Prognostic value of anti-CRP antibodies in XXXX in long-term follow-up.

@entity1 @entity1851 @entity8 @entity1252 @entity1988 @entity703
BACKGROUND: Autoantibodies against monomeric @entity1851 (anti-CRP-Ab) observed in @entity1 with @entity1252 ( @entity1252 ) and @entity1988 ( @entity1988 ) were suggested to be associated with active @entity1988 and a poor response to therapy during short-term follow-up. The aim of this study was to confirm this finding and to investigate the prognostic value of anti-CRP-Ab in @entity1 with @entity1988 during long-term follow-up. METHODS: Sera of 57 @entity1252 @entity1 (47 @entity1 , 10 @entity1 ) with biopsy proven @entity1988 and 122 healthy individuals were analyzed for the presence of anti-CRP-Ab by in-house ELISA. Anti-CRP-Ab levels were studied in relation to routine laboratory tests, urine analysis, levels of C3, C4, other immunological markers and the overall disease activity as assessed by @entity1252 ( @entity1252 ). The prognostic value of anti-CRP-Ab was tested in a subgroup of 29 newly diagnosed @entity1988 @entity1 (median follow-up 5.9  years). Response to therapy at various time points was assessed with respect to baseline anti-CRP-Ab levels. At least partial response in the first/second  year of treatment was considered as a "favorable outcome", while non-response, renal flare or end @entity703 were considered as "unfavorable outcome". RESULTS: Anti-CRP-Ab were only detected in @entity1 with @entity8 and their levels correlated with @entity1252 (rs   =   0.165, p   =   0.002). The time to response was shorter in patients being anti-CRP-Ab negative at baseline compared to anti-CRP-Ab positive @entity1 , p   =   0.037. In the second year of therapy, baseline anti-CRP-Ab positivity was a significant predictor of "unfavorable outcome" (OR [95  % CI]   =   15.6 [1.2-771]; p   =   0.021). The predictive value of "baseline anti-CRP positivity" further increased when combined with "non-response to therapy in the first year". Baseline anti-CRP-Ab positivity was not a predictor of "unfavorable outcome" at the end of follow-up, (OR [95  % CI]   =   5.5 [0.6-71.1], p   =   0.169). CONCLUSIONS: Baseline serum levels of anti-CRP-Ab seem to be a strong risk factor for a composite outcome of non-response, renal flare or end @entity703 after two years of standard treatment of @entity1988 . The response to therapy seems to be delayed in anti-CRP-Ab positive @entity1 .
