Haematological Parameters as Associate Marker of Disease Activity in Rheumatoid Arthritis: A Cross-Sectional Study from West Bengal Region of India
DOI:
https://doi.org/10.21276/apalm.3827Keywords:
rheumatoid arthritis, disease activity score 28 (DAS28), neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV), haemoglobin (Hb)Abstract
Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder that affects synovial joints. Monitoring the disease activity is essential for effective treatment and remission. While the Disease Activity Score 28 (DAS28) is commonly used, recent studies have suggested that haematological parameters from a complete blood count (CBC) may also indicate disease activity. This study evaluated parameters such as haemoglobin (Hb), red and white blood cell counts, platelets, and ratios (NLR, PLR, and MPV) across different levels of RA activity and assessed their predictive accuracy using ROC analysis.
Methods: A cross-sectional study was conducted from January to April 2024 in patients with RA meeting the ACR/EULAR 2010 criteria. Patients with coexisting autoimmune diseases, infections, or hematologic disorders were excluded from the study. The CBC and DAS28 scores were reviewed. The patients were classified into four groups: remission, low, moderate, and high disease activity. Statistical analyses involved Kruskal-Wallis tests and multivariate logistic regression analyses. Receiver operating characteristic (ROC) curves were used to determine diagnostic performance.
Result: Multivariate analysis identified Hb level, NLR, and MPV as independent predictors of RA activity. ROC analysis showed AUCs of 0.717 for Hb, 0.608 for NLR, and 0.679 for MPV, indicating moderate diagnostic value. CBC-derived parameters, particularly Hb level, MPV, and NLR, are correlated with RA disease activity. Their integration into routine assessment can enhance disease monitoring, cost-effectiveness, and wide accessibility.
Conclusion: CBC-derived markers low haemoglobin with elevated NLR and MPV reflect increased inflammatory burden in RA. As these tests are inexpensive and widely available, they can complement DAS28 to improve accessible and cost-effective RA disease monitoring.
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Copyright (c) 2026 Ritasman Baisya, Vikas Dagar, Juwain Nehil, Sudhanshu Shekhar, Indranil Chakrabarti, T Santosh
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