Osteoporosis in patients with rheumatoid arthritis: trends in the German National Database 2007–2017

Abstract Osteoporosis is a frequent comorbidity in rheumatoid arthritis (RA). Due to the improved treatment options for RA, we expect a long-term decrease in osteoporosis as an accompanying disease. Data from the German National Database (NDB) were used to investigate whether the frequency of osteoporosis has changed in the last 10 years. From 2007 to 2017, approximately 4000 patients were documented annually with data on therapy and comorbidity. The cross-sectional data were summarised descriptively. Age, sex, disease duration, disease activity and glucocorticoids were considered as influencing factors. The Cochrane-Armitage test for trend was used to test whether the frequency of osteoporosis at the first visit changed from 2007 to 2017. Osteoporosis frequency in RA patients (mean age 63 years, 75% female) decreased from 20% in 2007 to 6% in 2017 (p < 0.001). The decrease affected women (22% to 17%) and men (14% to 8%) in all age groups and both short-term (≤ 2-year disease duration: 9% to 3%) and long-term RA patients (> 10-year disease duration: 28% to 20%). Patients with high disease activity and patients who took glucocorticoids (GC) were more often affected by osteoporosis than patients in remission or without GC. Drug prophylaxis in patients without osteoporosis increased (20% to 41% without GC, 48% to 55% with GC). Men with GC received less prophylactic treatment than women (48% vs. 57% in 2017). In this cohort, osteoporosis in patients with RA is less frequently observed compared to former years. RA-specific risk factors for osteoporosis such as disease activity and GC therapy have declined but long-term GC use is still present. Assessment of osteoporosis in RA patients should be investigated more consistently by bone density measurement. Male RA patients still need to be given greater consideration regarding osteoporosis drug prophylaxis, especially when GC therapy is needed.

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Factors Associated with Objectively Measured Physical Activity in Patients with Seropositive Rheumatoid Arthritis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17239008 ◽

2020 ◽

Vol 17 (23) ◽

pp. 9008

Author(s):

Sandra Haider ◽

Michael Sedlak ◽

Ali Kapan ◽

Igor Grabovac ◽

Thomas Lamprecht ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Disease Activity ◽

Work Ability ◽

Disease Duration ◽

Smoking Status ◽

Vigorous Physical Activity ◽

Moderate Physical Activity ◽

Cross Sectional ◽

Functional Disabilities

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease, which is associated with low levels of physical activity (PA). However, the factors related to low physical activity levels have rarely been studied. Methods: In this cross-sectional study, 70 seropositive RA patients were included. Physical activity was objectively assessed with an ActiGraph GT3X+ accelerometer. In addition, body mass index, smoking status, work ability, and clinical parameters (functional disabilities, disease activity, disease duration, pain, and inflammation parameters) were measured. Results: RA patients performed a mean of 215.2 (SD: 136.6) min a week of moderate physical activity and 9.1 (SD: 26.3) min of vigorous physical activity. The total amount of moderate and vigorous physical activity (MVPA) was associated with BMI, and functional disabilities. In addition, non-smokers and patients with better work ability did more MVPA. No association could be seen with disease activity, disease duration, pain, and inflammatory markers. After mutual adjusting of all the variables, only BMI showed a significant relationship with MVPA. Conclusions: RA patients perform de facto no physical activity with vigorous intensity. Factors related to low physical activity are BMI, functional disabilities, workability and smoking status, whereas due to the study design no causal and temporal link could be made.

