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Titre du Document
The acute phase and function in early rheumatoid arthritis. C-reactive protein levels correlate with functional outcome
Objective. To discover whether normalization of C-reactive protein (CRP) in patients with rheumatoid arthritis (RA) results in stabilization of their functional state, and whether a measure of disease activity can be used as a predictor of functional outcome. To examine the relationship between change of CRP and Health Assessment Questionnaire (HAQ) over a 24 mo period to define the sensitivity of HAQ to change. Methods. A prospective study of 109 consecutive patients who fulfilled the American College of Rheumatology criteria for RA and had elevated CRP before steroid or 2nd line therapy. A full clinical assessment including HAQ was performed at presentation and at 3, 6, 12, and 24 mo. On the basis of the change in CRP at 6 mo, patients were divided into 3 groups : (1) CRP suppression to normal, (2) 50% reduction in CRP, and (3) less than 50% CRP change. Results. The 3 groups were clinically and immunologically similar at onset. At 6 mo the median HAQ fell to 5 (lower to upper quartiles 7.5 to 19) in Group I (CRP normalized, n = 34), 6 (3.75 to 10) in Group 2 (CRP reduced by 50%, n = 30), and 12 (6 to 18) in Group 3 (less than 50% CRP change, n = 44), p < 0.005 for Groups I and 2 versus Group 3. At 12 and 24 mo HAQ remained significantly lower in Groups I and 2 compared with Group 3. In Group I, patients either maintained a normal CRP (n = 28) or their CRP became elevated (n = 6). Only in those patients in whom a re-elevation of the CRP occurred was deterioration in HAQ subs
Journal of Rheumatology Publishing
Type du document
Conférence : International Workshop on Rheumatoid Arthritis Genetics, 5, Manchester, GBR, 1996-03-13
PMID : 9002004 ISSN : 0315-162X CODEN : JRHUA9
Journal of rheumatology A. 1997, vol. 24, n° 1, pp. 9-13 [bibl. : 22 ref.]
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