Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 49241, South Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
Rheumatol Int. 2019 May;39(5):859-868. doi: 10.1007/s00296-019-04276-x. Epub 2019 Mar 14.
Data are scarce regarding the association of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with treatment response and persistence of anti-TNF-α agents in patients with rheumatoid arthritis (RA). Thus, we investigated whether baseline NLR and PLR could predict 12-week treatment response and long-term persistence of anti-TNF-α agents in RA patients. This is a retrospective chart review analysis of 82 women with RA who started anti-TNF-α agents as the first-line biologic therapy and 328 healthy age-matched women. RA patients were divided into high and low baseline NLR or PLR subgroups using the median split. European League against Rheumatism (EULAR) treatment response was evaluated at 12 weeks. RA patients had significantly higher NLR and PLR than controls. High baseline NLR and PLR groups showed higher 12-week EULAR non-response rate than low NLR (30% vs 7.1%, p = 0.01) and PLR groups (27.5% vs 9.5%, p = 0.047), respectively. After adjusting for confounding factors, high baseline NLR (OR 5.57, p = 0.014) and PLR (OR 4.24, p = 0.04) were significantly associated with a higher risk of EULAR non-response at 12 weeks. During the study period, 47 (57.3%) RA patients (lack of efficacy: n = 31; adverse events: n = 16) discontinued anti-TNF-α agents. High baseline NLR was associated with an increased risk of anti-TNF-α agent withdrawal due to lack of efficacy (HR 2.12, p = 0.045). Our data suggest that baseline NLR and PLR are useful markers for predicting the treatment outcome of anti-TNF-α agents in RA patients.
关于中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）与类风湿关节炎（RA）患者抗 TNF-α 药物治疗反应和持续存在的关系的数据很少。因此，我们研究了基线 NLR 和 PLR 是否可以预测 RA 患者抗 TNF-α 药物治疗 12 周的反应和长期持续存在。这是一项对 82 名开始使用抗 TNF-α 药物作为一线生物治疗的女性 RA 患者和 328 名年龄匹配的健康女性的回顾性图表分析。使用中位数分割将 RA 患者分为基线 NLR 或 PLR 高和低亚组。在 12 周时评估欧洲抗风湿病联盟（EULAR）治疗反应。RA 患者的 NLR 和 PLR 明显高于对照组。基线 NLR 和 PLR 较高的组在 12 周时 EULAR 无反应率高于 NLR 较低的组（30%比 7.1%，p=0.01）和 PLR 较低的组（27.5%比 9.5%，p=0.047）。在调整混杂因素后，高基线 NLR（OR 5.57，p=0.014）和 PLR（OR 4.24，p=0.04）与 12 周时 EULAR 无反应的风险增加显著相关。在研究期间，47 名（57.3%）RA 患者（无疗效：n=31；不良事件：n=16）停止使用抗 TNF-α 药物。高基线 NLR 与因无疗效而停用抗 TNF-α 药物的风险增加相关（HR 2.12，p=0.045）。我们的数据表明，基线 NLR 和 PLR 是预测 RA 患者抗 TNF-α 药物治疗结果的有用标志物。
