Supplementary Material for: Prognostic implications of the hemoglobin-albumin-lymphocyte-platelet index in patients with pemphigus

Introduction: Pemphigus is a chronic autoimmune blistering disease with substantial morbidity and mortality. Although the hemoglobin-albumin-lymphocyte-platelet (HALP) index, a composite marker reflecting inflammatory and nutritional status, displays prognostic value concerning various immune-related diseases, its potential remains elusive in pemphigus. In this study, we investigated prognostic significance of the HALP index in 69 patients with pemphigus diagnosed between 2005 and 2024. Methods: We calculated the HALP index at diagnosis and stratified using maximally selected rank statistics, identifying a cut-off value of 45.9. Using Cox proportional hazards models, patients with low HALP index (≤45.9) had significantly poorer OS and lower remission rates than those with higher HALP. Results: Our multivariate analysis independently associated immunosuppressant use with improved OS (HR = 0.32; 95% CI: 0.13–0.79; p = 0.013), while a low HALP index was an independent mortality (HR = 2.84; 95% CI: 1.06–7.60; p = 0.038). Additionally, low HALP index was also independently associated with a longer time to remission time (HR = 0.55; 95% CI: 0.31–0.97; p = 0.039). Conclusion: The HALP index represents a simple and readily available biomarker that independently predicts survival and remission outcomes in patients with pemphigus, potentially helping risk stratification and personalized management in clinical practice.