Plasma Fibrinogen, D-dimer, and Fibrin Degradation Product as Biomarkers of Rheumatoid Arthritis

Li, Xue; Li, Ming; Li, Tao; Li, Xueyi; Wang, Wei; Wang, Yan; Wang, Biao; Zhang, Yanping; Gao, Ning; Dong, Yaru; Zhou, Ting; Liu, Zeshi; Liu, Hailong; He, Juntao; Li, Ké; Geng, Yun

doi:10.21203/rs.3.rs-49004/v1

Cited by 3 publications

(5 citation statements)

References 34 publications

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“…CRP and ESR, two known acute-phase reagents, are used clinically in the follow-up of JRA patients. In this study, and in line with other studies, these parameters were increased in patients with active disease and were normal in remission patients22 . Al-Matar et al They concluded that the highest ESR value in the first six months of the group with polyarticular involvement was one of the risk factors for patients without linear JRA.…”

supporting

confidence: 93%

Relationship of C-Reactive Proteins and Erythrocyte Sedimentation Rate with Active Disease in Patients with Juvenile Rheumatoid Arthritis

Farrukh¹,

Masood²,

Naseer³

et al. 2021

PJMHS

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Objective: To determine the relationship between serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) with active disease in patients with juvenile rheumatoid arthritis (JRA). Methods: This is a cross-sectional analytical study conducted at the Department of Paediatrics, Abbasi Shaheed Hospital, Karachi for one-year duration from April 2020 to April 2021. All patients who met the MJA’s American College of Rheumatology (ACR) criteria were enrolled in the study. The ACR 20 improvement criteria were used to define the pardon of the disease, and those who met the ACR20 recovery criteria were included in the remission group. Laboratory tests such as PCR and ESR. Statistical analysis was performed using SAS software (version 10.3). Results: The study involved 90 patients, including 28 in the remission group (31.2%) and 62(68.88%) in the active disease group. There were 61.11% (n = 55) of females, and the ratio of males to females was 3: 4. The mean age of the subjects was 10.12 ± 3.39 years (4–17 years). Distribution of the age of admission by different subgroups, 13 patients (14.44%) aged 1-5 years, 31 patients (34.44%) aged 5-10 years, 40 patients (44.44%) aged 10-15 years and 6 patients (6.66%) were over 15 years old. The mean duration of the disease was 2.40 + 2.11 years (range = 0.3–7 years). The onset of the disease in 21 patients (23.33%) lasting one year (22.9%) from the onset of the disease, 48 patients (53.33%) presented one to five years from the onset of the disease, and 21 patients (23.33%) over five years. The most common type of arthritis was polyarthritis in 43 patients (47.77%), followed by oligo-arthritis in 31 patients (34.44%) and systemic onset in 12 patients (13.33%). The mean ESR was 41.03 + 27.80 mm / hour 1. (Range = 07-128 mm / hour 1) And mean CRP 16.1 + 13.80 mg / L (range = 6-47 mg / L). While the ESR was> 30 mm / 1 hour in 50 of the 90 patients (55.55%), 43 of these 50 patients (86%) were in the active disease group. Similarly, positive CRP was found in 58 patients (64.44%), of whom 52 (89.7%) belonged to the group with active disease. Compared with the remission and active disease groups, 33 patients of active diseases were female. In the active disease group, the mean age was 11.01 + 3.30 years, and the duration of the disease began at one year in patients. Polyarthritis was detected in 26/62 (41.9%) of patients in the active disease group. Conclusion: High CRP and ESR parameters are good for predicting active disease in JRA patients. Keywords: C-reactive protein, Juvenile rheumatoid arthritis, JRA and Erythrocyte mentation rate.

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supporting

confidence: 93%

Relationship of C-Reactive Proteins and Erythrocyte Sedimentation Rate with Active Disease in Patients with Juvenile Rheumatoid Arthritis

Farrukh¹,

Masood²,

Naseer³

et al. 2021

PJMHS

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“…High D-dimer levels have also been associated with disease severity and mortality in patients with COVID-19 20 21. Despite high sensitivity, D-dimer levels have low specificity for VTE because levels increase with age, and high levels are reported in patients with inflammatory conditions such as RA 9 19. Furthermore, D-dimer levels fluctuate; in patients with RA, they correlate with markers of disease activity including Disease Activity Score in 28 joints (DAS28), erythrocyte sedimentation rate and CRP 9.…”

Section: Discussionmentioning

confidence: 99%

“…Despite high sensitivity, D-dimer levels have low specificity for VTE because levels increase with age, and high levels are reported in patients with inflammatory conditions such as RA 9 19. Furthermore, D-dimer levels fluctuate; in patients with RA, they correlate with markers of disease activity including Disease Activity Score in 28 joints (DAS28), erythrocyte sedimentation rate and CRP 9. D-dimer is most often used to exclude VTE based on the high sensitivity and resulting negative predictive value.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, patients with RA have elevated levels of D-dimer, a VTE biomarker and C-reactive-protein (CRP), a marker of inflammation. Furthermore, markers of RA disease activity also correlate with levels of D-dimer and CRP9 and are strongly associated with VTE risk,5 supporting the link between coagulation and inflammation. Accordingly, the impact of pharmacological treatments for RA on the risk of VTE should be carefully assessed.…”

