Association Between Pharmacotherapy And Circulating Hematological Profile In Rheumatoid Arthritis

Background — Hematological indices are useful predictors and prognostic biomarkers in rheumatoid arthritis (RA). Some antirheumatic drugs (ARD) have a negative effect on circulating blood cells and bone marrow and therefore may bias the interpretation of biomarker value. Objective — Our cross-sectional study aimed to demonstrate the effect of ADR use on peripheral blood indices in RA patients. Methods — This cross-sectional study was conducted on 103 adult RA patients and 21 healthy subjects at Rizgari Teaching Hospital in collaboration with the Department of Clinical Pharmacy and College of Pharmacy, Hawler Medical University, Erbil, Iraq, from January 2020 through December 2022. Patients were treated with methotrexate (MTX), hydroxychloroquine (HCQ), biologics (BL), MTX+HCQ, MTX+BL, and HCQ+BL. RA activity and complete blood count were obtained from patient records. Results — Our results implied that HCQ was associated with significantly lower hemoglobin levels, while MTX+BL was accompanied by significantly lower mean corpuscular volume. The mean platelet volume was significantly higher in all treatment groups than in healthy subjects. Conclusion — We concluded that BL use was statistically significantly associated with changes in hematological indices and ratios in patients with RA. It is important to consider the category of pharmacotherapy when interpreting circulating blood cell indices as predictors or prognostic biomarkers in RA.