Background Recently the relationship between inflammatory biomarkers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) has been found, with the increase in the percentage of red cell distribution width (RDW), events related to increase in cardiovascular risk in patients with rheumatoid arthritis (RA). RDW is a parameter that represents the heterogeneity of erythrocyte size and is calculated by an automatic blood analyzer, translates anisocytosis and in turn is related to atherosclerosis, is a predictor of mortality in patients with cardiovascular diseases such as acute myocardial infarction (AMI) and Congestive Heart Failure (CHF) plus it has the advantage of being very cheap. In patients with RA who receive treatment with methotrexate (MTX), particularly those with good therapeutic response with decreased disease activity, the values of ESR and CRP decrease.
Objectives The aim of this study is to verify if there is a decrease, increase or neither change in the value of RDW in the patients receiving or not MTX comparing the value prior to the start of treatment and the last value measured during their therapy.
Methods In this descriptive, non-experimental cross-sectional study, men and women older than 18 years of age with a diagnosis of rheumatoid arthritis according to ACR criteria (Aletaha et al., 2010) who were or not treated with methotrexate and other DMARDs. We excluded patients with less than two visits in this unit and the elimination criteria were patients who did not have baseline or last RDW test. The records of all patients included name, age, sex, date of diagnosis of RA, comorbidities, baseline and final laboratory exams during follow-up that included tests with RDW and medications.
Results A total of 403 all with a diagnosis of RA and an average of 4.62 years of evolution, of which 51 they do not take methotrexate in daily dose and 352 receive treatment and only 4.2% suffered from a cardiovascular event. The comparison was made grouping the patients in whom they received and not treatment with methotrexate and correlated with the value of baseline and final RDW as shown in Table 1.
The results shown in Table 1, do not appear to reveal a significant change in RDW values between the different subgroups; in the figures we compared the median of RDW for each group of patients who take methotrexate from all patients included in this study.
Conclusions The value of RDW does not appear to significantly change its value when taking methotrexate at a daily dose in RA patients. The value of RDW may have weight in the assessment of the risk of suffering a cardiovascular event in patients with rheumatoid arthritis.
Hassan, S. et al. (2015). Red Cell Distribution Width: a measure of cardiovascular risk in rheumathoid arthtritis patiens? Clin Rheumatol.
Woong Soo, L. et al. (2010). Relation between red cell distribution width and inflammatory biomarkers in rheumatoid arthritis. Seoul, Republic of Korea.
Aletaha, et al. (2010). 2010 Rheumatoid arthritis classification criteria, Arthritis & Rheumatism.
Disclosure of Interest None declared