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Value of acute-phase reactants in monitoring disease activity and treatment response in idiopathic retroperitoneal fibrosis


Pelkmans, Lindsey G; Aarnoudse, Albert-Jan L H; Hendriksz, Tadek R; van Bommel, Eric F H (2012). Value of acute-phase reactants in monitoring disease activity and treatment response in idiopathic retroperitoneal fibrosis. Nephrology, Dialysis, Transplantation, 27(7):2819-2825.

Abstract

BACKGROUND: Prospective evaluation of the value of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels in monitoring disease activity and treatment response in patients with idiopathic retroperitoneal fibrosis (RPF).METHODS: This study included 57 patients with idiopathic RPF receiving tamoxifen monotherapy with at least 8 months follow-up. Clinical, laboratory and radiological investigation was performed at presentation and at repeated follow-up. Remission was defined as significant clinical improvement within 6 weeks of treatment together with stable or decreasing mass size on follow-up computed tomography (CT) scanning at 4 months and definitive decrease in mass size on follow-up CT scanning at 8 months.RESULTS: ESR and CRP levels at presentation and their respective decreases over time correlated strongly with each other (P < 0.001). Baseline ESR and CRP levels correlated with visual analogue scale (VAS) score for pain (ESR, P < 0.01; CRP, P < 0.001); baseline ESR levels also correlated with VAS score for discomfort (P < 0.001). Short-term decreases in ESR or CRP levels at 6 weeks follow-up did not correlate with subsequent mass regression but decrease in ESR at 4 months and decrease in CRP at 4 and 8 months follow-up correlated with mass regression. Kaplan-Meier analysis showed no difference in remission rate between patients with normal or elevated baseline ESR or CRP (log-rank P = 0.22/P = 0.88) or between patients with or without (near-)normalization of ESR or CRP in first 6 weeks of treatment (log-rank P = 0.12/P = 0.32).CONCLUSIONS: Patients with idiopathic RPF who have elevated acute-phase reactant levels are more symptomatic. Neither acute-phase reactant levels or their initial changes can be taken as a major predictor for treatment success.

BACKGROUND: Prospective evaluation of the value of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels in monitoring disease activity and treatment response in patients with idiopathic retroperitoneal fibrosis (RPF).METHODS: This study included 57 patients with idiopathic RPF receiving tamoxifen monotherapy with at least 8 months follow-up. Clinical, laboratory and radiological investigation was performed at presentation and at repeated follow-up. Remission was defined as significant clinical improvement within 6 weeks of treatment together with stable or decreasing mass size on follow-up computed tomography (CT) scanning at 4 months and definitive decrease in mass size on follow-up CT scanning at 8 months.RESULTS: ESR and CRP levels at presentation and their respective decreases over time correlated strongly with each other (P < 0.001). Baseline ESR and CRP levels correlated with visual analogue scale (VAS) score for pain (ESR, P < 0.01; CRP, P < 0.001); baseline ESR levels also correlated with VAS score for discomfort (P < 0.001). Short-term decreases in ESR or CRP levels at 6 weeks follow-up did not correlate with subsequent mass regression but decrease in ESR at 4 months and decrease in CRP at 4 and 8 months follow-up correlated with mass regression. Kaplan-Meier analysis showed no difference in remission rate between patients with normal or elevated baseline ESR or CRP (log-rank P = 0.22/P = 0.88) or between patients with or without (near-)normalization of ESR or CRP in first 6 weeks of treatment (log-rank P = 0.12/P = 0.32).CONCLUSIONS: Patients with idiopathic RPF who have elevated acute-phase reactant levels are more symptomatic. Neither acute-phase reactant levels or their initial changes can be taken as a major predictor for treatment success.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:07 Faculty of Science > Institute of Molecular Life Sciences
Dewey Decimal Classification:570 Life sciences; biology
Language:English
Date:23 January 2012
Deposited On:26 Apr 2012 06:53
Last Modified:05 Apr 2016 15:47
Publisher:Oxford University Press
ISSN:0931-0509
Publisher DOI:10.1093/ndt/gfr779
PubMed ID:22273666
Permanent URL: http://doi.org/10.5167/uzh-61844

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