Pre-treatment calprotectin (MRP8/14) provides no added value to testing CRP alone in terms of predicting response to tumour necrosis factor (TNF) inhibitors in rheumatoid arthritis in a post hoc analysis
Authors' conclusion
Beyond correlation with CRP, we found no evidence to suggest that MRP8/14 explains additional variability in response to TNFi in patients with RA over and above CRP alone.
Study context
- Population
- Patients with rheumatoid arthritis (RA) about to commence adalimumab or etanerceptadalimumab 196 · or etanercept 274
- Participants
- 470 patients
- Comparison
- High (75th quartile) vs low (25th quartile) pre-treatment MRP8/14, and vs CRP alone, for predicting response to TNFi
- Primary endpoint
- EULAR response (DAS28-CRP 4C, and validated 3C and 2C versions), CDAI improvement criteria and change in individual outcome measures
Methodological detailslogistic/linear regression, MRP8/14 also measured in 3-month sera of 179 adalimumab-treated patients
- Logistic/linear regression
- MRP8/14 also measured in 3-month sera of 179 adalimumab-treated patients
Primary result
As reported in the abstract
EULAR response by pre-treatment MRP8/14 (3C and 2C models)
Times more likely to be European League against Rheumatism (EULAR) responders (3C model)
1.92
CI 1.04–3.54
High MRP8/14
Times more likely to be EULAR responders (2C model)
2.03
CI 1.09–3.78
High MRP8/14
Further findings
Clinical disease activity index (CDAI) response (CRP excluded from outcome) and MRP8/14
| OR (CI) | ||
|---|---|---|
| MRP8/14 | 1.00 (0.99–1.01) | |
| 0.512Odds ratio (log scale) |
| Outcome | Estimate |
|---|---|
| EULAR response with CRP alone as predictor (above vs below 75th quartile)CRP above 75th quartile | times more likely to be EULAR responders (3C) 3.79 (CI 1.81–7.93) |
| EULAR response with CRP alone as predictor (above vs below 75th quartile)CRP above 75th quartile | times more likely to be EULAR responders (2C) 3.58 (CI 1.74–7.35) |
- EULAR response with CRP alone as predictor (above vs below 75th quartile) — Addition of MRP8/14 did not significantly improve model fit (3C and 2C)
- p values=0.62 and 0.80, respectively
EULAR response with CRP alone as predictor (above vs below 75th quartile)
- No significant associations in the 4C analysis
Original publication
Pre-treatment calprotectin (MRP8/14) provides no added value to testing CRP alone in terms of predicting response to TNF inhibitors in rheumatoid arthritis in a post hoc analysis. Ann Rheum Dis. Published 21 February 2023. doi:10.
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