The association between C-reactive protein and the likelihood of progression to joint replacement in people with rheumatoid arthritis: a retrospective observational study

2008

C-reactive protein and joint replacement in rheumatoid arthritis

Sample size: 2421 publication Evidence: moderate

Author Information

Author(s): Chris D Poole, Pete Conway, Alan Reynolds, Craig J Currie

Primary Institution: 360° Research Limited, Penarth, UK

Hypothesis

This study sought to evaluate the association between systemic inflammation as measured by C-reactive protein and total joint replacement in patients diagnosed with rheumatoid arthritis.

Conclusion

CRP level predicts progression to major joint replacement after standardisation for relevant risk factors.

Supporting Evidence

Each additional unit increase in log mean CRP was associated with a hazard ratio for major orthopaedic surgery of 1.36.
In cases whose CRP remained high, the hazard ratio for joint replacement increased more than two-fold.
The median time from RA diagnosis to joint replacement was 49 months.

Takeaway

Doctors can use a blood test called CRP to see if people with rheumatoid arthritis might need surgery to replace their joints.

Methodology

A cohort of patients was selected from The Health Improvement Network dataset, and surgery-free survival was evaluated using Cox proportional hazards regression models.