title: Combined measurement of multiple acute phase reactants to predict relapse of rheumatoid arthritis.
abstract: OBJECTIVE
  Acute phase reactants (APRs), such as serum C-reactive protein (CRP), ferritin, plasma fibrinogen and platelet count, are common biomarkers used to monitor the status of inflammatory diseases. The aim of this study was to determine whether APRs are predictive markers of relapse in rheumatoid arthritis (RA).
  
  
  METHODS
  We analyzed forty RA patients in clinical remission (disease activity score [DAS28] < 2.6; baseline [t(0)]) or with low disease activity (DAS28 score ≤ 3.2; t(0)). The pre-existing therapeutic regimens were retained for each patient during a 4-week study period. APRs and patient characteristics were analyzed for normality of distribution by using the Kolmogorov-Smirnov test and correlations were assessed by Pearson's or Spearman's rank correlation coefficient.
  
  
  RESULTS
  APR levels were found to be significantly correlated with DAS28 score of RA, and serum CRP was the most strongly correlated APR for both the clinical remission and high disease activity groups. For all APRs, the correlation strength paralleled the increase in disease activity.
  
  
  CONCLUSIONS
  Measurement of multiple APRs in remission or low disease activity RA patients may predict relapse to active disease, thereby facilitating more timely clinical management and promoting efficacy of therapeutic intervention.
authors.affiliation: Department of Rheumatology, Qilu Hospital of Shandong University, Jinan.|Department of Rheumatology, People's Hospital of Rizhao, Rizhao, Shandong, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Lv
authors.affiliation: Department of Rheumatology, Qilu Hospital of Shandong University, Jinan.
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Song
authors.affiliation: Department of Rheumatology, Qilu Hospital of Shandong University, Jinan.
authors.forename: Xing-Fu
authors.initials: XF
authors.lastname: Li
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000209:Acute-Phase Proteins; D018501:Antirheumatic Agents; D015415:Biomarkers; D018836:Inflammation Mediators
keywords: C-reactive protein; ferritin; fibrinogen; platelet; rheumatoid arthritis