Investigating Neutrophil-Lymphocyte Ratio as a Predictive Marker of Disease Activity in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by synovitis, inflammation, and joint destruction that if not well controlled can destroy cartilage, bone, ligaments and tendons, and in some cases cause disability. The aim of this study was to evaluate the possible role of the ratio of neutrophil-lymphocyte (NLR) as an inflammatory marker in determining the severity of RA (Disease Activity Score 28 [DAS28]).

Fifty patients with RA attending the rheumatology clinic in Ilam Shahid Mostafa Khomeini Hospital, Iran, were examined for disease activity using physical and laboratory tests. NLR and disease severity were determined based on DAS28.

The disease activity, including remission and mild/moderate were seen in 34% (DAS28<2.6) and 66% (DAS28 2.6), respectively. The patients were 86% women and 14% men. Mean ages of patients with mild/moderate and remission RA were 51.30 and 36.82 years, respectively. The mean NLR was 1.80 in patients with remission RA and 1.93 in those with mild/moderate RA and no significant relationship was found in NLR between these two groups (P=0.99). There was a significant relationship between DAS28 and erythrocyte sedimentation rate (ESR) (P=0.02), and a weak relationship between DAS28 and age, gender, and medication (P≥0.1).

According to the results, perhaps ESR rather than NLR could be a prognostic factor for determining disease activity levels in RA patients with DAS28 <3.2.