AB0344 Association between Red Blood Cells Distribution Width and Disease Activity Score in Rheumatoid Arthritis

Red Blood Cell Distribution Width: A Potential Inexpensive Marker for Disease Activity in Patients with Rheumatic Diseases; Scoping Review

Background

Rheumatic diseases encompass a diverse group of autoimmune disorders that affect the joints and connective tissues. The red blood cell distribution width (RDW) has been widely investigated as an inflammatory marker. This scoping review aimed to explore the potential utility of RDW as an inexpensive marker for disease activity in patients with rheumatic diseases. By summarizing the available evidence, we aimed to determine whether RDW can serve as a reliable and accessible indicator of disease activity in these patients.

Methods

A comprehensive search was systematically performed across electronic databases, encompassing PubMed, Embase, and Web of Science. Studies have explored the relationship between RDW and disease activity in rheumatic diseases. Data extraction focused on the study characteristics, methodologies, and findings related to RDW as a disease activity marker.

Results

After removing duplicates, the initial search yielded 25 relevant studies. These studies encompassed a variety of rheumatic diseases, with rheumatoid arthritis being the most frequently studied condition. The association between RDW and disease activity was assessed by using various disease activity indices and clinical parameters. While some studies have reported a significant correlation between elevated RDW and disease activity, others have yielded inconclusive results.

Conclusion

From this review, we concluded that RDW is an inexpensive potential marker for the evaluation of disease activity in rheumatic diseases. RDW is promising as an inexpensive and readily available marker; however, its clinical utility in assessing disease activity in rheumatic conditions warrants more rigorous investigation through well-designed prospective studies.

Red cell distribution width and neutrophil-lymphocyte ratio in rheumatoid arthritis

Red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) are potential low-cost markers for detecting rheumatoid arthritis (RA) disease activity, but evidence on their accuracy for this purpose is conflicting. We aimed to determine the relationship between these and the Disease Activity Score of 28 joints (DAS-28) among Filipino RA patients, and to evaluate their ability to discriminate between patients with active RA and those in remission. This was a cross-sectional study done through a 7-year review of medical records of 134 adult patients with RA in a tertiary government hospital. Correlations were analyzed using Spearman analysis, and the receiver operating characteristic (ROC) curve was used to derive the sensitivity, specificity, and optimal cut-off values of RDW and NLR. Most patients were females with a mean disease duration of 7 years. Eighty-one percent (81%) had active disease using DAS-28 ESR. A weak positive correlation was found between NLR and DAS-28 and between NLR and ESR, but RDW did not correlate with either DAS-28 or ESR. The ROC analysis showed that in the differentiation of active RA and inactive RA, both RDW (area under the curve [AUC] 0.516, cut-off of ≥ 14.2% with 55.6% sensitivity and 42.3% specificity) and NLR (AUC 0.629, cut-off of ≥ 2.32 with 54.6% sensitivity and 76.9% specificity) had poor performance. NLR, but not RDW, was positively but weakly correlated with DAS-28 and ESR, making it a helpful marker of disease activity and inflammation in RA. Both NLR and RDW had low sensitivity and specificity for active RA and may not be useful in detecting disease activity.