Analysis of hematological parameters in rheumatoid arthritis patients receiving biological therapy: contribution to prevention of avoidable hematological complications

Abstract

Administration of biological therapy (BT) in rheumatoid arthritis (RA) patients is often associated with hematological complications, which result in switching among therapies. Thus, there is an instant need for suitable screening parameters that will help to individualize the therapy and minimize the onset of adverse effects. We analyzed the hematological profile of 99 RA patients receiving TNFα (Adalimumab - ADA, Golimumab - GOL, Etanercept - ETA) or IL-6 receptor (Tocilizumab - TCZ) inhibitors in order to find possible indicators to improve personalization of RA therapy. BTs significantly affect the levels of observed hematological parameters. In contrast to TNF-α inhibitors, TCZ normalized almost all monitored hematological parameters to values of healthy donors. Only GOL from the TNF-α inhibitors studied, was able to normalize neutrophil counts, as well as platelet indicators. Importantly, effects on the blood parameters (e.g. lymphocytes or platelet count) differ even within the same therapeutic group (anti-TNFα). Variable effects of individual biological agents in RA treatment point to importance to evaluate the patient's hematological profile to improve the selection of suitable BT. It will help to personalize the administration of BT and prevent unnecessary switching from an effective therapy just because of provocation of avoidable hematological complications.

Correlation of Hematological Indices and Acute-Phase Reactants in Rheumatoid Arthritis Patients on Disease-Modifying Antirheumatic Drugs: A Retrospective Cohort Analysis

“…Pereckova showed that RA patients treated with csDMAR have higher NLRs and PLRs compared to healthy donors and patients receiving anti-TNF and anti-IL6. However, the NLRs and PLRs of patients receiving anti-TNF and anti-IL6 are comparable [17]. The effect of treatment duration on these indices was not discussed.…”

“…In the realm of novel treatments for rheumatoid arthritis, specifically those involving anti-CD20 and JAK inhibitors (JAKis), it is important to note their substantial impacts on lymphocyte and neutrophil counts, as evidenced by previous research [15,16]. However, the influence of these treatments on hematological indices remains an area of limited investigation [17][18][19]. Pereckova showed that RA patients treated with csDMAR have higher NLRs and PLRs compared to healthy donors and patients receiving anti-TNF and anti-IL6.…”

Impact of biological and non-biological treatment on hematological indices in patients with ankylosing spondylitis and psoriatic arthritis

“…Autoimmune diseases are immune-mediated disorders affecting joints, kidneys, and others that usually alternate activity with quiescent stages [ 1 ]. These inflammatory disorders are characterised by, increased production of proinflammatory cytokines [ 2 ]. Which include tumor necrosis factor alpha (TNFα), interleukin-17 (IL-17), and interleukin (IL-6) [ 3 ].…”