ANKMJ
Ankyra Medical Journal

Ankyra Medical Journal (AnkMJ), formerly known as the Journal of Translational and Practical Medicine, regularly publishes international quality issues in the field of Medicine in the light of current information.

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Original Article
Relationship between pan-immune-inflammation value, systemic immune inflammation index, and systemic inflammation response index in patients with rheumatoid arthritis
Abstract
Aims: The aim of this study was to develop easily applicable tools that reflect systemic inflammation in rheumatoid arthritis (RA). In this context, the relationship between RA disease activity and pan-immune-inflammation value (PIV), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) was examined.
Methods: Patients and healthy controls who applied to Yozgat Bozok University Physical Medicine and Rehabilitation and Internal Medicine clinics between 01.01.2020 and 04.01.2025 were included in the study. Visual Analog Scale (VAS), Disease Activity Score-28 (DAS28), hemogram, and biochemistry parameters—including ALT, AST, fasting glucose, C-reactive protein (CRP), erythrocyte sedimentation rate, uric acid, creatinine, calcium, magnesium, alkaline phosphatase, parathyroid hormone, lipid profile, albumin, total protein, T4, TSH, rheumatoid factor (RF), and anti-cyclic citrullinated peptide (anti-CCP)—were retrospectively recorded from patient files. PIV, SII, and SIRI were calculated using complete blood count data from both the RA and control groups. Data were analyzed using SPSS, and a significance level of 0.05 was considered statistically significant.
Results: SII, SIRI, and PIV values were significantly higher in the RA group compared to the control group (p=0.002, p=0.001, and p=0.001, respectively). Among the three disease activity groups, SII, SIRI, and PIV levels were highest in the active disease group. A positive correlation was found between DAS28 and SII (r=0.305, p=0.012), and between DAS28 and PIV (r=0.270, p=0.028). However, no significant correlation was observed between DAS28 and SIRI (p=0.111). The difference among the activity groups was statistically significant for SII and PIV (p=0.016 and p=0.039, respectively), but not for SIRI (p=0.171). Furthermore, SII and PIV levels were significantly higher in patients receiving anti-TNF-? treatment compared to those using DMARDs (p=0.001 and p=0.003, respectively).
Conclusion: The significantly higher SII and PIV values in the RA group compared to controls, and their positive correlation with DAS28, suggest that these indices may be associated with RA disease activity. Additionally, the lower levels of SII and PIV in patients receiving anti-TNF-? treatment support their potential role in monitoring treatment response.

Keywords : Rheumatoid arthritis, disease activity, Systemic Immune Response Index, Systemic Immune Inflammation Index, Pan Immune-Inflammation Value

