Boulos D, et al. - Two-hundred and twenty-two patients with newly diagnosed rheumatoid arthritis (RA) were identified from the Early Arthritis Clinic at the Royal Adelaide Hospital by the experts in order to determine whether the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) could forecast those who subsequently need intensification of disease-modifying therapy because of continued disease activity in RA. By one year, 20% of the patients (n=45) were recognized who failed triple therapy. In those who failed triple therapy, the mean baseline NLR was markedly greater as that of those who did not fail triple therapy, however, no significant difference in PLR was observed. Hence, in individuals who subsequently failed triple-therapy for RA, the NLR has significantly higher values and it exceeded conventional markers of disease activity. Further, the NLR could provide a reasonable, objective and reproducible prognostic marker in RA. In order to verify its potential role in guiding the management of RA further studies are required.