Objectives: To study the correlation between neutrophil-to-lymphocyte ratio (NLR) and disease activity of systemic lupus erythematosus (SLE) using the SLE disease activity score (SLE-DAS).

Methods: Consecutive adult patients who fulfilled the ACR or SLICC criteria for SLE were recruited between March 2023 and February 2024. SLE activity was assessed by SLE-DAS, physicians’ global assessment (PGA) and SLE disease activity index-2000 (SLEDAI-2K). The calculated NLR was correlated with disease activity indices and serological parameters (anti-dsDNA, C3/4) by Spearman’s rank correlation. Patients were stratified into SLE-DAS remission, mild and moderate/severe disease activity and comparison of the NLR was performed among these subgroups by one-way ANOVA.

Results: A total of 420 SLE patients were studied (96.2% women, age 46.0±11.0 years, SLE duration 16.4±8.3 years). Moderate/severe, mild disease activity and SLE-DAS remission was present in 70(16.7%), 66(15.7%), and 284(67.6%) patients, respectively. SLE-DAS correlated significantly with SLEDAI-2K (rho 0.90; p<0.001) and PGA (Rho 0.60; p<0.001). The mean NLR of all patients was 3.54±4.0 and NLR correlated significantly with SLE-DAS (Rho 0.17; p<0.001). The NLR was significantly higher in active renal (urine P/Cr >0.5, active sediments or histological features) than inactive SLE (4.62 vs 3.27; p=0.02). The NLR in patients with moderate/severe SLE-DAS activity was significantly higher than those in remission (4.87 vs 3.27; p=0.007). ROC analysis showed that a NLR cut-off of 3.11 showed a sensitivity of 55.6% and specificity of 68.7% in detecting moderate/severe SLE-DAS activity (AUC 0.67[0.6-0.7]; p<0.001).

Conclusion: The NLR is a convenient marker that correlates significantly with disease activity in SLE.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.