{"id":"https://openalex.org/W4415475465","doi":"https://doi.org/10.1681/asn.2025rk623tg8","title":"Effect of Clazakizumab on Neutrophil-to-Lymphocyte Ratio in Patients Receiving Maintenance Hemodialysis: Secondary Analysis of the POSIBIL6ESKD Phase 2b Trial","display_name":"Effect of Clazakizumab on Neutrophil-to-Lymphocyte Ratio in Patients Receiving Maintenance Hemodialysis: Secondary Analysis of the POSIBIL6ESKD Phase 2b Trial","publication_year":2025,"publication_date":"2025-10-01","ids":{"openalex":"https://openalex.org/W4415475465","doi":"https://doi.org/10.1681/asn.2025rk623tg8"},"language":"en","primary_location":{"id":"doi:10.1681/asn.2025rk623tg8","doi":"https://doi.org/10.1681/asn.2025rk623tg8","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.2025rk623tg8","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5069844901","display_name":"Benjamin Peter Catanese","orcid":"https://orcid.org/0009-0000-7734-6550","observed_orcids":["https://orcid.org/0009-0000-7734-6550"]},"institutions":[{"id":"https://openalex.org/I4210153043","display_name":"Duke University Hospital","ror":"https://ror.org/04bct7p84","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210126298","https://openalex.org/I4210144876","https://openalex.org/I4210153043"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Benjamin Peter Catanese","raw_affiliation_strings":["Duke Health, Durham, North Carolina, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Duke Health, Durham, North Carolina, United States;","institution_ids":["https://openalex.org/I4210153043"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5080710180","display_name":"Mark A. Heise","orcid":"https://orcid.org/0009-0002-6064-0280","observed_orcids":["https://orcid.org/0009-0002-6064-0280"]},"institutions":[{"id":"https://openalex.org/I4210112753","display_name":"CSL (United States)","ror":"https://ror.org/01jxhxv92","country_code":"US","type":"company","lineage":["https://openalex.org/I4210112753","https://openalex.org/I4210153402"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Mark A. Heise","raw_affiliation_strings":["CSL Behring LLC, King of Prussia, Pennsylvania, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"CSL Behring LLC, King of Prussia, Pennsylvania, United States;","institution_ids":["https://openalex.org/I4210112753"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Anna Marie Chang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1320553840","display_name":"Amgen (United States)","ror":"https://ror.org/03g03ge92","country_code":"US","type":"company","lineage":["https://openalex.org/I1320553840"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Anna Marie Chang","raw_affiliation_strings":["Amgen Inc, Thousand Oaks, California, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Amgen Inc, Thousand Oaks, California, United States;","institution_ids":["https://openalex.org/I1320553840"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5059204501","display_name":"Gursimran Chandhok","orcid":"https://orcid.org/0000-0003-0597-0498","observed_orcids":["https://orcid.org/0000-0003-0597-0498"]},"institutions":[{"id":"https://openalex.org/I4210112753","display_name":"CSL (United States)","ror":"https://ror.org/01jxhxv92","country_code":"US","type":"company","lineage":["https://openalex.org/I4210112753","https://openalex.org/I4210153402"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Gursimran Chandhok","raw_affiliation_strings":["CSL Behring LLC, King of Prussia, Pennsylvania, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"CSL Behring LLC, King of Prussia, Pennsylvania, United States;","institution_ids":["https://openalex.org/I4210112753"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5080941710","display_name":"Elena Velkoska","orcid":"https://orcid.org/0000-0002-7946-0944","observed_orcids":["https://orcid.org/0000-0002-7946-0944"]},"institutions":[{"id":"https://openalex.org/I4210112753","display_name":"CSL (United States)","ror":"https://ror.org/01jxhxv92","country_code":"US","type":"company","lineage":["https://openalex.org/I4210112753","https://openalex.org/I4210153402"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Elena Velkoska","raw_affiliation_strings":["CSL Behring LLC, King of Prussia, Pennsylvania, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"CSL Behring LLC, King of Prussia, Pennsylvania, United States;","institution_ids":["https://openalex.org/I4210112753"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5082848246","display_name":"Jiyu Luo","orcid":"https://orcid.org/0000-0002-5799-1381","observed_orcids":["https://orcid.org/0000-0002-5799-1381","https://orcid.org/0009-0006-4315-8061"]},"institutions":[{"id":"https://openalex.org/I4210112753","display_name":"CSL (United States)","ror":"https://ror.org/01jxhxv92","country_code":"US","type":"company","lineage":["https://openalex.org/I4210112753","https://openalex.org/I4210153402"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jiyu