JMIR Publications

ABSTRACT

Background:

Spondyloarthritis (SpA) is divided into axial and peripheral subtypes. The axial subtype further consists of ankylosing spondylitis (AS) or radiographic axial SpA (r-axSpA) and non-radiographic axial Spondyloarthritis (nr-axSpA). Though AS and nr-axSpA share some common features, nr-axSpA lacks x-ray-based sacroiliitis as defined by modified New York criteria. Disease activity in either of them is measured via CRP levels or MRI imaging of the pelvis. A person with active disease can have normal CRP and/or MRI findings, especially in nr-axSpA. These groups of patients are frequently negative for existing objective markers of inflammation. Immune system activation during inflammation has been shown to alter the platelet maturation and morphology reflected by platelet indices.

Objective:

In this study, we will determine if platelet indices are reliable biomarkers in measuring disease activity in patients with non-radiological Axial Spondyloarthritis.

Methods:

All patients diagnosed with Axial Spondyloarthritis per ASAS Criteria will be included in this study. Patients will be divided into two case groups: patients without radiographic sacroiliitis as non-radiographic axial Spondyloarthritis(nr-axSpA), with radiographic sacroiliitis as Ankylosing spondylitis(AS) and normal individuals will be kept as controls to compare and correlate the platelet indices such as platelet count, platelet grit, mean platelet volume and platelet distribution width with CRP and MRI findings of AS with nr-axSpA.

Results:

At the end of study we would be able to correlate if platelet indices are better biomarkers of active disease in patients of nr-axSpA.

Conclusions:

If platelet indices prove to be better markers of active disease in nr-AxSpA then there exists a gap in clinical practice while evaluating such patients and these markers should be included in routine evaluation of nr-AxSpA patients as they usually have normal CRP and often lack signs of Sacroiliac joint inflammation on MRI.