FAQ: How is calprotectin useful to monitor treatment response in rheumatoid arthritis?

25. May 2021 | 8 min read

FAQ: How is calprotectin useful to monitor treatment response in rheumatoid arthritis?

Calprotectin levels correlate with disease activity in rheumatoid arthritis (RA)1-3 and can therefore be used in monitoring of disease activity, treatment response and relapse4-6. Calprotectin has been reported as valuable tool to monitor patients receiving a variety of different treatments, including disease-modifying anti-rheumatic drugs (DMARDs)7,8 like methotrexate6,9, tumour necrosis factor inhibitors (TNFi)10-12, IL-6 inhibitors13.


Why is calprotectin especially important to monitor patients treated with DMARDs?

Disease-modifying anti-rheumatic drugs (DMARDs) are frequently used to treat inflammation and underlying inflammation pathways in RA. They target pro-inflammatory proteins, like TNF-alpha and IL-6, directly. The resulting decrease in systemic inflammatory signalling will also decrease activity of downstream proteins and processes, like activity of acute‐phase reactants erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Since CRP and ESR are often used as inflammatory biomarkers in RA, the direct effect of the treatment on CRP might lead to an overestimation of the patients’ response rate. In contrast, calprotectin is released locally from phagocytes, independently of systemic inflammatory signalling, and has been shown to more accurately discriminate disease activity in RA patients receiving TNFi than CRP and ESR10 and more strongly correlate with treatment response to methotrexate than CRP6.


Can calprotectin in blood predict relapse in RA?

Calprotectin can be used to accurately predict relapse in patients in remission or with low disease activity receiving biological drugs, which potentially would guide therapeutic decisions towards safer and more cost-effective treatment strategies10,13,14.

calprotectin rheumatoid arthritis


Learn more about calprotectin in blood:

What type of assay is the Gentian Calprotectin Immunoassay GCAL®?

What is calprotectin’s role in neutrophil activation?

What is the clinical value of calprotectin in sepsis & severe infections?

Is calprotectin upregulated in sepsis in COVID-19?

What role can plasma & serum calprotectin play in severe COVID-19?

How is calprotectin useful to monitor treatment response in rheumatoid arthritis?


Get in touch

For more details about the Gentian Calprotectin Immunoassay GCAL®  please contact us at marketing@gentian.com or fill out the form below:



calprotectin rheumatoid arthritis


  1. Bae SC, Lee YH. Calprotectin levels in rheumatoid arthritis and their correlation with disease activity: a meta-analysis. Postgrad Med. 2017.
  2. Hammer HB et al. Calprotectin (a major leucocyte protein) is strongly and independently correlated with joint inflammation and damage in rheumatoid arthritis. Ann Rheum Dis. 2007.
  3. Hurnakova J, et al. Relationship between serum calprotectin (S100A8/9) and clinical, laboratory and ultrasound parameters of disease activity in rheumatoid arthritis: A large cohort study. PLoS One. 2017.
  4. Abildtrup M et al. Calprotectin as a biomarker for rheumatoid arthritis: a systematic review. J Rheumatol. 2015.
  5. Ramírez J et al. Clinical and sonographic biomarkers of structural damage progression in RA patients in clinical remission: A prospective study with 12 months follow-up. Semin Arthritis Rheum. 2017.
  6. Nielsen UB et al. Calprotectin in patients with chronic rheumatoid arthritis correlates with disease activity and responsiveness to methotrexate. Scand J Clin Lab Invest. 2018.
  7. Jonsson MK et al. Calprotectin as a marker of inflammation in patients with early rheumatoid arthritis. Ann Rheum Dis.2017.
  8. Andrés Cerezo L et al. Decreases in serum levels of S100A8/9 (calprotectin) correlate with improvements in total swollen joint count in patients with recent-onset rheumatoid arthritis. Arthritis Res Ther. 2011.
  9. Patro PS et al. Myeloid-related Protein 8/14 Levels in Rheumatoid Arthritis: Marker of Disease Activity and Response to Methotrexate. J Rheumatol. 2016.
  10. Inciarte-Mundo J et al. Serum Calprotectin Versus Acute-Phase Reactants in the Discrimination of Inflammatory Disease Activity in Rheumatoid Arthritis Patients Receiving Tumor Necrosis Factor Inhibitors [published correction appears in Arthritis Care Res (Hoboken). 2017.
  11. Choi IY et al. MRP8/14 serum levels as a strong predictor of response to biological treatments in patients with rheumatoid arthritis. Ann Rheum Dis. 2015.
  12. Hammer HB et al. The soluble biomarker calprotectin (an S100 protein) is associated to ultrasonographic synovitis scores and is sensitive to change in patients with rheumatoid arthritis treated with adalimumab. Arthritis Res Ther. 2011.
  13. Inciarte-Mundo J et al. Calprotectin more accurately discriminates the disease status of rheumatoid arthritis patients receiving tocilizumab than acute phase reactants. Rheumatology (Oxford). 2015.
  14. Inciarte-Mundo J et al. Calprotectin strongly and independently predicts relapse in rheumatoid arthritis and polyarticular psoriatic arthritis patients treated with tumor necrosis factor inhibitors: a 1-year prospective cohort study. Arthritis Res Ther. 2018.


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