Biomarkers in Ankylosing Spondylitis
2018 SPARTAN Annual Meeting, “Unmet Needs” Breakout Session
Marina Magrey, MD, MetroHealth Medical Center, Cleveland, OH, mmagrey(at)metrohealth.org
Nigil Haroon, MD, PhD, University Health Network, Toronto, Canada, Nigil.Haroon(at)uhn.ca
Walter P. Maksymowych, MD, University of Alberta, Edmonton, Canada, walter.maksymowych(at)ualberta.ca
Outcome in ankylosing spondylitis (AS) depends on early diagnosis, assessment of degree of inflammation, disease activity, disease severity, and damage. One of the key challenges in the management of AS is a lack of specific markers of disease activity and treatment response. Although ESR and CRP are routinely measured to assess the severity of inflammation, they correlate poorly with disease activity evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), or patient global assessment. Elevated ESR and/or CRP levels are present in only 30-40% of patients with active AS. Moreover, normal values do not rule out inflammation, especially in patients with exclusive axial disease. Therefore, for optimal management of AS there is a significant need for newer biomarkers, soluble and tissue-related, which can be reliably used to assess disease activity and inflammation.
- Identifying diagnostic, prognostic biomarkers, predictive biomarkers of the response to biologic therapy and biomarkers of disease activity that are easily measurable and reliable.
- Identifying biomarkers including imaging that predict or rapidly identify treatment response.
- Further development of longitudinal, clinically, well-characterized cohorts with appropriate imaging, tissue and fluid samples.
The session will include discussion about what biomarkers are currently available, ongoing research conducted by SPARTAN members and possibilities for collaboration, and discussion of what is in the pipeline. We will have brief presentations about each of the above objectives. This will be followed by a general discussion among the participants. Finally, we will outline take home points and next steps.