Correlation of Neutrophil to Lymphocyte Ratio and Disease Activity in Patients of Ankylosing Spondylitis on Etanercept Therapy

Background: Ankylosing spondylitis, a chronic disease, in which spinal inflammation develops which continuously causes backache and inadequacy in the functions of spine.  Anti-inflammatory medications are available but along with that, assessment of inflammatory markers is obligatory to assess disease activity.   Objective: To determine association between neutrophil to lymphocyte ratio and activity of disease in patients of ankylosing spondylitis on etanercept therapy Study type settings & duration: This quasi experimental trial was conducted at Department of Rheumatology, Mayo Hospital, Lahore from September 2019 to March 2020. Methodology: Patients of aged 41-49 years of both genders diagnosed with ankylosing spondylitis and were taking etanercept as medication for 6 months were enrolled. Blood samples were taken at baseline and after 6 months of therapy and analyzed for assessment of neutrophil lymphocyte ratio (NLR) and ASDAS score. Data was entered, decoded and analyzed using SPSS version 22. Results: The mean age of the participants was 45.03 (±2.44) years and majority of them 24 (80%) were males. The mean NLR was 2.9 (±1.0) at baseline which reduced significantly to 1.6 (±0.5) after six months therapy (p <0.05). Similarly the mean baseline ASDAS was 3.8 (±0.9) which significantly reduced to 2.4 (±0.6) after six months of therapy (p <0.05). There was statistical significant positive correlation between NLR and ASDAS i.e. r=0.659 (p <0.05). Conclusion: NLR and activity of disease showed positive correlation in patients with ankylosing spondylitis, which illustrated that NLR can also be used as a key predictor of inflammation that makes it a ........