Relationship between pan-immune-inflammation value, systemic immune inflammation index, and systemic inflammation response index in patients with rheumatoid arthritis

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.