Spondyloarthritis & psoriatic arthritis
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
Authors' conclusion
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.
Study context
- Population
- Patients with axial spondyloarthritis (SpA) in the PULSAR registry; most White, male and HLA-B27 positive
- Participants
- 354 patients
- Exposure
- Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) vs traditional inflammatory markers (ESR, C-reactive protein (CRP)) as predictors of radiographic sacroiliitis and active disease; Tumor necrosis factor inhibitor (TNFi) use and elevated laboratory values
- Outcome
- Radiographically confirmed sacroiliitis and active disease (prediction by NLR and PLR)
Methodological detailsROC-derived cutoffs, multivariable logistic regression
- ROC-derived cutoffs
- Multivariable logistic regression
Main finding
As reported in the abstract
Independent predictors of radiographic sacroiliitis
NLR, OR (P = 0.034)
1.459
PLR, OR (P < 0.001)
4.842
ESR, OR (P < 0.001)
4.397
CRP, OR (P = 0.001)
2.911
Observational data: associations, not effects.
Further findings
Predictors of active disease
- NLR, OR (P = 0.002)
- 6.931
- CRP, OR (P = 0.004)
- 2.678
- Model with both NLR and CRP performed better than CRP alone
Odds of elevated laboratory values with TNFi use
- Elevated NLR, OR (P < 0.001)
- 0.172
- Elevated PLR, OR (P < 0.001)
- 0.073
- Elevated ESR, OR (P < 0.001)
- 0.319
- Elevated CRP, OR (P < 0.001)
- 0.407
- Models including NLR or PLR and traditional biomarkers performed best
Original publication
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. Arthritis Rheumatol. Published 23 December 2022. doi:10.
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