Role of systemic immune-inflammation index (SII) in assessing clinical efficacy of TNF-α inhibitors for rheumatoid arthritis.

objectiveTo find out if systemic immune-inflammation index (SII) has the potential to determine the clinical efficacy of TNF-α inhibitors in treating rheumatoid arthritis (RA).

methodsA retrospective analysis was conducted in 154 RA patients who were treated from January 2021 to January 2023. The patients were grouped, based on their treatment response, into ineffective (32 cases) and effective (122 cases) groups. Univariate analysis was conducted to evaluate the clinical data, test indicators, and functional scores. Lasso regression was employed to identify factors impacting patient outcomes. Predictive utility of these factors was assessed via receiver operating characteristic curves, and differences were evaluated using the DeLong test.

resultsNo significant difference was identified in age, gender, disease duration, and other clinical parameters between the two groups (P>0.05). The effective group exhibited lower pre-treatment counts of neutrophils, lymphocytes, as well as SII, C-reactive protein (CRP), rheumatoid factor (RF), and erythrocyte sedimentation rate (ESR), but higher platelet count (P<0.01). Lasso regression found that neutrophil count, lymphocyte count, SII, CRP, RF, and ESR were associated with the treatment efficacy (P<0.05). Among these, SII and lymphocytes demonstrated the highest predictive value in the DeLong test.

conclusionSII along with multiple other pre-treatment parameters are significantly associated with the efficacy of TNF-α inhibitors in the treatment of RA. Notably, SII emerges as a crucial tool in evaluating the efficacy of this treatment.