A method for optimizing the assessment of the activity of rheumatoid arthritis

Download in PDF

Aim

To study the possibility of optimizing the assessment of the degree of activity of rheumatoid arthritis (RA).

Material and methods

In 102 patients hospitalized with an exacerbation of RA, we calculated the ratios of the neutrophils to the lymphocytes counts (NLR) and the platelets to the lymphocytes counts (PLR) and the product of PLR and NLR – the systemic immuno-inflammatory index (SIVI). The control group consisted of healthy donors.

Results

In RA patients with a high disease activity, NLR, PLR and SIVI were significantly higher than in the control group (p = 0.001 in all cases). In RA patients with a moderate disease activity, PLR and SIVI were also significantly higher compared to donors (p = 0.001 and p = 0.003, respectively), whereas the difference in NLR between the two groups was statistically insignificant. The ROC analysis confirmed the acceptable sensitivity and specificity of NLR, PLR and SIVI indices. At the second stage of our study, a scoring algorithm for assessing the RA activity was developed using NLR, PLR, SIVI, ESR and C-reactive protein.

Conclusion

The inflammatory activity index developed on the basis of available inflammatory markers (NLR, PLR, SIVI, C-reactive protein and ESR) excludes subjective indicators that depend on the opinion of physician and are being used to assess RA activity

Key words

Rheumatoid arthritis, disease activity, DAS28, the ratio of the neutrophils to the lymphocytes counts, the ratio of the platelets to the lymphocytes counts, the systemic immuno-inflammatory index, C-reactive protein, ESR