ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 286

Clinical Significance and Prognostic Value of Neutrophil to Lymphocyte Ratio in Patients with Dermatomyositis

Jaehyung Hur1, Dong Jin Go2, Sang Wan Chung3, You Jung Ha3, Eun Ha Kang1, Jin Kyun Park4, Eun Young Lee2, Eun Bong Lee2, Yeong Wook Song4 and Yun Jong Lee5, 1Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea, The Republic of, 2Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea, The Republic of, 3Division of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea, 4Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea, 5Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: , ,

Session Information

Date: Sunday, November 13, 2016

Title: Muscle Biology, Myositis and Myopathies - Poster I: Basic/Translational

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:  Recent studies have suggested that neutrophil to lymphocyte ratio (NLR) could be an emerging predictive marker of disease activity or mortality in patients with chronic inflammatory diseases, cardiovascular diseases or malignancies. This study was aimed to evaluate the clinical significance and prognostic value of NLR in patients with dermatomyositis.

Methods:  We retrospectively reviewed 176 patients with newly diagnosed dermatomyositis who satisfied Peter and Bohan criteria between August 2003 and January 2016. Clinical characteristics and laboratory findings were compared between survivor group and non-survivor group. Using the receiver operating characteristics curves, the cut-off value of NLR for predicting survival was calculated. Univariate and multivariate analyses using Cox proportional hazard model were performed to identify associated factors with survival.

Results:  During follow-up (range 0.22-119.4 months), 24 patients (13.6%) died. Non-survivor group had older age (p = 0.011), more interstitial lung disease (ILD, p = 0.015), higher NLR (p = 0.011), lower albumin (p < 0.001), and higher creatinine level (p = 0.005) than survivor group. NLR showed significant positive correlation with C-reactive protein (CRP, r = 0.386, p <0.001), creatine kinase (CK, r = 0.161, p = 0.036), and lactate dehydrogenase (LDH, r = 0.3253, p = 0.001), and negative correlation with albumin (r = -0.298, p <0.001). The optimal cut-off value of NLR for overall survival was 3.8 with the area under the curve of 0.717. According to the cut-off value of 3.8, we classified 87 patients (49.4 %) into the low NLR group and 83 patients (47.2 %) into the high NLR group. The higher NLR group was associated with fever (p = 0.001), the higher muscle enzymes (CK, p = 0.025; LDH, p = 0.001), higher CRP (p < 0.001), lower albumin (p < 0.001), high-dose glucocorticoid therapy (p = 0.031), acute interstitial pneumonia (p = 0.024) and death (p < 0.001). Kaplan-Meier analysis and log-rank test demonstrated a significant difference in survival curves according to NLR of 3.8 (p < 0.001). Cox hazard regression analysis showed that NLR >=3.8, low albumin, the presence of ILD and old age were independent predictors for death (Table 1).

Conclusion:  Our results demonstrated that higher level of the NLR was associated with worse overall survival and the NLR may play a role as an independent prognostic marker in patients with dermatomyositis.

  • Table 1. Multivariate Cox hazard regression analysis of risk factors for death in patients with dermatomyositis
    Variable

    Death

    HR

    95% CI

    p-value

    Age

    1.087

    1.038-1.137

    <0.001

    NLR >= 3.8

    4.905

    1.413-17.025

    0.012

    Interstitial lung disease

    3.421

    1.313-8.917

    0.012

    Albumin

    0.498

    0.270-0.921

    0.026

    • Disclosure: J. Hur, None; D. J. Go, None; S. W. Chung, None; Y. J. Ha, None; E. H. Kang, None; J. K. Park, None; E. Y. Lee, None; E. B. Lee, None; Y. W. Song, None; Y. J. Lee, None.

    To cite this abstract in AMA style:

    Hur J, Go DJ, Chung SW, Ha YJ, Kang EH, Park JK, Lee EY, Lee EB, Song YW, Lee YJ. Clinical Significance and Prognostic Value of Neutrophil to Lymphocyte Ratio in Patients with Dermatomyositis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/clinical-significance-and-prognostic-value-of-neutrophil-to-lymphocyte-ratio-in-patients-with-dermatomyositis/. Accessed .

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