The systemic immune-inflammation index is superior to predicting clinical remission and relapse for ulcerative colitis patients treated with vedolizumab

BackgroundVedolizumab (VDZ), a novel biologic targeting α4β7 integrin, is safe and effective for the treatment of patients with ulcerative colitis (UC). The objective of this study was to compare the potential of the Platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and syste...

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Main Authors: Jing Yan, Jun Wu, Rongkun Wang, Pin Meng, Ailing Liu, Yonghong Xu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1524307/full
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author Jing Yan
Jun Wu
Rongkun Wang
Pin Meng
Ailing Liu
Yonghong Xu
author_facet Jing Yan
Jun Wu
Rongkun Wang
Pin Meng
Ailing Liu
Yonghong Xu
author_sort Jing Yan
collection DOAJ
description BackgroundVedolizumab (VDZ), a novel biologic targeting α4β7 integrin, is safe and effective for the treatment of patients with ulcerative colitis (UC). The objective of this study was to compare the potential of the Platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in predicting clinical remission and treatment failure in patients with moderate-to-severe UC on VDZ therapy and to explore the risk factors for treatment failure.MethodsSeventy-four UC patients treated with VDZ at our institution between December 1, 2020, and October 1, 2023, who had medical records were included in this study. We retrospectively collected baseline NLR, PLR, and SII values and assessed the predictive ability of the three indices for clinical remission and treatment failure using the receiver operating characteristic (ROC) curves.ResultsPatients in the severe group (n = 47) had significantly higher baseline PLR and SII values than those in the moderate group (n = 27) (p < 0.05). Patients with MES3 had significantly higher PLR and SII values than patients with MES2 (p < 0.05). At 14 weeks after VDZ treatment, 28 patients obtained steroid-free clinical remission, whereas 46 did not. The area under the ROC curve (AUC) for SII was 0.659 for predicting clinical remission and exhibited the best predictive ability. Of the 52 patients who achieved long-term remission, 35 patients responded consistently to VDZ, whereas 17 patients experienced disease relapse. The SII, with an AUC of 0.793, showed the best predictive ability (sensitivity: 94.1%; specificity: 57.1%; cut-off value: 602.0). Cox regression analysis revealed that SII ≥602.0, was a potential predictor of relapse after VDZ treatment in UC patients (p = 0.048, hazard ratio: 8.651; 95% confidence interval: 1.017–73.593).ConclusionThe SII performed better than NLR and PLR in predicting clinical remission and relapse for UC patients on VDZ therapy. Moreover, patients with high SII may relapse after VDZ treatment and should be treated with caution.
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spelling doaj-art-649070c78441433db823cb210a56f7082025-08-20T02:04:51ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-03-011210.3389/fmed.2025.15243071524307The systemic immune-inflammation index is superior to predicting clinical remission and relapse for ulcerative colitis patients treated with vedolizumabJing Yan0Jun Wu1Rongkun Wang2Pin Meng3Ailing Liu4Yonghong Xu5Department of Gastroenterology, Peking University People's Hospital Qingdao Hospital, Qingdao Women's and Children's Hospital, Qingdao, Shandong, ChinaDepartment of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of Vascular Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaBackgroundVedolizumab (VDZ), a novel biologic targeting α4β7 integrin, is safe and effective for the treatment of patients with ulcerative colitis (UC). The objective of this study was to compare the potential of the Platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in predicting clinical remission and treatment failure in patients with moderate-to-severe UC on VDZ therapy and to explore the risk factors for treatment failure.MethodsSeventy-four UC patients treated with VDZ at our institution between December 1, 2020, and October 1, 2023, who had medical records were included in this study. We retrospectively collected baseline NLR, PLR, and SII values and assessed the predictive ability of the three indices for clinical remission and treatment failure using the receiver operating characteristic (ROC) curves.ResultsPatients in the severe group (n = 47) had significantly higher baseline PLR and SII values than those in the moderate group (n = 27) (p < 0.05). Patients with MES3 had significantly higher PLR and SII values than patients with MES2 (p < 0.05). At 14 weeks after VDZ treatment, 28 patients obtained steroid-free clinical remission, whereas 46 did not. The area under the ROC curve (AUC) for SII was 0.659 for predicting clinical remission and exhibited the best predictive ability. Of the 52 patients who achieved long-term remission, 35 patients responded consistently to VDZ, whereas 17 patients experienced disease relapse. The SII, with an AUC of 0.793, showed the best predictive ability (sensitivity: 94.1%; specificity: 57.1%; cut-off value: 602.0). Cox regression analysis revealed that SII ≥602.0, was a potential predictor of relapse after VDZ treatment in UC patients (p = 0.048, hazard ratio: 8.651; 95% confidence interval: 1.017–73.593).ConclusionThe SII performed better than NLR and PLR in predicting clinical remission and relapse for UC patients on VDZ therapy. Moreover, patients with high SII may relapse after VDZ treatment and should be treated with caution.https://www.frontiersin.org/articles/10.3389/fmed.2025.1524307/fullulcerative colitisvedolizumabbiomarkerssystemic immuneinflammation indexprognosis
spellingShingle Jing Yan
Jun Wu
Rongkun Wang
Pin Meng
Ailing Liu
Yonghong Xu
The systemic immune-inflammation index is superior to predicting clinical remission and relapse for ulcerative colitis patients treated with vedolizumab
Frontiers in Medicine
ulcerative colitis
vedolizumab
biomarkers
systemic immuneinflammation index
prognosis
title The systemic immune-inflammation index is superior to predicting clinical remission and relapse for ulcerative colitis patients treated with vedolizumab
title_full The systemic immune-inflammation index is superior to predicting clinical remission and relapse for ulcerative colitis patients treated with vedolizumab
title_fullStr The systemic immune-inflammation index is superior to predicting clinical remission and relapse for ulcerative colitis patients treated with vedolizumab
title_full_unstemmed The systemic immune-inflammation index is superior to predicting clinical remission and relapse for ulcerative colitis patients treated with vedolizumab
title_short The systemic immune-inflammation index is superior to predicting clinical remission and relapse for ulcerative colitis patients treated with vedolizumab
title_sort systemic immune inflammation index is superior to predicting clinical remission and relapse for ulcerative colitis patients treated with vedolizumab
topic ulcerative colitis
vedolizumab
biomarkers
systemic immuneinflammation index
prognosis
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1524307/full
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