SynthesisRMD open2022
Systematic review of the use of CRP in clinical trials for psoriatic arthritis: a concern for clinical practice?
Synthesis in RMD open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Ischemia-modified albumin in rheumatic diseases: A systematic review and meta-analysis.Immunity, inflammation and disease · 2024Pooled it
- A systematic review and meta-analysis of neopterin in rheumatic diseases.Frontiers in immunology · 2023Pooled it
- Article
- Article
- Correlations between serum 25-hydroxyvitamin D levels and nailfold microvascular changes in psoriatic arthritis patients with distal interphalangeal arthritis treated with TNF inhibitors.Frontiers in immunology · 2026Observational
- Association of Higher Levels of High-Sensitivity C-Reactive Protein With Future Development of Psoriatic Arthritis in Psoriasis: A Prospective Cohort Study.Arthritis care & research · 2025Article
- Article
- Investigation of serum biomarkers in rheumatoid and psoriatic arthritis patients for disease-specific signatures.Arthritis research & therapy · 2025Article
- Demographic Characteristics and Inflammatory Biomarker Profile in Psoriatic Arthritis Patients with Comorbid Fibromyalgia: A Cross-Sectional Study.Medicina (Kaunas, Lithuania) · 2025Article
- A Promising Approach to Psoriasis Vulgaris Management with N-Acetylcysteine and Vitamin E: Targeting the Interplay of Inflammatory and Oxidative Stress.Biomedicines · 2025Article
- Can Circulating MicroRNAs, Cytokines, and Adipokines Help to Differentiate Psoriatic Arthritis from Erosive Osteoarthritis of the Hand? A Case-Control Study.International journal of molecular sciences · 2025Article
- Deciphering difficult-to-treat psoriatic arthritis (D2T-PsA): a GRAPPA perspective from an international survey of healthcare professionals.Rheumatology advances in practice · 2024Article
- PsABIOnd Study and eDaily Substudy Design: Long-Term Effectiveness and Safety of Guselkumab and IL-17 Inhibitors in Routine Clinical Practice in Patients with Psoriatic Arthritis.Rheumatology and therapy · 2023Article
- Genetic association of circulating C-reactive protein levels with idiopathic pulmonary fibrosis: a two-sample Mendelian randomization study.Respiratory research · 2023Article
- Reliability of C-reactive protein as an inflammatory marker in patients with immune-mediated inflammatory diseases and liver dysfunction.Rheumatology advances in practice · 2023Article
- Application of clinical and molecular profiling data to improve patient outcomes in psoriatic arthritis.Therapeutic advances in musculoskeletal disease · 2023Review
- Normal C-reactive protein in active psoriatic arthritis: results from real-world clinical practice.Therapeutic advances in musculoskeletal disease · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundC reactive protein (CRP) levels are suggested as serum biomarkers in the diagnosis and prognosis of psoriatic arthritis (PsA). However, increased CRP levels are found in less than 50% of PsA patients even in the presence of active disease.
objectivesTo evaluate the role of CRP levels in interventional clinical trials in PsA patients to better understand the trial generalisability, relationship with disease activity and predictive value for treatment response and decision making.
methodsA systematic review was conducted via PubMed, Cochrane and Embase. We focused on phase III trials in PsA.
resultsEight of 22 studies applied minimum baseline CRP levels for inclusion. Baseline CRP levels were wide-ranging (0.1-238 mg/L) and lower in studies without CRP in the enrolment criteria. All 22 studies used the American College of Rheumatology (ACR20) response and other endpoints that integrated CRP levels. One of seven studies that evaluated individual ACR-score components revealed a decrease in CRP levels along with improvement of other endpoints. Subanalyses show conflicting evidence on CRP levels as predictor of disease course.
conclusionCRP levels were inconsistently used as inclusion criterion in clinical trials, often limiting generalisability of the data. The use of composite scores such as ACR20 or Disease Activity Score-28-CRP is also limited since baseline levels of CRP affects their sensitivity to change. High CRP levels may be an individual predictor for disease progression and response to treatment, but the current conflicting findings and selective patient trial inclusions, do not allow CRP to play a very prominent role in treatment decision making.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.