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Background: Ankylosing spondylitis, a chronic disease, in which spinal inflammation develops which continuously causes backache and inadequacy in the functions of spine. Anti-inflammatory medications are available but along with that, assessment of inflammatory markers is obligatory to assess disease activity. Objective: To determine association between neutrophil to lymphocyte ratio and activity of disease in patients of ankylosing spondylitis on etanercept therapy Study type settings & duration: This quasi experimental trial was conducted at Department of Rheumatology, Mayo Hospital, Lahore from September 2019 to March 2020. Methodology: Patients of aged 41-49 years of both genders diagnosed with ankylosing spondylitis and were taking etanercept as medication for 6 months were enrolled. Blood samples were taken at baseline and after 6 months of therapy and analyzed for assessment of neutrophil lymphocyte ratio (NLR) and ASDAS score. Data was entered, decoded and analyzed using SPSS version 22. Results: The mean age of the participants was 45.03 (±2.44) years and majority of them 24 (80%) were males. The mean NLR was 2.9 (±1.0) at baseline which reduced significantly to 1.6 (±0.5) after six months therapy (p <0.05). Similarly the mean baseline ASDAS was 3.8 (±0.9) which significantly reduced to 2.4 (±0.6) after six months of therapy (p <0.05). There was statistical significant positive correlation between NLR and ASDAS i.e. r=0.659 (p <0.05). Conclusion: NLR and activity of disease showed positive correlation in patients with ankylosing spondylitis, which illustrated that NLR can also be used as a key predictor of inflammation that makes it a dependable tool for assessing activity of disease in patients of ankylosing spondylitis on Etanercept therapy.

Samara Siddique, Sarmad Zahoor, Hafiz Mudabbar Mahboob, Yasir Imran, Sadia Asif, Uzma Malik. (2020) Correlation of Neutrophil to Lymphocyte Ratio and Disease Activity in Patients of Ankylosing Spondylitis on Etanercept Therapy, Pakistan Journal of Medical Research, Volume-59, Issue-4.
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