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Objective A novel inflammation-based score, C-reactive protein(CRP)-to-albumin ratio (CAR), has been shown to have an association with theinflammatory status in several diseases. We aimed to analyse the associationbetween CAR and disease activity in patients with early rheumatoid arthritis(RA) and to determine the cut-off value of CAR in early and established RA.  Methods A total of 177 patients with RA and 111 age and gender-matchedhealthy controls were included in this study. Cases with a disease duration ofless than 1 year were classified as early RA. Serum albumin, CRP, erythrocytesedimentation rate (ESR), Disease Activity Score-28 (DAS-28-ESR), ClinicalDisease Activity Index (CDAI) and Health Assessment Questionnaire (HAQ) scoreswere recorded.  Results CAR was 2.44 (0.21–30.83) in the RA group and 0.45(0.21–10.47) in the control group (p&lt;0.001). Eighty-seven(49.15%) of the RA cases were classified as early RA. The analysesindicated that the ESR, CRP and CAR values were higher in patients with early RAthan in those with established RA and controls. CAR was correlated with albumin,CRP, ESH, DAS-28 and HAQ scores in both early RA and established RA groups. Thereceiver operating characteristic curves revealed a CAR cut-off value of 2.67(80% sensitivity and 85% specificity) and 1.63 (77%sensitivity and 72% specificity) for the prediction of early andestablished RA, respectively.  Conclusion CAR, a formulated ratio, has been described as a predictor fordisease activity in patients with early RA as well as in those with establishedRA. However, CAR has higher sensitivity and specificity for early RA than forestablished RA.

C-Reactive Protein-to-Albumin Ratio: A Novel Inflammatory Marker and Disease Activity Sign in Early Rheumatoid Arthritis