Serum calprotectin as a biomarker for Large vessel vasculitis: a multicenter cross-sectional study

Abstract

Large vessel vasculitis (LVV), namely Takayasu arteritis (TAK) and giant cell arteritis (GCA), is the most common type of primary vasculitis affecting adult patients with significant and potentially debilitating consequences. Even though C-reactive protein (CRP) and erythrocyte sedimentation rate are widely utilized biochemical markers for disease activity among LVV patients, such biomarkers are not without major drawbacks, especially with the more widespread use of anti-interleukin-6 based therapies. Methods We have conducted a multicentered, cross-sectional cohort study involving a total of 149 LVV patients with 183 clinical visits from seven tertiary care centers with specialized rheumatology clinics. Results A total of 42 GCA and 107 TAK patients with a mean age of 51.2 (±18.04) years and female predominance have been included in our study while 14.1% of the patients were classified as in active disease state. We have failed to demonstrate a statistically significant association between serum calprotectin levels and disease activity states among LVV patients 1.65 (1.15–2.08) vs 1.26 (0.65–1.81) μg/mL, p = 0.077), the GCA subgroup (1.65 (1.47–1.70) vs 0.88 (0.59–1.75) μg/mL, p = 0.136), or the TAK subgroup (1.73 (0.86–2.08) vs 1.32 (0.92–1.77) μg/mL, p = 0.466). In contrast, CRP was significantly higher in active disease in the overall cohort (7.13 (0.56–21.70) vs 2.60 (0.84–6.58) mg/L, p = 0.044) and in the GCA subgroup (14.75 (6.97–19.80) vs 1.44 (0.50–6.00) mg/L, p = 0.039), but not in the TAK subgroup (p = 0.162). Conclusion Our large-scale multicentered cohort study has failed to demonstrate superiority of serum calprotectin assay in the assessment of disease activity among LVV patients. With the growing use of numerous biological agents in LVV treatment, the need for a reliable biomarker with strong discriminative power still continues.