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Aktuelle Rheumatologie
DOI: 10.1055/a-2243-3308
Original Article

Neutrophil-lymphocyte ratio: an independent predictor of the herpes zoster risk in rheumatoid arthritis patients treated with tofacitinib

Neutrophil-Lymphozyten-Verhältnis: Ein unabhängiger Prädiktor für das Risiko von Herpes Zoster bei rheumatoider Arthritis unter Behandlung mit Tofacitinib
Pengcheng Liu
1   Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
,
Min Zhang
1   Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
,
Yueqin Zhang
1   Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
,
Shujiao Yu
1   Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
,
Rui Wu
1   Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
› Author Affiliations Funding Information The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by a grant from the National Natural Science Foundation of China (NO.82260898) and the Natural Science Foundation of Jiangxi Province (NO.20192BAB205122).
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Abstract

To investigate the role of the neutrophil-lymphocyte ratio (NLR) in the risk of developing herpes zoster (HZ) in patients with rheumatoid arthritis (RA) receiving tofacitinib. This was a prospective observational study recruiting patients who were diagnosed with RA and treated with tofacitinib. Patients with previous herpes zoster infections were excluded from this study. All patients were assessed for HZ every 1–3 months and were followed up for 12 months. Univariate and multivariate logistic regression analyses were used to assess the relationship between NLR and HZ. A cutoff value of NLR was determined based on an ROC curve. A total of 277 patients were included in this study, 19 of whom developed herpes zoster. Univariate and multivariate logistic regression analyses showed that NLR (OR=19.813, p<0.05), neutrophils (OR=15.521, p<0.05) and lymphocytes (OR=0.001, p<0.05) were independent influencing factors of HZ. Through the analysis of the ROC curve, it was found that neutrophils, lymphocytes and NLR had a high predictive value for HZ (AUC=0.75; AUC=0.76; AUC=0.94). The cutoff values were 4.46*10^9/L, 1.70*10^9/L and 3.24, respectively. Given that the NLR is easy to test, NLR was also expected to be a very promising quantitative biomarker for predicting the risk of developing herpes zoster in patients with RA receiving tofacitinib.

Key words

herpes zoster - rheumatoid arthritis - tofacitinib - biomarker - neutrophil-lymphocyte ratio


Publication History

Received: 08 June 2023

Accepted: 09 January 2024

Article published online:
19 February 2024

© 2024. Thieme. All rights reserved.

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