Neutrophil‐to‐Lymphocyte Ratio and Platelet‐to‐Lymphocyte Ratio as Biomarkers in Axial Spondyloarthritis: Observational Studies From the Program to Understand the Longterm Outcomes in Spondyloarthritis Registry
Objectives This study was conducted to assess the utility of neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) in predicting radiographic sacroiliitis and active disease in axial spondyloarthritis (SpA) and to explore the association between use of a tumor necrosis factor i...
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Published in | Arthritis & rheumatology (Hoboken, N.J.) Vol. 75; no. 2; pp. 232 - 241 |
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Main Authors | , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Boston, USA
Wiley Periodicals, Inc
01.02.2023
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Objectives
This study was conducted to assess the utility of neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) in predicting radiographic sacroiliitis and active disease in axial spondyloarthritis (SpA) and to explore the association between use of a tumor necrosis factor inhibitor (TNFi) and these laboratory values compared with traditional inflammatory markers.
Methods
Observational data from the Program to Understand the Longterm Outcomes in Spondyloarthritis (PULSAR) registry were analyzed. We generated receiver operating characteristic curves to calculate laboratory cutoff values; we used these values in multivariable logistic regression models to identify associations with radiographically confirmed sacroiliitis and active disease. We also used logistic regression to determine the likelihood of elevated laboratory values after initiation of TNFi.
Results
Most study participants (n = 354) were White, male, and HLA–B27 positive. NLR (odds ratio [OR] 1.459, P = 0.034), PLR (OR 4.842, P < 0.001), erythrocyte sedimentation rate (OR 4.397, P < 0.001), and C‐reactive protein (CRP) level (OR 2.911, P = 0.001) were independent predictors of radiographic sacroiliitis. Models that included PLR with traditional biomarkers performed better than those with traditional biomarkers alone. NLR (OR 6.931, P = 0.002) and CRP (OR 2.678, P = 0.004) were predictors of active disease, but the model that included both NLR and CRP performed better than CRP alone. TNFi use reduced the odds of elevated NLR (OR 0.172, P < 0.001), PLR (OR 0.073, P < 0.001), erythrocyte sedimentation rate (OR 0.319, P < 0.001), and CRP (OR 0.407, P < 0.001), but models that included NLR or PLR and traditional biomarkers performed best.
Conclusions
These findings demonstrate an association between NLR and PLR and sacroiliitis and disease activity, with NLR and PLR showing response after TNFi treatment and adding useful clinical information to established biomarkers, thus perhaps assisting in management of axial SpA. |
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Bibliography: | https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Fart.42333&file=art42333‐sup‐0001‐Disclosureform.pdf The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. The Program to Understand the Longterm Outcomes in Spondyloarthritis (PULSAR) registry is supported by the Rocky Mountain Regional Veterans Affairs Medical Center. Dr. Sen's work was supported by the Department of Veterans Affairs OAA GME Enhancement Award, NIH grant 5T32‐AR‐007534‐35, and the Spondyloarthritis Research and Treatment Network Pilot Project. Dr. Napier's work was supported by Department of Veterans Affairs Career Development Award IK2‐BX0004523, a Spondyloarthritis Research and Treatment Network Junior Investigator grant, and grants from the Arthritis National Research Foundation and Spondyloarthritis Association of America. Dr. Caplan's work was supported by the Department of Veterans Affairs, an NIH All of Us Study sub‐award (Denver Research Institute), a Spondyloarthritis Research and Treatment Network sub‐award, and a Shear Family Foundation grant (CU Foundation). . Author disclosures are available at ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 |
ISSN: | 2326-5191 2326-5205 2326-5205 |
DOI: | 10.1002/art.42333 |