Changes in neutrophil–lymphocyte or platelet–lymphocyte ratios and their associations with clinical outcomes in idiopathic pulmonary fibrosis

Steven D. Nathan*, Jayesh Mehta, John Stauffer, Elizabeth Morgenthien, Ming Yang, Susan L. Limb, Sangeeta Bhorade

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Identification of prognostic and predictive biomarkers in idiopathic pulmonary fibro-sis (IPF) could aid assessment of disease severity and prediction of progression and response to treatment. This analysis examined reference ranges for neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in IPF, and the relationship between NLR or PLR changes and clinical outcomes over 12 months. This post hoc analysis included patients with IPF from the Phase III, double-blind trials of pirfenidone, ASCEND (NCT01366209) and CAPACITY (NCT00287716 and NCT00287729). The relationship between change from baseline to Month 12 in NLR or PLR (divided into quartiles (Q1–Q4)) and outcomes (mortality, respiratory hospitalization, declines in lung function, exercise capacity and quality of life) was assessed. Estimated reference ranges at baseline for all patients analyzed (n = 1334) were 1.1–6.4 for NLR and 56.8–250.5 for PLR. Significant trends were observed across NLR and PLR quartiles for all outcomes in placebo-treated patients, with patients manifesting the greatest NLR or PLR changes experiencing the worst outcomes. These results suggest that the greatest NLR or PLR changes over 12 months were associated with worse clinical outcomes. Further research is needed to determine the utility of NLR and PLR as prognostic biomarkers in IPF.

Original languageEnglish (US)
Article number1427
JournalJournal of Clinical Medicine
Volume10
Issue number7
DOIs
StatePublished - Apr 1 2021

Keywords

  • Biomarker
  • Clinical outcomes
  • Idiopathic pulmonary fibrosis
  • NLR
  • PLR

ASJC Scopus subject areas

  • General Medicine

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