Red Cell Distribution Width and Absolute Lymphocyte Count Associate With Biomarkers of Inflammation and Subsequent Mortality in Rheumatoid Arthritis
Authors' conclusion
RDW and ALC before disease-modifying antirheumatic drug therapy are associated with biomarkers of monocyte/macrophage inflammation and subsequent mortality.
Study context
- Population
- Patients with rheumatoid arthritis (RA) treated with methotrexate (MTX)+/- TNFi, single Veterans Affairs (VA) Rheumatology Clinic; validated in national VA cohortnational cohort n = 13,914
- Participants
- 327 patients
- Exposure
- High vs low RDW and low vs high absolute lymphocyte count (ALC) before MTX
- Outcome
- Subsequent mortality
- Follow-up
- 10 years
Methodological detailssingle-centre, national validation cohort
- Single-centre
- National validation cohort
Main finding
As reported in the abstract
Mortality over 10 years by pre-MTX RDW and ALC
- High RDW and low ALC prior to MTX associated with subsequent mortality
- both P < 0.001
Observational data: associations, not effects.
Further findings
Inflammatory markers (immunology cohort)
- Soluble and cellular inflammatory markers higher in RA than controls
- ALC correlated with age, plasma tumor necrosis factor (TNF) receptor II, NK HLA-DR MFI and CD4CM/CD8CM HLA-DR/CD38%; RDW associated with age and ALC
RDW and ALC during therapy
- MTX initiation followed by increase in RDW and decrease in ALC
- TNFi added to MTX increased ALC
Original publication
Red Cell Distribution Width and Absolute Lymphocyte Count Associate With Biomarkers of Inflammation and Subsequent Mortality in Rheumatoid Arthritis. J Rheumatol. Published 1 November 2022. doi:10.
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