CRP at diagnosis in psoriatic arthritis: what it means and associations with long-term outcomes

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ID: 324237
2026
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Abstract
OBJECTIVE: The role of C-reactive protein (CRP) in Psoriatic Arthritis (PsA) as a diagnostic and prognostic marker is debated. We compared clinical and epidemiological features, as well as long-term outcomes, between patients with "elevated" (>0.5 mg/dL) and patients with "normal" (≤0.5 mg/dL) CRP at diagnosis. METHODS: In this real-world study, we analyzed data from 609 PsA patients categorized by their CRP at diagnosis. Demographics, clinical characteristics, comorbidities, and long-term outcomes were compared. The statistically significant variables in the univariate analyses were used to build two multivariable logistic regression models: i. assessing associations between CRP and features at PsA diagnosis, ii. examining its link with long-term outcomes (including "difficult to manage" and "persistent disease") and characteristics throughout the disease course. RESULTS: Of 609 patients, 132 (21.7%) displayed normal and 477 (78.3%) elevated CRP values at diagnosis. By univariate analysis, elevated CRP was associated with longer disease follow-up, BMI > 25 Kg/m2, enthesitis (at diagnosis and disease course), hypertension, hyperuricemia, new bone formation and "persistent disease". By multivariable analyses, elevated CRP at diagnosis was independently linked with BMI >25 Kg/m2 (OR 1.69, 95% CI 1.05-2.72), enthesitis (OR 2.04, 95% CI 1.24-3.38), hypertension (OR 2.07, 95% CI 1.04-4.11), new bone formation (OR 2.57, 95% CI 1.33-4.94), and "persistent disease" (OR 4.36, 95% CI 2.22-8.59). CONCLUSION: Overall PsA characteristics are comparable, irrespective of the CRP-levels at diagnosis, apart from new bone formation, enthesitis, "persistent disease" and increased cardiometabolic burden which were independently associated with elevated CRP-levels at PsA diagnosis.
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Authors Angeliki E. Dimopoulou, C Papagoras, Niki Kyriazi, Sousana Gazi, Evangelia Mole, Michael Krikelis, Paraskevi V Voulgari, Evripidis Kaltsonoudis, Nikolaos Koletsos, P. Katsimpri, Dimitrios Boumpas, Dimitrios Katsifis-Nezis, Nikolaos Kougkas, Theodoros Dimitroulas, Petros P Sfikakis, Maria G. Tektonidou, Konstantinos D Vassilakis, D.P. Bogdanos, Theodora Simopoulou, Christos Koutsianas, Eugenia Mavrea, Gkikas Katsifis, Konstantinos Kottas, Maria Konsta, Matthoula Tziafalia, Evangelia Kataxaki, Eleni Kalavri, Kalliopi Klavdianou, Αναστάσιος Καραμανάκος, Ioannis Xynogalas, Dimitrios Daoussis, George Iliopoulos, Ilias Bournazos, Konstantinos Georganas, Dimos Patrikos, Dimitrios Vassilopoulos, George E Fragoulis
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Journal Lara D. Veeken
Year 2026
DOI
10.1093/rheumatology/keag398
URL
https://doi.org/10.1093/rheumatology/keag398
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