Berman Mark, Berliner Shlomo, Bashouti Nancy, Elkayam Ori, Ziv-Baran Tomer
Department of Rheumatology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Internal Medicine E Department, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Heliyon. 2023 May 25;9(6):e16665. doi: 10.1016/j.heliyon.2023.e16665. eCollection 2023 Jun.
C-reactive protein (CRP) is a marker of inflammation and infection. The main proinflammatory cytokine that leads to CRP gene expression is IL-6. The study aimed to compare CRP level between patients who were treated with Tocilizumab (TCZ), an il-6 receptor blocker, and other advanced anti-inflammatory treatments (AAIT), as well as with other admitted and non-admitted populations.
A cross-sectional study of all patients (≥18 years) hospitalized at tertiary medical center between December 2009 and February 2020 and treated before hospitalization with (AAIT). Only the first hospitalization of each patient was included. Women admitted to obstetrics department were excluded. Demographic data, first blood tests results, and comorbidities were collected.
The study included 563 patients treated with AAIT (2.5% received TCZ). Patients treated with TCZ were older (median 75 vs. 50 years, p < 0.001), had higher Charlson score (median 5 vs. 1, p < 0.001) and more infectious diseases at admission (50% vs. 23.4%, p = 0.05). Patients treated with TCZ had lower CRP levels (median 0.5 vs. 25 mg/l, p < 0.001) and more common normal values (64.3% vs. 20.8%, p < 0.001) compared to patients treated with other AAIT.CRP level in patients treated TCZ (median 0.5 mg/l) was lower than that of 58,548 patients admitted to the hospital between 2010 and 2020 (median 12.55 mg/l, p < 0.001) and not statistically different from 140 non-admitted randomly selected individuals without acute disease (1.33 mg/l, p = 0.294).
Tocilizumab is associated with lower levels of CRP in patients admitted to acute care hospital. This finding must be considered by treating physician to avoid misinterpretation of CRP results.
C反应蛋白（CRP）是炎症和感染的标志物。导致CRP基因表达的主要促炎细胞因子是白细胞介素-6（IL-6）。本研究旨在比较接受IL-6受体阻滞剂托珠单抗（TCZ）治疗的患者与其他先进抗炎治疗（AAIT）患者以及其他住院和非住院人群之间的CRP水平。
对2009年12月至2020年2月在三级医疗中心住院且住院前接受过（AAIT）治疗的所有患者（≥18岁）进行横断面研究。仅纳入每位患者的首次住院情况。排除产科住院的女性。收集人口统计学数据、首次血液检查结果和合并症。
该研究纳入了563例接受AAIT治疗的患者（2.5%接受TCZ治疗）。接受TCZ治疗的患者年龄更大（中位数75岁对50岁，p<0.001），Charlson评分更高（中位数5对1，p<0.001），入院时感染性疾病更多（50%对23.4%，p=0.05）。与接受其他AAIT治疗的患者相比，接受TCZ治疗的患者CRP水平更低（中位数0.5对25mg/l，p<0.001），正常数值更常见（64.3%对20.8%，p<0.001）。接受TCZ治疗的患者的CRP水平（中位数0.5mg/l）低于2010年至2020年期间入院的58548例患者（中位数12.55mg/l，p<0.001），与140例随机选择的无急性疾病的非住院个体（1.33mg/l，p=0.294）无统计学差异。
托珠单抗与急性护理医院住院患者较低的CRP水平相关。治疗医生必须考虑这一发现，以避免对CRP结果的错误解读。
