An assessment of the joint involvement severity in rheumatoid arthritis patients using anticoagulants

Objective: This study aims to determine the relationship between the use of anticoagulants and the severity of joint involvement in patients with active rheumatoid arthritis who use anticoagulants (for venous thromboembolism prophylaxis or due to additional diseases such as atrial fibrillation, coronary artery disease, pulmonary embolism, etc.). Methods: A total of 42 participants who met the 2010 ACR/EULAR Rheumatoid Arthritis Classification Criteria and were diagnosed with RA, aged between 18-70, without any known additional rheumatological diseases, and according to the rheumatoid arthritis activity index (DAS28-ESR and/or DAS28-CRP ≥2.6) values considered to have RA attack, were included in the study. 23 participants, already receiving venous thromboembolism (VTE) prophylaxis (LVWH) due to immobilization and limitation of movement and the remaining 19 participants having not received VTE prophylaxis constitute the LMWH prophylaxis and control group respectively. In RA attack patients receiving VTE prophylaxis, DAS28-CRP, DAS28-ESR, CRP, ESR, morning stiffness and visual analog scale (VAS), were calculated on the day of hospitalization before and after prophylaxis with a one-day interval. RA attack patients who did not receive VTE prophylaxis had DAS28-CRP, DAS28-ESR, CRP, ESR, morning stiffness and VAS, calculated with a one-day interval. In both groups, global VAS was considered the same on both days to account for a significant difference. Results: When the demographic data of the groups included in the study are compared, no significant difference was found in terms of age and diagnosis time. When the two groups having received and not LMWH prophylaxis and during RA attack were compared, it was seen that the first measurements of painful joint, swollen joint, DAS28- CRP, DAS28-ESR, CRP, ESR, morning stiffness and VAS levels were similar; but was observed that the final measurements of painful joint, swollen joint, DAS28-CRP, DAS28-ESR, CRP, morning stiffness and VAS levels of the LMWH prophylaxis group patients were significantly different than the control group. (p=0,01, p=0,01, p=0,01, p=0,01, p=0,01, p=0,01, p=0,01). It was determined that the levels of painful joint, swollen joint, DAS28- CRP, DAS28-ESR, CRP, morning stiffness and VAS in the group receiving LMWH prophylaxis were significantly lower than the control group. Conclusion: In this study, it was observed that disease activity in the group receiving LMWH prophylaxis decreased significantly compared to the control group. Considering the RA patient population, if there is no contraindication, LMWH treatment added to the current treatment can reduce the patient's increased VTE risk as well as the dose and duration of corticosteroids given to the patient; which is thus likely to be beneficial in reducing the risk of potential VTE and probable complications of corticosteroid use.