Serum survivin measurement can increase diagnostic accuracy and improve early treatment strategies for the prospective transition from arthralgia to rheumatoid arthritis (RA), according to the results of a study published in Frontiers in Medicine.
The aim of the current study was to identify combinations of serologic and clinical markers that could improve diagnosis of impending RA in patients being treated for arthralgia. Researchers recruited 1743 patients visiting a rheumatology ward in Gothenburg, Sweden for the first time from November 5, 2012 to November 4, 2013. Of these, 73 were diagnosed with undifferentiated arthritis, 63 with RA, and 180 with arthralgia of unknown origin. Patients with new cases of RA diagnosed in the following 48 months were included in the preclinical RA group, and their first-visit symptoms were analyzed to identify a set of symptoms and data concerning RA-specific antibodies, survivin in serum, and C-reactive protein (CRP), which could distinguish patients with arthralgia from patients with preclinical RA and RA.
The presence of survivin in serum proved to be strongly associated with clinical arthralgia joint symptoms. Additionally, having several small joint areas with a combination of symptoms, an increasing number of symptomatic joints, and patient-identified small hand joint swelling at the first clinical visit could identify pre-RA cases with 93% specificity. When the aforementioned symptoms were grouped with data on 3 clinical parameters, including serum survivin, CRP or female gender, and RA-specific antibodies, the transition from arthralgia to RA could be predicted between 55.2% and 91% of the time (AUC=.729, P <.001; sensitivity 43.8%).
Study investigators conclude that, “grouping [these] clinical parameters with information about serum levels of survivin, female gender or autoantibodies improves the sensitivity to prospective transition from arthralgia to RA and increases diagnostic precision favorable for early healthcare strategies.”
Erlandsson MC, Turkkila M, Pullerits R, Bokarewa MI. Survivin measurement improves clinical prediction of transition from arthralgia to RA-biomarkers to improve clinical sensitivity of transition from arthralgia to RA. Front Med (Lausanne). 2018;5:219.