Eosinophil to lymphocyte ratio may predict OCS reduction and change in quality of life (AQLQ) resulting from asthma biological treatment

Abstract

Objectives

Simple clinical parameters that could be helpful in choice of monoclonal antibodies and prediction of their effectiveness are being sought. The aim was to assess if neutrophil-to-lymphocyte, eosinophil-to-lymphocyte and platelet-to-lymphocyte ratios may predict outcomes of biologic therapy for severe asthma.

Methods

Retrospective, single-center study including severe asthma patients treated with three different biologics. The blood ratios were assessed at initiation of treatment (point 0) and after six months (point 1). The chi-square test was used to analyze differences in nominal variables. Quantitative variables were compared by Student’s t-test, Mann–Whitney U or Wilcoxon signed-rank tests.

Results

53 patients with severe asthma were included, among them 21 patients (40%) treated with omalizumab and 32 patients (60%) with mepolizumab or benralizumab. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios did not change during six-month-course of biological treatment. Eosinophil-to-lymphocyte ratio was higher at the point 0 (p = 0.016) in the group treated with anti-eosinophils than in the omalizumab group and lower at the point 1 (p = 0.006). In the anti-eosinophil group this ratio decreased between points 0 and 1 (p < 0.001). In the omalizumab group there was an inverse correlation between the initial ratio and oral corticosteroid dose reduction (r_s = −0,67). In the a/eos group there were significant correlations between initial ratio and age (r_s = 0.36), and ACQ (r_s = −0.4) and ACQ (r_s = 0.41) measured at the point 1.

Conclusions

Pretreatment eosinophil-to-lymphocyte ratio may predict oral corticosteroid dose reduction resulting from omalizumab treatment and change in quality of life and asthma control resulting from anti-IL-5 and IL-5R treatment.

Keywords:

• Asthma
• biological treatment
• ELR
• NLR
• PLR
• personalized therapy

Ethical approval

The research was approved by the Bioethics Committee at the Silesian Medical University in Katowice, Resolution No. PCN/CBN/0052/KB/171/22.

Author contributions

Olga Branicka – Designed the study, analyzed and interpreted the data for the project, made tables and wrote the substantial part of the manuscript. Final approval of the version to be published; Agreement to be accountable for all aspects of the project in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Radosław Gawlik – Substantial contributions to the design of the project; Revising manuscript critically for important intellectual content; Final approval of the version to be published. Agreement to be accountable for all aspects of the project in ensuring that questions related to the accuracy or integrity of any part of the project are appropriately investigated and resolved.

Joanna Glück – Main contributions to the conception and design of the project, interpretation of data of the project; preparation of parts of the manuscript and graphs and revising the project critically for important intellectual content; Final approval of the version to be published; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.

Additional information

Funding

The study was supported by grant PCN-1-174/N/1/K from the Medical University of Silesia Katowice, Poland. This work was supported by Slaski Uniwersytet Medyczny w Katowicach.