6 Recommendations for research

6.1 The Committee agreed that further research would be of value to investigate factors which can predict the likelihood of rapid progression of disease and response to treatment with biological DMARDs. Factors to investigate include:

  • persistent elevation of inflammatory markers (such as C‑reactive protein [CRP]) and

  • presence of erosions on X‑ray and

  • positive for anti‑citrullinated protein antibodies (ACPA; see section 4.94).

    The Committee felt that how these factors interact with each other and to what extent the likelihood of progression is affected by the use of different thresholds would be of value.

  • National Institute for Health and Care Excellence (NICE)