Neutrophil-to-Lymphocyte Ratio for Predicting Loss of Response to Infliximab in Ulcerative Colitis

Yu, Ning; Hosomi, Shuhei; Yamagami, Hirokazu; Yukawa, Tomomi; Otani, Koji; Nagami, Yasuaki; Tanaka, Fumio; Taira, Koichi; Kamata, Noriko; Tanigawa, Tetsuya; Shiba, Masatsugu; Watanabe, Kenji; Watanabe, Toshio; Tominaga, Kazunari; Fujiwara, Yasuhiro

doi:10.1371/journal.pone.0169845

Cited by 59 publications

(60 citation statements)

References 36 publications

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“…Subsequently, the predictive value of NLR for clinical response to infliximab in UC patients was also examined in one study involving 59 patients with moderate‐to‐severe active UC treated with infliximab, and 37 patients experienced clinical response after induction therapy. During the observational period, 14 of 37 patients on maintenance therapy lost the response, and the NLR baseline levels of patients who lost to response were significantly higher than those in patients with sustained response . Taken together, these two studies indicated that the pre‐treatment levels of NLR could serve as predictor of sustained response to a 52‐week course of infliximab therapy among patients with CD and UC, and taking NLR into account in patients with CD and UC may lead to more appropriate clinical management of those patients treated with infliximab.…”

Section: Discussionmentioning

confidence: 86%

“…Apart from the value of assessing disease activity, a few studies were performed to determine the clinical value of NLR and PLR in treatment response in the field of rheumatology . In a study involving 358 RA patients treated with bDMARDs (infliximab, etanercept, adalimumab, TCZ, and abatacept), NLR decreased significantly after treatment with each bDMARDs except for abatacept, and △NLR was positively correlated with △DAS28‐ESR, indicating that △NLR might be applied to reflect the efficacy of bDMARDs .…”

Section: Discussionmentioning

confidence: 99%

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The clinical value of hematological markers in rheumatoid arthritis patients treated with tocilizumab

Zhou

Xiao

Qin

et al. 2019

Clinical Laboratory Analysis

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BackgroundEmerging evidence indicates that some hematological markers have critical value in evaluating treatment response. This study was performed to determine the clinical value of hemoglobin (Hb), platelet (Plt), neutrophil‐to‐lymphocyte ratio (NLR), and platelet‐to‐lymphocyte ratio (PLR) in rheumatoid arthritis (RA) patients treated with tocilizumab (TCZ).MethodsFifty‐two RA patients receiving TCZ were recruited and followed for 6 months. The values of abovementioned hematological markers were collected. Clinical disease activity index (CDAI) and disease activity score based on 28 joints (DAS28)‐ESR were calculated. Correlation analysis was conducted by calculating Pearson's correlation coefficient. The change in disease activity between groups according to the baseline level of hematological markers was compared by t test.ResultsSignificant correlation between change in NLR (△NLR), change in PLR (△PLR), and change in CDAI (△CDAI) was found (△NLR: r = 0.30, P = 0.03; △PLR: r = 0.31, P = 0.03). The change in Plt (△Plt) was correlated with change in DAS28‐ESR (△DAS28‐ESR) (r = 0.36, P = 8.24 × 10−3). Greater improvement in CDAI was seen in patients categorized into Plt high group (t = 2.06, P = 0.04), NLR high group (t = 2.15, P = 0.04), and PLR high group (t = 2.41, P = 0.02) compared with the contrast group.ConclusionOur study demonstrated that △Plt, △NLR, and △PLR could be used to monitor the clinical response to TCZ. RA patients with high baseline levels of Plt, NLR, and PLR achieved more improvement, indicating these hematological markers might be utilized to guide TCZ treatment.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

The clinical value of hematological markers in rheumatoid arthritis patients treated with tocilizumab

Zhou

Xiao

Qin

et al. 2019

Clinical Laboratory Analysis

View full text Add to dashboard Cite

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“…The value of albumin, haemoglobin and CRP for predicting anti‐TNF response has been reported in several studies (Table S7). Evidence from one study suggests that baseline neutrophil‐to‐lymphocyte ratio predicts secondary loss of response to IFX treatment in UC patients (HR 3.86 [1.20‐12.4], P = 0.023; AUC 0.798) …”

Section: Resultsmentioning

confidence: 99%

Systematic review: predictive biomarkers of therapeutic response in inflammatory bowel disease—personalised medicine in its infancy

