Rheumatology · 2 h ago
Pretreatment Calprotectin May Predict Tofacitinib Response in Rheumatoid Arthritis
In a 51-patient study, researchers assessed whether pretreatment plasma calprotectin was associated with response after 24 weeks of tofacitinib for rheumatoid arthritis. Calprotectin showed moderate discrimination, but its difference between responders and nonresponders was not statistically significant.
- Study included 51 patients treated with tofacitinib for 24 weeks.
- Calprotectin AUC for response prediction was 0.732.
- Responder and nonresponder baseline levels did not differ significantly.
- Further validation is needed before clinical use.
Researchers enrolled 51 patients with rheumatoid arthritis receiving tofacitinib for 24 weeks and 25 healthy controls. They measured plasma calprotectin and assessed disease activity using DAS28-ESR. Response was defined as remission or low disease activity; patients with post-treatment DAS28-ESR above 3.2 were classified as nonresponders.
Twenty-eight patients (54.9%) were responders. Pretreatment calprotectin was higher in nonresponders than responders (median 1.70 vs 0.58 μg/mL), but the difference was not statistically significant (p=0.094). Calprotectin was associated with baseline DAS28 and ESR. For predicting response, the area under the ROC curve was 0.732 (95% CI 0.586–0.879) at a 0.98 μg/mL cutoff, with 73.9% sensitivity and 75.0% specificity. Its AUC exceeded that of ESR, but not CRP or DAS28-ESR.
The findings suggest calprotectin may warrant further study as a response biomarker, but do not establish a clinically reliable threshold or support changing treatment decisions. The study was small, and the reported difference between response groups was not significant; validation in larger cohorts is needed.
In practice
This small study suggests pretreatment plasma calprotectin may help distinguish likelihood of response among patients with rheumatoid arthritis starting tofacitinib, with an AUC of 0.732 at the reported cutoff. However, the calprotectin difference between responders and nonresponders was not statistically significant, and performance did not significantly exceed CRP or DAS28-ESR. The result is preliminary and does not establish a validated threshold or justify using calprotectin to select or withhold tofacitinib without further validation.
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Clinical Rheumatology: Pretreatment calprotectin level as a potential predictor of therapeutic response to tofacitinib in rheumatoid arthritis patients ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.