Clinical Relevance of the HALP Score in Rheumatoid Arthritis: Association with Disease Activity and Inflammatory Burden

Abstract

Background/Aims: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel biomarker reflecting systemic inflammation and nutritional status. While it has been studied in oncology and some inflammatory diseases, its clinical role in rheumatoid arthritis (RA) remains unclear. This study aimed to investigate the relationship between HALP, disease activity, and inflammatory burden in RA.

Materials and Methods: This retrospective cross-sectional study included 106 patients with RA diagnosed according to the 2010 ACR/EULAR criteria and 110 age-, sex-, and BMI-matched healthy controls. Clinical and laboratory data were recorded, and HALP scores were calculated. Disease activity was assessed using the disease activity score-28-C-reactive protein (DAS28-CRP). Group comparisons, Spearman correlation analysis, receiveroperating characteristic (ROC) curve analysis, and multivariable logistic regression were performed.

Results: The HALP scores were significantly lower in patients with RA compared with healthy controls (P < .0001). Among patients with RA, those with active disease exhibited significantly lower HALP scores than those in remission (P < .05), with a decreasing trend across DAS28-CRP disease activity categories. The HALP scores showed negative correlations with CRP (r = −0.329), Visual Analog Scale (VAS)-pain (r = −0.399), and DAS28-CRP (r = −0.348) (all P ≤ .001). The ROC analysis demonstrated moderate discriminative ability for distinguishing active disease from remission (AUC = 0.708, 95% CI: 0.63-0.81). In multivariable logistic regression analysis, lower HALP scores and older age were independently associated with active RA.

Conclusion: The study demonstrates that lower HALP scores are associated with higher disease activity in rheumatoid arthritis. As a simple and routinely available laboratory-based index, the HALP score may serve as a supportive marker of inflammatory burden. Prospective multicenter studies are required to validate these findings and to clarify the longitudinal utility of the HALP score.

Cite this article as: Çelik G, Çilingiroğlu Ç, Uğur S, Kızıl ŞD. Clinical relevance of the HALP score in rheumatoid arthritis: Association with disease activity and inflammatory burden. Arch Rheumatol. 2026;41(2):134-143.