Hematological indices useful in monitoring disease activity in patients with RA treated with JAK inhibitors

Literature studies validate the role of hematological indices as reliable markers for the assessment of disease activity in rheumatoid arthritis (RA). A recent study published in Medicina 2022 has concluded the potential benefits of hematological indices in monitoring changes in disease activity in patients with RA treated with JAK inhibitors.

The study considered 123 patients with RA who completed a regimen of JAK inhibitors, baricitinib or tofacitinib for 24 weeks, and age- and sex-matched controls. Hematological indices evaluated were neutrophil-to-hemoglobin and lymphocyte (NHL) score, systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). The researchers noted significantly elevated SII, NHL score, NLR, and PLR in patients with RA at baseline in RA patients to controls (P <0.001). Association of SII, NHL score, NLR, and PLR at baseline with DAS28-ESR was also noted P <0.05). Changes in these scores were associated with those in DAS28-ESR during treatment with JAK inhibitors. The treatment contributed to a marked reduction in the score values compared to those at baseline (p < 0.001), but no decrease in PLR (p = 0.056) was noted. Changes in these scores between baricitinib and tofacitinib treatments were also comparable. However, none of the hematological indices were found to be predictive of non-response to JAK inhibitor treatment.

The present study revealed a significant correlation of the hematological indices, SII, NHL score, NLR, and PLR with DAS28-ESR for the assessment of disease activity in RA patients treated with JAK inhibitors. However, further prospective longitudinal studies using JAK inhibitors are warranted to verify the usefulness of hematological indices.

References: Choe, J.-Y.; Kim, S.-K. Association between Hematological Indices and Disease Activity in

Patients with Rheumatoid Arthritis Treated with Janus Kinase Inhibitors for 24 Weeks. Medicine 2022, 58, 426.