Luo","raw_affiliation_strings":["CSL Behring LLC, King of Prussia, Pennsylvania, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"CSL Behring LLC, King of Prussia, Pennsylvania, United States;","institution_ids":["https://openalex.org/I4210112753"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5034939991","display_name":"Glenn Matthew Chertow","orcid":"https://orcid.org/0000-0002-7599-0534","observed_orcids":["https://orcid.org/0000-0002-7599-0534"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Glenn M. Chertow","raw_affiliation_strings":["Stanford University, Stanford, California, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Stanford University, Stanford, California, United States;","institution_ids":["https://openalex.org/I97018004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5008906136","display_name":"Myles Selig Wolf","orcid":"https://orcid.org/0000-0002-1127-1442","observed_orcids":["https://orcid.org/0000-0002-1127-1442"]},"institutions":[{"id":"https://openalex.org/I4387153466","display_name":"Weill Cornell Medicine","ror":"https://ror.org/02r109517","country_code":"US","type":"education","lineage":["https://openalex.org/I205783295","https://openalex.org/I4387153466"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Myles Wolf","raw_affiliation_strings":["Weill Cornell Medicine, New York, New York, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Weill Cornell Medicine, New York, New York, United States","institution_ids":["https://openalex.org/I4387153466"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5088433847","display_name":"Peter Szecs\u00f6dy","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210112753","display_name":"CSL (United States)","ror":"https://ror.org/01jxhxv92","country_code":"US","type":"company","lineage":["https://openalex.org/I4210112753","https://openalex.org/I4210153402"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Peter Szecs\u00f6dy","raw_affiliation_strings":["CSL Behring LLC, King of Prussia, Pennsylvania, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"CSL Behring LLC, King of Prussia, Pennsylvania, United States;","institution_ids":["https://openalex.org/I4210112753"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5009676752","display_name":"Daniel L. Edmonston","orcid":"https://orcid.org/0000-0003-2589-6993","observed_orcids":["https://orcid.org/0000-0003-2589-6993"]},"institutions":[{"id":"https://openalex.org/I4210153043","display_name":"Duke University Hospital","ror":"https://ror.org/04bct7p84","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210126298","https://openalex.org/I4210144876","https://openalex.org/I4210153043"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Daniel Edmonston","raw_affiliation_strings":["Duke Health, Durham, North Carolina, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Duke Health, Durham, North Carolina, United States;","institution_ids":["https://openalex.org/I4210153043"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":5,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.33371103,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"36","issue":"10S","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10291","display_name":"Dialysis and Renal Disease Management","score":0.8324999809265137,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10291","display_name":"Dialysis and Renal Disease Management","score":0.8324999809265137,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11355","display_name":"Inflammatory Biomarkers in Disease Prognosis","score":0.15860000252723694,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10408","display_name":"Chronic Kidney Disease and Diabetes","score":0.0008999999845400453,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/clazakizumab","display_name":"clazakizumab","score":1.0},{"id":"https://openalex.org/keywords/neutrophil-to-lymphocyte-ratio","display_name":"neutrophil-to-lymphocyte ratio","score":0.9890000224113464},{"id":"https://openalex.org/keywords/maintenance-hemodialysis","display_name":"maintenance hemodialysis","score":0.9110000133514404},{"id":"https://openalex.org/keywords/end-stage-renal-disease","display_name":"end-stage renal disease","score":0.9900000095367432},{"id":"https://openalex.org/keywords/il-6-receptor-inhibition","display_name":"IL-6 receptor inhibition","score":0.8080000281333923},{"id":"https://openalex.org/keywords/high-sensitivity-c-reactive-protein","display_name":"high-sensitivity C-reactive protein","score":0.8650000095367432},{"id":"https://openalex.org/keywords/inflammatory-markers","display_name":"inflammatory markers","score":0.7590000033378601},{"id":"https://openalex.org/keywords/major-adverse-cardiovascular-events","display_name":"major adverse cardiovascular events","score":0.8659999966621399},{"id":"https://openalex.org/keywords/atherosclerotic-cardiovascular-disease","display_name":"atherosclerotic cardiovascular