Stevens

Matheeuwsen

Lönnkvist

et al. 2018

Aliment Pharmacol Ther

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Summary Background Inflammatory bowel disease (IBD) is characterised by substantial heterogeneity in treatment response. With an expanding number of therapeutic agents, identifying optimal treatment at the patient level remains a major challenge. Aim To systematically review the available literature on predictive biomarkers of therapeutic response in IBD. Methods An electronic literature search was performed on 30 January 2018 using MEDLINE, EMBASE and the Cochrane Library. Retrospective, prospective, uncontrolled and controlled studies reporting on biomarkers predicting therapeutic response in paediatric and adult IBD populations were eligible for inclusion. The methodological quality of the included studies was assessed using the QUIPS tool. Due to anticipated heterogeneity and limited data, a qualitative, rather than quantitative, assessment was planned. Results Of the 10 638 citations identified, 92 articles met the inclusion criteria. Several potential DNA, mRNA and protein markers were evaluated as predictive biomarkers. Most studies focused on predicting response to anti‐TNF agents. Substantial between‐study heterogeneity was identified with respect to both the biomarkers studied and the definition of response. None of the included studies received a low risk of bias rating for all six domains. Currently, none of the biomarkers is sufficiently predictive for clinical use. Conclusions The search for predictive biomarkers is still in its infancy and current evidence is limited. Future research efforts should take into account the high patient heterogeneity within prospective trials with objective response assessment. Predictive models will most likely comprise a combination of several molecular markers from integrated omics‐levels and clinical characteristics.

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“…Furthermore, we used not only NLR but also MER and PLR as indicative parameters of systemic inflammation in the present study. Inflammation parameters such as NLR, MER, and PLR have an important role in inflammatory, oncologic, and cardiovascular diseases (Imtiaz et al ., ; Nishida et al ., ). Yoon et al .…”

Section: Discussionmentioning

confidence: 97%

“…Our study revealed a cutoff value of 1.8 (AUC 0.712, p < 0.001; sensitivity 61.1%; specificity 75.0%) discrimination of the phases of PD for the NLR. Various cutoff values have been found in different studies for NLR ranged between 1 and 5 (Nishida et al ., ; Yucel et al ., ; Ventimiglia et al ., ). Forget et al .…”

Section: Discussionmentioning

confidence: 97%

The role of inflammatory parameters (neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and monocyte‐to‐eosinophil ratio) in patients with Peyronie's disease

et al. 2019

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Objectives The aim of the study was to investigate the ability of the systemic inflammatory parameters to predict the discrimination of the phases of Peyronie's disease (PD). Materials and methods Demographic, clinical, and laboratory data from 156 patients with PD were analyzed. A complete blood count (CBC) was obtained for every patient, and the neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and monocyte‐to‐eosinophil ratio (MER) were calculated for every men. Subsequently, patients were divided into two groups based upon the phase of the disease. Results The mean age was 51.9 ± 9.6 in all study population. The mean duration between symptom onset and patient evaluation was 4.2 ± 3.2 months in acute phase group, while it was 32.7 ± 31.7 months in chronic phase group (p < 0.001). There were no significant differences between the groups according to comorbidities such as diabetes, hypertension, lipid abnormalities, ischemic heart disease, smoking, and alcohol consumption. There was a statistically significant difference in NLR and PLR between two groups (p = 0.008, p = 0.008, respectively). NLR and PLR were significantly correlated with discrimination status in univariate analysis (p = 0.003, p = 0.005, respectively). Multivariate regression analysis revealed that NLR was the only independent risk factor for discrimination of the phases of PD (p < 0.001). The ROC analysis revealed a cutoff value of 1.8 (AUC 0.712, p < 0.001; sensitivity 61.1%; specificity 75.0%) for the NLR. Conclusion Our study demonstrated that NLR could be helpful to differentiate the chronic phase from the acute phase in patients with PD. Therefore, NLR could be used as an objective biomarker to the management of the disease and choosing the appropriate treatment.

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Neutrophil-to-Lymphocyte Ratio for Predicting Loss of Response to Infliximab in Ulcerative Colitis

Cited by 59 publications

References 36 publications

The clinical value of hematological markers in rheumatoid arthritis patients treated with tocilizumab

The clinical value of hematological markers in rheumatoid arthritis patients treated with tocilizumab

Systematic review: predictive biomarkers of therapeutic response in inflammatory bowel disease—personalised medicine in its infancy

The role of inflammatory parameters (neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and monocyte‐to‐eosinophil ratio) in patients with Peyronie's disease

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