Effectiveness of biological treatment in rheumatoid arthritis through the prism of inflammation indices

Abstract

Background. Rheumatoid arthritis is a systemic autoimmune disease marked by chronic synovial inflammation, causing progressive joint destruction and disability. Biological treatments, especially targeted agents, have transformed disease management by effectively controlling inflammation and significantly reducing pain. Objective(s). Evaluating the efficacy of biological treatment in RA through the dynamics of inflammatory markers, their correlation with disease activity (DAS28) and assessing their utility as monitoring biomarkers. Materials and methods. The study included a group of 150 patients diagnosed with RA, treated with biological agents (anti-TNFα, tocilizumab, rituximab), within the Republican Clinical Hospital. Patients were evaluated initially and during treatment at regular intervals, monitoring clinical (DAS28, pain, mobility) and laboratory parameters (ESR, CRP, PLR). Results. Biological treatment resulted in a significant decrease in inflammatory indices: ESR (p<0.01), CRP (p<0.01), NLR (from median 3.12 to 2.01, p<0.001) and PLR (from 180.5 to 135.7, p<0.005). The reduction of these markers correlated with improvement in DAS28 score, especially in the first 3–6 months of treatment. The most marked changes were observed in patients treated with tocilizumab and TNFα inhibitors. Significant correlations were identified between NLR and disease activity (r=0.79, p<0.01), and PLR proved useful in assessing chronic progression (r=0.65, p<0.05). Patients also reported a substantial reduction in pain. Conclusion(s). Biological treatment in RA effectively reduces systemic inflammation, shown by decreased inflammatory markers and improved disease activity. NLR and PLR indices are useful, accessible biomarkers to monitor therapy effectiveness and disease progression, supporting personalized treatment plans.