P591 The effect of Infliximab therapy on the Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios in Inflammatory Bowel Disease patients
E. Stefanidis1, P. Katsinelos1, N. Papanikolaou2, K. Anastasiadou1, J. Kountouras*1
1Aristotle University of Thessaloniki, Second Medical Clinic, Ippokration Hospital, Thessaloniki, Greece, 2Aristotle University of Thessaloniki, Department of Biochemistry, Medical School, Thessaloniki, Greece
Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) have been described as prognostic markers in many chronic inflammatory and malignant diseases. The aim of this retrospective cohort study was to investigate the effect of infliximab treatment on the NLR and PLR in patients with inflammatory bowel disease (IBD) and whether this effect was affected by other Disease Modifying Anti-Rheumatic Drugs (DMARDs), the sex of the patients and the type of IBD (Crohn's disease, CD, or Ulcerative colitis, UC).
Medical records of adult IBD patients on infliximab treatment were retrospectively studied. The NLR and the PLR were estimated at baseline T(-1), at the beginning of the treatment and before the 1st dose of infliximab (T0) and at 2 (T2), 6 (T6), 14 (T14) and 22 (T22) weeks, before the 2nd, 3rd, 4th and 5th dose, respectively. Wilcoxon-Signed Ranks test was used to determine the significance of the change of the NLR and the PLR between the aforementioned time intervals. Mann-Witney U test was used for the comparison of the change of the NLR and the PLR between patients pre-treated or not with sulfasalazine+/-azathioprine, between males and females and between patients with CD and UC. p<0,01 was considered to be significant. SPSS v22 was used for the analyses.
35 adult IBD patients (22 with CD) were included in the study (17 men). 17 patients were on mesalazine+/- azathioprine therapy at T0. At T(-1) (available data from 20 patients) the median NLR was 2.72 (1.66-3.98) and the median PLR was 120,68 (91,5-240,9). At T0 (available data from 35 patients) the median NLR was 2,84 (2,04-7,21) and the median PLR was 201,35 (128,59-263). From T(-1) to T0 both the NLR and the PLR were not significantly increased, p=0.1 and p=0.07, respectively. Two weeks after the introduction of infliximab, at T2, the median NLR was 2,13 (1,26-2,56), p<0,001 and the median PLR was 142,02 (90,43-186,66), p<0,001. The reduction of the NLR remained statistically significant up to T6 while the reduction of the PLR remained statistically significant up to T22. The decrease of the NLR and the PLR at T2 was the same between patients pre-treated or not with mesalazine+/-azathioprine, between males and females and between patients with CD and UC.
Infliximab therapy in IBD patients may result in a significant reduction of both the NLR and the PLR. This reduction seems to be independent of the pre-treatment with other DMARDs, particularly mesalazine+/-azathioprine, the sex of the patients and the type of IBD. Further larger studies are required to confirm the above results and determine whether these indices could serve as prognostic markers of response to infliximab therapy in IBD patients.