High Baseline Neutrophil-to-Lymphocyte Ratio Could Serve as a Biomarker for Tumor Necrosis Factor-Alpha Blockers and Their Discontinuation in Patients with Ankylosing Spondylitis

• Published in: Pharmaceuticals (Basel, Switzerland) Vol. 16; no. 3; p. 379
• Main Authors: Moon, Dong-Hyuk, Kim, Aran, Song, Byung-Wook, Kim, Yun-Kyung, Kim, Geun-Tae, Ahn, Eun-Young, So, Min-Wook, Lee, Seung-Geun
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.03.2023; MDPI
• Subjects: Analysis; Ankylosing spondylitis; ankylosing spondylitis (AS); Arthritis; Biological markers; Biomarkers; blood cells; Blood platelets; Diagnosis; Disease; Dosage and administration; Drug therapy; Females; Health aspects; Lymphocytes; Measurement; Neutrophils; Patient outcomes; Psoriasis; Regression analysis; Statistical significance; treatment outcome; Tumor necrosis factor inhibitors; tumor necrosis factor-alpha (TNF-α); Tumor necrosis factor-TNF; South Korea; ankylosing spondylitis (AS); blood cells; tumor necrosis factor-alpha (TNF-α); treatment outcome; biomarkers
• ISSN: 1424-8247; 1424-8247
• DOI: 10.3390/ph16030379

This study explores the association of neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), and platelet-to-lymphocyte (PLR) ratios with the 3-month treatment response and persistence of tumor necrosis factor-alpha (TNF-α) blockers in patients with ankylosing spondylitis (AS). This retrospective cohort study investigated 279 AS patients who were newly initiated on TNF-α blockers between April 2004 and October 2019 and 171 sex- and age-matched healthy controls. Response to TNF-α blockers was defined as a reduction in the Bath AS Disease Activity Index of ≥50% or 20 mm, and persistence referred to the time interval from the initiation to discontinuation of TNF-α blockers. Patients with AS had significantly increased NLR, MLR, and PLR ratios as compared to controls. The frequency of non-response at 3 months was 3.7%, and TNF-α blockers' discontinuation occurred in 113 (40.5%) patients during the follow-up period. A high baseline NLR but not high baseline MLR and PLR showed an independently significant association with a higher risk of non-response at 3 months (OR = 12.3, = 0.025) and non-persistence with TNF-α blockers (HR = 1.66, = 0.01). NLR may be a potential marker for predicting the clinical response and persistence of TNF-α blockers in AS patients.