Red cell distribution width as a predictor of disability in relapsing-remitting multiple sclerosis

El ancho de distribución de los glóbulos rojos como predictor de discapacidad en la esclerosis múltiple remitente-recidivante


Red blood cell distribution width (RDW) reflects the variability of circulating red blood cells. The relationship between multiple sclerosis (MS) and RDW is not well studied. The main objective of this work was to compare baseline RDW to EDSS at 5 years of diagnosis and verify if RDW predicts worse disability.


We conduct a retrospective observational study of relapsing-remitting MS (RRMS) patients followed in the Neuroimmunology Clinic that had at least one measuring of RDW at baseline.


We included 82 patients with RRMS meeting inclusion criteria, 73,2% female with a mean age of 33,56 years old. Median EDSS score at baseline was 1.5.

9,8% patients had new T2 lesions in MRI at 5 years and 4,9% showed lesions capturing contrast at 5 years. Regarding DMT, 75,6% were treated with interferon, glatiramer acetate, teriflunomide, or dimethyl fumarate, and 21,9% were under fingolimod, natalizumab, rituximab, and cladribine, and the remaining 2,4% were without treatment at 5 years.

A multiple linear regression model confirmed increased disability (EDSS at 5 years) for patients undergoing second-line treatment (β=0,86;p=,003) and higher RDW at baseline (β=0,47;p=,007). Presenting RDW results for quartiles, it was statistically significant for quartile 4 [13,5;16,4[(β=0,74;p=,039), suggesting that a very increased RDW at baseline is strongly associated with higher EDSS at 5 years.


Higher RDW at baseline was correlated with a worse disability at 5 years in RRMS patients. Furthermore, RDW equal to or higher than 13,5% may be useful in identifying patients that will have a worse disability at 5 years.

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