Serum C-reactive protein in polymyalgia rheumatica. A prospective serial study

Area of Science:

• Rheumatology
• Clinical Immunology
• Internal Medicine

Background:

• Polymyalgia rheumatica (PMR) is an inflammatory condition characterized by muscle pain and stiffness.
• Assessing disease activity and treatment response in PMR often relies on nonspecific inflammatory markers.

Purpose of the Study:

• To evaluate the behavior of erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) during initial prednisolone therapy for polymyalgia rheumatica.
• To determine which inflammatory marker, ESR or CRP, provides a more precise reflection of clinical improvement in PMR patients.

Main Methods:

• A prospective serial study involving 13 treatment-naive patients diagnosed with polymyalgia rheumatica.
• Monitoring of clinical symptoms, erythrocyte sedimentation rate (ESR), and serum C-reactive protein (CRP) levels during prednisolone induction therapy.

Main Results:

• All patients demonstrated rapid and complete clinical response to prednisolone treatment.
• Serum CRP levels, initially elevated in all patients, normalized rapidly, mirroring clinical improvement.
• Erythrocyte sedimentation rate (ESR) decreased more slowly than CRP, with half of the patients still showing elevated ESR after 14 days.

Conclusions:

• Serum CRP concentration is a precise and objective indicator of disease activity and treatment response in polymyalgia rheumatica during initial steroid therapy.
• Routine CRP measurements can significantly aid in the management of polymyalgia rheumatica, offering a more sensitive marker than ESR.