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Long-term effectiveness and safety of infliximab, golimumab and golimumab-IV in rheumatoid arthritis patients from a Canadian prospective observational registry

BMC Rheumatology ◽

10.1186/s41927-020-00145-4 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Proton Rahman ◽

Philip Baer ◽

Ed Keystone ◽

Denis Choquette ◽

Carter Thorne ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Adverse Events ◽

Disease Activity ◽

Randomized Clinical Trials ◽

Disease Duration ◽

Routine Care ◽

Treatment Modalities ◽

The Mean ◽

Over Time

Abstract Background Long-term clinical registries are essential tools to evaluate new therapies in a patient population that differs from those in randomized clinical trials. The objectives are to describe the profile of rheumatoid arthritis (RA) patients treated with anti-TNF agents in Canadian routine care. Methods RA patients eligible for treatment with Infliximab (IFX), golimumab (GLM) or intravenous golimumab (GLM-IV) as per their respective Canadian product monographs were enrolled into the BioTRAC registry between 2002 and 2017. Study visits occurred at baseline and every 6 months thereafter. Effectiveness was assessed by changes in disease activity. Safety was evaluated by the incidence of adverse events (AEs) and drug survival. Results Of the 890 IFX-, 530 GLM- and 157 GLM-IV-treated patients, the proportion of females ranged from 77.0–86.6%, the mean ages from 55.8–57.7 and the mean disease duration from 6.5–8.6 years. A significant decrease in baseline disease duration and disease activity parameters (DAS, TJC, SJC, HAQ, AM stiffness, MDGA, PtGA, CRP, ESR) was observed over time. Treatment with IFX, GLM- and GLM-IV significantly improved all disease parameters over time. The incidence of AEs was 105, 113 and 82.6 /100 PYs and the incidence of SAEs was 11.7, 11.2 and 4.68 /100 PYs for IFX, GLM- and GLM-IV-treated patients, respectively. Conclusion Differences in baseline characteristics between patients treated with an anti-TNFs over time shows the evolution of treatment modalities over time. All treatments significantly reduced disease activity and improved functionality in a similar fashion. The incidence of adverse events was consistent with the safety profiles of IFX and GLM. Trial registration ClinicalTrials.gov Identifier: NCT00741793 (Retrospectively registered on August 26, 2008).

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Long-Term Effectiveness and Safety of Infliximab, Golimumab and Golimumab-IV in Rheumatoid Arthritis Patients from a Canadian Prospective Observational Registry

10.21203/rs.2.24628/v2 ◽

2020 ◽

Author(s):

Proton Rahman ◽

Philip Baer ◽

Ed Keystone ◽

Denis Choquette ◽

Carter Thorne ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Adverse Events ◽

Disease Activity ◽

Randomized Clinical Trials ◽

Disease Duration ◽

Routine Care ◽

Treatment Modalities ◽

The Mean ◽

Over Time

Abstract Background: Long-term clinical registries are essential tools to evaluate new therapies in a patient population that differs from those in randomized clinical trials. The objectives are to describe the profile of rheumatoid arthritis (RA) patients treated with anti-TNF agents in Canadian routine care.Methods: RA patients eligible for treatment with Infliximab (IFX), golimumab (GLM) or intravenous golimumab (GLM-IV) as per their respective Canadian product monographs were enrolled into the BioTRAC registry between 2002 and 2017. Study visits occurred at baseline and every 6 months thereafter. Effectiveness was assessed by changes in disease activity. Safety was evaluated by the incidence of adverse events (AEs) and drug survival.Results: Of the 890 IFX-, 530 GLM-SC- and 157 GLM-IV-treated patients, the proportion of females ranged from 77.0-86.6%, the mean ages from 55.8-57.7 and the mean disease duration from 6.5-8.6 years. A significant decrease in baseline disease duration and disease activity parameters (DAS, TJC, SJC, HAQ, AM stiffness, MDGA, PtGA, CRP, ESR) was observed over time. Treatment with IFX, GLM-SC and GLM-IV significantly improved all disease parameters over time. The incidence of AEs was 105, 113 and 82.6 /100 PYs and the incidence of SAEs was 11.7, 11.2 and 4.68 /100 PYs for IFX, GLM-SC and GLM-IV-treated patients, respectively. Conclusion: Differences in baseline characteristics between patients treated with an anti-TNFs over time shows the evolution of treatment modalities over time. All treatments significantly reduced disease activity and improved functionality in a similar fashion. The incidence of adverse events was consistent with the safety profiles of IFX and GLM.Trial Registration: NCT00741793

