ROLE OF BLOOD CALPROTECTIN LEVEL (MRP8/14) DETERMINATION FOR PREDICTION OF JUVENILE IDIOPATHIC ARTHRITIS FLARES AFTER DISCONTINUATION OF TREATMENT
Summary. After discontinuation of treatment some of the patients with juvenile idiopathic arthritis (JIA) develop flare of the disease. It is important to define appropriate biomarkers of subclinical activity of the disease that would help to identify patients with JIA who will not develop flare of the disease after discontinuation of treatment. The aim of this study is to determine prognostic value of blood calprotectin level (MRP8/14) for prediction of the disease flare development risk in patients with juvenile idiopathic arthritis before complete discontinuation of treatment. Results. It was shown that in 3 months after discontinuation of treatment in JIA patients demonstrating clinically inactive disease, flare developed in 5 (9.3%) out of 54 patients. Median value of calprotectin level prior to discontinuation of treatment was 1,700 ng/mL in patients who developed flare, and 1,500 ng/mL in the rest of the cohort. In 6 months 3 (6.3%) additional patients out of 48 under follow-up developed a flare, with median value of calprotectin being 1,300 and 1,500 ng/mL respectively. In 12 months flares developed additional 13 (28.9%) patients out of 45 patients under follow-up, with median value of calprotectin in these patients before discontinuation of treatment being 1,100 and 1,650 ng/mL respectively. Conclusion. After discontinuation of treatment in patients demonstrating clinically inactive disease, 38.5% of patients developed a flare over the next year of the follow-up. The study results did not found statistical difference in blood calprotectin level between those JIA patients with clinically inactive disease prior to complete discontinuation of treatment who developed flare of the disease, and those without a flare in 3; 6 and 12 months.
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