Section: Introductionmentioning

confidence: 91%

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Biomarkers to predict risk of venous thromboembolism in patients with rheumatoid arthritis receiving tofacitinib or tumour necrosis factor inhibitors

et al. 2022

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ObjectiveIn the ORAL (Oral Rheumatoid Arthritis triaL) Surveillance study of patients with rheumatoid arthritis aged ≥50 years with ≥1 additional cardiovascular risk factor, incidence of pulmonary embolism was higher with tofacitinib 10 mg two times per day than with tumour necrosis factor inhibitors (TNFi). This exploratory post hoc analysis examined whether biomarkers explained the associations of tofacitinib versus TNFi with venous thromboembolism (VTE).MethodsORAL Surveillance was a prospective, open-label, event-driven, non-inferiority, postauthorisation safety study. Patients were randomised 1:1:1 to receive tofacitinib 5 mg or 10 mg two times per day or a TNFi. For this analysis, 294 soluble, proteomic, genetic and antibody biomarkers (of which 79 had a known role in inflammation, coagulation, vascular biology or Janus kinase signalling) were quantified in serum collected at baseline, month 12 and study end.ResultsOverall, 4362 patients were randomised and treated. The exploratory biomarker data set included 285 patients (57 VTE cases; 228 matched controls). D-dimer was quantified in 3732 patients (54 VTE cases; 3678 controls). No biomarker demonstrated a clear mechanistic association with the increased risk of VTE for tofacitinib versus TNFi. Month 12 D-dimer levels were positively associated with risk of a subsequent VTE within the tofacitinib 5 mg and 10 mg two times per day arms.ConclusionsOverall, this post hoc analysis did not identify biomarkers that explained the increased VTE risk for tofacitinib versus TNFi. Individual VTE risk should be considered when making decisions about initiation or maintenance of tofacitinib treatment.Trial registration numberNCT02092467; ClinicalTrials.gov.

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“…We observed that the patient's d ‐dimer levels declined after the use of the combination therapy. d ‐dimer is a biomarker of immune inflammation 39 . Studies have shown that tofacitinib can be used to treat SLE and its complicated premature atherosclerosis 40,41 .…”

Section: Discussionmentioning

confidence: 99%

Case report: Joint deformity associated with systemic lupus erythematosus

Chen

Zheng

Zhang

et al. 2022

Immunity Inflam & Disease

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Objective Typically, Jaccoud arthropathy (JA) is characterized by joint deformation without bone erosion. However, some recent studies have shown that bone erosion also occurs in JA; however, this remains controversial. To date, there have been no unified diagnostic standards for JA. Herein, we report a case of systemic lupus erythematosus complicated with JA without bone erosion. Methods A 27‐year‐old woman was admitted to our department with a 2‐year history of pain, swelling, and progressive deformities of her hands and feet. She was diagnosed with systemic lupus erythematosus and class V lupus nephritis 5 years prior. Upon examination, her erythrocyte sedimentation rate and C‐reactive protein levels were found to be increased. She was positive for antinuclear antibodies, antidouble stranded DNA antibodies, and antiextractable nuclear antigen antibodies, with a decreased complement C3 and C4. Radiography and magnetic resonance imaging revealed no bone erosion. The patient was diagnosed with JA. She was treated with oral prednisone (10 mg daily), tofacitinib (5 mg twice daily), methotrexate (10 mg weekly), and celecoxib (0.2 g twice daily). Results The patient's joint symptoms improved after treatment. No further progress was observed during the 4‐month follow‐up period. Conclusion We believe that bone erosion is the key to distinguish rhupus syndrome from JA. However, this needs to be confirmed with further long‐term follow‐up studies. We found that the use tofacitinib, MTX, and celecoxib in combination with prednisone may be an effective regimen for the treatment of JA.

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Plasma Fibrinogen, D-dimer, and Fibrin Degradation Product as Biomarkers of Rheumatoid Arthritis

Cited by 3 publications

References 34 publications

Relationship of C-Reactive Proteins and Erythrocyte Sedimentation Rate with Active Disease in Patients with Juvenile Rheumatoid Arthritis

Relationship of C-Reactive Proteins and Erythrocyte Sedimentation Rate with Active Disease in Patients with Juvenile Rheumatoid Arthritis

Biomarkers to predict risk of venous thromboembolism in patients with rheumatoid arthritis receiving tofacitinib or tumour necrosis factor inhibitors

Case report: Joint deformity associated with systemic lupus erythematosus

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