High sensitivity C-reactive protein as a disease activity marker in RA

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J Rheumatol. 2004 Jun;31(6):1095-7.

High sensitivity C-reactive protein as a disease activity marker in

rheumatoid arthritis.

Dessein PH, Joffe BI, Stanwix AE.

Department of Rheumatology, Johannesburg Hospital, Johannesburg, South

Africa.

OBJECTIVE: To elucidate the potential contribution of high sensitivity

C-reactive protein (hs-CRP) testing in the assessment of disease

activity in rheumatoid arthritis (RA). METHODS: We recorded clinical and

psychological variables, the hs-CRP, and erythrocyte sedimentation rate

(ESR) in 146 consecutive patients with RA. We analyzed the associations

between the ESR and hs-CRP versus the other recorded variables. RESULTS:

The median (interquartile range) ESR (mm/h) and hs-CRP (mg/l) were 15

(7-36) and 5 (2.3-13.9), respectively. Thirty-two (22%) patients had an

hs-CRP < 2 mg/l, 61 (42%) an hs-CRP of 2-8 mg/l and 53 (36%) an hs-CRP >

8 mg/l. In patients with an hs-CRP of 2-8 mg/l, the swollen joint counts

and the physician disease activity scales were higher, and remission

rates were lower than in patients with an hs-CRP of < 2 mg/l. The hs-CRP

was consistently more closely associated with disease activity,

depression, and helplessness than was the ESR.

CONCLUSION: High sensitivity CRP testing reveals systemic inflammation

that is generally not detectable with routine CRP assays and that is

associated with disease activity in RA.

PMID: 15170920

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