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Lookup NU author(s): Professor John IsaacsORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Objective: Previous publications have reported that increased absolute monocyte counts are associated with treatment non-response in patients with rheumatoid arthritis (RA). This study investigated whether full blood count (FBC) components from routine clinical testing before treatment with a biological disease-modifying anti-rheumatic drug (bDMARD) were associated with treatment non-response after 6 months of treatment. Method: From a UK-based prospective multicentre study of patients with RA starting a bDMARD, data from 246 patients attending five of the participating centres were retrieved. FBC components were analysed for their association with European Alliance of Associations for Rheumatology non-response after 6 months of treatment using backward stepwise logistic regression, adjusting for potential confounders. Final models underwent resampling with 200 repeats of out-of-bag bootstrapping to assess model performance using area under the receiver operating characteristics (AUROC) curves. Model fit was compared using the Akaike information criterion (AIC). Results: After 6 months of treatment, the only FBC component predictive of non-response was pretreatment absolute monocyte count [adjusted odds ratio (ORadj) 9.56, 95% confidence intervals (CI) 1.61-59.86, p = 0.01, AUROC = 60.42%). The model including monocytes as a predictor demonstrated superior performance to the covariates-only model (AIC 184.36 vs 188.51, respectively). Conclusion: In the largest study to date, increasing absolute monocyte counts were associated with bDMARD non-response after 6 months of treatment, replicating previous reports. Validation and mechanistic studies are required to inform future treatment selection.
Author(s): Ling SF, Ho P, Bukhari M, Mewar D, Chinoy H, Morgan AW, Isaacs JD, Wilson AG, Hyrich KL, Barton A, Plant D
Publication type: Article
Publication status: Published
Journal: Scandinavian Journal of Rheumatology
Year: 2025
Volume: 54
Issue: 5
Pages: 325-330
Online publication date: 21/05/2025
Acceptance date: 22/04/2025
Date deposited: 02/06/2025
ISSN (print): 0300-9742
ISSN (electronic): 1502-7732
Publisher: Taylor and Francis Ltd.
URL: https://doi.org/10.1080/03009742.2025.2497606
DOI: 10.1080/03009742.2025.2497606
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