P.06.9 TWO NEW PROGNOSTIC MARKERS OF MUCOSAL HEALING IN PATIENTS TREATED WITH ANTI-TNF FOR ULCERATIVE COLITIS: THE NEUTROPHIL-TO-LYMPHOCYTE-RATIO AND THE PLATELET-TO-LYMPHOCYTE-RATIO

2019 ◽  
Vol 51 ◽  
pp. e216
Author(s):  
L. Bertani ◽  
N. De Bortoli ◽  
G. Tapete ◽  
E. Albano ◽  
R. Mazzanti ◽  
...  
2020 ◽  
Vol 26 (10) ◽  
pp. 1579-1587 ◽  
Author(s):  
Lorenzo Bertani ◽  
Federico Rossari ◽  
Brigida Barberio ◽  
Maria Giulia Demarzo ◽  
Gherardo Tapete ◽  
...  

Abstract Background Anti-tumor necrosis factor drugs (anti-TNFs) are widely used for the treatment of ulcerative colitis (UC). However, many patients experience loss of response during the first year of therapy. An early predictor of clinical remission and mucosal healing is needed. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of subclinical inflammation poorly evaluated in UC patients treated with anti-TNFs. The aim of this multicenter study was to evaluate whether NLR and PLR could be used as prognostic markers of anti-TNF treatment response. Methods Patients with UC who started anti-TNF treatment in monotherapy were evaluated. Patients with concomitant corticosteroid treatment ≥20 mg were excluded. We calculated NLR, PLR, and fecal calprotectin before treatment and after induction. The values of NLR and PLR were correlated with clinical remission and mucosal healing at the end of follow-up (54 weeks) using the Mann-Whitney U test and then multivariate analysis was conducted. Results Eighty-eight patients were included. Patients who reached mucosal healing after 54 weeks of therapy displayed lower levels of both baseline NLR and PLR (P = 0.0001 and P = 0.04, respectively); similar results were obtained at week 8 (P = 0.0001 and P = 0.001, respectively). Patients who presented with active ulcers at baseline endoscopic evaluation had higher baseline NLR and PLR values compared with those without detected ulcers (P = 0.002 and P = 0.0007, respectively). Conclusions BothNLR and PLR showed a promising role as early predictors of therapeutic response to anti-TNF therapy in UC patients. If confirmed in larger studies, classification and regression trees proposed in this article could be useful to guide clinical decisions regarding anti-TNF treatment.


2018 ◽  
Vol 37 (2) ◽  
pp. 155-162 ◽  
Author(s):  
Muhammet Yener Akpinar ◽  
Yasemin Ozderin Ozin ◽  
Mustafa Kaplan ◽  
Ihsan Ates ◽  
Ismail Hakki Kalkan ◽  
...  

SummaryBackground:We investigated the sensitivity of neutrophil to lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as well as a combination of NLR and PLR to predict endoscopic disease severity based on mucosal assessment in ulcerative colitis (UC).Methods:The study group consisted 104 patients with active UC, 104 patients in remission, and 105 healthy individuals. Disease activity was described with Rachmilewitz endoscopic activity index (EAI). Curve analysis was used to determine the optimal cutoff values of NLR and PLR for obtaining remission. The patients with both PLR and NLR values higher than the cutoff values were coded as »high risk,« those with one parameter higher were coded as »moderate risk«, those with both parameters lower than the cutoff values were coded as »low-risk« patients.Results:The mean NLR and PLR values in the endoscopically active disease group were higher than the others, with higher values in the endoscopic remission group compared with the control group (p<0.001). Rachmilewitz EAI in high-risk patients was significantly higher than that in others (p<0.001). In Cox regression analyses, moderate and high risk, high erythrocyte sedimentation rate and high EAI were found as independent predictors of endoscopic active disease.Conclusions:This is the first study that investigated the use of NLR and PLR combination to assess endoscopic disease severity in UC. Either high NLR or PLR levels can predict active endoscopic disease. However, the use of these parameters in combination is more accurate in evaluating mucosal disease and inflammation in UC.


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