Obesity, C-Reactive Protein, and Calprotectin in Adalimumab-Treated Rheumatoid Arthritis Patients: Association with Clinical Response: A cross-sectional comparative study
1
College of Medicine, University of Al-Qadisiyah, Al-Diwaniyah/ Iraq
2
Al-Hamzah General Hospital, Al-Qadisiyah Health Directorate, Al-Diwaniyah, Iraq
10.36582/ksj.2026.171634.1056
Abstract
Background: Rheumatoid arthritis (RA) is a long-lasting inflammatory disease characterized via synovial inflammation and joint destruction. Tumor necrosis factor-alpha and interleukin-6 are key mediators. Adalimumab is operative; a percentage of patients show inadequate response. C-reactive protein and erythrocyte sedimentation rate are widely used inflammatory markers, but limited ability to predict treatment response. Calprotectin has been projected as a biomarker of illness activity. Adipose tissue secretes pro-inflammatory cytokines and related to reduced response to TNF inhibitors. Objectives: To assess serum CRP and calprotectin ranks in RA patients cured with adalimumab and to evaluate their connotation with BMI and medical response. Methodology: A cross-sectional comparative study included 130 participants: 75 RA patients receiving adalimumab and 55 controls. Patients included 25 males and 50 females; mean age 47.57 ±10.68 (responders n = 35) and 46.40 ±8.76 (non-responders n = 40), classified according to European Alliance of Associations for Rheumatology criteria, using Disease Activity Score28 with Erythrocyte sedimentation rate. CRP and calprotectin were measured using Enzyme-Linked Immunosorbent Assay. Results: RA patients showed higher CRP and calprotectin levels paralleled to controls (p < 0.001). Calprotectin did not differ between responders and non-responders, while CRP was higher in non-responders (p < 0.001). BMI was positively correlated with calprotectin (r = 0.746) and CRP (r = 0.655) (p < 0.001). Conclusion: CRP and calprotectin are elevated in RA patients treated with adalimumab; Only CRP is associated with treatment response. Calprotectin reflects inflammatory burden, while obesity is related with augmented inflammatory indicators and may negatively influence outcomes.
Abed,G Kareem, Swadi,A Abdul Jaleel and ALzubaidi,Z Hussam. (2026). Obesity, C-Reactive Protein, and Calprotectin in Adalimumab-Treated Rheumatoid Arthritis Patients: Association with Clinical Response: A cross-sectional comparative study. Al-Kunooze Scientific Journal, 12(3), 217-228. doi: 10.36582/ksj.2026.171634.1056
MLA
Abed,G Kareem, , Swadi,A Abdul Jaleel, and ALzubaidi,Z Hussam. "Obesity, C-Reactive Protein, and Calprotectin in Adalimumab-Treated Rheumatoid Arthritis Patients: Association with Clinical Response: A cross-sectional comparative study", Al-Kunooze Scientific Journal, 12, 3, 2026, 217-228. doi: 10.36582/ksj.2026.171634.1056
HARVARD
Abed G Kareem, Swadi A Abdul Jaleel, ALzubaidi Z Hussam. (2026). 'Obesity, C-Reactive Protein, and Calprotectin in Adalimumab-Treated Rheumatoid Arthritis Patients: Association with Clinical Response: A cross-sectional comparative study', Al-Kunooze Scientific Journal, 12(3), pp. 217-228. doi: 10.36582/ksj.2026.171634.1056
CHICAGO
G Kareem Abed, A Abdul Jaleel Swadi and Z Hussam ALzubaidi, "Obesity, C-Reactive Protein, and Calprotectin in Adalimumab-Treated Rheumatoid Arthritis Patients: Association with Clinical Response: A cross-sectional comparative study," Al-Kunooze Scientific Journal, 12 3 (2026): 217-228, doi: 10.36582/ksj.2026.171634.1056
VANCOUVER
Abed G Kareem, Swadi A Abdul Jaleel, ALzubaidi Z Hussam. Obesity, C-Reactive Protein, and Calprotectin in Adalimumab-Treated Rheumatoid Arthritis Patients: Association with Clinical Response: A cross-sectional comparative study. KSJ. 2026;12(3):217-228. doi: 10.36582/ksj.2026.171634.1056