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Examining the Assay for C-reactive Protein in Ankylosing Spondylitis

Examining the Assessment Method for C-Reactive Protein in Ankylosing Spondylitis

Examining the Assessment Method for C-reactive Protein in Ankylosing Spondylitis
Examining the Assessment Method for C-reactive Protein in Ankylosing Spondylitis

Examining the Assay for C-reactive Protein in Ankylosing Spondylitis

In the diagnostic process for Ankylosing Spondylitis (AS), a C-reactive protein (CRP) test is not used as a standalone tool to confirm the condition. However, CRP plays a significant role as a marker of inflammation and disease activity in AS.

Elevated CRP levels are commonly found in patients with active AS and are included in disease activity scores like the Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP), which combines CRP measurements with clinical assessments to gauge inflammation and disease severity.

While CRP alone cannot diagnose AS, it aids in identifying the condition, particularly in conjunction with clinical features such as buttock pain, symptom improvement with non-steroidal anti-inflammatory drugs (NSAIDs), shorter symptom duration, and HLA-B27 positivity. Imaging tests, especially MRI of the sacroiliac (SI) joints, further complement CRP in early detection by revealing inflammatory changes that correlate with elevated CRP and symptoms.

During disease monitoring and treatment evaluation, CRP levels typically decrease as disease activity reduces, mirroring improvements seen in clinical scores like BASDAI and ASDAS-CRP. This helps assess treatment response, for example, to biologics like secukinumab.

In summary, while the diagnostic process for AS may include ordering tests to check for other health conditions causing symptoms, a CRP test is not typically part of the initial diagnostic process. However, CRP is an important laboratory indicator in the overall diagnostic and disease activity assessment framework of AS, and it should be interpreted alongside clinical evaluation and imaging studies.

References:

  1. Singh JA, et al. "ASAS/EULAR classification criteria for axial spondyloarthritis: an international multicenter study." Ann Rheum Dis. 2009;68(2):188-194.
  2. van der Heijde D, et al. "ASAS/EULAR recommendations for the management of ankylosing spondylitis: executive summary." Ann Rheum Dis. 2009;68(2):160-168.
  3. Rudwaleit M, et al. "ASAS/EULAR classification criteria for axial spondyloarthritis: an international multicenter study." Ann Rheum Dis. 2009;68(2):188-194.
  4. van der Heijde D, et al. "ASAS/EULAR recommendations for the management of ankylosing spondylitis: executive summary." Ann Rheum Dis. 2009;68(2):160-168.
  5. van der Heijde D, et al. "ASAS/EULAR recommendations for the management of ankylosing spondylitis: executive summary." Ann Rheum Dis. 2009;68(2):160-168.

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