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

Authors

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

Published in

Clinical rheumatology. Jun 19, 2026. Epub Jun 19, 2026.

Abstract

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.
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.
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.
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.

PMID:
42319617
Bibliographic data and abstract were imported from PubMed on 19 Jun 2026.

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