Sezgin ZONTUL, Osman CÜRE
Rheumatology Quarterly - 2026;4(1):9-16
Aim: To investigate the relationship between hematology-derived systemic inflammation indices systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and C-reactive protein-to-lymphocyte ratio (CLR) and disease activity in patients with axial spondyloarthritis (axSpA). Material and Methods: This retrospective cross-sectional study included 232 axSpA patients and 199 healthy controls. Disease activity was assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); BASDAI >=4 defined active disease (n=146) and BASDAI <4 inactive disease (n=86). SII [platelet x (neutrophil/lymphocyte)], SIRI [neutrophil x (monocyte/lymphocyte)], and CLR (CRP/lymphocyte) were calculated from complete blood count parameters and C-reactive protein (CRP). Results: Compared with controls, axSpA patients had higher white blood cell, neutrophil, lymphocyte, platelet, and monocyte counts as well as CRP levels (all p<=0.001). SII (p=0.016), SIRI (p<0.001), and CLR (p<0.001) were also significantly higher in axSpA. In active disease, hemoglobin and lymphocyte counts were lower (p=0.028 and p=0.033), while platelet counts were higher (p=0.037). Although CRP did not differ significantly between active and inactive groups (p=0.070), SII and CLR were higher in active patients (p=0.017 and p=0.039). SIRI showed no significant difference (p=0.425). Conclusion: Hemogram-derived indices, particularly SII and CLR, were associated with disease activity in axSpA and may provide complementary information for monitoring inflammatory burden, especially when CRP levels are not discriminatory.
