A Cross-Sectional Study on Elevated Serum Calcitonin Gene-Related Peptide Levels in Rheumatoid Arthritis Patients and Their Relationship with Disease Activity

Abstract

Background/Aims: This study aims to assess serum levels of calcitonin gene-related peptide (CGRP) in patients with rheumatoid arthritis (RA), compare these levels with those of healthy controls, and analyze their correlation with disease activity.

Materials and Methods: This cross-sectional, case-controlled study involved 80 individuals diagnosed with RA based on the American College of Rheumatology/The European Alliance of Associations for Rheumatology (ACR/EULAR) 2010 criteria and 40 healthy individuals serving as the control group. Demographic data, along with clinical and laboratory findings of the participants, were documented for analysis. C-reactive protein (CRP), CGRP, and erythrocyte sedimentation rate (ESR) levels were measured in both the RA and control groups. Disease activity among patients with RA was assessed using the Visual Analog Scale (VAS), Disease Activity Score- 28 (DAS-28), and Health Assessment Questionnaire (HAQ). Logistic regression was performed to identify significant predictors, and the optimal cut-off value was established through receiver operating characteristic (ROC) analysis.

Results: The median serum CGRP level in patients with RA (91.1 pg/mL) was significantly higher than that of the control group (40.8 pg/mL) (P < .001). The median serum CGRP level was significantly greater in seropositive patients with RA (118.7 pg/mL) compared to seronegative patients (66.1 pg/mL) (P = .017). The ROC analysis identified 61.78 pg/mL as the optimal CGRP cut-off to distinguish patients with RA from controls, with 70% sensitivity and 87.5% specificity (Area Under the Curve (AUC): 0.839, P < .001). A significant correlation was observed between CGRP levels in patients with RA and the scores of DAS-28, HAQ, VAS-Patient, and VASPhysician (P = .001, P = .006, P < .001, P = .001). Logistic regression analyses demonstrated that increases in CGRP (P = .002) and CRP (P = .011), as well as CGRP (P = .001) and ESR (P < .001), were each significantly associated with higher odds of active disease.

Conclusion: The findings suggest that higher serum CGRP levels may contribute to the pathophysiology of RA, potentially indicating disease progression, joint damage, and supporting prognosis in the management of RA.

Cite this article as: Dede Akpınar M, Ataoğlu S, Cangür Ş. A crosssectional study on elevated serum calcitonin gene-related peptide levels in rheumatoid arthritis patients and their relationship with disease activity. ArchRheumatol. 2026;41(1):29-39.