Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

Correlation Biomarkers of Cartilage and Bone Turnover with Disease Activity, Function, Quality of Life, Radiology and Magnetic Resonance Imaging in Patients with Early Spondiloarthritis.

Almodovar1,  Raquel, Rios2,  Valeria, Ocana1,  Sara, Gobbo3,  Milena, Casas1,  Marisa, Zarco4,  Pedro, Juanola-Roura5,  Xavier

Hospital Universitario Fundación Alcorcón, Alcorcon. Madrid, Spain
Hospital universitario Belvitge,, Barcelona, Spain
Spanish Society of Rheumatology, Madrid, Spain
Fundación Hopsital Alcorcon, Alcorcon, Madrid, Spain
Hospital Universitario de Bellvitge, Barcelona, Spain


To analyse the influence of sex, HLA B27, psoriasis, osteitis in MRI and involvement pattern on biomarkers of cartilage and bone turnover[matrix metalloproteinase-3(MMP-3), high sensitivity C-reactive protein (hsCRP), C Telopéptide (CTX) and D-Pyridoline] in early spondiloarthritis (SpA) To determine the relationship between the biomarkers and activity, functional capacity, quality of life and radiology in early SpA.


A cross-sectional study of baseline visits from 60 patients included in Esperanza program was performed. Patients analyzed were under 45 years old, with onset symptoms within the range of 3 to 24 months. All patients included met the following criteria: a) inflammatory back pain, or b) symmetric arthritis, or c) back pain /articular pain, in addition to at least one of the following: a) psoriasis, b) inflammatory bowel disease (IBD), c) anterior uveitis (AU), d) radiographic sacroiliitis, e) family history of spondylitis, psoriasis, IBD, or AU, f) HLA-B27 positive. Data collected: social/demographic, ESR, CRP, HLA-B27, BASDAI, BASFI, total BASRI and ASQol. MRI of sacroiliac joints (SIJs) was performed on 23 patients and activity was defined according to the ASAS Group definitions for active lesions on MRI. Serum MMP-3 (ELISA), CTX (Cromatogrphic), hsCRP (Nefelometric) and urinary D-pyridoline (QLIA) were measured in all patients. Analysis: Chi square was used to compare rates and U de Mann-Whitney to analyze continuous variables. Pearson correlation coefficient analysis was performed to examine the contribution of differents biomarkers.


At baseline, a total of 60 patients diagnosed of early SpA were included: 26 male (43%) and 34 female (56.6%), with age 32.3± 6.6 years and disease duration of 12.4± 6.7 moths. Eight percent of patients had axial affectation, 23% peripheral, 2% mixed and 3% enthesitic pattern. The HLA B27 was positive in 26.6% patients. Thirteen percent had psoriasis. Six patients (26%) had active sacroiliitis by MRI. The values (mean ± SD) were: nocturnal pain (cm) 4.5± 2.6; BASDAI (cm) 4.2 ± 2.4; ESR (ml/h)15± 14; CRP (mg/L) 5.3± 9.4; BASFI (cm) 2.7± 2.4; total BASRI 0.38 ±1 and ASQol 6.7± 5. Biomarkers showed no significant differences between HLA-B27 positive or negative patients, with or without psoriasis patients, with or without osteitis in MRI and type of involvement pattern. CTX (0.53 mgr/L vs. 0.24mgr/L; p=0.001) and MMP-3 (0.53 mgr/L vs. 0.24mgr/L; p=0.001) were significantly higher in male than in female with early SpA. Of the biomarkers examined, only the high sensitivity C-reactive protein (hsCRP) showed a significant correlation with the ESR level (r=0.3, p=0.04). MMP-3 and urinary D-pyridoline demonstrated a trend toward a positive correlation with ESR (r=0.2, p=0.08) and (r=0.3, p=0.08), respectively. hsCRP showed a trend toward a positive correlation with total BASRI (r=0.3, p=0.05).


In our study, the male sex is associated with higher levels of CTX and MMP-3 in early SpA, which may indicate higher radiographic damage in men. HLAB27, psoriasis and osteitis in MRI had no influence on any biomarkers. We found only a significant correlation between hsCRP and ESR.

To cite this abstract, please use the following information:
Almodovar, Raquel, Rios, Valeria, Ocana, Sara, Gobbo, Milena, Casas, Marisa, Zarco, Pedro, et al; Correlation Biomarkers of Cartilage and Bone Turnover with Disease Activity, Function, Quality of Life, Radiology and Magnetic Resonance Imaging in Patients with Early Spondiloarthritis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1311

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