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AB0216 LONG-TERM RESULTS OF T2T THERAPY INITIATED AT THE ONSET OF RHEUMATOID ARTHRITIS (DATA FROM OREL REGISTRY)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1552 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1134.2-1134

Author(s):

V. Rybakova ◽

A. Avdeeva ◽

Y. Olyunin ◽

E. Nasonov

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Disease Duration ◽

Long Term Results ◽

Treatment Target ◽

Low Disease Activity ◽

Synthetic Dmards ◽

Real Clinical Practice

Background:Current guidelines for the treatment of rheumatoid arthritis (RA) recommend early administration of methotrexate (MTX) and addition of a biologic if MTX monotherapy does not provide remission or low activity of the disease. Efficacy of this strategy in real clinical practice was assessed using data from the Russian RA registry OREL.Objectives:To analyze long-term results of intensive treatment initiated at RA onset in real clinical practice.Methods:141 RA patients with disease duration less than 3 years (29 men, 112 women) were included. 112 were positive for rheumatoid factor and 119 – for anti-cyclic citrullinated peptide antibody. Subcutaneous MTX was initiated at 10-15 mg per week with further dose escalation up to 20-30 mg per week. Therapy was adjusted every 3 months. If MTX monotherapy did not allow to achieve treatment target of remission or low disease activity, biologics were added.Results:Median DAS 28 at baseline was 5,31 [4,79; 6,14]. Initiation of treatment resulted in steady decrease of disease activity (p<0.05, table1). After 1 year of follow-up 33.8% of patients received MTX monotherapy, 33.8% – MTX in combination with tumor necrosis factor alpha inhibitors, 22.0% – MTX +abatacept, 0.55% – MTX+ tocilizumab, 0.47% – MTX + rituximab. Low disease activity was achieved in 16.3% patients, and remission - in 45.8%. After 6 years median age of patients was 58 [49; 66] years, disease duration – 84 [79; 89] months, low disease activity was documented in 21.3%, and remission – in 7.8% of cases (fig. 1). 7% of patients were able to maintain remission without any treatment. Biologics were discontinued in 15 patients after achieving remission or low disease activity, and synthetic DMARDs – in 5 patients having remission.Conclusion:Intensive therapy initiated at RA onset demonstrates high effectiveness, allowing 61.5% of patients to achieve low disease activity or remission within 12 months, and to maintain these results after 6 years of treatment in 29.2%. Adherence to this strategy allowed to discontinue biologics in 15 patients and synthetic DMARDs in 5 patients after achieving treatment target.Figure 1.Changes of the disease activity during follow-upTable 1.Changes of the main inflammatory activity measures, Me [25th; 75th percentile]Parametres012 months6 yearsDAS285,31 [4,79; 6,14]2,85 [2; 3,90] *4,008 [3,4; 4,59] *SDAI28,27 [18,79; 40,73]5,67 [2; 11,98] *15,06 [9,32; 21] *CDAI25 [17; 36]5 [1,7; 11] *15 [9; 21] *ESR (mm/hr)32 [19; 50]16 [8; 30] *16 [10; 25] *CRP (mg/l)26,55 [6,4; 45,30]3,85 [1,5; 11,3]*2,2 [0,9; 4,9] ** p<0.05 in all cases.Disclosure of Interests:None declared

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Effect of Irregular Treatment on Severity of Osteoporosis in Rheumatoid Arthritis Patients

Diyala Journal of Medicine ◽

10.26505/djm.21026230921 ◽

2021 ◽

Vol 21 (2) ◽

pp. 83-88

Author(s):

