Ann Rheum Dis: The Meaning of CRP Baseline Levels and Early Changes in Clinical Outcomes in Rheumatoid Arthritis Patients

Rheumatoid arthritis (RA) is characterized by clinical joint swelling and elevated levels of acute stage reactants, usually measured by C-reactive protein (CRP)In addition to inhibition of IL-6, clinical and inflammatory responses are usually consistent, while IL-6 directly inhibits the liver's production of CRP leading to a decrease in CRPThis study explores whether pre-treatment OF CRP can be a useful marker to guide the selection of TREATMENT for EL-6 inhibitionanalyzed data on 1126 courses of tobee monoantigen (TCZ; early RA), 250 courses of rituxima (RTX; confirmed RA) and 249 courses of methotrexate (MTX; confirmed RA)The clinical disease activity index (CDAI) and its changes during its 24-week follow-up were compared with baseline CRP or early changesThe results were validated using trial data from another TCZ treatment for early RACrP levels in the TCZ group dropped an average of 74% over a four-week periodPatients with CDAI remission at 24 weeks with TCZ had the highest baseline CRP levels, while patients with high disease activity had the lowest levels of CRPIn the RTX and MTX groups, this association is negativePatients with TCZ who received remission at week 24 had the most reductions in CRP levels at week 4 compared to patients with increased activity with the diseaseEarly CRP non-reactive indications are of the risk of not meeting clinical treatment objectives (p.0.038)in the TCZ treatment group, baseline CRP appeared to be positively correlated with achieving the treatment goal, but had negative predictive effecton stomping on RTX and MTXEarly CRP unresponsive TCZ treatment patients have a lower chance of reaching remissionCRP and its early changes provide some basis for the evaluation of the potential treatment success of RA patients