ESR or CRP, which inflammatory measure can accurately replace clinical measures in rheumatoid arthritis?

Abstract

Background: ESR and CRP are two commonly used laboratory inflammatory parameters. The controversy remains which of the two is a better measure to use and which parameter closely reflects the clinical measures of inflammation as well the disease process in Rheumatoid arthritis.

Characterization of neutrophil‐to‐lymphocyte ratio as a measure of inflammation in rheumatoid arthritis

“…ESR is a dependent variable of these factors. The associations among ESR, CRP and DAS28‐CRP(3) are in line with our previous study findings, which demonstrated better overlapping of CRP with clinical features of RA than ESR . DAS28‐CRP(3) showed strong correlation with joint counts, general health measures and pain scale than with CRP, ESR and NLR.…”

“…The associations among ESR, CRP and DAS28-CRP(3) are in line with our previous study findings, which demonstrated better overlapping of CRP with clinical features of RA than ESR. 16 DAS28-CRP(3) showed strong correlation with joint counts, general health measures and pain scale than with CRP, ESR and NLR. In contrast, NLR correlated better with CRP, ESR, DAS28-CRP(3) and health outcome measures.…”

“…NLR being an immune marker is more objective and least influenced by this perception. In addition, biochemical laboratory parameters such as NLR, which would assist in identifying various stages of RA disease activity, would benefit in therapeutic intervention . The study has not addressed the changes in NLR with regard to time frames and treatment as reflected by DAS, and its clinical use in patients with high and low disease activities titrating for the DMARD dosage.…”

Remission in rheumatoid arthritis by different criteria does not converge over the inflammatory markers

“…While the question of which inflammatory parameter, ESR or CRP, to use in defining remission has temporarily been put to rest by the recent recommendation of ACR/EULAR 2011 by choosing CRP over ESR, the confusion is still present. As noted in our study CRP represents more closely clinical measures of inflammation . The differences in choice of inflammatory parameter (ESR vs .…”

Rheumatoid arthritis

“…The ESR may be aff ected by multiple factors, such as age, anaemia and immunoglobulin concentration. The CRP may be more specifi c for infl ammation, but elevation may relate to smoking and associated insulin resistance 11. RF is an antibody to immunoglobulin G, seen in 80-90% of patients with established RA.…”