Saif Abdulkareem Raoof Al-Shaibani ◽

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Disease Duration ◽

Fragility Fractures ◽

Cross Sectional Study ◽

Inflammatory Disorder ◽

Severe Osteoporosis ◽

Cross Sectional ◽

Systemic Complications ◽

Delay In Diagnosis

Background:Rheumatoid arthritis is a chronic systemic inflammatory disorder that is associated with progressive disability and systemic complications. One of these complications is osteoporosis. Patients with severe osteoporosis have one or more fragility fractures in addition to T-score -2.5 or lower. Osteoporosis is more prevalent in rheumatoid arthritis patients who have higher disease activity. Objective: To show the effect of irregular treatment in patients with rheumatoid arthritis on the severity of osteoporosis. Patients and Methods: A cross-sectional study enrolled a total of 40 female patients who had rheumatoid arthritis. The data collected from patients include disease duration, disease activity and patients’ compliance to their drugs. They were sent to dual-energy x- ray absorptiometry scan and results were recorded. Results: The mean age was 45.95 ± 10.0 years; 45% of them had rheumatoid arthritis for less than five years; 55% had a low level of disease activity; and 65% of them had received treatment irregularly. Osteoporosis was diagnosed in 60% of them and 41.7% of them had severe osteoporosis. The highest prevalence of osteoporosis among patients with rheumatoid arthritis was seen significantly among older patients, patients with longer duration of rheumatoid arthritis, those with higher activity of rheumatoid arthritis, and those with irregular treatment. More than half of those who received treatment irregularly had severe osteoporosis with a significant association between treatment regularity of rheumatoid arthritis and severity of osteoporosis. Conclusion: Severe osteoporosis occurs in rheumatoid arthritis patients with a history of irregular treatment which occurs either due to patient incompliance or delay in diagnosis. Osteoporosis is more prevalent in rheumatoid arthritis patients with longer disease duration, older age, higher disease activity and those who received treatment irregularly. Keywords: Rheumatoid arthritis, Osteoporosis, Irregular Treatment

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POS0308 TRAJECTORIES OF FATIGUE IN EARLY RA OVER 10 YEARS: RESULTS FROM THE ESPOIR COHORT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.214 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 380.1-380

Author(s):

S. Rodriguez-Muguruza ◽

B. Combe ◽

F. Guillemin ◽

A. Olive ◽

O. Valero ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cluster Analysis ◽

Psychological Distress ◽

Disease Activity ◽

Disease Duration ◽

Sleep Problems ◽

Multinomial Logistic Regression ◽

Cross Sectional ◽

Early Ra ◽

Patient Reported

Background:Fatigue is one of the most prevalent symptom reported by persons with RA. RA-related fatigue is a complex concept with biological, psychological and social interactions.Objectives:In a cohort of early RA patients, to determine and characterize fatigue trajectories over 10 years of follow-up and identify predictors of trajectory membership.Methods:Patients fulfilling the 2010 ACR/EULAR criteria for RA included in the ESPOIR cohort. We used a cluster analysis to obtain fatigue (assessed by fatigue visual analogue scale) trajectories over the course of 10 years from enrolment. Chi-square tests or ANOVA were performed to evaluate differences of baseline variables between fatigue trajectories. Using a multinomial logistic regression we could identify predictors of trajectory membership.Results:We analysed 598 patients with mean disease duration at enrolment of 26.2 ± 40.9 days. Cluster analysis revealed 3 trajectories: high (18%), moderate (52%) and low fatigue (30%). Compared to patients with moderate or low fatigue trajectory, patients with high fatigue trajectory were predominantly women and reported significantly higher duration and intensity of morning stiffness, HAQ score, number of tender joints, levels of pain, number of awakenings due to arthritis, levels of physician and patient global assessment and more frequent sleep problems, and increased psychological distress. Female patients with pain, psychological distress and presence of sicca symptoms had higher risk of being in high trajectory group.Conclusion:These findings suggest that levels of fatigue are rather stable over time in each trajectory. Baseline clinical measures and baseline patient-reported measures of functional status better distinguished the three fatigue trajectories. We did not find differences between trajectories in baseline laboratory measures. Inflammatory activity was not a predictor of being in high trajectory fatigue group.References:[1]Pollard LC, Choy EH, Gonzalez J, Khoshaba B, Scott DL. Fatigue in rheumatoid arthritis reflects pain, not disease activity. Rheumatology (Oxford) 2006;45:885–9[2]Repping-Wuts H, van Riel P, van Achterberg T. Fatigue in patients with rheumatoid arthritis: what is known and what is needed. Rheumatology (Oxford) 2009;48:207–9.[3]Pilgaard T, hagelund L, Stallknecht SE, jensen HH, Esbensen BA. Severity of fatigue in people with rheumatoid arthritis, psoritic artrhitis and spondyoarthritis- Results of cross-sectional study. Plos One. 2019;14:e0211831[4]Feldthusen C, Grimby-Ekman A, Forsblad-d’Elia H, Jacobsson L, Mannerkorpi K. Explanatory factors and predictors of fatigue in persons with rheumatoid arthritis: a longitudinal study. J Rehabil Med 2016 28;48:469–76.[5]Madsen SG, Danneskiold-Samsøe B, Stockmarr A, Bartels EM. Correlations between fatigue and disease duration, disease activity, and pain in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol. 2016;45:255-61.[6]Olsen CL, Lie E, Kvien TK, Zangi HA. Predictors of fatigue in rheumatoid arthritis patients in remission or in a low disease activity state. Arthritis Care Res (Hoboken) 2016;68:1043–8.[7]Druce K, Jones GT, Macfarlane GJ, Verstappen SMM, Basu N. The longitudinal course of fatigue in rheumatoid arthritis: results from the Norfolk Arthritis Register. J Rheumatol 2015;42:2059–65.Disclosure of Interests:None declared

