AB0254 NEUTROPHIL-LYMPHOCYTE RATIO AND PLATELET-LYMPHOCYTE RATIO IN PATIENTSRECEIVING ANTIRHEUMATIC THERAPY: RELATIONSHIP TO CLINICAL AND LABORATORY MARKERS OF DISEASE ACTIVITY

Background The use of antirheumatic drugs is key to limit or prevent inflammation and joint damage in rheumatoid arthritis (RA). Recently, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) has been considered markers of clinical activity in RA1, however its relationship with serological and clinical parameters in patients receiving disease modifying drugs (DMARDs) therapy has been poorly evaluated. Objectives To analyze the association of NLR and PLR with serological and clinical parameters related to the clinical prognosis in RA patients with antirheumatic treatment. Methods A cross-sectional study was carried out in 150 women with RA (mean age of 45.5 years, and mean duration of disease of 8 years) all diagnosed according to ACR/EULAR 2010 criteria and receiving DMARDs and corticosteroids (Cs) therapy. The clinical features and DAS-28 score were analyzed by a rheumatologist professional. The NLR and PLR, as well as the erythrocyte sedimentation rate (ESR), high sensitivity C reactive protein (hsCRP) levels, rheumatoid factor (RF) and anti-cyclic citrullinated peptides (anti-CCPs) antibodies, were determined in the laboratory. Results The medical schemes prescribed commonly were: Methotrexate (MTX) monotherapy and MTX combination with chloroquine, sulfasalazine, leflunomide and Cs. The NLR was correlated with DAS28-ESR and DAS28-hsCRP scores. The values of NLR >2.2 (percent neutrophil/percent lymphocyte) were associated with hsCRP >12 mg/L (OR=2.45, p=0.036), DAS28-hsCRP >5.1 (OR=2.69, p=0.07) and with anti-CCPs-positive (>5 U/mL) (OR=1.57, p=0.41). While, PLR >10.4 (platelet count×103/mm3/percent lymphocyte) was too associated (OR=3.72, p=0.004; OR=2.51, p=0.08; OR=2.96, p=0.07, respectively). Serological autoantibodies, when was considered in combination, the anti-CCPs/RF-positive patients showed a higher correlation between NLR and PLR with the parameters of clinical activity [tender joints count (r=0.19, p=0.036; r=0.16, p=0.07), swollen joints count (r=0.15, p=0.08; r=0.14, p=0.11) and DAS28-hsCRP score (r=0.16, p=0.06; r=0.17, p=0.05)], however this correlation was higher in anti-CCPs-positive but RF-negative patients. In addition, was observed that patients with DMARDs combination and a greater number of drugs had increased NLR and PLR. Conclusion NLR and PLR could be considered markers for the evaluation of the clinical course and response to therapy DMARDs in RA patients. Reference [1] Sargin G, Senturk T, Yavasoglu I, et al. Relationship between neutrophil-lymphocyte, platelet-lymphocyte ratio and disease activity in rheumatoid arthritis treated with rituximab. Int J Rheum Dis. 2018. doi.org/10.1111/1756-185X.13400 Disclosure of Interests None declared