Kearney Niamh, Chen Xin, Bi Yingtao, Hew Kinjal, Smith Kathleen M, Kirby Brian
Department of Dermatology, St Vincent's University Hospital Dublin, Ireland.
School of Medicine, University College Dublin, Ireland.
Clin Exp Dermatol. 2025 Jan 27;50(2):339-347. doi: 10.1093/ced/llae324.
Hidradenitis suppurativa (HS) is associated with increased cardiovascular disease (CVD) risk. Systemic immune inflammation index (SII), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) are biomarkers of systemic inflammation and CVD. One small study identified a lower NLR and PLR in patients treated with adalimumab (ADA).
To assess changes in SII, NLR, PLR and MLR in a larger cohort and to evaluate their association with disease severity and treatment response.
This was a post hoc analysis of PIONEER I (ClinicalTrials.gov ID: NCT01468207) and PIONEER II (ClinicalTrials.gov ID: NCT01468233), two phase III randomized placebo-controlled clinical trials of ADA for HS. SII, NLR, PLR and MLR were log10-transformed and a linear mixed model was used to estimate the treatment effect.
SII, NLR, PLR and MLR decreased from baseline levels with ADA treatment by week 12, when the primary response endpoint was assessed. Significant changes first appeared at week 4 and were maintained to week 36. In contrast, no significant changes were observed in placebo-treated patients. In patients re-randomized at week 12 from placebo to ADA, SII, NLR, PLR and MLR also reduced within 4 weeks. In patients re-randomized from ADA to placebo, these biomarkers returned to baseline by week 36. In addition, SII, NLR and PLR correlated with draining fistula count (r = 0.26-0.43, P < 0.001). ADA nonresponders in PIONEER I had a higher SII, NLR and PLR at baseline and week 12, but this change did not achieve statistical significance when draining fistulae were adjusted for.
Treatment of patients with HS with ADA resulted in rapid sustained reduction in systemic inflammation, measured by the biomarkers SII, NLR, PLR and MLR, which correlate with CVD risk. SII, NLR and PLR may predict ADA response, although this may be dependent on their interaction with the number of draining fistulae.
化脓性汗腺炎（HS）与心血管疾病（CVD）风险增加相关。全身免疫炎症指数（SII）、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）和单核细胞/淋巴细胞比值（MLR）是全身炎症和CVD的生物标志物。一项小型研究发现接受阿达木单抗（ADA）治疗的患者NLR和PLR较低。
评估更大队列中SII、NLR、PLR和MLR的变化，并评估它们与疾病严重程度和治疗反应的相关性。
这是对PIONEER I（ClinicalTrials.gov标识符：NCT01468207）和PIONEER II（ClinicalTrials.gov标识符：NCT01468233）的事后分析，这两项是ADA治疗HS的III期随机安慰剂对照临床试验。对SII、NLR、PLR和MLR进行log10转换，并使用线性混合模型估计治疗效果。
在评估主要反应终点的第12周，ADA治疗使SII、NLR、PLR和MLR从基线水平下降。显著变化首先出现在第4周，并持续到第36周。相比之下，安慰剂治疗的患者未观察到显著变化。在第12周从安慰剂重新随机分组至ADA的患者中，SII、NLR、PLR和MLR在4周内也有所降低。在从ADA重新随机分组至安慰剂的患者中，这些生物标志物在第36周时恢复至基线水平。此外，SII、NLR和PLR与引流性瘘管数量相关（r = 0.26 - 0.43，P < 0.001）。PIONEER I中ADA无反应者在基线和第12周时SII、NLR和PLR较高，但在对引流性瘘管进行校正后，这种变化未达到统计学显著性。
用ADA治疗HS患者可使通过生物标志物SII、NLR、PLR和MLR测量的全身炎症迅速持续降低，这些生物标志物与CVD风险相关。SII、NLR和PLR可能预测ADA反应，尽管这可能取决于它们与引流性瘘管数量的相互作用。
