Author Of 1 Presentation
P0757 - The neutrophil-to-lymphocyte ratio in aquaporin-4-positive NMOSD patients: A Latin American multicenter study (ID 1034)
Abstract
Background
Neutrophil-to-lymphocyte ratio (NLR) has been investigated in many autoimmune diseases as a marker of both inflammation and disease activity. So far, the role of NLR in aquaporin-4(AQP4)-ab-positive neuromyelitis optica spectrum disorders (NMOSD) is uncertain due to a lack of data.
Objectives
The aim of this study was to evaluate NLR in AQP4-ab-positive NMOSD patients at disease onset and determine their clinical significance during follow-up.
Methods
We retrospectively included and reviewed the medical records of all recent/newly diagnosed treatment-naïve AQP4-ab-positive NMOSD patients (n=90) according to the 2015 international diagnostic criteria. Additionally, demographic, clinical, paraclinical (e.g. new/enlarging or contrast-enhancing lesions) and prognostic (via EDSS) data at 12 and 24 months were also evaluated. NRL was calculated as the absolute count of neutrophils divided by the absolute count of lymphocytes from peripheral blood samples. Three-hundred and sixty-five healthy subjects who underwent routine physical exam were included as controls. Multivariate regression analysis was used to describe and identified independent association between log-transformed NLR and clinical (relapses and EDSS change) as well as MRI activity (new/enlarging and/or contrast-enhancing MRI lesions). P<0.05 was considered as significant.
Results
NLR was higher in NMOSD patients during the first relapse compared with controls (2.9 ±1.6vs. 1.8 ±0.6;p<0.0001). Regardless of immunosuppressants’ initiation at disease onset, NLR continued to be higher in NMOSD patients at 12 (2.8 ±1.3;p<0.0001) and 24 (3.1 ±1.6;p<0.0001) months compared with controls. No association was observed at 12 and 24 months between log-transformed NLR and the presence of relapses ([OR=0.66, CI95%0.28-1.58, p=0.36] and [OR=0.76, CI95%0.30-1.93, p=0.57], respectively), new/enlarging and/or contrast-enhancing MRI lesions ([OR=1.72, CI95%0.58-5.04, p=0.32] and [OR=0.42, CI95%0.47-2.52, p=0.82], respectively) and physical disability ([OR=-0.21, CI95%-1.04-0.61, p=0.60] and [OR=-0.15, CI95%-1.01-0.69, p=0.71], respectively).
Conclusions
This study suggested that NLR may be a marker of inflammation in AQP4-ab-positive NMOSD patients. However, a higher NLR was not an independent predictor of clinical or radiological disease activity in our model.