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

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.