Moon Dong-Hyuk, Kim Aran, Song Byung-Wook, Kim Yun-Kyung, Kim Geun-Tae, Ahn Eun-Young, So Min-Wook, Lee Seung-Geun
Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea.
Pharmaceuticals (Basel). 2023 Mar 1;16(3):379. doi: 10.3390/ph16030379.
This study explores the association of neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), and platelet-to-lymphocyte (PLR) ratios with the 3-month treatment response and persistence of tumor necrosis factor-alpha (TNF-α) blockers in patients with ankylosing spondylitis (AS).
This retrospective cohort study investigated 279 AS patients who were newly initiated on TNF-α blockers between April 2004 and October 2019 and 171 sex- and age-matched healthy controls. Response to TNF-α blockers was defined as a reduction in the Bath AS Disease Activity Index of ≥50% or 20 mm, and persistence referred to the time interval from the initiation to discontinuation of TNF-α blockers.
Patients with AS had significantly increased NLR, MLR, and PLR ratios as compared to controls. The frequency of non-response at 3 months was 3.7%, and TNF-α blockers' discontinuation occurred in 113 (40.5%) patients during the follow-up period. A high baseline NLR but not high baseline MLR and PLR showed an independently significant association with a higher risk of non-response at 3 months (OR = 12.3, = 0.025) and non-persistence with TNF-α blockers (HR = 1.66, = 0.01).
NLR may be a potential marker for predicting the clinical response and persistence of TNF-α blockers in AS patients.
本研究探讨强直性脊柱炎（AS）患者中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）以及血小板与淋巴细胞比值（PLR）与肿瘤坏死因子-α（TNF-α）阻滞剂3个月治疗反应及持续使用情况之间的关联。
这项回顾性队列研究调查了2004年4月至2019年10月期间开始新使用TNF-α阻滞剂的279例AS患者以及171例年龄和性别匹配的健康对照者。对TNF-α阻滞剂的反应定义为巴斯强直性脊柱炎疾病活动指数降低≥50%或20毫米，持续使用情况是指从开始使用TNF-α阻滞剂至停药的时间间隔。
与对照组相比，AS患者的NLR、MLR和PLR比值显著升高。3个月时无反应的频率为3.7%，在随访期间113例（40.5%）患者停用了TNF-α阻滞剂。高基线NLR而非高基线MLR和PLR与3个月时无反应的较高风险（OR = 12.3，P = 0.025）以及TNF-α阻滞剂的非持续使用（HR = 1.66，P = 0.01）独立显著相关。
NLR可能是预测AS患者对TNF-α阻滞剂临床反应和持续使用情况的潜在标志物。
