Could c-reactive protein predict psoriatic arthritis

[Fred]

This study suggests higher c-reactive protein (CRP) levels were associated with future development of psoriatic arthritis (PsA)

Quote:

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Objective:
We aimed to assess whether high sensitivity c-reactive protein (hsCRP) could predict the development of psoriatic arthritis (PsA) in patients with psoriasis.

Methods:
We analyzed data from a prospective cohort of patients with psoriasis without PsA at enrollment. Participants were assessed annually by a rheumatologist for signs and symptoms of PsA. Information on patient demographics, psoriasis features, medications and musculoskeletal symptoms was collected. hsCRP levels were measured in serum samples collected at baseline using standard commercial assays. The association between hsCRP levels and risk of development of PsA was assessed using multivariable Cox proportional hazards model adjusted for age, sex, psoriasis severity and duration, nail lesions, body mass index (BMI), fatigue, and medication use.

Results:
A total of 589 patients with psoriasis followed from 2006 to 2019 were analyzed. 57 patients developed PsA during the follow up period. Mean level of hsCRP was 3.1±5.5 mg/L (hsCRP levels in incident PsA cases: 5.4±13.1). Significantly higher levels of hs-CRP at baseline were found in patients with arthralgia, obesity and in females. Higher hs-CRP levels were associated with future development of PsA in multivariable analysis (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.01, 1.07, p=0.007). Similar effect size was seen in males and females. No significant interaction was found between hsCRP and sex or BMI.

Conclusion:
Higher levels of systemic inflammation, as measured by hsCRP, are associated with future development of PsA.

Source: onlinelibrary.wiley.com

*Funding: Early view funding unknown.

[Kat]

Interesting

[Fred]

Interesting

Yes mine always went higher with a psoriatic arthritis flare.

[Caroline]

Interesting

Yes mine always went higher with a psoriatic arthritis flare.

It certainly is interesting. I read that it is increased in various conditions, such as:

• Chronic inflammation (such as rheumatism)

• Infections

• Obesity

• Stress

It seems to be a measurement of inflammation and it is very sensitive it can detect already few inflammation. In that sense it could certainly be predictive… or of predictive nature.
They state they have adjusted for a number of other combinations of signals that may predict PsA, so it really might be that we have a new thing to early measure..
Curious on how this will progress.

[Forest Walker]

I wonder why doctors ever use the basic C-Reactive Protein test?  Why don't they always use the High-Sensitivity C-Reactive Protein test?

[Caroline]

I wonder why doctors ever use the basic C-Reactive Protein test?  Why don't they always use the High-Sensitivity C-Reactive Protein test?

yes… it seems to be a nobrainer in relation to the development of Psoriatic Arthritis

[mataribot]

I wonder why doctors ever use the basic C-Reactive Protein test?  Why don't they always use the High-Sensitivity C-Reactive Protein test?

yes… it seems to be a nobrainer in relation to the development of Psoriatic Arthritis

It’s not a realistic test to administer for most people since it requires measuring twice - exactly two weeks apart. It’s a predictor of cardiovascular disease and not sure how doctors can sort that one out. CRP is general being high is associated with back disease rather than PSA as more people with back disease tend to have elevated CRP. There are also drugs that lower CRP, but do not help psoriasis and PSA.

[Forest Walker]

I wonder why doctors ever use the basic C-Reactive Protein test?  Why don't they always use the High-Sensitivity C-Reactive Protein test?

yes… it seems to be a nobrainer in relation to the development of Psoriatic Arthritis

It’s not a realistic test to administer for most people since it requires measuring twice - exactly two weeks apart. It’s a predictor of cardiovascular disease and not sure how doctors can sort that one out.  CRP is general being high is associated with back disease rather than PSA as more people with back disease tend to have elevated CRP. There are also drugs that lower CRP, but do not help psoriasis and PSA.

Thanks, Mataribot.  Measuring twice likely costs the patient twice in lab fees, too.