Funding: National Health and Medical Research Council of Australia.
Treatment-induced stable, moderate reduction in blood cell counts correlate to disease control in early rheumatoid arthritis
Version of Record online: 28 JUN 2008
© 2009 The Authors. Journal compilation © 2009 Royal Australasian College of Physicians
Internal Medicine Journal
Volume 39, Issue 5, pages 296–303, May 2009
How to Cite
Lester, S. E., Proudman, S. M., Lee, A. T. Y., Hall, C. A., McWilliams, L., James, M. J. and Cleland, L. G. (2009), Treatment-induced stable, moderate reduction in blood cell counts correlate to disease control in early rheumatoid arthritis. Internal Medicine Journal, 39: 296–303. doi: 10.1111/j.1445-5994.2008.01737.x
Potential conflicts of interest: None
- Issue online: 15 JUN 2009
- Version of Record online: 28 JUN 2008
- Received 15 December 2007; accepted 4 May 2008.
- rheumatoid arthritis;
- disease-modifying anti-inflammatory drug;
- disease activity;
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.
Conclusion: Moderate reductions in cell counts are well tolerated in RA and appear to contribute to disease control.