disease","score":0.9879999756813049},{"id":"https://openalex.org/keywords/diabetes-mellitus","display_name":"diabetes mellitus","score":0.6539999842643738}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7028999924659729},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.520799994468689},{"id":"https://openalex.org/C44280652","wikidata":"https://www.wikidata.org/wiki/Q104837","display_name":"Phase (matter)","level":2,"score":0.47099998593330383},{"id":"https://openalex.org/C126894567","wikidata":"https://www.wikidata.org/wiki/Q105650","display_name":"Urology","level":1,"score":0.34779998660087585},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.3433000147342682},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.3050000071525574},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.30320000648498535},{"id":"https://openalex.org/C31760486","wikidata":"https://www.wikidata.org/wiki/Q7180990","display_name":"Phases of clinical research","level":3,"score":0.25949999690055847},{"id":"https://openalex.org/C134121241","wikidata":"https://www.wikidata.org/wiki/Q899301","display_name":"Yield (engineering)","level":2,"score":0.2264000028371811},{"id":"https://openalex.org/C2989005","wikidata":"https://www.wikidata.org/wiki/Q214963","display_name":"Nuclear medicine","level":1,"score":0.22419999539852142}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1681/asn.2025rk623tg8","doi":"https://doi.org/10.1681/asn.2025rk623tg8","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.2025rk623tg8","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4399010918","https://openalex.org/W7128822282","https://openalex.org/W4306254725","https://openalex.org/W4310459840","https://openalex.org/W3030518473","https://openalex.org/W4403833201","https://openalex.org/W2619183282","https://openalex.org/W2908859061","https://openalex.org/W3006826574","https://openalex.org/W4403806917"],"abstract_inverted_index":{"Background:":[0],"Few":[1],"therapies":[2],"improve":[3],"cardiovascular":[4],"(CV)":[5],"outcomes":[6,247],"in":[7,27,54,114,159,169,182,196,224,248],"end-stage":[8],"kidney":[9],"disease.":[10],"The":[11,178,229],"neutrophil-lymphocyte":[12],"ratio":[13],"(NLR)":[14],"is":[15],"an":[16],"emerging":[17],"inflammatory":[18],"biomarker":[19,214],"which":[20],"predicts":[21],"major":[22],"adverse":[23],"CV":[24,31,246],"events":[25],"(MACE)":[26],"patients":[28,55,75,226],"with":[29,56,78,165,216],"atherosclerotic":[30],"disease":[32],"(ASCVD).":[33],"In":[34,204],"the":[35,45,66,105,160,170,197,234,241,262],"POSIBIL6ESKD":[36],"phase":[37],"2b":[38],"trial,":[39],"clazakizumab,":[40,135],"a":[41,120,213],"monoclonal":[42],"antibody":[43],"against":[44],"interleukin-6":[46],"ligand":[47],"significantly":[48,210],"reduced":[49,211],"high-sensitivity":[50],"C-reactive":[51],"protein":[52],"(hs-CRP)":[53],"ASCVD":[57,217],"and/or":[58],"diabetes":[59],"on":[60,70,76,112,227,240,245],"maintenance":[61],"hemodialysis":[62],"(HD).":[63],"We":[64,73],"determined":[65],"effects":[67,242],"of":[68,87,90,107,127,233,243,259],"clazakizumab":[69,91,108,162,198,209,244,266],"NLR.":[71,129],"Methods:":[72],"randomized":[74],"HD":[77],"elevated":[79],"hs-CRP":[80],"to":[81,189,201,206],"receive":[82],"either":[83],"placebo":[84,111,171,263],"or":[85,96],"one":[86],"three":[88],"doses":[89],"(2.5":[92],"mg,":[93,95],"5":[94],"10":[97],"mg)":[98],"every":[99],"4":[100],"weeks,":[101,149],"we":[102],"evaluated":[103],"(post-hoc)":[104],"effect":[106],"(pooled)":[109],"versus":[110],"change":[113,168,181],"NLR":[115,150,183,260],"at":[116,193],"12":[117,148,194,222],"weeks":[118,195,223],"using":[119],"linear":[121],"mixed":[122],"model":[123],"incorporating":[124],"repeated":[125],"measures":[126,258],"log-transformed":[128],"Results:":[130],"Among":[131],"127":[132],"participants":[133],"(96":[134],"31":[136],"placebo),":[137],"mean":[138],"age":[139],"was":[140,184],"62":[141],"years":[142],"and":[143,218,264],"33%":[144],"were":[145],"women.":[146],"At":[147],"decreased":[151],"30%":[152],"(95%":[153,174,186],"CI":[154,175],"\u201338%,":[155],"\u201321%)":[156],"from":[157],"baseline":[158],"pooled":[161,265],"group":[163,199],"compared":[164,200],"essentially":[166],"no":[167],"group,":[172],"5%":[173],"\u201315%,":[176],"28%).":[177],"between":[179],"groups":[180,267],"\u201333%":[185],"CI:":[187],"\u201347%":[188],"\u201315%;":[190],"P=0.001)":[191],"lower":[192],"placebo.":[202],"Conclusion:":[203],"addition":[205],"reducing":[207],"hs-CRP,":[208],"NLR,":[212],"associated":[215],"incident":[219],"MACE,":[220],"after":[221],"high-risk":[225],"HD.":[228],"Phase":[230],"3":[231],"component":[232],"trial":[235],"will":[236],"provide":[237],"definitive":[238],"evidence":[239],"this":[249],"population.":[250],"Funding:":[251],"Commercial":[252],"Support":[253],"-":[254],"CSL":[255],"BehringFigure:":[256],"Repeated":[257],"for":[261]},"counts_by_year":[],"updated_date":"2026-09-29T14:09:16.559479","created_date":"2025-10-23T00:00:00"}