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1. Rashid T, Darlington G, Kjeldsen-Kragh J, et al. Proteus IgG antibodies and C-reactive protein in English, Norwegian and Spanish patients with rheumatoid arthritis. Clin Rheumatol. 1999;18(3):190-195. doi:10. 1007/s100670050208
2. Aletaha D, Smolen JS. Diagnosis and management of rheumatoid arthritis: a review. JAMA. 2018;320(13):1360-1372. doi:10.1001/jama. 2018.13103
3. England BR, Tiong BK, Bergman MJ, et al. 2019 update of the American College of Rheumatology recommended rheumatoid arthritis disease activity measures. Arthritis Care Res (Hoboken). 2019;71(11):1540-1555. doi:10.1002/acr.23831
4. Colglazier CL, Sutej PG. Laboratory testing in the rheumatic diseases: a practical review. South Med J. 2005;98(2):185-189. doi: 10.1097/01.smj. 0000153103.06303
5. Erre GL, Paliogiannis P, Castagna F, et al. Meta-analysis of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in rheumatoid arthritis. Eur J Clin Invest. 2019;49(10):e13037. doi:10.1111/eci.13037
6. Ulutaş F, Çobankara V. Pan-immune-inflammation value (PIIV) in lupus nephritis. Med Sci Discov. 2023;10(3):234-238. doi:10.17546/msd. 1200
7. Baba Y, Nakagawa S, Toihata T, et al. Pan-immune-inflammation value and prognosis in patients with esophageal cancer. Ann Surg Open. 2021; 3(1):e113. doi:10.1097/AS9.0000000000000113
8. Dincer ABK, Sezer S. Systemic immune inflammation index as a reliable disease activity marker in psoriatic arthritis. J Coll Physicians Surg Pak. 2022;32(6):773-778. doi:10.29271/jcpsp.2022.06.773
9. Ozdemir A, Baran E, Kutu M, et al. Could systemic immune inflammation index be a new parameter for diagnosis and disease activity assessment in systemic lupus erythematosus? Int Urol Nephrol. 2023;55(1):211-216. doi:10.1007/s11255-022-03355-4
10. Zhang P, Li Y, Zhang H, et al. Prognostic value of the systemic inflammation response index in patients with aneurysmal subarachnoid hemorrhage. Br J Neurosurg. 2020;34(1):1-7. doi:10.1080/02688697.2019. 1632117
11. Chao B, Ju X, Zhang L, et al. A novel prognostic marker, systemic inflammation response index (SIRI) for operable cervical cancer patients. Front Oncol. 2020;10:766. doi:10.3389/fonc.2020.00766
12. Pacheco-Barcia V, Solís RM, France T, et al. A systemic inflammation response index (SIRI) correlates with survival in metastatic pancreatic cancer. Pancreatology. 2020;20(2):254-264. doi:10.1016/j.pan.2019.11.013
13. Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria. Arthritis Rheum. 2010;62(9):2569-2581. doi:10. 1002/art.27584
14. Tutan D, Doğan AG. Pan-immune-inflammation index as a biomarker for RA progression. Cureus. 2023;15(4):e46609. doi:10.7759/cureus.46609
15. Delgado DA, Lambert BS, Boutris N, et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. J Am Acad Orthop Surg Glob Res Rev. 2018;2(3):e088. doi:10.5435/JAAOSGlobal-D-18-00088
16. de Bandt M, Fautrel B, Maillefert JF, et al. Determining a low disease activity threshold for DMARD continuation in RA. Arthritis Res Ther. 2009;11(4):R157. doi:10.1186/ar2796
17. Ulutaş F, Aydın M. Pan-immune-inflammation value in FMF patients. Med Sci Discov. 2023;10(4):364-367. doi:10.17546/msd.1212
18. Yoshikawa T, Furukawa T, Tamura M, et al. Systemic immune-inflammation index in RA patients: relation to disease activity. Ann Rheum Dis. 2019;78(3):325. doi:10.1136/annrheumdis-2018-eular.3741
19. Okutan İ, Aci R, Keskin Â, et al. New inflammatory markers in RA: PIV, SII, and SIRI. Reumatologia. 2024;62(6):439-446. doi:10.5114/reum.2024.124231
20. Dervisevic A, Fajkic A, Jahic E, et al. Systemic immune-inflammation index in RA patients. Medeni Med J. 2024;39(3):183-191. doi:10.5222/MMJ.2024.183
21. Bai J, Tian Y, Wang F, et al. Role of systemic immune-inflammation index in assessing tumor necrosis factor-α inhibitor efficacy in rheumatoid arthritis. Am J Transl Res. 2023;15:6524-6533. doi:10.7150/ajtr.86597
22. Jang DI, Lee AH, Shin HY, et al. The role of TNF-alpha in autoimmune disease and therapeutics. Int J Mol Sci. 2021;22(5):2719. doi:10.3390/ijms2205271
23. Liu B, Wang J, Li YY, Li KP, Zhang Q. The association between systemic immune-inflammation index and rheumatoid arthritis: evidence from NHANES 1999-2018. Arthritis Res Ther. 2023; 25(1): 34. doi:10.1186/s13075-023-03018-6
24. Başaran PÖ, Doğan M. Relationship between disease activity and PIV/SII in RA. Medicine (Baltimore). 2024;103(9):e37230. doi:10.1097/MD. 0000000000037230
25. Peng XC, Yin R, Luo LP, Xu S, Shuai Z. Rheumatoid factor titer as an indicator of the risk of rheumatoid arthritis activity: dose-effect analysis with the restricted cubic spline model. J Inflamm Res. 2024;17:10699-10709. doi:10.2147/JIR.S488605
26. Mikuls TR, O’Dell JR, Stoner JA, et al. Association of rheumatoid arthritis treatment response and disease duration with declines in serum levels of IgM rheumatoid factor and anti-cyclic citrullinated peptide antibody. Arthritis Rheum. 2004;50(12):3776-3782. doi:10.1002/art.20659
Article available in :
Volume 4, Issue 3, 2025
Page : 45-50
https://doi.org/10.51271/ANKMJ-0046
Article Information
Received : 03 Tem 2025
Accepted : 26 Tem 2025
Published : 29 Tem 2025
Corresponding Author :

Duygu Felek: Department of Internal Medicine, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkiye

[email protected]
Citation : Ersoy E, Felek D. Relationship between pan-immune-inflammation value, systemic immune inflammation index, and systemic inflammation response index in patients with rheumatoid arthritis. Ank Med J. 2025;4(3):45-50.

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