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Clinical Trial
. 2019 Jun;33(5):e22862.
doi: 10.1002/jcla.22862. Epub 2019 Feb 19.

The clinical value of hematological markers in rheumatoid arthritis patients treated with tocilizumab

Li Zhou  1 , Dong-Mei Xiao  1 , Wen Qin  1 , Bin-Hua Xie  1 , Ting-Hui Wang  1 , Hua Huang  1 , Bao-Jing Zhao  1 , Xi Han  1 , Qing-Qing Sun  2   3 , Xiu-Di Wu  1 , Han Cen  2   3
Affiliations
Clinical Trial

The clinical value of hematological markers in rheumatoid arthritis patients treated with tocilizumab

Li Zhou et al. J Clin Lab Anal. 2019 Jun.

Abstract

Background: Emerging evidence indicates that some hematological markers have critical value in evaluating treatment response. This study was performed to determine the clinical value of hemoglobin (Hb), platelet (Plt), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in rheumatoid arthritis (RA) patients treated with tocilizumab (TCZ).

Methods: Fifty-two RA patients receiving TCZ were recruited and followed for 6 months. The values of abovementioned hematological markers were collected. Clinical disease activity index (CDAI) and disease activity score based on 28 joints (DAS28)-ESR were calculated. Correlation analysis was conducted by calculating Pearson's correlation coefficient. The change in disease activity between groups according to the baseline level of hematological markers was compared by t test.

Results: Significant correlation between change in NLR (△NLR), change in PLR (△PLR), and change in CDAI (△CDAI) was found (△NLR: r = 0.30, P = 0.03; △PLR: r = 0.31, P = 0.03). The change in Plt (△Plt) was correlated with change in DAS28-ESR (△DAS28-ESR) (r = 0.36, P = 8.24 × 10-3 ). Greater improvement in CDAI was seen in patients categorized into Plt high group (t = 2.06, P = 0.04), NLR high group (t = 2.15, P = 0.04), and PLR high group (t = 2.41, P = 0.02) compared with the contrast group.

Conclusion: Our study demonstrated that △Plt, △NLR, and △PLR could be used to monitor the clinical response to TCZ. RA patients with high baseline levels of Plt, NLR, and PLR achieved more improvement, indicating these hematological markers might be utilized to guide TCZ treatment.

Keywords: hemoglobin; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; rheumatoid arthritis; tocilizumab.

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Conflict of interest statement

The authors declare that there is no conflict of interest associated with this study.

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