SOME ASPECTS OF FUTURE MARKERS FOR EVALUATION OF RHEUMATOID ARTHRITIS

Abstract

Introduction. Reactants of the acute phase like ESR and CRP indirectly reflect synovitis, but at the same time they are sensitive tools which enable objectivization and measurement of immune-mediated inflammatory response in RA. Simultaneous testing especially of ESR, CRP and RF (that are reversible measures of inflammation) together with clinical variables of inflammatorysynovitis are recommended for evaluation of disease activity. Aim. Evaluation of the activity of rheumatoid arthritis (RA) with the reactants of the acute phase-erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and rheumatoid factor (RF) and their assessment as prognostic markers for disease activity in patients with early RA treated with methotrexate. Methods. This study included 35 patients (pts) with early RA, while 35 pts were in the healthy control group. Pts were treated with methotrexate at an average dose of 10mg once weekly. For clinical evaluation of disease activity at certain time intervals (0 time, after 6, 9 and 12 months) we analyzed ESR, CRP and RF in every patient. Results. RA was evaluated following the dynamics of changes of the mean values of ESR, CRP and RF. Statistical analysis showed statistically significant differences among mean values of ESR in the four time intervals (p=0.00002). In regard of CRP there were statistically significant differences among mean values in all four time intervals (p=0.0428) (standard deviations were with great variations). There were no statistically significant differences of RF in the four time intervals (p=0.573). We found high values of CRP and RF in most of the patients. Conclusion. In spite of the therapy with methotrexate, disease progression continues especially in patients with elevated values of ESR, CRP and RF, which are shown as predictors for aggressive course of disease. This enables selection of high-risk groups of patients for aggressive course of disease and point the need for early and aggressive treatment.