The effect of TNF-alpha inhibitors used in rheumatologic diseases on hematological parameters

INTRODUCTION: Tumor necrosis factor (TNF) inhibitors are used in patients resistant to conventional treatments for rheumatologic diseases such as rheumatoid arthritis (RA)and spondyloarthropathy (SpA). It is known that agents used in the treatment of rheumatic diseases have effects on hematological parameters. In this study, we evaluated hematological parameters in patients with rheumatıc inflammation diseases, who started anti-TNF treatment at our center.
METHODS: A total of 109 patients diagnosed with RA, SPA, and PsA who applied to the Inonu University Rheumatology Clinic and started TNF inhibitor treatment were included in the study. The patients' diagnoses, demographic data such as age and gender, and laboratory parameters (white blood cell, eosinophil, lymphocyte, monocyte, neutrophil counts, hemoglobin, platelet, mean platelet volume, MPV/PLT ratio, neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio and eosinophil/lymphocyte ratio) at the beginning of treatment and at the 1st month of treatment were recorded.
RESULTS: The rheumatic inflammatory patients included in our study consisted of 29 RA, 16 PSA and 64 spondyloarthritis without psoriatic arthritis patients. Seventy-seven patients were female (70.6%), and 32 were male (29.4%), with a mean age of 46 (18-78). When all patients were evaluated together, a statistically significant decrease in white blood cell, neutrophil, and platelet counts; a statistically significant increase in hemoglobin, lymphocyte, and eosinophil counts; and a statistically significant decrease in NLR and MLR ratioswith an increase in MPV and MPR were observed at the 1st month of treatment. No complications related to laboratory changes were observed, and no patient discontinued treatment.
DISCUSSION AND CONCLUSION: Although there were changes in hematological parameters in patients receiving TNF inhibitor treatment in our study, we believe that regular hemogram monitoring should be performed at regular intervals in patients undergoing anti-TNF treatment, despite the absence of any complications in our study, as cases of severe cytopenia and eosinophilia have been reported in the literature following TNF inhibitor treatment.