Objectives Cardiovascular mortality is up to 43% greater in patients with Psoriatic Arthritis (PsA) when compared to the general population. Whilst composite cardiovascular disease risk prognosticators exist, an emerging inexpensive biomarker known as the neutrophil–lymphocyte ratio (NLR) has been demonstrated to be a risk-associated biomarker of cardiovascular disease (CVD) in the general population. This study therefore aimed to assess the effect of biologic disease modifying antirheumatic drug (bDMARDs) on the NLR in a cohort of adult patients diagnosed with PsA. Methods A retrospective single-centre observational study was conducted using an electronic health record database including 183 adult patients diagnosed with PsA between 1983 and 2024. The NLR of patients was calculated pre- and post-initiation of bDMARDs and statistical significance was analysed using several different statistical analysis tools. Results The overall number of patients in the higher NLR risk stratification group (NLR > 2) was significantly reduced from 104 to 64 post-biologic initiation. Additionally, there was a statistically significant reduction of 24.0% in the average NLR of the entire patient cohort from 2.58 to 1.96 pre- and post-biologic initiation respectively. Conclusion Our study demonstrates that over a third of patients had a significant NLR reduction post-biologic initiation. The mean NLR of the entire patient cohort demonstrated a shift to a lower CVD risk-associated stratified NLR group (NLR < 2), post-biologic treatment. BDMARD treatment in PsA patients therefore demonstrates a significant reduction in the NLR metric, with a varying degree of theoretical impact on the CVD risk reduction among different biologic drugs and classes. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • bDMARDs reduce the Neutrophil–Lymphocyte Ratio in Psoriatic Arthritis patients. • Both TNF inhibitor and IL-17 inhibitors bDMARDs were associated with significant reductions in the Neutrophil–Lymphocyte Ratio in Psoriatic Arthritis patients. </entry> </row> </tbody> </tgroup> </Table>

The effect of biologic disease modifying anti-rheumatic drugs on the neutrophil–lymphocyte ratio in psoriatic arthritis patients

期刊论文
发表日期：

2026年6月19日

查看全文

Martin Lauran,
Chelsea Kyeremateng,
Afrida Haque,
Sara Rizal,
Humairaa Ahmed,
Samyak Pandey,
Muhammad K. Nisar

摘要

Objectives

Cardiovascular mortality is up to 43% greater in patients with Psoriatic Arthritis (PsA) when compared to the general population. Whilst composite cardiovascular disease risk prognosticators exist, an emerging inexpensive biomarker known as the neutrophil–lymphocyte ratio (NLR) has been demonstrated to be a risk-associated biomarker of cardiovascular disease (CVD) in the general population. This study therefore aimed to assess the effect of biologic disease modifying antirheumatic drug (bDMARDs) on the NLR in a cohort of adult patients diagnosed with PsA.

Methods

A retrospective single-centre observational study was conducted using an electronic health record database including 183 adult patients diagnosed with PsA between 1983 and 2024. The NLR of patients was calculated pre- and post-initiation of bDMARDs and statistical significance was analysed using several different statistical analysis tools.

Results

The overall number of patients in the higher NLR risk stratification group (NLR > 2) was significantly reduced from 104 to 64 post-biologic initiation. Additionally, there was a statistically significant reduction of 24.0% in the average NLR of the entire patient cohort from 2.58 to 1.96 pre- and post-biologic initiation respectively.

Conclusion

Our study demonstrates that over a third of patients had a significant NLR reduction post-biologic initiation. The mean NLR of the entire patient cohort demonstrated a shift to a lower CVD risk-associated stratified NLR group (NLR < 2), post-biologic treatment. BDMARD treatment in PsA patients therefore demonstrates a significant reduction in the NLR metric, with a varying degree of theoretical impact on the CVD risk reduction among different biologic drugs and classes.

Key Points

• bDMARDs reduce the Neutrophil–Lymphocyte Ratio in Psoriatic Arthritis patients.

• Both TNF inhibitor and IL-17 inhibitors bDMARDs were associated with significant reductions in the Neutrophil–Lymphocyte Ratio in Psoriatic Arthritis patients.