Neutrophil to lymphocyte ratio predicts glucocorticoid resistance in polymyalgia rheumatica
| Autor: | Jessica L Y Leung, Claire E Owen, Andrew M. Scott, Christopher McMaster, Russell R C Buchanan, David F L Liew |
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| Rok vydání: | 2020 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Neutrophils Prednisolone education Drug Resistance Drug resistance Proof of Concept Study Risk Assessment Gastroenterology Polymyalgia rheumatica Rheumatology Predictive Value of Tests Risk Factors Internal medicine Humans Medicine Lymphocyte Count Lymphocytes Prospective Studies Neutrophil to lymphocyte ratio Prospective cohort study Glucocorticoids Aged business.industry Odds ratio Middle Aged medicine.disease Polymyalgia Rheumatica Predictive value of tests Female business medicine.drug |
| Zdroj: | International Journal of Rheumatic Diseases. 24:56-62 |
| ISSN: | 1756-185X 1756-1841 |
| Popis: | Aim Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) correlate with disease activity in several rheumatic diseases; however, their utility in polymyalgia rheumatica (PMR) remains unclear. This study evaluated their relationship with disease activity and glucocorticoid resistance in PMR. Method Data for disease activity (PMR-AS) and full blood examination was obtained from a prospective observational cohort comprising newly diagnosed, steroid-naive PMR patients treated with low-dose glucocorticoid therapy. Glucocorticoid resistance was defined as non-response to prednisolone 15 mg/d or initial response followed by flare (PMR-AS ≥ 9.35 or ∆ ≥6.6) upon weaning to 5 mg/d. Univariable Bayesian linear regression analysis of the relationship between PMR-AS (baseline and mean) and NLR and PLR was performed. Predictors of glucocorticoid resistance were identified using a multivariable outcome model, with variables derived from Bayesian model selection. Results Of the 32 included patients, 16 (50%) fulfilled the primary outcome measure of glucocorticoid resistance. These participants were older, typically female, and had higher baseline C-reactive protein than their glucocorticoid-responsive counterparts. A statistically significant relationship was identified between PMR-AS and both NLR (odds ratio [OR] 28.1; 95% CI 1.6-54.7) and PLR (OR 40.6; 95% CI 10.1-71.4) at baseline, with PLR also found to correlate with disease activity during follow-up (OR 15.6; 95% CI 2.7-28.2). Baseline NLR proved a statistically significant predictor of glucocorticoid-resistant PMR (OR 14.01; 95% CI 1.49-278.06). Conclusion Baseline NLR can predict glucocorticoid resistance in newly diagnosed PMR patients. Both NLR and PLR may be reliable biomarkers of disease activity in PMR. |
| Databáze: | OpenAIRE |
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