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AB0146 HAND AND WRIST ACTIVE RANGE OF MOTIONS AND CONTRIBUTING FACTORS IN RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3763 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1100-1101

Author(s):

M. He ◽

W. Zhou ◽

J. Guo ◽

J. Liu ◽

C. Dong ◽

...

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Disease Activity ◽

Disease Duration ◽

Multivariate Analyses ◽

Cross Sectional Study ◽

Sectional Study ◽

Contributing Factors ◽

Cross Sectional

Background:Patients with rheumatoid arthritis (RA) usually impaired range of motions (ROMs), especially hand and wrist active ROMs (AROMs), thus influencing their ability to perform daily activities and health-related quality of life (HR-QoL). However, little is known about the potential factors of reduced hand and wrist AROMs and their relations to quality of life in Chinese RA patients.Objectives:To explore the contributing factors of hand and wrist AROMs and their associations with HR-QoL and functional limitation in Chinese RA population.Methods:In this cross-sectional study, 108 patients were enrolled from Affiliated Hospital of Nantong University between November 2018 and July 2019. We measured all the participants’ AROMs with different directions of the hand and wrist in both sides, including volar flexion, ulnar deviation, radial deviation and radial deviation of the wrist joint, the first metacarpophalangeal (MCP1) flexion, interphalangeal (IP) flexion, volar abduction, radial abduction and thumb opposition (cm) in the thumb, average flexion, hypertension and abduction of the MCP2-5, average proximal interphalangeal (PIP) 2-5 and distal interphalangeal (DIP) 2-5 flexions, total active range of motion (TAM) of the second to the fifth fingers (TAM2-TAM5). Their sociodemographic, physical, psychological, disease-related data, acute phase reactants, laboratory indicators, drug usage and HR-QoL were examined as well. Statistical analysis used Pearson’s and Spearman’s correlation analysis, univariate and multivariate linear regression analyses.Results:In univariate analyses, we found that living in rural area, longer disease duration, comorbidity, hospitalization, more swollen joints, higher disease activity, pain level, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), red blood cell count and glucocorticoids usage were associated with most of the decreased hand and wrist AROMs (P ≤ 0.050), while higher education and annual income were related to most of the increased hand and wrist AROMs (P ≤ 0.048). In multivariate analyses, higher disease duration (P ≤ 0.023) and higher disease activity (P ≤ 0.033) were corelated with most of the decreased hand and wrist AROMs. Interestingly, the psychological factor, anxiety, was only positively associated with thumb opposition in both univariate and multivariate analyses (P ≤ 0.001). Additionally, most of the declined hand and wrist AROMs were associated with functional impairment and poor HR-QoL, especially in physical components (P < 0.05).Conclusion:Various factors, especially longer disease duration and higher disease activity, were related to decreased hand and wrist AROMs, and thus causing functional impairment and poor HR-QoL in RA patients. Clinical physicians and medical faculties should pay more attention to disease activity and disease-related symptoms of these patients in order to maintain their activity of daily living (ADL) ability and improve HR-QoL.References:[1]Rheumatoid arthritis. Nat Rev Dis Primers. 2018;4:18002.[2]Zhang L, Cao H, Zhang Q, Fu T, Yin R, Xia Y, et al. Motion analysis of the wrist joints in Chinese rheumatoid arthritis patients: a cross-sectional study. BMC Musculoskelet Disord. 2018;19(1):270.Acknowledgements:This work was funded by Postgraduate Research & Practice Innovation Program of Jiangsu Province (Grant/Award number: KYCX19_2071), National Natural Science Foundation of China (Grant/Award number: 81871278, Science and technology Project of Jiangsu Province (Grant/Award number: BE2018671)Disclosure of Interests:None declared

