Machold et al, [32] demonstrated that, despite early treatment, substantial damage occurred in some patients with a very early arthritis was associated with presence of strong 'constitutive' predictors such as anti-CCP antibodies and RF as well as the presence of high long-term clinical disease activity as indicated by the level of CRP, swollen joint counts and the absence of a good clinical response (assessed by the failure to achieve lasting low disease activity). The gene discussed is CRP; the disease is arthritic joint disease.