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Title: Association of C-reactive protein with high disease activity in systemic sclerosis: Results from the Canadian Scleroderma Research Group
Authors: Chayawee Muangchan
Sarah Harding
Sarit Khimdas
Ashley Bonner
Murray Baron
Janet Pope
Western University
McMaster University
Sir Mortimer B. Davis Jewish General Hospital
Mahidol University
Keywords: Medicine
Issue Date: 1-Sep-2012
Citation: Arthritis Care and Research. Vol.64, No.9 (2012), 1405-1414
Abstract: Objective This study was performed to determine the prevalence of elevated C-reactive protein (CRP) levels and the significance of CRP in clinical parameters in systemic sclerosis (SSc; scleroderma) patients. Methods Canadian Scleroderma Research Group data were used. Statistical comparisons were made for CRP levels â8 mg/liter versus > 8 mg/liter, early (a;circ3 years from first non-Raynaud's phenomenon symptom) versus late SSc, and diffuse cutaneous SSc (dcSSc) versus limited cutaneous SSc (lcSSc). A survival analysis was analyzed between patients with normal versus elevated CRP levels. Results A total of 1,043 patients (mean ± SD age 55.4 ± 12.1 years, mean ± SD disease duration of 11.0 ± 9.5 years) were analyzed; elevation of CRP level and erythrocyte sedimentation rate (ESR; > 20 mm/hour) occurred in 25.7% and 38.2%, respectively. Mean ± SD baseline CRP level in dcSSc (11.98 ± 25.41 mg/liter) was higher than in lcSSc (8.15 ± 16.09 mg/liter; P = 0.016). SSc patients with an early disease duration had a higher mean ± SD CRP level (12.89 ± 28.13 mg/liter) than those with a late disease duration (8.60 ± 17.06 mg/liter; P = 0.041). Although not consistent in all subsets, CRP was significantly associated (P < 0.01) with ESR, modified Rodnan skin score (MRSS), worse pulmonary function parameters, disease activity, damage, and Health Assessment Questionnaire. CRP level seemed to normalize in many SSc patients ov er time. Total lung capacity < 80% predicted, MRSS, and serum creatinine were predictors of elevated CRP levels in SSc (odds ratio [OR] 2.76 [95% confidence interval (95% CI) 1.73-4.40] , P = 0.0001; OR 1.03 [95% CI 1.01-1.05], P = 0.005; and OR 1.005 [95% CI 1.001-1.010] , P = 0.02, respectively). Survival for patients with elevated CRP levels was less than for patients with normal CRP levels (P = 0.001). Conclusion CRP level is elevated in one-quarter of SSc patients, especially early disease. It is correlated with disease activity, severity, poor pulmonary function, and shorter survival. Copyright © 2012 by the American College of Rheumatology.
ISSN: 21514658
Appears in Collections:Scopus 2011-2015

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