Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy; Division of Internal Medicine, Immunorheumatology Unit, CAAD (Center for Translational Research on Autoimmune and Allergic Disease) Maggiore della Carità Hospital, Novara, Italy; IRCAD, Interdisciplinary Research Center of Autoimmune Diseases, Novara.
Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy; Division of Internal Medicine, Immunorheumatology Unit, CAAD (Center for Translational Research on Autoimmune and Allergic Disease) Maggiore della Carità Hospital, Novara.
Reumatismo. 2020 Apr 10;72(1):16-20. doi: 10.4081/reumatismo.2020.1243.
Red cell distribution width (RDW) is an unconventional biomarker of inflammation. We aimed to explore its role as a predictor of treatment response in rheumatoid arthritis (RA). Eighty-two RA patients (55 females), median age [interquartile range] 63 years [52-69], were selected by scanning the medical records of a rheumatology clinic, to analyze the associations between baseline RDW, disease activity scores and inflammatory markers, as well as the relationship between RDW changes following methotrexate (MTX) and treatment response. The lower the median baseline RDW, the greater were the chances of a positive EULAR response at three months, 13.5% [13.0-14.4] being among those with good response, vs 14.0% [13.2-14.7] and 14.2% [13.5- 16.0] (p=0.009) among those with moderate and poor response, respectively. MTX treatment was followed by a significant RDW increase (p<0.0001). The increase of RDW was greater among patients with good EULAR response, becoming progressively smaller in cases with moderate and poor response (1.0% [0.4-1.4] vs. 0.7 [0.1-2.0] vs. 0.3 [-0.1-0.8]; p=0.03). RDW is a strong predictor of early response to MTX in RA. RDW significantly increases after MTX initiation in parallel to treatment response, suggesting a role as a marker of MTX effectiveness.
红细胞分布宽度（RDW）是一种非常规的炎症生物标志物。我们旨在探讨其作为类风湿关节炎（RA）治疗反应预测因子的作用。通过扫描风湿病诊所的病历，选择了 82 名 RA 患者（55 名女性），中位年龄[四分位数范围]为 63 岁[52-69]，分析基线 RDW、疾病活动评分和炎症标志物之间的关系，以及甲氨蝶呤（MTX）治疗后 RDW 变化与治疗反应的关系。基线 RDW 中位数越低，三个月时 EULAR 反应阳性的可能性越大，其中良好反应者为 13.5%[13.0-14.4]，中度和差反应者分别为 14.0%[13.2-14.7]和 14.2%[13.5-16.0%]（p=0.009）。MTX 治疗后 RDW 显著升高（p<0.0001）。良好 EULAR 反应者的 RDW 升高幅度较大，而中度和差反应者的 RDW 升高幅度逐渐减小（1.0%[0.4-1.4]比 0.7%[0.1-2.0]比 0.3%[-0.1-0.8]；p=0.03）。RDW 是 RA 对 MTX 早期反应的有力预测因子。在 MTX 开始后，RDW 显著增加，与治疗反应平行，这表明它可能是 MTX 有效性的标志物。
