This article is more than 5 years old. Information may no longer be current.
Disease activity, acute phase reactant levels did not correlate in RA patients
Click Here to Manage Email Alerts
Acute phase reactant levels often did not correlate with disease activity in patients with active rheumatoid arthritis, when measured by joint counts or global assessments, according to recent study results.
Researchers used the Consortium of Rheumatology Researchers of North American database from Oct. 1, 2001, through Feb. 27, 2011, to identify 9,135 patients with active rheumatoid arthritis (RA). Both erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) had been drawn and patients had a visit at which clinical disease activity index (CDAI) was greater than 2.8, considered not in remission.
Fifty-eight percent of the patients (n=5,295) did not have an elevated ESR or CRP, while 16.5% (n=1,507) experienced elevated levels of both ESR and CRP, 13.3% (n=1,212) had elevated ESR but not CRP, and 12.3% (n=1,121) had an elevated CRP but not ESR. There were 4,228 patients who had a 1-year follow-up visit, with 59.6% (n=2,520) having neither elevated ESR nor CRP, while 15.4% (n=650) experienced elevated levels of both ESR and CRP, 13.2% (n=557) had an elevated level of ESR but not CRP, and 11.8% (n=501) had elevated CRP but not ESR.
Baseline and 1-year follow-up modified Health Assessment Questionnaire (mHAQ) and CDAI scores were lowest for patients with neither acute phase reactant (APR) elevated at the 1-year follow-up visit.
“Both mHAQ and CDAI scores increased sequentially with the number of elevated APR levels at baseline,” the researchers reported.
At baseline and at 1-year follow-up, each individual CDAI component followed the same trend. The number of APRs at baseline had positive association with the scope of improvement in both CDAI and mHAQ scores at 1 year.
“These data strongly suggest that it is appropriate to obtain both ESR and CRP from RA patients at the initial visit,” the researchers concluded. “Requiring an elevation in APR levels as a criterion for inclusion of RA patients in studies of experimental agents may exclude some patients with active disease.”
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts