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High Sensitivity C-Reactive Protein as a Disease Activity Marker in Rheumatoid Arthritis
PATRICK H. DESSEIN, BARRY I. JOFFE, and ANNE E. STANWIX
ABSTRACT.
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. (J Rheumatol 2004;31:1095-7) Key Indexing Terms:
HIGH SENSITIVITY C-REACTIVE PROTEIN
From the Department of Rheumatology and the Centre for Diabetes and Endocrinology, Johannesburg Hospital and Milpark Hospital, University of the Witwatersrand, Johannesburg, South Africa. P.H. Dessein, MD, FCP(SA); A.E. Stanwix, MRCP(UK), Department of Rheumatology; B.I. Joffe, DSc, Centre for Diabetes and Endocrinology. Address reprint requests to Dr. P.H. Dessein, P.O. Box 1012, Melville 2109, Johannesburg, South Africa. E-mail: Dessein@lancet.co.za Submitted July 28, 2003; revision accepted December 31, 2003.
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