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Spasovski D and Sotirova T
Aim: The aim of the study was to determine the most useful biochemical marker of the acute phase reactants for evaluation of disease activity in rheumatoid arthritis (RA).
Material and methods: 60 patients with RA were included, 27 of them treated with non-steroid anti-inflammatory drugs (NSAIDs) and Methotrexate (MTH). The control group consisted of 33 patients treated only with NSAIDs due to irregular control. In the first group disease activity was evaluated in four time intervals and in the control group in three time intervals, following the scores of the articular indices, complete blood count (CBC), elevated sedimentation rate (ESR) and C-reactive protein (CRP) in every patient.
Results: In the first group of patients decreased activity of RA was found in every subsequent control, with consecutive decrease in the mean values of the scores of the articular indices with statistically significant differences in the four time intervals. Considering laboratory parameters there were statistically significant differences in the mean values of hemoglobin (Hb), erythrocytes (Er), platelets (Plt), ESR (p=0.0462, p=0.0076, p= 0.0058, p= 0.0003). Mean values of CRP did not show statistically significant differences, but the number of patients who were CRP negative increased (standard deviation increased, also). In the group of patients treated only with NSAIDs, there were statistically significant differences in the mean values of the scores of the articular indices with increase in every subsequent control (in favour of disease progression). There were not statistically significant differences considering CBC, ESR and CRP (in favour of permanently active disease).
Conclusion: CRP is the most useful marker in the prospective evaluation of patients with rheumatoid arthritis.