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Long-Term Effectiveness and Safety of Infliximab, Golimumab and Golimumab-IV in Rheumatoid Arthritis Patients from a Canadian Prospective Observational Registry

10.21203/rs.2.24628/v1 ◽

2020 ◽

Author(s):

Proton Rahman ◽

Philip Baer ◽

Ed Keystone ◽

Denis Choquette ◽

Carter Thorne ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Adverse Events ◽

Disease Activity ◽

Randomized Clinical Trials ◽

Disease Duration ◽

Routine Care ◽

Treatment Modalities ◽

The Mean ◽

Over Time

Abstract Background Long-term clinical registries are essential tools to evaluate new therapies in a patient population that differs from those in randomized clinical trials. The objectives are to describe the profile of rheumatoid arthritis (RA) patients treated with anti-TNF agents in Canadian routine care. Methods RA patients eligible for treatment with Infliximab (IFX), golimumab (GLM) or intravenous golimumab (GLM-IV) as per their respective Canadian product monographs were enrolled into the BioTRAC registry between 2002 and 2017. Study visits occurred at baseline and every 6 months thereafter. Effectiveness was assessed by changes in disease activity. Safety was evaluated by the incidence of adverse events (AEs) and drug survival. Results Of the 890 IFX-, 530 GLM-SC- and 157 GLM-IV-treated patients, the proportion of females ranged from 77.0-86.6%, the mean ages from 55.8-57.7 and the mean disease duration from 6.5-8.6 years. A significant decrease in baseline disease duration and disease activity parameters (DAS, TJC, SJC, HAQ, AM stiffness, MDGA, PtGA, CRP, ESR) was observed over time. Treatment with IFX, GLM-SC and GLM-IV significantly improved all disease parameters over time. The incidence of AEs was 105, 113 and 82.6 /100 PYs and the incidence of SAEs was 11.7, 11.2 and 4.68 /100 PYs for IFX, GLM-SC and GLM-IV-treated patients, respectively. Conclusion Differences in baseline characteristics between patients treated with an anti-TNFs over time shows the evolution of treatment modalities over time. All treatments significantly reduced disease activity and improved functionality in a similar fashion. The incidence of adverse events was consistent with the safety profiles of IFX and GLM.

