Association Between Osteoarticular Scores and Acute Phase Reactant Levels in Rheumatoid Arthritis

Association Between Osteoarticular Scores and Acute Phase Reactant Levels in Rheumatoid Arthritis The aim of this prospective control study was a quantitative evaluation of the activity of rheumatoid arthritis (RA) in certain time intervals, using articular indexes (set of 28 sensitive and 28 swollen joints), laboratory parameters (Hb, Hct, Er, Le and Plt) and acute phase reactants (ESR, RF, CRP); to determine which of the acute phase reactants is the most useful biochemical marker for the evaluation of disease activity in RA; to quantify the therapeutical and laboratory differences in certain time intervals in the group with and without immunomodulatory therapy with Methotrexate. Sixty patients with RA were included, 27 of who were treated with non-steroid antiinflammatory drugs (NSAIDs) and Methotrexate (MTX). The control group consisted of 33 patients treated only with NSAIDs because of irregular controls. In the first group of patients the disease activity was estimated at four time intervals, and in the control group of patients at three time intervals following the scores of the articular indexes, blood cell counts, ESR and CRP in every patient. In the first group of patients decreased activity of RA was found upon every following control with a consecutive decrease in mean values of the scores of articular indexes with statistically significant differences at the four time intervals. Considering laboratory parameters, there were statistically significant differences in the mean values of Hb, Er, Plt, ESR, (p=0.0462, p=0.0076, p= 0.0058, p= 0.0003). Mean values of CRP did not show statistically significant differences, but the number of patients who were CRP negative increased (there were great standard deviations). In the group of patients treated only with NSAIDs, there were statistically significant differences in the mean values of the scores of articular indexes with an increse at every following control (in favour of progression of the disease). There were no statistically significant differences considering blood cell counts, ESR and CRP (in favour of permanently active disease). In conclusion, CRP is the most useful marker for the prospective follow-up of patients with RA. Veza Između Osteoartikularnih Indeksa I Reaktanata Akutne Faze Kod Reumatoidnog Artritisa Cilj ovog istraživanja bio je da se izvrši kvantitativna procena reumatoidnog artritisa (RA) u određenim vremenskim intervalima pomoću osteoartikularnog indeksa (set od 28 osetljivih i otečenih zglobova), laboratorijskih parametara (Hb, Hct, Er, Le i PLT) i reaktanata akutne faze (Se, RF, CRP), da se utvrdi koji od reaktanata akutne faze bi bio najkorisniji marker za procenu aktivnosti bolesti kod dugoročnog praćenja RA pacijenata, kao i da se registruju i kvanificiraju kliničke i laboratorijske razlike u određenim vremenskim periodima u grupi pacijenata tretiranih imunomodulatornom terapijom sa metotreksatom i bez njega. Ispitano je 60 pacijenata sa RA (27 tretiranih kombinovanom upotrebom NSAIL i metotreksata, 33 pacijenata samo sa NSAIL). Isti su ispitivani u nekoliko vremenskih intervala. U prvoj grupi pacijenata registrovano je smanjenje aktivnosti RA sa progresivnim smanjenjem srednje vrednosti artikularnih indeksa u svim vremenskim intervalima. Postoje statistički značajne razlike u srednjim vrednostima Hb, Er, Thr, SE (p = 0.0462, p = 0.0076, p= 0.0058, p=0.0003). Srednje vrednosti CRP nisu pokazale statistiški značajne razlike, no broj pacijenata koji su bili CRP negativni se povećao (postojale su velike standardne devijacije). U grupi tretiranoj samo sa NSAIL, postojale su statistički značajne razlike srednjih vrednosti skorova artikularnih indeksa sa povećanjem nivoa pri svakoj narednoj kontroli (u prilog progresije aktivnosti bolesti). Nisu utvrđene statistički značajne razlike u odnosu na hemogram, Se i CRP (u prilog postojanja aktivne bolesti). U zaključku, CRP je najkorisniji marker za procenu aktivnosti RA kod dugoročnog praćenja RA pacijenata.