Banu TAŞKIN, Bachar MEMET, Eren VURGUN, Sibel ALPER

Orta şiddette ve şiddetli psoriasis hastalarında ustekinumab tedavisi sonrası inflamatuar belirteçlerde azalma

Giriş: Psoriazis kronik, inflamatuar ve sistemik bir hastalıktır. Psoriaziste hastalık şiddetini ölçmek için Psoriazis Alan Şiddet İndeksi (PAŞİ) yanı sıra daha objektif laboratuar araçlarına ihtiyaç vardır. Nötrofil lenfosit oranı (NLO), trombosit lenfosit oranı (TLO), ve oratalama trombosit hacmi (OTH) çeşitli inflamatuar hastalıklarda arttığı bilinen belirteçlerdir. Bu çalışmada amacımız orta şiddette ve şiddetli psoriasis vulgarisi olan hastalarda NLO, TLO ve OTH değerlerinin ustekinumab tedavisi ile değişimlerini araştırmaktır. Gereç ve yöntem: Çalışmada orta şiddette veya şiddetli psoriazis vulgarisi olup, ustekinumab tedavisi verilen kronik plak tipi psoriasis tanılı 25 hasta retrospektif olarak değerlendirilmiştir. Hastaların tedavi öncesi PASI, tam kan sayımı parametreleri, serum CRP seviyeleri ve PAŞİ 75 ve/veya üzeri başarı elde edildikleri kontrollerindeki değerleri kaydedilmiştir. Tam kan sayımı belirteçleri, OTH ve CRP değeri determine edilmiştir. Ek inflamatuar hastalığı ve eşlik eden enfeksiyonu olanlar çalışma dışı bırakılmıştır. Bulgular: Hastaların PASI 75 başarı ve üzeri elde ettikleri incelemelerde NLO, TLO oranlarında istatistiksel olarak anlamlı düşme (p<0.05) saptanırken OTH ve CRP değerlerinde tedavi başarısı sonrası anlamlı değişiklik izlenmemiştir. Tartışma: NLO ve TLO değerlerinde tedavi yanıtı alınmasıyla anlamlı düşme olduğu gösterdik. Bu göstergeler rutin pratikte kolay ölçülebilen ve maliyet açısından verimli belirteçlerdir.

Anahtar Kelimeler:

Psoriazis, tedavi, nötrofil lenfosit oranı

Decrease in inflammation markers with ustekinumab treatment in moderate-severe psoriasis

Purpose: Psoriasis is a chronic, inflammatory, and systemic disease. The disease activity is usually measured by Psoriasis Area and Severity Index (PASI), however, further objective laboratory tools are needed. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and mean platelet volume (MPV) are objectively calculated markers that increase in inflammation. This study aimed to investigate the utility of these markers for follow-up of systemic inflammation and response to treatment. Material and methods: A total of 25 patients who had moderate or severe psoriasis vulgaris, who received ustekinumab treatment were retrospectively evaluated in the study. In patients, pre-treatment PASI, complete blood count parameters, serum CRP levels and NLR, PLR and MPV values in the follow up when they achieved PASI 75 and/or more improvement were recorded. Patients with an additional inflammatory disease or accompanying infection were excluded from the study. Results: While a statistically significant decline was recorded in NLR and PLR (p<0.05), no significant change was observed in MPV and CRP after the therapy success where patients achieved an improvement greater than or equal to PASI 75. Conclusion: We conclude that the correlation with the response to treatment and NLR and PLR levels show that these markers may be beneficial for assessment of disease severity either in combination with current scores or alone. These markers are cost effective predictors that can easily be measured in routine practice.

Keywords:

Psoriasis, Treatment, Neutrophyl lymphocyte ratio,

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