Treatment-induced stable, moderate reduction in blood cell counts correlate to disease control in early rheumatoid arthritis.
BACKGROUND
Treatment of rheumatoid arthritis (RA) has become more intensive, thereby raising concerns regarding toxicities, including leucopenia. The objective was to analyse cell counts obtained as routine surveillance for adverse effects to assess the effect of intensive treatment and treatment dosage and to examine correlations to disease activity scores.


METHODS
Patients with early RA were treated with combinations of disease-modifying anti-inflammatory drugs according to pre-defined rules, with dose adjustments contingent on residual disease activity and tolerance.


RESULTS
Mean leucocyte, neutrophil and platelet counts fell with levels that correlated to disease activity scores. The strongest correlation was between platelets and disease activity scores. There was a modest, inverse correlation between methotrexate dose and monocyte and lymphocyte counts. No serious toxicity associated with the therapy was seen.


CONCLUSIONS
Moderate reductions in cell counts are well tolerated in RA and appear to contribute to disease control.
Lester
S E
SE
Arthritis Research Laboratory, Hanson Research Institute, Adelaide, South Australia, Australia.
Proudman
S M
SM
Lee
A T Y
AT
Hall
C A
CA
McWilliams
L
L
James
M J
MJ
Cleland
L G
LG
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D001772:Blood Cell Count / Q000379:methods; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013997:Time Factors; D016896:Treatment Outcome
D018501:Antirheumatic Agents