Neutrophil-to-Lymphocyte Ratio Predicts Development of Immune-Related Adverse Events and Outcomes from Immune Checkpoint Blockade: A Case-Control Study.

The utility of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) utility in predicting immune-related adverse events (irAEs) and survival have not been well studied in the context of treatment with immune checkpoint inhibitors (ICIs). We performed a case-control study of cancer patients who received at least one dose of ICI in a tertiary hospital. We examined NLR and PLR in irAE cases and controls. Logistic and Cox regression models were used to identify independent risk factors for irAEs, progression-free survival (PFS), and overall survival (OS). The study included 91 patients with irAEs and 56 controls. Multiple logistic regression showed that NLR < 3 at baseline was associated with higher occurrence of irAEs. Multivariate Cox regression showed that development of irAEs and reduction in NLR from baseline to week 6 were associated with longer PFS. Higher NLR values at baseline and/or week 6 were independently associated with shorter OS. A reduction in NLR from baseline to week 6 was associated with longer OS. In this study of cancer patients treated with ICIs, NLR has a bidirectional relationship with adverse outcomes. Lower NLR was associated with increased occurrence of irAEs while higher NLR values were associated with worse clinical outcomes.

Prevalence and risk factors for falls in patients with spondyloarthritis: A systematic review.

OBJECTIVE: Patients with spondyloarthritis (SpA) may have a greater risk of falling due to poor postural balance and decreased mobility. To our best knowledge, there are no published reviews that study falls in patients with SpA. Therefore, we aim to systematically review the literature and identify the prevalence and risk factors of falls in patients with SpA. METHODS: We conducted a systematic review using 5 electronic databases: PubMed, EMBASE, Scopus, Web of Science and Google Scholar using controlled vocabulary terms (eg MeSH terms) in the search strategy for the concepts: falls, fall risk, SpA and its subtypes. RESULTS: We identified 7279 articles, of which 3 studies with a total of 441 patients were included. Prevalence of falls ranged from 13% to 25%. We identified 16 main factors across 5 categories. Under socio-demographic factors, functional limitation, decreased quality of life, advanced age and job loss were associated with an increased risk of falls. Poor balance and mobility and fear of falling were associated with increased risk of falls. Active disease and symptoms of SpA were medical factors that were associated with increased risk of falls. Medication factors including polypharmacy, myorelaxants and antidepressants were not associated with increased fall risk. CONCLUSION: We identified potentially modifiable risk factors associated with increased risk of falls in patients with SpA, including functional limitation, poor balance and mobility, fear of falling and active disease. Clinicians should recognize these factors and address them in the holistic management of patients with SpA, thereby reducing falls and their complications.

Quality of English-language videos on YouTube as a source of information on systemic lupus erythematosus.

BACKGROUND: Many patients turn to online platforms to obtain healthcare information, but the quality and accuracy of the information is largely unknown. The objective of this study was to evaluate the reliability and quality of the most viewed English-language YouTube videos on systemic lupus erythematosus (SLE). METHODS: YouTube was searched using keywords "systemic lupus erythematosus" and videos were categorized as useful information, misleading information, useful patient opinion, and misleading patient opinion. Reliability was scored using a modified 5-point DISCERN tool (where higher scores represent greater reliability), while quality was rated using the 5-point Global Quality Scale (GQS). Content covered included epidemiology, pathogenesis, clinical features, diagnosis and treatment of SLE. RESULTS: Of the top 183 relevant videos, 124 (67.8%) were classified as useful information, 21 (11.5%) as misleading information, 29 (15.8%) as useful patient opinion, 9 (4.9%) as misleading patient opinion. Useful information videos were primarily produced by professionals (62.1%), with videos being of greater reliability and quality than other groups. However, video characteristics collected were largely comparable across all groups. The majority (68.9%) of the videos addressed patients. CONCLUSION: Our findings highlight an abundance of YouTube videos with useful information on SLE, that are mostly reliable and of high quality. However, in order to effectively educate patients, pitfalls such as misleading content, falsely elevated video characteristics and non-professional sources need to be made known to patients. As part of holistic care, healthcare professionals should advise patients to seek information from reputed sources.