Spondyloarthritis & psoriatic arthritis
C-reactive protein thresholds for discriminating active disease in axial spondyloarthritis: should we lower them?
Authors' conclusion
Our results suggest adopting lower than standard CRP cut-off values for a better assessment of both the global activity of the disease and a better interpretation of the composite activity indices used in axSpA.
Study context
- Population
- Consecutive patients with axial spondyloarthritis (axSpA), with/without biologics122 men · 78 women
- Participants
- 200 patients
- Comparison
- C-reactive protein (CRP) thresholds for discriminating high/very high disease activity in axSpA
- Outcome
- CRP thresholds discriminating high/very high disease activity (AUROC)
Methodological detailsconsecutive patients, Youden index, sensitivity analyses by biologic exposure
- Consecutive patients
- Youden index
- Sensitivity analyses by biologic exposure
Performance
As reported in the abstract
Discrimination of high/very high disease activity
| Test or model | Area under the ROC curve (AUROC) | OR | P | Specificity | Sensitivity |
|---|---|---|---|---|---|
| CRP ≥0.25 mg/dl | 0.71 | 3.9 | p<0.001 | ||
| CRP ≥0.5 mg/dl | 0.90 | 0.35 |
Area under the ROC curve (AUROC)
CRP ≥0.25 mg/dl0.71
CRP ≥0.5 mg/dl— not stated in the abstract
OR
CRP ≥0.25 mg/dl3.9
CRP ≥0.5 mg/dl— not stated in the abstract
P
CRP ≥0.25 mg/dlp<0.001
CRP ≥0.5 mg/dl— not stated in the abstract
Specificity
CRP ≥0.25 mg/dl— not stated in the abstract
CRP ≥0.5 mg/dl0.90
Sensitivity
CRP ≥0.25 mg/dl— not stated in the abstract
CRP ≥0.5 mg/dl0.35
Further findings
Baseline CRP, whole cohort
- Median CRP 0.20 mg/dl (IQR 0.10-0.40)
Discriminative CRP threshold for high/very high disease activity, without biological therapy (sensitivity analysis)
- CRP ≥0.35 mg/dl threshold, AUROC
- 0.72
- CRP ≥0.35 mg/dl threshold, OR (p<0.001)
- 10.4
Discriminative CRP threshold for high/very high disease activity, exposed to biologics (sensitivity analysis)
- CRP ≥0.25 mg/dl threshold, AUROC
- 0.70
- CRP ≥0.25 mg/dl threshold, OR (p<0.001)
- 4.02
Standard CRP value (≥0.5 mg/dl) for detecting high/very high disease activity
- Specificity
- 0.90
- Sensitivity
- 0.35
- Less discriminatory than previous thresholds
Original publication
C-reactive protein thresholds for discriminating active disease in axial spondyloarthritis: should we lower them? Clin Exp Rheumatol. Published 3 August 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →