title: Neutrophil lymphocyte ratio can be a valuable marker in defining disease activity in patients who have started anti-tumor necrosis factor (TNF) drugs for ankylosing spondylitis.
abstract: OBJECTIVE
  Neutrophil lymphocyte ratio (NLR) has emerged as a valuable and reliable method for follow-up of systemic inflammatory disease. We herein aimed to evaluate the role of NLR in the clinical follow-up of inflammation and also to compare its relationship with other measures, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).
  
  
  METHODS
  A total of 35 active ankylosing spondylitis (AS) and 38 healthy volunteers were included in the study. The patient group was enrolled for treatment with one anti-tumor necrosis factor (TNF) drug. Total blood count, ESR, CRP, and BASDAI score were obtained before and 3 months following the treatment. NLR was found with a mathematical calculation of the ratio of neutrophils with lymphocytes.
  
  
  RESULTS
  The mean NLR value of the control group and patients was 1.90±0.89 and 2.67±1.17, respectively (p<0.05). After a 3-month course of treatment, the patient group had a mean NLR value of 1.8±0.7, which was significantly lower than pretreatment values (p<0.001). The post-treatment mean ESR, CRP, and BASDAI scores were significantly lower than mean baseline scores (p<0.001, p=0.007, p<0.001, respectively). Also, NLR was found to be correlated with BASDAI, ESR, and CRP (r=0.388, p<0.001; r=0.455, p<0.0001; and r=0.3389, p<0.005, respectively).
  
  
  CONCLUSIONS
  Neutrophil lymphocyte ratio could be a reliable and easily accessible method for follow-up of patients with AS.
authors.affiliation: Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Belkıs Nihan
authors.initials: BN
authors.lastname: Coşkun
authors.affiliation: Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Mustafa Ferhat
authors.initials: MF
authors.lastname: Öksüz
authors.affiliation: Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Selime
authors.initials: S
authors.lastname: Ermurat
authors.affiliation: Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Ayşe Nur
authors.initials: AN
authors.lastname: Tufan
authors.affiliation: Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Nurdan
authors.initials: N
authors.lastname: Oruçoğlu
authors.affiliation: Department of Internal Medicine, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Akif
authors.initials: A
authors.lastname: Doğan
authors.affiliation: Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Ediz
authors.initials: E
authors.lastname: Dalkılıç
authors.affiliation: Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Pehlivan
keywords: Ankylosing spondylitis; disease activity; neutrophil lymphocyte ratio