RESEARCH - Calprotectin predicts 10-year radiographic progression in patients with RA

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Ann Rheum Dis. 2008 Dec 18. [Epub ahead of print]

Calprotectin (a major S100 leukocyte protein) predicts 10-year

radiographic progression in patients with rheumatoid arthritis.

Hammer HB, Odegard S, Syversen SW, Landewé R, van der Heijde D, Uhlig

T, Mowinckel P, Kvien TK.

Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.

OBJECTIVE: The plasma levels of calprotectin, a major S100 leukocyte

protein, is cross-sectionally associated to clinical and laboratory

markers of inflammation and to radiographic damage in rheumatoid

arthritis (RA). High amounts of calprotectin are found in synovial

fluid from RA patients. Our objective was to examine if calprotectin

could be an independent predictor of joint destruction over time.

METHODS: A total of 124 RA patients were assessed at baseline and

after 10 years with inflammatory markers (calprotectin, CRP, ESR),

serological variables (anti-CCP, IgA and IgM RF) and radiographic and

clinical assessments of joint damage (hand radiographs and Rheumatoid

Arthritis Articular Damage (RAAD) score). Progression of radiographic

damage was assessed according to van der Heijde modified Sharp score.

RESULTS: The highest calprotectin levels were at both examinations

found in patients positive for anti-CCP, IgA and IgM RF (p<0.001).

Calprotectin had moderate to good correlations with inflammatory and

serological markers (r=0.41-0.67, p<0.001). Patients with normal

baseline calprotectin levels had lower degree of joint damage

(p<0.001). High univariate associations were found between baseline

calprotectin levels and progression in Sharp Score (p=0.007) as well

as RAAD score (p=0.003). Baseline calprotectin was independently

associated with progression in Sharp Score (p=0.045) and with the RAAD

score (p=0.012) in multiple linear regression analyses including

baseline levels of CRP, ESR, anti-CCP in addition to demographic

variables.

CONCLUSION: Calprotectin was an independent predictor of clinical and

radiographic joint damage after 10 years. These findings support that

calprotectin may be a prognostic biomarker for erosive disease in

patients with RA.

PMID: 19095696

http://www.ncbi.nlm.nih.gov/pubmed/19095696

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