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Shadick et al1(p2492) have reported that C-reactive protein (CRP) level “was not found to be associated with an increased risk of subsequently developing RA [rheumatoid arthritis].” I would like to offer some thoughts on both the study design and its interpretation.
The study construct presents 2 issues for discussion. First, smoking is known to be a risk factor for clinical RA, possibly by triggering a shared epitope response to autoantigens modified by citrullination,2 yet in the study cohort, “women with RA were more likely to be never smokers” (38%) than were those without RA (52%).1(p2491) The second issue is the apparent lack of screening for statin use.
Tanzer J. C-Reactive Protein Is Still a Potential Aid in Rheumatoid Arthritis Predictors. Arch Intern Med. 2007;167(14):1552. doi:10.1001/archinte.167.14.1552-a
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