AJPS, 2011, Vol. 10, No.2 The effect of chloroquine phosphate on C-reactive protein and erythrocyte sedimentation rate measurement in knee osteoarthritic patients

Osteoarthritis (OA) is the most common articular disease world wide. It is the result of both mechanical and biological events that destabilize the normal coupling of degeneration synthesis of articular cartilage and subchondral bone. Rheumatologist often routinely order tests for rheumatoid factor and erythrocyte sedimentation rate (ESR) for all patients with joint complaints as well as C reactive protein (CRP) as a laboratory marker important in the AJPS, 2011, Vol. 10, No.2 2 assessment of inflammation. Anti malarial drugs are used for treatment of many rheumatic diseases. Chloroquine phosphate (CQP) was used previously as a disease modifying anti rheumatic drug and in this study its effect appears through decreasing the measurement of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in knee osteoarthritic patients (KOA). Abbreviation: HCQ, hydroxy chloroquine; CQ, chloroquine; DMARD, disease modifying anti rheumatic drug; APP, acute phase protein; ACR, American College of Rheumatology; RA, rheumatoid arthritis; SLE, systemic lupus erythematosus; RF, rheumatoid factor. Introduction OA is a disease characterized by a progressive articular cartilage destruction, osteophyte formation, subchondral bone sclerosis and secondary synovitis. The acute phase response is a major pathophysiologic phenomenon that accompanies acute and chronic inflammation . CRP is one of APPs that influence one or more stage of inflammation so it has both pro inflammatory and anti inflammatory action . ESR is an indirect measurement of plasma APPs concentration and can be greatly influenced by many factors . Rheumatologist often routinely order tests for RF, ESR for all patients with joint complaints . However neither the presence of RF nor mildly elevated ESR excludes a diagnosis of OA in elder patient . CQ is an amino-quinoline derivate drug that previously used in treatment of malaria. It has a beneficial therapeutic effect in SLE, RA and viral infection [9, 10, 11, . Phosphate salt of CQ is used in this study to ameliorate the signs and symptoms of disease by reducing blood level of ESR and CRP. Materials and Methods: Sixty patients (40 female and 20 male) are classified as KOA by Rheumatologist according to ACR criteria , in Out Patient Clinic in Baghdad Teaching Hospital, Medical Center, Baghdad, from January to September 2008 with fifty healthy people (30 female and 20 male). The patient ages are ranged from (55 to 67) years, their mean values ± standard mean of error are (62.7± 5.2). CQP is used for one month to treat all patients, two tablets are taken daily after meal (Medoquine 250 mg /Medochem Company equivalent to 150 mg CQ base). CRP was assessed by antigen-antibody reaction technique (quantitative turbidity metric method). ESR was estimated by Wintrob's Haematocrit tube . Whole blood was used to determine ESR while the serum was used to determine CRP. AJPS, 2011, Vol. 10, No.2