scholarly journals FRI0063 LEVEL OF N-TERMINAL FRAGMENT OF BRAIN NATRIURETIC PEPTIDE PROGENITOR AND ATHEROSCLEROTIC DAMAGE OF BRACHIOCEPHALIC ARTERIES IN PATIENTS WITH EARLY AND LONG-STANDING ACTIVE RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 608.2-608
Author(s):  
H. Gerasimova ◽  
T. Popkova ◽  
M. Cherkasova ◽  
E. Markelova ◽  
S. Glukhova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Natriuretic Peptide ◽  
Disease Duration ◽  
Atherosclerotic Lesion ◽  
Control Group ◽  
Early Ra ◽  
Terminal Fragment ◽  
Traditional Risk Factors ◽  
Brachiocephalic Arteries

Background:The high prognostic significance of the N-terminal fragment of the B-type natriuretic peptide (NT-proBNP) concentration in the development of cardiovascular diseases (CVD) was identified for rheumatoid arthritis (RA) patients (pts) and general population.Objectives:To investigate the significance of NT-proBNP levels in pts with early untreated and long-standing RA with high disease activity; to identify potential relationship of NT-pro-BNP levels with atherosclerotic lesion of the brachiocephalic arteries (BCA), traditional risk factors and inflammatory markers.Methods:A total of 227 RA pts (76%females, 24%males, 55 [46;61]years old, moderate to high activity (DAS28-5,3[4,6;6,3], SDAI–27(22;35), positive for ACCP (73%)/RF (87%),) were enrolled in the study: 136 pts with early RA (disease duration ≤12 months) and 91 pts with long-standing RA (>12 months). All early RA pts were not treated with glucocorticoids and disease-modifying antirheumatic drugs (DMARDs). Long-standing RA pts already developed the lack of efficacy/resistance and/or intolerance of DMARDs. Lack of efficacy of 3 or more DMARDs was established in 46% of pts, intolerance to previous DMARDs therapy - in 54% pts. 73% were receiving methotrexate, 21% - leflunomide, 7% - sulfasalazine, 46% glucocorticoids. Pts with early and long-standing RA were comparable in terms of age, sex, body mass index and RA activity rates (DAS28, SDAI, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels). High incidence of traditional risk factors was found in early and long-standing RA pts: the incidence rate of arterial hypertension (58%vs68%), overweight (58%vs61%), smoking (27%vs17%), DM type 2 (4%vs7%) were not significantly different. Pts with congestive heart failure were not include in the study. The control group consisted of 20 healthy donors, matched to pts by age and sex. Serum levels of NT-proBNP (pg/mL) were measured using electrochemiluminescence test Elecsys proBNP II (Roche Diagnostics, Switzerland). NT-proBNP levels > 125,0 pg/mL were considered as elevated. The BCA intima-media thickness (IMT) was assessed by duplex ultrasound scanning. Atherosclerotic lesion of BCA was documented in the presence of plaque (IMT≥1,2mm).Results:The NT-proBNP levels were significantly higher in RA pts than in the control group (median 92,1 (48,2-164,7) pg/mL vs 55,3 (36,6-67,3) pg/mL,p<0.05). Pts with early RA had higher NT-proBNP levels (118,9 (60,2-201,3) pg/ml) than pts with long-standing RA (73,4 (43,0-114,3) pg/ml,p<0,001). Elevated NT-proBNP concentrations were found in 71 (52%) early RA pts vs 21 (23%) pts with long- standing RA (р<0,01). Atherosclerotic lesion of the BCA was detected in 73 (54%) pts with early RA and in 37 (41%) pts with long- standing RA (p>0,05). The NT-proBNP levels correlated with age (r=0,51,p<0,001), CRP (0,23,p=0,001) and IMT of BCA (r=0,46,p=0,03) in RA pts. Aforementioned correlations were significantly remained for both groups of RA pts. Association between IMT of BCA and CRP concentrations was not found.Conclusion:NT-pro-BNP levels are higher in pts with active RA than in control subjects. Early untreated RA pts had a higher NT-proBNP levels than pts with disease duration >12 months and resistance or intolerance of DMARDs. The increased concentration NT-pro-BNP (>125pg/ml) were found in half of pts with early untreated RA and every fourth pts with long-standing active RA. NT-proBNP concentration correlated with CRP level in pts with active RA. Correlation between NT-pro-BNP concentrations and IMT of BCA may be indicative of possible impact of this biomarker on atherosclerotic damage of BCA in pts with early and long-standing active RA.Disclosure of Interests:None declared

scholarly journals Level of N-terminal fragment of brain natriuretic peptide progenitor and atherosclerotic damage of brachocephalic arteries in patients with rheumatoid arthritis with inefficiency and/or injurability of basic anti - inflammatory treatment

2019 ◽  
Vol 91 (5) ◽  
pp. 34-39
Author(s):  
E V Gerasimova ◽  
T V Popkova ◽  
A V Martynova ◽  
E I Markelova ◽  
D S Novikova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Natriuretic Peptide ◽  
Prognostic Significance ◽  
Atherosclerotic Lesion ◽  
Control Group ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Traditional Risk Factors

