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Published on: February 7, 2025
Red cell distribution width is a potential predictor of early relapse in polymyalgia rheumatica
1Department of Translational Medicine, University of Piemonte Orientale UPO, Novara; Division of Internal Medicine, Immunorheumatology Unit, "Maggiore della Carità" Hospital, Novara. daniele.soddu88@gmail.com.
Abstract:
Red blood cell distribution width (RDW) has been studied as a prognostic biomarker for different chronic inflammatory diseases. In this paper we aim to evaluate its potential role in the prediction of early relapse in patients affected by polymyalgia rheumatica (PMR). We revised retrospectively clinical records of patients who received a diagnosis of PMR, according to 2012 ACR/EULAR classification criteria, for whom baseline clinical and laboratory data were available. The baseline RDW variation coefficient was correlated to the risk of relapse, in the first 6 months of the disease. We identified 44 patients [females 15 (34.0%)/males 29 (66.0%); median age 80 (72-83)], 9 of whom had an early relapse. These patients showed a larger median RDW than patients who did not relapse [13.7 (13.5-14.9)% vs 13.5 (12.7-14.2)%; p=0.04). The two groups were comparable for all the other clinical and laboratory parameters considered. Interestingly, patients in the higher half of the RDW distribution showed a shorter relapse-free survival (p<0.03). In a stepwise logistic regression, RDW (p=0.01) predicted the risk of relapse at 6 months, while age, gender, CRP, ESR, Hb, MCV and prednisone dose did not fit the model. Our results show that RDW is an independent biomarker of early relapse, making this parameter a potentially promising predictive marker in PMR.
Insights
Red blood cell distribution width (RDW) can predict early relapse in polymyalgia rheumatica (PMR) patients. Higher RDW levels indicate a greater risk of relapse within six months, independent of other factors.
Area of Science:
- Rheumatology
- Clinical Medicine
- Hematology
Background:
- Red blood cell distribution width (RDW) is a recognized prognostic biomarker in chronic inflammatory diseases.
- Polymyalgia rheumatica (PMR) is characterized by inflammation, and early relapse is a significant clinical concern.
Purpose of the Study:
- To investigate the potential of RDW as a predictive biomarker for early relapse in PMR patients.
- To correlate baseline RDW with the risk of relapse in the first six months of PMR diagnosis.
Main Methods:
- Retrospective review of clinical records for 44 PMR patients diagnosed using 2012 ACR/EULAR criteria.
- Analysis of baseline clinical and laboratory data, focusing on RDW variation coefficient.
- Correlation of RDW with relapse risk and relapse-free survival using statistical models.
Main Results:
- Nine out of 44 patients experienced early relapse.
- Patients with early relapse exhibited a significantly higher median RDW compared to those without relapse (13.7% vs 13.5%, p=0.04).
- Higher RDW levels were associated with shorter relapse-free survival (p<0.03) and independently predicted 6-month relapse risk (p=0.01).
Conclusions:
- RDW serves as an independent biomarker for predicting early relapse in polymyalgia rheumatica.
- RDW is a potentially valuable and accessible predictive marker for managing PMR patients.
- Further research can explore RDW's role in tailoring PMR treatment strategies.
