Association of CBC-Derived Indices of Inflammation with Response to Glecaprevir/Pibrentasvir for PTSD

Objective: Inflammation has been proposed as a possible mechanism and treatment target for posttraumatic stress disorder (PTSD), but traditional methods for measuring it are performed infrequently in clinical practice. The present study sought to determine if widely available complete blood count (CBC)-derived indices of inflammation predicted treatment response to Glecaprevir/Pibrentasvir (GLE/PIB), a potential inflammation modulator, in patients with PTSD. Methods: We performed a secondary analysis of an uncontrolled trial of GLE/PIB in 10 patients with PTSD. Nearest CBC lab tests were taken from the Veterans Affairs electronic health record, and six CBC-derived indices of inflammation were calculated and Z-standardized. The effect of the indices on PTSD symptoms following GLE/PIB treatment, as measured by the Clinician Administered PTSD Scale for DSM-5 (CAPS), was determined through multiple linear regression. Results: Four of the six indices of inflammation tested had statistically significant associations with post-treatment CAPS scores at an α = 0.05 significance level. Regression coefficients for the statistically significant findings ranged from -19.56 (95% CI: -28.99, -10.14) to -14.24 (95% CI: -25.51, -2.98), indicating lower post-treatment CAPS scores in patients with greater inflammatory indices. Conclusions: CBC-derived indices of inflammation may be an efficient and widely available biomarker for predicting treatment response in medications targeting potential inflammatory mechanisms of PTSD.