Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Calprotectin in Rheumatoid Arthritis: Relation with Disease Activity in a Transversal and Longitudinal Study.
Garcia-Arias1, Miriam, Balsa2, Alejandro, Pascual-Salcedo3, Dora, Ramiro4, Susana, Alcocer1, Patricia, Carazo1, Sara García, Mola2, Emilio Martín
Biomarkers are useful in the management of rheumatoid arthritis (RA) by enabling assessment of disease severity and monitoring of response to therapy. Calprotectin, a major leucocyte protein, has shown to correlate with clinical and laboratory markers of activity in several inflammatory diseases. The objective of this study is to analyze the relation between calprotectin and disease activity in RA patients and to evaluate changes in calprotectin levels during treatment. Also, this study investigates whether baseline calprotectin levels can predict response to treatment.
Two different cohorts of patients were studied. One transversal study included 60 patients with different disease activity according to DAS28: 15 (25%) were in clinical remission, 15 (25%) had low disease activity, 15 (25%) had moderate activity and 15 (25%) had high disease activity. In the second cohort, 20 patients who started biological treatment, 10 responders and 10 non responders, were longitudinally evaluated at three different time points. Disease activity was measured by DAS28 and SDAI. Serum calprotectin levels were determined by ELISA. Non parametric test and Pearson correlation analysis were using to perform the univariate analysis. A linear mixed model for longitudinal data was adjusted to analyzed changes in calprotectin.
In the transversal study serum concentrations of calprotectin correlated significantly with swollen joint counts (r=0.41; p<0.01), erythrocyte sedimentation rate (r=0.28; p<0.05), C reactive protein (r=0.37; p<0.01) and disease activity (DAS28 r=0.27; p<0.05 and SDAI r=0.40; p<0.01). Patients with higher disease activity had higher calprotectin levels as compared with patients with mild, low disease activity and remission, according to both DAS28 (6.80 ± 4.19 vs 3.93 ± 2.41 vs 3.51 ± 1.80 vs 4.34 ± 3.10, p<0.05) and SDAI (7.73 ± 4.87 vs 4.97 ± 2.27 vs 3.99 ± 3.83 vs 3.29 ± 1.60, p<0.01). In the longitudinal study, serum calprotectin levels decreased during treatment in responders (6.23 ± 0.47 vs 3.47 ± 0.47 vs 3,03 ± 0.47, p<0.0001), but no differences in calprotectin were found in non responders (6.72 ± 1.65 vs 6.03 ± 1.65 vs 6.72 ± 1.65, p=0.94). There were no differences between basal calprotectin levels in responders as compared with non responders (6.23 ± 3.52 vs 6.72 ± 3.50, p=0.85). No correlation between changes in calprotectin levels and changes in disease activity was found in the mixed model (p=0.85).
Calprotectin correlates with clinical and laboratory markers of disease activity in RA patients. Thus, calprotectin may be a promising marker in the assessment and monitoring of disease activity. However, baseline calprotectin levels were not predictive for response to treatment.
To cite this abstract, please use the following information:
Garcia-Arias, Miriam, Balsa, Alejandro, Pascual-Salcedo, Dora, Ramiro, Susana, Alcocer, Patricia, Carazo, Sara García, et al; Calprotectin in Rheumatoid Arthritis: Relation with Disease Activity in a Transversal and Longitudinal Study. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :355