Systemic immune-inflammation index and other inflammatory parameters in patients receiving biological or targeted synthetic DMARDs for inflammatory rheumatic disease

Year 2022, Volume: 35 Issue: 3, 316 - 322, 31.10.2022

Halise Hande Gezer Ozlem Pehlıvan

https://doi.org/10.5472/marumj.1186732

Cited By: 1

Abstract

Objective: To investigate the short – and long-term dynamics in inflammation markers [systemic immune-inflammation index (SII),
neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/ monocyte ratio (LMR)] before and after
biological disease-modifying antirheumatic drugs (bDMARD) or targeted synthetic DMARD (tsDMARD) treatment.
Patients and Methods: Two hundred twenty-six patients (115 women, 47±13.8 years) were included. Age, gender, disease duration, and
treatments were recorded retrospectively. Complete blood counts including neutrophil, lymphocyte, platelet, monocyte and acute
phase reactants were noted at the visit before the biological treatment, at the 3rd month, 6th month, and the last visit on medication.
SII, NLR, PLR and LMR were calculated, and their dynamics over time were compared.
Results: Significant changes were observed over time in all parameters reflecting inflammation (SII, NLR, PLR, LMR, ESR, and CRP)
(p<0.05). In the correlation analysis of changes at baseline and six months, significant correlations with ΔESR were observed with
ΔCRP, ΔPLR, ΔSII and ΔNLR (p<0.05), but no correlation with LMR was detected. Also, significant correlations with ΔCRP were
noted with ΔNLR, ΔSII, ΔPLR, and ΔLMR (p<0.05).
Conclusion: Significant and favourable changes were observed in all inflammatory parameters after treatment, and this variation
remained stable as long as the drug was continued.

Keywords

Inflammation, Systemic immune inflammation index, Biological treatment, Inflammation, Systemic immune inflammation index, Biological treatment

