Comparative Usefulness of C-reactive Protein and Erythrocyte Sedimentation Rate in Patients with Rheumatoid Arthritis

Abstract

Background: Laboratory tests such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) have been utilized as indicators of inflammation and disease activity in rheumatoid arthritis (RA), but there is still no clear consensus on when to employ one, the other, or both. Aim of the Study: The study aims to analyze the association between ESR and CRP levels in active RA patients and disease activity indicators. Methods: This study was conducted at the Orthopaedics OPD at TMSS medical college hospital & Ibne Sina Diagnostic Centre Bogura, Bangladesh, from January 2023 to December 2023. In the study, 120 patients with active RA were involved. All of the data was gathered, recorded into a Microsoft Excel work sheet, and then descriptive statistics were used in SPSS 23.0 for analysis. Results: the study included 120 RA patients, with 88 females and 32 males. The participants' ages ranged from 25 to 69 years (Mean±SD = 47.7±11.3). During the trial, all patients had disease activity, with DAS28 scores ranging from 2.9 to 7.5 (Mean ± SD = 5.42 ± 1.1). ESR readings ranged from 10 to 150mm/h in the first hour (Mean±SD = 52.9±33.9). CRP was positive in 81 patients but negative in 39 (67.5% vs. 32.5%). CRP levels ranged from 0.6 to 65 mg/dL (Mean±SD = 18.1±15.8). Male and female patients revealed significant differences in DAS28 (P=0.031). The study found a significant correlation between DAS28 values, tender and swollen joints, and ESR values (P values < 0.001, < 0.001, 0.004, respectively). However, there was no significant correlation between DAS28 patients' age and CRP values (P values 0.60, 0.18, respectively). Conclusion: Our study reveals that CRP is not a reliable indicator of inflammatory activity in RA patients in clinical settings. The use of CRP as a marker of inflammation in everyday practice should be reconsidered. ESR values were positively correlated and significant with DAS28 values.