Systemic sclerosis & Raynaud's
Blood Neutrophil Count and Neutrophil‐to‐Lymphocyte Ratio for Prediction of Disease Progression and Mortality in Two Independent Systemic Sclerosis Cohorts
Authors' conclusion
Higher blood neutrophil count and NLR are predictive of more severe disease course and increased mortality, indicating that these easily obtainable laboratory studies might be a reflection of pathologic immune processes in SSc.
Study context
- Population
- Systemic sclerosis (SSc) patients in the GENISOS cohort, with confirmation in the SLS II377 with baseline counts
- Participants
- 447 patients
- Exposure
- Higher vs lower baseline blood neutrophil count and NLR
- Outcome
- Disease severity (serial FVC% and MRSS) and mortality
Methodological detailstwo independent cohorts (GENISOS and SLS II), generalized linear mixed models, Cox proportional hazards models
- Two independent cohorts (GENISOS and SLS II)
- Generalized linear mixed models
- Cox proportional hazards models
Main finding
As reported in the abstract
Prediction of serially obtained FVC% and MRSS and of long-term mortality by baseline neutrophil count and NLR (GENISOS)
- Baseline neutrophil count → lower serial FVC%
- b = −4.74, P = 0.009
- Baseline NLR → lower serial FVC%
- b = −2.68, P = 0.028
- Baseline neutrophil count → higher serial MRSS
- b = 4.07, P < 0.001
- Baseline NLR → higher serial MRSS
- b = 2.32, P < 0.001
- Baseline neutrophil count → long-term mortality, adjusted HR
- HR 1.42, P = 0.02
- Baseline NLR → long-term mortality, adjusted HR
- HR 1.48, P < 0.001
Observational data: associations, not effects.
Further findings
Longitudinal neutrophil and NLR vs concurrent FVC% and MRSS
- Significantly correlated with lower concurrent FVC% and higher concurrent MRSS
Replication in SLS II
- Predictive significance of higher baseline neutrophil count and NLR for declining FVC% and increased long-term mortality confirmed
Original publication
Blood Neutrophil Count and Neutrophil‐to‐Lymphocyte Ratio for Prediction of Disease Progression and Mortality in Two Independent Systemic Sclerosis Cohorts. Arthritis Care Res (Hoboken). Published 17 November 2022. doi:10.
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