Detailed long-term dynamics of neutrophil-to-lymphocyte ratio under biologic treatment reveal differential effects of tumour necrosis factor-alpha and interleukin 12/23 antagonists

Psoriasis is thought to be associated with a reduced life expectancy through systemic inflammation. A comparative, retrospective analysis of neutrophil-to-lympho-cyte ratio, a biomarker of systemic inflammation and cardiovascular risk, under 196 treatments with tumour necrosis factor-α and interleuk...

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Main Authors: Hoffmann, Jochen (Author) , Knoop, Christian (Author) , Enk, Alexander (Author) , Hadaschik, Eva (Author)
Format: Article (Journal)
Language:English
Published: Sep 30, 2021
In: Acta dermato-venereologica
Year: 2021, Volume: 101, Issue: 10, Pages: 1-5
ISSN:1651-2057
DOI:10.2340/actadv.v101.271
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.2340/actadv.v101.271
Verlag, lizenzpflichtig, Volltext: https://medicaljournalssweden.se/actadv/article/view/271
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Author Notes:Jochen H.O. Hoffmann, Christian Knoop, Alexander H. Enk and Eva N. Hadaschik

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520 |a Psoriasis is thought to be associated with a reduced life expectancy through systemic inflammation. A comparative, retrospective analysis of neutrophil-to-lympho-cyte ratio, a biomarker of systemic inflammation and cardiovascular risk, under 196 treatments with tumour necrosis factor-α and interleukin-12/23 antagonists was performed. Neutrophil-to-lympho-cyte ratio decreased significantly within 3 months of initiation of treatment and remained stable at reduced levels for at least 33 months. Dynamics were more pronounced and neutrophil-to-lympho-cyte ratio under treatment was lower in patients treated with tumour necrosis factor-α compared with interleukin-12/23 antagonists (geometric mean (95% confidence interval): 2.03 (1.9, 2.1) vs 2.63 (2.2, 3.2), respectively, p = 0.014). tumour necrosis factor-α antagonist treatment and baseline neutrophil-to-lympho-cyte ratio were independent predictors of a median low cardiovascular risk neutrophil-to-lympho-cyte ratio (< 2.15) during treatment (odds ratio (95% confidence interval): 0.53 (0.4-0.8) and 4.68 (1.0-19.1), p = 0.001 and p = 0.032, respectively). These results demonstrate a rapid and sustained reduction in biomarkers of systemic inflammation under biologic treatment. Furthermore, these data suggest class-specific effects on systemic inflammation, which may be relevant for the prevention of psoriasis co-morbidity by systemic treatment. 
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