References

• Kim MJ, Lee EB, Song YW, Park JK. Profile of common inflammatory markers in treatment-naïve patients with systemic rheumatic diseases. Clin Rheumatol 2020;39:2899- 906.doi:10.1007/s10067.020.05049-9
• Kadiyoran C, Zengin O, Cizmecioglu HA, et al. Monocyte to lymphocyte ratio, Neutrophil to lymphocyte ratio, and red cell distribution width are the associates with gouty arthritis. Acta Medica (Hradec Kralove)
• Gasparyan AY, Ayvazyan L, Mukanova U, et al. The plateletto- lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med 2019;39:345-57.doi:10.3343/ alm.2019.39.4.345
• Walzik D, Joisten N, Zacher J, Zimmer P. Transferring clinically established immune inflammation markers into exercise physiology: focus on neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immuneinflammation index. Eur J Appl Physiol 2021;121:1803-14. doi:10.1007/s00421.021.04668-7
• Hemond CC, Glanz BI, Bakshi R, Chitnis T, Healy BC. The neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios are independently associated with neurological disability and brain atrophy in multiple sclerosis. BMC Neurol 2019;19:23.doi:10.1186/s12883.019.1245-2
• Han BK, Wysham KD, Cain KC, Tyden H, Bengtsson AA, Lood C. Neutrophil and lymphocyte counts are associated with different immunopathologiceal mechanisms in systemic lupus erythematosus. Lupus Sci Med 2020;7: e000382.doi:10.1136/
• Hoffmann JHO, Knoop C, Enk A, Hadaschik EN. Detailed Long-term dynamics of neutrophil-to-lymphocyte ratio under biologic treatment reveals differential effects of tumour necrosis factor-alpha and interleukin 12/23 antagonists. Acta Derm Venereol 2021;101:adv00568.doi:10.2340/actadv. v101.271
• An I, Ucmak D, Ozturk M. The effect of biological agent treatment on neutrophil-to-lymphocyte ratio, platelet-tolymphocyte ratio, mean platelet volume, and C-reactive protein in psoriasis patients. Postepy Dermatol Alergol 2020;37:202-6.doi:10.5114/ada.2020.94838
• Turkmen K, Erdur FM, Ozcicek F, et al. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-tolymphocyte ratio in end-stage renal disease patients. Hemodial Int 2013;17:391-6.doi:10.1111/hdi.12040
• Geng Y, Shao Y, Zhu D, et al. Systemic immune-inflammation index predicts prognosis of patients with esophageal squamous cell carcinoma: a propensity score-matched analysis. Sci Rep 2016;6:39482.doi:10.1038/srep39482
• Strand V, Kimberly R, Isaacs JD. Biologic therapies in rheumatology: lessons learned, future directions. Nat Rev Drug Discov 2007;6:75-92.doi:10.1038/nrd2196
• Boyle DL, Soma K, Hodge J, et al. The JAK inhibitor tofacitinib suppresses synovial JAK1-STAT signalling in rheumatoid arthritis. Ann Rheum Dis 2015;74:1311-6.doi:10.1136/ annrheumdis-2014-206028
• Zahorec R. Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratisl Lek Listy 2021;122:474-88. doi:10.4149/BLL_2021_078
• Yorulmaz A, Hayran Y, Akpinar U, Yalcin B. Systemic immune-inflammation index (SII) predicts increased severity in psoriasis and psoriatic arthritis. Curr Health Sci J 2020;46:352-7.doi:10.12865/CHSJ.46.04.05
• Dayer E, Dayer JM, Roux-Lombard P. Primer: the practical use of biological markers of rheumatic and systemic inflammatory diseases. Nat Clin Pract Rheumatol 2007;3:512- 20.doi:10.1038/ncprheum0572.
• Ahn SS, Jung SM, Song JJ, Park YB, Lee SW. Neutrophil to lymphocyte ratio at diagnosis can estimate vasculitis activity and poor prognosis in patients with ANCA-associated vasculitis: a retrospective study. BMC Nephrol 2018;19:187. doi:10.1186/s12882.018.0992-4
• Uslu AU, Küçük A, Şahin A, et al. Two new inflammatory markers associated with Disease Activity Score-28 in patients with rheumatoid arthritis: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio. Int J Rheum Dis 2015;18:731-5. doi:10.1111/1756-185X.12582
• Kim S, Eliot M, Koestler DC, Wu WC, Kelsey KT. Association of neutrophil-to-lymphocyte ratio with mortality and cardiovascular disease in the jackson heart study and modification by the duffy antigen variant. JAMA Cardiol 2018;3:455-62. doi:10.1001/jamacardio.2018.1042
• Walvick MD, Walvick MP. Giant cell arteritis: laboratory predictors of a positive temporal artery biopsy. Ophthalmology 2011;118:1201-4.doi:10.1016/j.ophtha.2010.10.002
• Oh LJ, Wong E, Andrici J, McCluskey P, Smith JEH, Gill AJ. Full blood count as an ancillary test to support the diagnosis of giant cell arteritis. Intern Med J 2018;48:408-13. doi:10.1111/ imj.13713
• Zhang Y, Yin Y, Kuai S-g, Shan Z, Pei H, Wang J. Combination of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as diagnostic biomarker for rheumatoid arthritis. Int J Clin Exp Med 2016;9:22076-22081
• Sargin G, Senturk T, Yavasoglu I, Kose R. Relationship between neutrophil-lymphocyte, platelet-lymphocyte ratio and disease activity in rheumatoid arthritis treated with rituximab. Int J Rheum Dis 2018;21:2122-7.doi:10.1111/1756-185X.13400
• Asahina A, Kubo N, Umezawa Y, Honda H, Yanaba K, Nakagawa H. Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol 2017;44:1112-21.doi:10.1111/1346-8138.13875
• Qian H, Chen R, Wang B, et al. Associations of platelet count with inflammation and response to anti-tnf-α therapy in patients with ankylosing spondylitis. Front Pharmacol 2020;11:559593.doi:10.3389/fphar.2020.559593
• Boyraz I, Koç B, Boyacı A, Tutoğlu A, Sarman H, Ozkan H. Ratio of neutrophil/lymphocyte and platelet/lymphocyte in patient with ankylosing spondylitis that are treating with anti- TNF. Int J Clin Exp Med 2014;7:2912-5.
• Li C, Tian W, Zhao F, et al. Systemic immune-inflammation index, SII, for prognosis of elderly patients with newly diagnosed tumors. Oncotarget 2018;9:35293-9.doi:10.18632/ oncotarget.24293
• Satis S. New inflammatory marker associated with disease activity in rheumatoid arthritis: the systemic immuneinflammation index. Curr Health Sci J 2021;47:553-7. doi:10.12865/CHSJ.47.04.11
• Kim JW, Jung JY, Suh CH, Kim HA. Systemic immuneinflammation index combined with ferritin can serve as a reliable assessment score for adult-onset Still’s disease. Clin Rheumatol 2021;40:661-8. doi:10.1007/s10067.020.05266-2
• Chen JB, Tang R, Zhong Y, et al. Systemic immuneinflammation index predicts a reduced risk of end-stage renal disease in Chinese patients with myeloperoxidase-antineutrophil cytoplasmic antibody-associated vasculitis: A retrospective observational study. Exp Ther Med 2021;22:989. doi:10.3892/etm.2021.10421
• Tanacan E, Dincer D, Erdogan FG, Gurler A. A cutoff value for the Systemic Immune-Inflammation Index in determining activity of Behçet disease. Clin Exp Dermatol 2021;46:286-91. doi:10.1111/ced.14432