Lack of CRP response in patients with active rheumatoid arthritis
Research type
Research Study
Full title
Lack of CRP response in patients with active rheumatoid arthritis, as defined by ultrasound evidence of synovitis - What are the clinical implications and immunological causes?
IRAS ID
160142
Contact name
Jessica Manson
Contact email
Sponsor organisation
University College London Hospitals NHS Foundation Trust
Clinicaltrials.gov Identifier
WI190882, Pfizer Tracking Number ; Z6364106/2014/07/45, UCL Data Protection Registration, reference No
Research summary
Rheumatologist-led musculoskeletal ultrasound clinics are used increasingly to assess for joint erosions and disease activity in patients with rheumatoid arthritis (RA). Using this technique we have identified an atypical subgroup of RA patients who have active disease demonstrated on the scan, but do not have elevated inflammation levels in the blood (C-reactive protein (CRP) levels). We questioned whether this unusual presentation was associated with either a delay in diagnosis or in relative under treatment, risking worse disease outcome and disability. This project aims to define this subpopulation of RA patients both clinically and immunologically. Specifically, RA patients with active disease, confirmed on ultrasound, will be divided into two groups depending upon whether they have normal or raised CRP levels. We will compare the clinical features of these two patient groups with particular attention to erosion accrual and drug history; analyse their serum and cellular immunological markers and correlate the immunological findings with clinical characteristics and disability scores. By investigating the immunological markers, and comparing this to the clinical features, we aim to identify a specific signature or ‘barcode’ that can be used to identify patients that need more aggressive treatment despite having a normal CRP response. Thus this study, originating from a clinical observation, will provide important information that could directly impact patient care.
REC name
London - Hampstead Research Ethics Committee
REC reference
14/LO/1506
Date of REC Opinion
19 Aug 2014
REC opinion
Favourable Opinion