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

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. (C) 2018 Publishing services provided by Elsevier B.V. on behalf of Egyptian Society of Rheumatic Diseases.