Elem YORULMAZ, Duygu GELER KÜLCÜ

The effect of IL-17 blockage on the neutrophil to lymphocyte ratio in patients with axial spondylarthritis: a comparative study with anti-TNF

Objectives: This study aims to evaluate the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with axial spondyloarthritis receiving different biologic treatments. Methods: The study included 33 axial spondyloarthritis patients (20 males, 13 females) receiving anti-TNF or secukinumab therapy. Patients’ age, disease duration, ongoing therapy duration, serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), neutrophil, lymphocyte and platelet counts, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, NLR, and PLR were recorded retrospectively. Results: The patients' mean age was 44 years, and the disease's mean duration was 121.55 months. Fourteen (42.4%) patients were receiving secukinumab, 57.6% of the patients were receiving anti-TNF agents. The male/female ratio was 6/8 in the secukinumab group and 14/5 in the anti-TNF group. The ongoing therapy duration was 8 ± 5.1 months for the secukinumab group and 27 ± 27.6 months for the anti-TNF group. Only NLR was significantly higher in the secukinumab group, and there was no other statistical difference between groups. There was no correlation between NLR, PLR, and CRP, ESR, BASDAI. Conclusions: The results of our study show that only NLR is significantly higher in the secukinumab group compared to the anti-TNF group. Hence NLR may be a useful and sensitive parameter in terms of monitoring disease activity.

Keywords:

Axial spondyloarthritis, neutrophil to lymphocyte ratio platelet to lymphocyte ratio, secukinumab,

PDF

___

1. Huang Y, Deng W, Zheng S, Feng F, Huang Z, Huang Q, et al. Relationship between monocytes to lymphocytes ratio and axial spondyloarthritis. Int Immunopharmacol 2018;57:43-6.
2. Reveille JD. Biomarkers for diagnosis, monitoring of progression, and treatment responses in ankylosing spondylitis and axial spondyloarthritis. Clin Rheumatol 2015;34:1009-18.
3. Yang Z, Zhang Z, Lin F, Ren Y, Liu D, Zhong R, et al. Comparisons of neutrophil-, monocyte-, eosinophil-, and basophil- lymphocyte ratios among various systemic autoimmune rheumatic diseases. APMIS 2017;125:863-71.
4. Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med 2019;39:345-57.
5. Zeb A, Khurshid S, Bano S, Rasheed U, Zammurrad S, Khan MS, et al. The role of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as markers of disease activity in ankylosing spondylitis. Cureus 2019;11:e6025.
6. Al-Osami MH, Awadh NI, Khalid KB, Awadh AI. Neutrophil/lymphocyte and platelet/lymphocyte ratios as potential markers of disease activity in patients with ankylosing spondylitis: a case-control study. Adv Rheumatol 2020;60:13.
7. Seng JJB, Kwan YH, Low LL, Thumboo J, Fong WSW. Role of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) in assessing disease control in Asian patients with axial spondyloarthritis. Biomarkers 2018;23:335-8.
8. Bozan N, Alpaycı M, Aslan M, Cankaya H, Kıroğlu AF, Turan M, et al. Mean platelet volume, red cell distribution width, platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios in patients with ankylosing spondylitis and their relationships with high-frequency hearing thresholds. Eur Arch Otorhinolaryngol 2016;273:3663-72.
9. Kucuk A, Uslu AU, Ugan Y, Bagcaci S, Karahan AY, Akarmut A, et al. Neutrophil-to-lymphocyte ratio is involved in the severity of ankylosing spondylitis. Bratisl Lek Listy 2015;116:722-5.
10. 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.
11. Mercan R, Bitik B, Tufan A, Bozbulut UB, Atas N, Ozturk MA, et al. The association between neutrophil/lymphocyte ratio and disease activity in rheumatoid arthritis and ankylosing spondylitis. J Clin Lab Anal 2016;30:597-601.
12. Coşkun BN, Öksüz MF, Ermurat S, Tufan AN, Oruçoğlu N, Doğan A, et al. Neutrophil lymphocyte ratio can be a valuable marker in defining disease activity in patients who have started anti-tumor necrosis factor (TNF) drugs for ankylosing spondylitis. Eur J Rheumatol 2014;1:101-5.
13. Gökmen F, Akbal A, Reşorlu H, Gökmen E, Güven M, Aras AB, et al. Neutrophil-lymphocyte ratio connected to treatment options and inflammation markers of ankylosing spondylitis. J Clin Lab Anal 2015;29:294-8.
14. Koenders MI, Lubberts E, van de Loo FA, Oppers-Walgreen B, van den Bersselaar L, Helsen MM, et al. Interleukin-17 acts independently of TNF-alpha under arthritic conditions. J Immunol 2006;176:6262-9.
15. Rudwaleit M, van der Heijde D, Landewé R, Listing J, Akkoc N, Brandt J, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 2009;68:777-83.
16. Ay S, Kutlay Ş, Kurtaiş Y, Yanık B. Adaptation and validation of the Turkish version of the bath ankylosing spondylitis disease activity index (BASDAI). Arch Rheumatol 2004;19:139-46.
17. Sari I, Sunbul M, Mammadov C, Durmuş E, Bozbay M, Kıvrak T, et al. Relation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography. Kardiol Pol 2015;73:1310-6.
18. Demirdal T, Sen P. The significance of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and lymphocyte-monocyte ratio in predicting peripheral arterial disease, peripheral neuropathy, osteomyelitis and amputation in diabetic foot infection. Diabetes Res Clin Pract 2018;144:118-25.
19. Guo W, Lu X, Liu Q, Zhang T, Li P, Qiao W, et al. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for breast cancer patients: an updated meta-analysis of 17079 individuals. Cancer Med 2019;8:4135-48.