AB0259 PREDICTIVE VALUE OF C-REACTIVE PROTEIN/ALBUMIN RATIO(CAR) FOR THE DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS: A PROSPECTIVE COHORT STUDY

• Published in: Annals of the rheumatic diseases Vol. 82; no. Suppl 1; p. 1312
• Main Authors: N Öz, Duruöz, M T
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2023
• Subjects: Age; Albumin; Antineutrophil cytoplasmic antibodies; Autoimmune diseases; C-reactive protein; Cohort analysis; Colorectal carcinoma; Demography; Disease; Erythrocyte sedimentation rate; Gender; Inflammatory bowel diseases; Joint diseases; Leukocytes (neutrophilic); Lymphocytes; Meta-analysis; Proteins; Questionnaires; Rheumatoid arthritis; Rheumatology; Synovitis; Vasculitis
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2023-eular.1796

BackgroundRheumatoid arthritis (RA) is a chronic, systemic and disabling autoimmune disease with inflammatory synovitis. Many biochemical factors are used as diagnostic, activation and prognostic markers in certain diseases. The C-reactive protein/albumin ratio(CAR) is an inflammatory marker that is considered to have prognostic value in many disease. The CAR has shown high value in colorectal cancer, inflammatory bowel disease and ANCA-associated vasculitis activity.ObjectivesIn this study, we aimed to evaluate the predictive value of CAR for disease activity in RA patients.MethodsThis prospective study included 144 RA patients who fulfilled the 2010 revised criteria of the American College of Rheumatology (ACR) for RA. The demographic characteristics of the patients, duration of the disease and clinic characteristics of the patients such as the 28-joint Disease Activity Score based on the erythrocyte sedimentation rate (DAS28-ESR), Visual Analogue Scale, Health Assessment Questionnaire-Disability Index were collected. Labotaruvary finding such as erythrocyte sedimentation rate, CRP, albumin were noted. The CAR ratio was obtained by dividing the CRP level with albumin level. Based on the DAS28-ESR level, the included patients were categorized into two groups, namely, inactive to mild active RA (n=69; DAS28-ESR level <3.2) and moderate to highly active RA (n=75; DAS28-ESR level ≥3.2). These group were compared with the parameters described above.ResultsOne hundred ten patients (76.4% female) with mean age 52.3 SD 11.8 years were recruited into the study. Age and disease therapy duration of the patients were similar in both groups. Female gender was significantly higher in the DAS28-ESR ≥3.2 group. Patients who DAS28-ESR ≥3.2 had a significantly higher CAR compared to those who did not (0,11 SD 0,09 vs. 0,20 SD 0,16, p<0.001) (Table 1). Multivariate logistic regression analyses revealed that CAR was an independent predictor of moderate to highly active RA (OR: 2.180, 95%CI: 1.307–3.637; p=0.003). A receiver operating characteristic curves analysis yielded that the optimal cut-off value of CAR for moderate to highly active RA was 0.126 with sensitivity 64.0% and specificity 66.2% (AUC: 0.683, 95%CI: 0.597-0.769, p<0.001) (Figure 1).ConclusionBased on the study findings, we were able to show that simple and easily obtained CAR could be an independent predictor of disease activity in rheumatoid arthritis patients.References[1] Tian Y, Liu N, Yin H, Duan L. Corrigendum: Relationship between c-reactive protein/serum albumin ratio, neutrophil/lymphocyte ratio, and ANCA-associated vasculitis activity: A retrospective single center cohort study. Front Med (Lausanne). 2022 Jul 25;9:963919.[2] Meznerics FA, Kemény LV, Gunther E Et al. Multi-biomarker disease activity score: an objective tool for monitoring rheumatoid arthritis? A systematic review and meta-analysis. Rheumatology (Oxford). 2022 Dec 28:keac715.Table 1.Demographic, clinical features and laboratory findings of the patients with rheumatoid arthritis based on disease activity measured by DAS28-ESRDAS28-ESR <3.2 n=(69)DAS28-ESR ≥3.2 n=(75)P valueAge (years; mean SD)53,46 SD 11,5751,30 SD 12,000.275Female, gender, n (%)46 (%66,7)64 (%85,3)0.008Disease symptoms duration (month; mean SD)117,1 SD 116,398,6 SD 75,00.265Disease therapy duration (month; mean SD)97,7 SD 105,290,9 SD 73,00.663DAS28-ESR (mean SD)2,41 SD 0,554,27 SD 0,80<0.001Visual Analogue Scale (mm, mean SD)30,14 SD 19,6661,60 SD 17,55<0,001Health Assessment Questionnaire-Disability Index (mean SD)0,61 SD 0,640.82 SD 0,990,151ESR (mm/h, mean SD)19,72 SD 15,8027,20 SD 16,370.006CRP (mg/L, mean SD)4,88 SD 3,948,54 SD 6,44<0.001Albumin (g/L, mean SD)44,10 SD 2,6942,72 SD 3,590.011C-reactive Protein/Albumin Ratio (mean SD)0,11 SD 0,090,20 SD 0,16<0,001Abbreviations: DAS28-ESR, the 28-joint Disease Activity Score based on the erythrocyte sedimentation rate; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein.Acknowledgements:NIL.Disclosure of InterestsNone Declared.