Background/Purpose: Relapsing polychondritis (RP) is a rare autoimmune disease marked by episodic inflammation of cartilaginous tissues. A major challenge in its clinical management is the absence of reliable biomarkers to track disease activity. Conventional inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) often fail to correlate with clinical disease flares. As part of a prospective cohort study of patients with relapsing polychondritis we evaluated the utility of Factor VIII levels as a potential biomarker for disease activity in patients with RP.

Methods: Patients older than 18 years old with a confirm diagnosis of RP were included in this study. All patients were evaluated prospectively as part of a dedicated relapsing polychondritis cohort at the University of Maryland. Each patient underwent standardized assessment for disease activity and organ damage using clinical evaluations at the time of laboratory testing. Serum levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Factor VIII were measured in all participants. Statistical analysis was performed using t-tests for categorical variables to evaluate associations between biomarkers and disease activity.

Results: Of the 50 patients included, the majority were female (87%). Factor VIII levels ranged from 70% to 400%, with a median value of 172%. Laboratory values were collected at the time of clinical evaluation. Elevated Factor VIII was identified in 27 patients; of these, 22 (81%) had clinically active disease, a statistically significant association (p = 0.02). In contrast, ESR was elevated in only 2 patients and CRP in just 1, demonstrating poor correlation with disease activity. LDH, measured in a subset, also correlated with both elevated Factor VIII and clinical activity.

Conclusion: Factor VIII appears to be a promising biomarker for disease activity in relapsing polychondritis, showing a statistically significant correlation with active disease. In contrast, traditional inflammatory markers like ESR and CRP were elevated in very few patients and did not reflect disease status. These findings support the need for further investigation of Factor VIII as a more reliable tool for monitoring RP, and highlight the limitations of relying solely on ESR and CRP in clinical assessment

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/factor-viii-as-a-potential-biomarker-of-disease-activity-in-relapsing-polychondritis/