title: C-reactive protein predicts response to infliximab in patients with chronic sarcoidosis.
abstract: BACKGROUND
  This study assessed the value of C-reactive protein as a predictor of disease severity and response to infliximab therapy in patients with chronic pulmonary sarcoidosis.
  
  
  METHODS
  Sera were collected through week 52 from 138 patients with chronic pulmonary sarcoidosis who received placebo or infliximab in a randomized, double-blind, placebo-controlled study. We evaluated the response to therapy by baseline CRP using a dichotomous cutpoint (0.8 mg/dL) for the change from baseline in percent-predicted forced vital capacity (FVC), Saint George's Respiratory Questionnaire (SGRQ), 6-minute walk distance (6MWD), Borg's CR10 dyspnea score, and Physician Organ Assessment (POA).
  
  
  RESULTS
  CRP was elevated in 36% of patients at baseline, and was significantly reduced by infliximab by week 2. Among patients with elevated baseline CRP, infliximab-treated patients improved significantly compared with placebo-treated patients in percent-predicted FVC (+2.5 versus -2.6%), 6MWD (+8.0 versus -34.1), Borg's CR10 dyspnea score (pre-6MWD -0.8 versus +0.9, post-6MWD -1.1 versus +0.8), and POA (-3.1 versus -0.3). Patients with lower CRP levels at baseline did not show significant differences between the placebo and infliximab groups in most endpoints evaluated.
  
  
  CONCLUSIONS
  In chronic sarcoidosis patients, elevated CRP appears to identify a subset with more severe disease who may respond better to treatment with infliximab.
authors.affiliation: University of Chicago, Chicago, IL, USA. nsweiss@medicine.bsd.uchicago.edu
authors.forename: N J
authors.initials: NJ
authors.lastname: Sweiss
authors.forename: E S
authors.initials: ES
authors.lastname: Barnathan
authors.forename: K
authors.initials: K
authors.lastname: Lo
authors.forename: M A
authors.initials: MA
authors.lastname: Judson
authors.forename: R
authors.initials: R
authors.lastname: Baughman
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002908:Chronic Disease; D017322:Clinical Trials, Phase II as Topic; D004311:Double-Blind Method; D004417:Dyspnea / Q000188:drug therapy / Q000276:immunology; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D017565:Sarcoidosis, Pulmonary / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014797:Vital Capacity; D016138:Walking
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D015415:Biomarkers; D002097:C-Reactive Protein; D000069285:Infliximab