Comment on 'Implication of baseline levels and early changes of C-reactive protein for subsequent clinical outcomes of patients with rheumatoid arthritis treated with tocilizumab'.

We read with interest the article ‘Implication of baseline levels and early changes of C-reactive protein for subsequent clinical outcomes of patients with rheumatoid arthritis treated with tocilizumab’ by Shafran et al .1 This was an exploratory analysis of multiple studies and concluded that baseline C-reactive protein (CRP) and its early course may inform, to some extent, the estimation of potential therapeutic success in patients with rheumatoid arthritis (RA) treated with tocilizumab. Although we appreciate the pursuit of personalised treatment decisions in RA, this conclusion is not the only interpretation, and previously published analyses of these data further characterise the relationship between CRP and clinical outcomes with tocilizumab treatment in patients with RA.2 Shafran et al 1 concluded that baseline and early changes in CRP levels are predictive of tocilizumab response. Although CRP levels were affected differently by tocilizumab than rituximab or methotrexate treatment, decreasing to near zero in tocilizumab-treated patients, the …