Background Rheumatoid Arthritis (RA) is an autoimmune disease,
symmetrically affecting the small joints. Biomarkers are tools that can
be used in the diagnosis and monitoring of RA. Aim To systematically
explore the role of the biomarkers: C-reactive protein (CRP), Rheumatoid
factor (RF), Anti-cyclic citrullinated protein (Anti-CCP), 14-3-3η and
the multi-biomarker disease activity (MBDA) score for the diagnosis and
treatment of RA. Methods A systematic review of the English literature
using four different databases was carried out. Results
CRP>7.1 mg/L predicted poor conventional synthetic disease
modifying anti-rheumatic drugs (csDMARDs) outcome in RA. Anti-CCP, CRP
≥0.3 mg/dL and RF predicted bone erosion and cartilage destruction.
Combination of high 14-3-3η with RF and CRP improved the prediction of
rapid erosion progression (REP). Anti-CCP was not associated with
disease activity, but was associated with increased radiographic damage
(r=0.46, p=0.048). RF was not associated with joint damage but
correlated with ultrasound-detected bone erosion. 14-3-3η significantly
correlated with inflammation, bone remodelling and osteoporosis in RA
patients (p<0.05). 14 3 3η positively correlated with RA
duration (p=0.003), disease activity and positive RF (P=0.025) and it
distinguished early from established RA. Early MBDA scores correlated
with later response in disease activity, after 6 and 12 weeks of
treatment (p<0.05). MBDA score was able to differentiate
between small differences in disease activity and predicted remission
over one year period. Conclusion The investigated biomarkers are helpful
tools in clinical practice for diagnosis, monitoring of treatment and
predicting prognosis in RA patients. However, further research is still
required to investigate novel biomarkers for the pre-treatment selection
of potentially responsive patients before starting therapy for a
precision medicine in this area.