Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
PLoS One. 2019 Mar 7;14(3):e0213505. doi: 10.1371/journal.pone.0213505. eCollection 2019.
Although tacrolimus is useful as an induction therapy in patients with ulcerative colitis (UC), information regarding the long-term outcome after tacrolimus therapy is insufficient. The aim of this study was to evaluate the clinical significance of the pretreatment neutrophil-to-lymphocyte ratio (NLR) as a prognostic factor in patients with UC receiving tacrolimus, to aid treatment selection.
Patients with moderate-to-severe active UC who received oral tacrolimus induction therapy and subsequent immunomodulatory maintenance therapy at our hospital between 2009 and 2017 and who showed clinical response at week 12, were retrospectively enrolled. Cox regression analysis was conducted to study the prognostic role of the pretreatment NLR. The combined impact of the NLR and other known prognostic factors was investigated with multivariate regression.
Among 45 patients included in this study, 21 patients experienced relapse during a median follow-up period of 16.6 months. Multivariate Cox regression analysis identified the pretreatment NLR (hazard ratio [HR]: 0.82, 95% confidence interval [CI]: 0.72-0.94, P < 0.01) and the use of immunomodulators at the start of tacrolimus treatment (HR: 0.18, 95% CI: 0.05-0.66, P = 0.01) as independent predictors of clinical relapse.
The pretreatment NLR is an independent prognostic factor in patients with UC treated with tacrolimus.
尽管他克莫司在溃疡性结肠炎（UC）患者的诱导治疗中有用，但关于他克莫司治疗后的长期结果的信息不足。本研究的目的是评估治疗前中性粒细胞与淋巴细胞比值（NLR）作为接受他克莫司治疗的 UC 患者的预后因素的临床意义，以辅助治疗选择。
本研究回顾性纳入了 2009 年至 2017 年期间在我院接受口服他克莫司诱导治疗和随后免疫调节剂维持治疗且在第 12 周时显示临床缓解的中重度活动期 UC 患者。采用 Cox 回归分析研究治疗前 NLR 的预后作用。采用多元回归分析研究 NLR 与其他已知预后因素的综合影响。
本研究纳入的 45 例患者中，21 例在中位随访 16.6 个月时复发。多因素 Cox 回归分析确定治疗前 NLR（风险比 [HR]：0.82，95%置信区间 [CI]：0.72-0.94，P < 0.01）和在开始使用他克莫司治疗时使用免疫调节剂（HR：0.18，95% CI：0.05-0.66，P = 0.01）是临床复发的独立预测因素。
治疗前 NLR 是接受他克莫司治疗的 UC 患者的独立预后因素。
