ArticleArthritis research & therapy2019
Circulating calprotectin (S100A8/A9) is higher in rheumatoid arthritis patients that relapse within 12 months of tapering anti-rheumatic drugs.
Article in Arthritis research & therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Pooled it
- Article
- Diagnostic, prognostic and therapeutic biomarkers in rheumatoid arthritis.Nature reviews. Rheumatology · 2026Review
- Paired longitudinal tear proteomics reveals persistent ocular surface dysregulation after teprotumumab therapy in thyroid eye disease.Communications medicine · 2026Article
- Biomarkers in the diagnosis, prognosis and management of rheumatoid arthritis: A comprehensive review.Annals of clinical biochemistry · 2025Review
- The Role of Alarmins in the Pathogenesis of Rheumatoid Arthritis, Osteoarthritis, and Psoriasis.Current issues in molecular biology · 2024Review
- Computational inhibition of S100A8 (calgranulin A) as a potential non-invasive biomarker for rheumatoid arthritis.In silico pharmacology · 2024Article
- Bioinformatics analyses of potentially common pathogenic networks for primary Sjögren's syndrome complicated with acute myocardial infarction.Scientific reports · 2023Article
- Relevance of circulating Semaphorin 4A for rheumatoid arthritis response to treatment.Scientific reports · 2023Article
- Tailored therapeutic decision of rheumatoid arthritis using proteomic strategies: how to start and when to stop?Clinical proteomics · 2023Review
- Serum calprotectin levels do not predict subsequent relapse in rheumatoid arthritis in remission: a post-hoc analysis of STRASS study.RMD open · 2023Article
- 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.Annals of the rheumatic diseases · 2023Article
- The Involvement of Alarmins in the Pathogenesis of Sjögren's Syndrome.International journal of molecular sciences · 2022Review
- Role of the S100 protein family in rheumatoid arthritis.Arthritis research & therapy · 2022Review
- From bench to bedside: Calprotectin (S100A8/S100A9) as a biomarker in rheumatoid arthritis.Frontiers in immunology · 2022Review
- Biomarkers to Predict DMARDs Efficacy and Adverse Effect in Rheumatoid Arthritis.Frontiers in immunology · 2022Review
- Preclinical Markers in Inflammatory Bowel Disease. A Nested Case-Control Study.Crohn's & colitis 360 · 2021Article
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Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate whether calprotectin (S100A8/A9 or MRP8/14), an inflammatory complex released by monocytes, could indicate residual subclinical inflammation in rheumatoid arthritis (RA) patients who are in stable remission on disease-modifying anti-rheumatic drugs (DMARDs) and serve as a marker for disease flare after DMARD tapering.
methodsWe used data from two trials. Patients from the IMPROVED study had early (< 2 years) RA, and when they achieved disease activity score remission (DAS44 < 1.6), they stopped methotrexate to attempt drug-free remission. Patients from the RETRO study had established RA in stable remission (DAS28 < 2.6) and either tapered by 50% or stopped (biological or conventional) DMARDs. Circulating calprotectin at the tapering time point was determined by ELISA, and its predictive value for flare (loss of remission) within 12 months of DMARD tapering/stopping was determined.
resultsIn both IMPROVED (n = 104) and RETRO (n = 57), patients that flared within 12 months had higher calprotectin at the moment of DMARD tapering/stopping. Twofold higher calprotectin at the moment of DMARD tapering/stopping was associated with an increased risk (odds ratio) of flare of 1.07 (95% CI 0.98-1.18, p = 0.14) in the IMPROVED and 3.62 (95% CI 1.76-7.46, p < 0.001) in the RETRO. Correcting for clinical predictors of flare (DAS at study inclusion, anti-CCP2 positivity, gender) did not change these estimates. The area under the receiver operating curve of calprotectin levels for predicting flare within 12 months was 0.63 (95% CIs 0.51-0.76) in the IMPROVED study and 0.80 (95% CIs 0.69 to 0.92) in the RETRO study.
conclusionCirculating calprotectin levels in RA patients in remission on DMARDs are higher in patients that will flare upon DMARD tapering/stopping. Since the differences between the cohorts precluded definitive conclusions, more research is needed to determine whether calprotectin has prognostic value in predicting flare after attempting drug tapering in RA.
trial registrationIMPROVED, ISRCTN11916566. RETRO, 2009-015740-42.
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