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Evaluation of Serum Calprotectin Level and Disease Activity in Patients with Rheumatoid Arthritis

Current Rheumatology Reviews ◽

10.2174/1573397115666190122113221 ◽

2019 ◽

Vol 15 (4) ◽

pp. 316-320

Author(s):

Mir Amir Aghdashi ◽

Seyedmostafa Seyedmardani ◽

Sholeh Ghasemi ◽

Zohre Khodamoradi

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Inflammatory Arthritis ◽

Unknown Etiology ◽

Tender Joint Count ◽

Serum Samples ◽

Tender Joint ◽

Cross Sectional ◽

Calprotectin Level ◽

Remission Phase

Background: Rheumatoid Arthritis (RA) is the most common type of chronic inflammatory arthritis with unknown etiology marked by a symmetric, peripheral polyarthritis. Calprotectin also can be used as a biomarker of disease activity in inflammatory arthritis and other autoimmune diseases. Objective: In this study, we evaluated the association between serum calprotectin level and severity of RA activity. Methods: A cross-sectional study was conducted on 44 RA patients with disease flare-up. Serum samples were obtained from all patients to measure calprotectin, ESR, CRP prior to starting the treatment and after treatment period in the remission phase. Based on Disease Activity Score 28 (DAS28), disease activity was calculated. Results: Of 44 RA patients, 9(20.5%) were male and 35(79.5%) were female. The mean age of our cases was 53±1.6 years. Seventeen (38.6%) patients had moderate DAS28 and 27(61.4%) had high DAS28. The average level of calprotectin in the flare-up phase was 347.12±203.60 ng/ml and 188.04±23.58 ng/ml in the remission phase. We did not find any significant association between calprotectin and tender joint count (TJC; P=0.22), swollen joint count (SJC; P=0.87), and general health (GH; P=0.59), whereas significant associations were found between the calprotectin level and ESR (p=0.001) and DAS28 (p=0.02). The average calprotectin level in moderate DAS28 (275.21±217.96 ng/ml) was significantly lower than that in high DAS28 (392.4±183.88 ng/ml) (p=0.05). Conclusion: We showed that the serum level of calprotectin can be a useful and reliable biomarker in RA activity and its severity. It also can predict treatment response.

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SAT0082 FRAX AND DAS IN MOROCCAN RHEUMATOID ARTHRITIS PATIENTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4467 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 975.1-975

Author(s):

H. Azzouzi ◽

O. Lamkhanat ◽

I. Linda

Keyword(s):

Rheumatoid Arthritis ◽

Fracture Risk ◽

Disease Activity ◽

Descriptive Analysis ◽

Cross Sectional Study ◽

Fracture Probability ◽

Mineral Density ◽

Cross Sectional ◽

Risk Probability ◽

Fracture Assessment

Background:Rheumatoid Arthritis (RA) is one of the risk factors for the calculation of the 10 years fracture probability assessed by the FRAX tool.Objectives:The aim was to study the association of disease activity and the 10 year fracture risk probability by the FRAX tool in our RA patients and their impact on fracture prevalence.Methods:Cross-sectional study of the association FRAX and disease activity score (DAS 28 CRP) was designed. Patients with RA were included. Mean DAS was calculated for each patient adjusted on his follow-up duration. Data about patients (demographic, disease characteristics and fracture assessment) were collected. The 10 year fracture risk probability for major osteoporotic fracture was calculated with and without BMD (bone mineral density) using the FRAX tool for Morocco. Descriptive analysis and regressions were performed with SPSS.20. p<0.05 was considered significant.Results:One hundred and ninety nine RA patients were included with mean age of 55.5±12 years. Women represented 91% and 40.1% had osteoporosis. Remission was observed in 86.4% with 95.5% taking methotrexate. 17.1% had vertebral fractures. FRAX and DAS were associated (p=0.03), and both explained vertebral fracture (VF) prevalence. When adjusted on disease parameters, FRAX with and without BMD explained the vertebral prevalence (p=0.02, OR=1.09[1.01-1.19]). However, age remains the only predictor of VF when adjusted on osteoporosis factors (DAS28CRP, menopause, BMI, smoking, diabetes, gender, steroid use, HAQ) and FRAX BMD.Conclusion:Persistent disease activity was associated to high 10 year fracture risk probability calculated by the FRAX tool in RA.Disclosure of Interests:None declared

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