UTILITY OF NON-INVASIVE HEMATOLOGICAL BIOMARKERS IN NEWLY DIAGNOSED RHEUMATOID ARTHRITIS PATIENTS

Аннотация

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by persistent inflammation of the synovium, leading to joint damage and systemic complications. Methotrexate (MTX) is commonly used as a first-line treatment for RA due to its immunosuppressive properties. However, a significant proportion of patients exhibit resistance to MTX therapy. Lately, certain complete blood count (CBC) derived biomarkers such as red cell distribution width (RDW), hemoglobin platelet ratio (HPR), and hemoglobin-monocyte ratio (HMR) have emerged as promising indicators in various inflammatory conditions, providing insights into disease prognosis and therapeutic response. However, there is currently limited data available on the effectiveness of the abovementioned biomarkers as prognostic ones to predict treatment outcomes in newly diagnosed RA patients who are initiating MTX treatment.

Objective: This study aimed to determine the potential of RDW, HPR, and HMR as prognostic biomarkers in newly diagnosed RA patients commencing MTX therapy. Additionally, to investigate their possible correlation with the Disease Activity Score of 28 joints (DAS-28).

Methods: We conducted a comprehensive analysis involving 64 RA patients categorized into Methotrexate-resistant (MTXR) and Methotrexate-sensitive (MTXS) groups and 28 age- and sex-matched healthy individuals. Standard T-tests were used to compare specific biomarkers between MTXR, MTXS, and control groups. For the comparison of categorical variables between the groups Chi-square test was employed. We examined correlations with Pearson’s correlation test between RDW, HPR, HMR, and DAS28 in both groups. To determine the predictive capabilities of these biomarkers, Receiver Operating Characteristic (ROC) curve analysis was performed.

Results: We identified statistically significant different RDW-SD values in MTXR and MTXS groups, according to an unpaired t-test. The RDW-SD was higher in the MTXR group compared to the MTXS. No significant positive correlations were identified between hematological biomarkers of interest and DAS-28 in either the MTXR or MTXS group. Additionally, The ROC curve analysis showed that their predictive capability was insignificant.

Conclusion: Elevated RDW-SD levels can be an early indicator of MTX resistance at the beginning of therapy in newly diagnosed RA patients. Additionally, based on our study cohort RDW-SD, HPR, and HMR cannot replace DAS-28 for assessing and monitoring disease activity in RA patients.