Neutrophil-lymphocyte and platelet-lymphocyte ratios in rheumatoid arthritis patients: Relation to disease activity

Abstract

Aim of the work: To assess the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in rheumatoid arthritis (RA) patients and compare between active cases and those in remission. Patients and methods: The study included 50 RA patients and 20 matched control. Patients were enrolled into 2 equally divided groups; group A (active) with a disease activity score (DAS-28) ≥2.6 and group B (remission) <2.6. Laboratory investigations included the calculation of the NLR and PLR for all subjects. Results: The mean age of patients was 40.7 ± 10.1 years and the mean of disease duration was 5.9 ± 3.4 years. The DAS-28 was 3.9 ± 0.9 in active patients and 2.1 ± 0.3 in those in remission (p = .001). NLR was 2.8 ± 2.1 in the patients and 2.1 ± 0.59 in the control (p = .15). PLR was 1.7 ± 0.9 in the patients and 1.27 ± 0.46 in the control (p = .09). Active patients had an NLR of 3.27 ± 2.81 and PLR of 1.8 ± 1.2 while they were 2.3 ± 0.84 and PLR 1.5 ± 0.59 in patients in remission (p = .05 and p = .18 respectively). There was a significant difference regarding NLR and PLR between active patients and control (2.1 ± 0.59 and 1.27 ± 0.46; p = .03 and p = .04 respectively). In active patients, the NLR and PLR significantly correlated with the patients age (p = .02 and p = .006) and with the DAS-28 (p = .001 and p = .03 respectively). Conclusion: NLR and PLR are 2 emerging inflammatory biomarkers which could be used to evaluate disease activity in active RA patients. A larger scale longitudinal study is recommended to confirm the present results and further demonstrate the relation to medications received and disease outcome. Keywords: Rheumatoid arthritis, DAS-28, Neutrophil-lymphocyte ratio, Platelet-lymphocyte ratio