{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:54:54Z","timestamp":1792684494114,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study was conducted to assess the utility of neutrophil\u2010to\u2010lymphocyte ratio (NLR) and platelet\u2010to\u2010lymphocyte ratio (PLR) in predicting radiographic sacroiliitis and active disease in axial spondyloarthritis (SpA) and to explore the association between use of a tumor necrosis factor inhibitor (TNFi) and these laboratory values compared with traditional inflammatory markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Observational data from the Program to Understand the Longterm Outcomes in Spondyloarthritis (PULSAR) registry were analyzed. We generated receiver operating characteristic curves to calculate laboratory cutoff values; we used these values in multivariable logistic regression models to identify associations with radiographically confirmed sacroiliitis and active disease. We also used logistic regression to determine the likelihood of elevated laboratory values after initiation of TNFi.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most study participants (n\u00a0=\u00a0354) were White, male, and HLA\u2013B27 positive. NLR (odds ratio [OR] 1.459, <jats:italic>P<\/jats:italic> =\u20090.034), PLR (OR 4.842, <jats:italic>P<\/jats:italic> &lt;\u20090.001), erythrocyte sedimentation rate (OR 4.397, <jats:italic>P<\/jats:italic> &lt;\u20090.001), and C\u2010reactive protein (CRP) level (OR 2.911, <jats:italic>P<\/jats:italic> =\u20090.001) were independent predictors of radiographic sacroiliitis. Models that included PLR with traditional biomarkers performed better than those with traditional biomarkers alone. NLR (OR 6.931, <jats:italic>P<\/jats:italic> =\u20090.002) and CRP (OR 2.678, <jats:italic>P<\/jats:italic> =\u20090.004) were predictors of active disease, but the model that included both NLR and CRP performed better than CRP alone. TNFi use reduced the odds of elevated NLR (OR 0.172, <jats:italic>P<\/jats:italic> &lt;\u20090.001), PLR (OR 0.073, <jats:italic>P<\/jats:italic> &lt;\u20090.001), erythrocyte sedimentation rate (OR 0.319, <jats:italic>P<\/jats:italic> &lt;\u20090.001), and CRP (OR 0.407, <jats:italic>P<\/jats:italic> &lt;\u20090.001), but models that included NLR or PLR and traditional biomarkers performed best.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings demonstrate an association between NLR and PLR and sacroiliitis and disease activity, with NLR and PLR showing response after TNFi treatment and adding useful clinical information to established biomarkers, thus perhaps assisting in management of axial SpA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.42333","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T06:24:05Z","timestamp":1661495045000},"page":"232-241","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["<scp>Neutrophil\u2010to\u2010Lymphocyte<\/scp> Ratio and <scp>Platelet\u2010to\u2010Lymphocyte<\/scp> Ratio as Biomarkers in Axial Spondyloarthritis: Observational Studies From the Program to Understand the Longterm Outcomes in Spondyloarthritis Registry"],"prefix":"10.1002","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3411-8379","authenticated-orcid":false,"given":"Rouhin","family":"Sen","sequence":"first","affiliation":[{"name":"Rocky Mountain Regional VAMC, and University of Colorado School of Medicine  Denver Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmeline","family":"Kim","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VAMC, and University of Colorado School of Medicine  Denver Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth J.","family":"Napier","sequence":"additional","affiliation":[{"name":"Portland VAMC and Oregon Health Sciences University  Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Cheng","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VAMC, and University of Colorado School of Medicine  Denver Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VAMC, and University of Colorado School of Medicine  Denver Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan S.","family":"Manning","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VAMC, and University of Colorado School of Medicine  Denver Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric R.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Aurora Rheumatology  Racine Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle D.","family":"Maier","sequence":"additional","affiliation":[{"name":"San Antonio Military Medical Center  San Antonio Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mena","family":"Hashim","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VAMC, and University of Colorado School of Medicine  Denver Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail S.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Georgetown University Hospital, Howard University Hospital, and Washington DC VAMC  Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meika A.","family":"Fang","sequence":"additional","affiliation":[{"name":"West Los Angeles VAMC, and David Geffen School of Medicine at UCLA  Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason K.","family":"Hou","sequence":"additional","affiliation":[{"name":"Houston VAMC and Baylor College of Medicine  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Chang","sequence":"additional","affiliation":[{"name":"Phoenix VAMC  Phoenix Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4563-0845","authenticated-orcid":false,"given":"Jessica A.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Salt Lake City VAMC and University of Utah Hospital  Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siba 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