Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index in evaluating the effectiveness of secukinumab in treating patients with psoriatic arthritis
10.3760/cma.j.cn141217-20230718-00006
- VernacularTitle:中性粒细胞与淋巴细胞比值血小板与淋巴细胞比值系统性免疫炎症指数评估司库奇尤单抗治疗银屑病关节炎疗效
- Author:
Yuan CHEN
1
;
Xiaohui ZHANG
;
Zhuoli ZHANG
Author Information
1. 北京大学第一医院风湿免疫科，北京 100034
- Keywords:
Arthritis, psoriatic;
Neutrophil-to-lymphocyte ratio;
Platelet-to-lymphocyte ratio;
Systemic immune-inflammation index;
Secukinumab
- From:
Chinese Journal of Rheumatology
2024;28(7):452-459
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) in reflecting the effectiveness of secukinumab (SEC) in psoriatic arthritis (PsA).Methods:Forty-nine patients treated with SEC betwee January 2019 and March 2023 from the PsA cohort (PKUPsA cohort) were enrolled. Demographic data and disease activity indexes, laboratory markers including NLR, PLR, SII, patient-reported outcome measures at baseline, 6 months and 12 months after SEC treatment were retrospectively analyzed. Paired-sample t test and Wilcoxon signed-rank test were used to compare the changes of inflammatory markers before and after the treatment, Spearman correlation analysis was used to explore the correlation between NLR, PLR, SII and other clinical and laboratory indicators, and Cox proportional hazards model was used to analyze the predictive factors of achieving minimal disease activity (MDA) during 12 months of SEC treatment. Results:After 6 months of SEC treatment, PLR and SII decreased significantly from the baseline (142 ±62 vs. 164 ± 61, t=2.55, P= 0.016, n=31; 553 ± 428 vs. 725 ± 361, t= 2.28, P= 0.030, n=31); After 12 months of treatment, SII also showed a statistically significant decline from the baseline (613 ± 407 vs. 792 ± 365, t=2.33, P=0.028, n=26). Patients′ C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and disease activity index for psoriatic arthritis (DAPSA) score at the 6th and the 12th month of SEC treatment were significantly lower than baseline as well. In terms of the correlation between NLR, PLR, SII and other indicators, there was a stable positive correlations between the baseline level and the changes over 6-month and 12-month after SEC treatment in NLR, PLR, SII, CRP and ESR ( r=0.29~0.61, P<0.05). Similarly, NLR, SII at baseline and the changes at month 6 and month 12 from baseline showed positive associations consistently with tenderness joint counts ( r=0.34~0.63, P<0.05) and DAPSA score ( r=0.30~0.68, P<0.05). Stable positive correlations of SII with visual analogue scale (VAS) of pain ( r=0.39~0.56, P<0.01) and patient global assessment (PtGA) ( r=0.33~0.62, P<0.05) were also observed. In addition, there was also positive correlation of NLR, PLR and SII with the generalized anxiety disorder scale (GAD-7) and patient health questionnaire-9 (PHQ-9) score at baseline and 12-month after SEC treatment ( r=0.33~0.78, P<0.05; r=0.37~0.58, P<0.05). Cox proportional hazards model showed that baseline PLR and DAPSA score were adverse factors for achieving MDA during 12 months of treatment, however, baseline DAPSA score was the only independent predictor [ HR(95% CI)=0.87 (0.78, 0.97), P=0.010]. Conclusion:NLR, PLR, and SII can be used as biomarkers for monitoring the improvement in disease activity, anxiety and depression levels of patients with PsA, but baseline NLR, PLR, and SII cannot predict the achievement of MDA at 12 months after SEC treatment.
