THE EFFECT OF TNF-ALPHA INHIBITORS USED IN RHEUMATOLOGIC DISEASES ON HEMATOLOGICAL PARAMETERS

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Aim:Tumor necrosis factor (TNF) inhibitors are used in patients resistant to conventional treatments for rheumatologic diseases such as rheumatoid arthritis (RA) and spondyloarthropathy (SpA). Agents used for treating rheumatic diseases affect hematological parameters. In this study, we evaluated hematological parameters in patients with inflammatory rheumatic diseases who started anti-TNF treatment at our center. Material and Methods:A total of 109 patients diagnosed with RA, SpA without psoriatic arthritis (PsA) and PsA who applied to the İnönü 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 (PLT), mean platelet volume (MPV) ratio, neutrophil to lymphocyte ratio, monocyte/lymphocyte ratio and eosinophil/lymphocyte ratio) at the beginning of treatment and at the first month of treatment were recorded. Results:The rheumatic inflammatory patients included in our study comprised 29 RA, 16 PsA, and 64 spondyloarthritis without PsA 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 PLT counts, a statistically significant increase in hemoglobin, lymphocyte, and eosinophil counts, and a statistically significant decrease in neutrophil to lymphocyte and monocyte to lymphocyte ratios with an increase in MPV and mean platelet volume to platelet count were observed at the 1st month of treatment. No complications related to laboratory changes were observed, and no patient discontinued treatment. 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.