Joëlle Benessiano) was in charge of centralising and managing biological data of the ASAS axSpA criteria. In the clinical bidimetry (Roche Diagnostics, Switzerland).
national Society (ASAS) SpA criteria,3 and positive hsCRP and CRP were ≥2 mg/l and sensitive tests, so-called high-sensitivity Sociodemographic—and IBP characteristics and imaging—and lab results are displayed in table 1. Serum levels of CRP were higher rheumatic chronic inflammatory diseases,7 In the subgroup of patients with negative and show a better correlation with disease CRP, mean serum levels of hsCRP were also patients. Future studies including patients activity parameters compared with routine Victoria Navarro-Compán,1 Désirée van der aim of this study was to assess the contri- Heijde,1 Bernard Combe,2 Claudine Cosson,3 bution of hsCRP versus CRP to classifica- difference was not statistically significant 1Department of Rheumatology, Leiden University (p=0.06) (table 2). Substituting the ASAS classification criteria for the probability of 2Department of Rheumatology, Hôpital Lapeyronie, inflammatory back pain (IBP) duration of SpA according to the treating physician,9 3Department of Biochemistry, Hôpital Bicêtre, more than 3 months, but less than 3 years, also did not indicate increased levels of Assistance Publique Hôpitaux de Paris, Paris, France hsCRP in patients with a high probability of Correspondence to Dr Victoria Navarro-Compán, Indifferenciees Recentes cohort was used.
Department of Rheumatology, Leiden University Medical Center, PO Box 9600, Leiden 2333 RC, 2011. Design, inclusion criteria, CRP mea- surements using conventional methods, and would be classified as axSpA substituting Acknowledgements The DESIR cohort is conductedunder the control of Assistance Publique-Hopitaux deParis via the Clinical Research Unit Paris-Centre andunder the umbrella of the French Society ofRheumatology and INSERM (Institut National de la Characteristics of patients with early inflammatory back pain from the DESIR cohort Santé et de la Recherche Médicale). The databasemanagement is performed within the department of epidemiology and biostatistics (Professor Jean-Pierre Daurès, DIM, Nîmes, France). An unrestricted grantfrom Wyeth Pharmaceuticals was allocated for the first 5 years of the follow-up of the recruited patients. We also wish to thank the different regional participatingcentres: Pr Maxime Dougados (Paris Pr André Kahan (Paris—Cochin A), Pr Olivier Meyer (Paris—Bichat), Pr Pierre Bourgeois (Paris—La Pitié-Salpetrière), Pr Francis Berenbaum (Paris—Saint Antoine), Pr Pascal Claudepierre (Créteil), Pr Maxime Breban (Boulogne Billancourt), Dr BernadetteSaint-Marcoux (Aulnay-sous-Bois), Pr Philippe Goupille (Tours), Pr Jean-Francis Maillefert (Dijon), Dr Xavier ASAS, Assessment of SpondyloArthritis international Society; CRP, C-reactive protein; DESIR, Devenir des Puéchal (Le Mans), Pr Daniel Wendling (Besançon), Spondylarthopathies Indifferenciees Recentes.
Pr Bernard Combe (Montpellier), Pr Liana Euller-Ziegler Copyright Article author (or their employer) 2013. Produced by BMJ Publishing Group Ltd (& EULAR) under licence.
(Nice), Dr Pascal Richette (Paris—Lariboisière), Pr Pierre Hermann J, Giessauf H, Schaffler G, et al. Early Lafforgue (Marseille), Dr Patrick Boumier (Amiens), spondyloarthritis: usefulness of clinical screening.
Pr Jean-Michel Ristori (Clermont-Ferrand), Dr Nadia Rheumatology (Oxford) 2009;48:812–6.
Mehsen (Bordeaux), Pr Damien Loeuille (Nancy), Ridker PM, Danielson E, Fonseca FA, et al.
Pr René-Marc Flipo (Lille), Pr Alain Saraux (Brest), Rosuvastatin to prevent vascular events in men and Pr Corinne Miceli (Le Kremlin Bicêtre), Pr Alain women with elevated C-reactive protein. N Engl J Cantagrel (Toulouse), Pr Olivier Vittecoq (Rouen).
Nielen MM, van Schaardenburg D, Reesink HW, Contributors VNC and FvG performed the statistical Feldtkeller E, Khan MA, van der Heijde D, et al. Age et al. Increased levels of C-reactive protein in serum analysis. FvG and DvdH participated in the design of at disease onset and diagnosis delay in HLA-B27 from blood donors before the onset of rheumatoid the study and interpreted the results. VNC, DvdH, BC, negative vs. positive patients with ankylosing arthritis. Arthritis Rheum 2004;50:2423–7.
CC and FvG drafted the manuscript. All authors read spondylitis. Rheumatol Int 2003;23:61–6.
Poddubnyy DA, Rudwaleit M, Listing J, et al.
Rudwaleit M, Landewé R, van der Heijde D, et al.
The development of Assessment of SpondyloArthritis Comparison of a high sensitivity and standard C reactive Funding VNC was partially supported by a grant from international Society classification criteria for axial protein measurement in patients with ankylosing the Fundación Andaluza de Reumatología.
spondyloarthritis ( part I): classification of paper spondylitis and non-radiographic axial Spondyloarthritis.
patients by expert opinion including uncertainty appraisal. Ann Rheum Dis 2009;68:770–6.
Dougados M, d’Agostino MA, Benessiano J, et al.
Ethics approval French Departmental Directorate of Rudwaleit M, van der Heijde D, Landewé R, et al.
The DESIR cohort: a 10-year follow-up of early The development of Assessment of SpondyloArthritis inflammatory back pain in France: study design and Provenance and peer review Not commissioned; international Society classification criteria for axial baseline characteristics of the 708 recruited patients.
The development of Assessment of SpondyloArthritis international Society classification criteria for axial Whicher JT. BCR/IFCC reference material for plasma To cite Navarro-Compán V, van der Heijde D, spondyloarthritis ( part II): validation and final Combe B, et al. Ann Rheum Dis Published Online First: selection. Ann Rheum Dis 2009;68:777–83.
Reference. International Federation of Clinical [ please include Day Month year] doi:10.1136/ Rudwaleit M, van der Heijde D, Khan MA, et al.
Chemistry. Clin Biochem 1998;31:459–65.
How to diagnose axial spondyloarthritis early. Ann Value of high-sensitivity C-reactive protein
for classification of early axial
spondyloarthritis: results from the DESIR

Victoria Navarro-Compán, Désirée van der Heijde, Bernard Combe, etal.
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