The high prognostic significance of the concentration of the N-terminal - pro-B-type natriuretic peptide (NT-proBNP) in the development of cardiovascular diseases (CVD) was identified for rheumatoid arthritis (RA) and general populations. Aim: to investigate the significance of NT-proBNP level in patients (pts) with RA with the ineffectiveness and/or intolerance of basic anti - inflammatory therapy; compare the level of NT-proBNP with atherosclerotic lesion of the brachiocephalic arteries (BCA), traditional risk factors and inflammatory markers. Materials and methods. The investigation enrolled 28 pts (24women/4men) with the lack of efficacy/resistance and/or intolerance of basic anti - inflammatory drugs (DMARDs); median age was 55 [46; 61] years, median disease duration 114 [60; 168] month; DAS28 6,2 [5.1; 7.0]; SDAI 35.0[23.9; 51.0], CDAI 30.0[21.0; 42.0], serum positivity for rheumatoid factor (RF) (100%)/anti - cyclic citrullinated peptide antibodies (ACCP) (86%). The study did not include RA pts with congestive heart failure. High incidence of traditional risk factors was found in RA pts: arterial hypertension - in 75%, dyslipidemia - 61%, smoking - 17%, overweight - 61%, family history of cardiovascular diseases - 36%, hypodynamia - 68%. Coronary artery disease was diagnosed in 11% RA pts. Lack of efficacy of 3 or more DMARDs was found in 46% of pts, intolerance to previous therapy with DMARDs - in 54% pts. 47% were receiving methotrexate (20 [18; 25] mg/week), 11% - leflunomide, 7% - sulfasalazine, 46% - glucocorticoids, 75% - non - steroidal anti - inflammatory drugs. The control group consisted of 20 healthy donors, comparable to pts by age and sex. Serum levels of of NT-proBNP were measured using electrochemiluminescence method Elecsys proBNP II (Roche Diagnostics, Switzerland). The determination of the intima - media thickness (IMT) BCA were assessed from duplex scanning. Atherosclerotic lesion of BCA was assessed by the presence of atherosclerotic plaque (IMT ≥1.2 mm). Results. NT-proBNP concentrations in RA pts proved to be higher (78.7 [41.4; 101.3] pg/ml) than those in the control group (55.3 [36.6; 67.3] pg/ml, p100 pg/ml - 1 group (n=6) and ≤100 pg/ml - 2 group (n=22). Groups of RA pts did not differ in gender, age, activity of RA, frequency of detection of traditional risk factors. Atherosclerotic lesion of the BCA was detected in 3 (50%) pts of the 1 group and in 8 (36%) pts of the 2 group (p>0.05). In RA pts the level of NT-proBNP correlated with age (r=0.39; p

scholarly journals AB0033 MACROPHAGE ACTIVATION IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS AND SYSTEMIC LUPUS ERYTHEMATOSUS (PRELIMINARY DATA)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1049.3-1050
Author(s):  
E. Gerasimova ◽  
T. Popkova ◽  
T. Kirichenko ◽  
А . Markin ◽  
Y. Markina ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Macrophage Activation ◽  
Disease Duration ◽  
Monocyte Activation ◽  
Systemic Lupus ◽  
Early Ra ◽  
Traditional Risk Factors

Background:The study of the ability of monocytes to activate associated with the clinical activity of immunological markers of inflammation in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) will provide important and fundamentally new information on the involvement of these cells in the development of autoimmune rheumatic diseases (ARDs).Objectives:To study macrophage activation in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients (pts).Methods:A total of 21 active ARDs pts (11 RA, 10 SLE) were enrolled in the study (median age was 55[44; 63] years; disease duration was 8 [2; 14] months). There are 11 pts with early RA (disease duration was ≤12 months), moderate to high activity (DAS28 was 6.1[4.9;6.7]; SDAI was 25(22;31); ACCP was positive in 73% and RF in 87% cases) and 10 pts with active SLE (SLADAI-2K was 7 [6;8]) in the study. All early RA pts and 4 SLE pts were not treated with glucocorticoids and disease-modifying antirheumatic drugs. Six SLE pts received low-dose glucocorticoids and hydroxychloroquine.All pts were assessed for macrophage activation and laboratory data: ESR, RF, ACCP, CRP, ANA, anti-dsDNA. Isolation of monocytes was carried out according to the standard procedure for obtaining a leukocyte fraction in a Ficoll gradient and subsequent selection of CD14 + cells using magnetic separation. After isolation, the cells were cultured in X-Vivo medium. To assess the degree of monocyte activation, cells were stimulated by the addition of LPS. The value of monocyte activation was expressed as a ratio of the level of secretion of proinflammatory cytokines by monocytes cultured with and without LPS addition. Secretion levels were determined by ELISA. The belonging of the isolated cells to CD14 + monocytes was additionally confirmed by flow cytometry.Results:Macrophage activation was 2.6 (2.0;5.4) and 4.8 (2.8;7.3) in RA and SLE pts, respectively (p>0.05). In RA and SLE pts macrophage activation was independent of age, sex, body mass index, traditional risk factors (arterial hypertension, overweight, smoking, family history of cardiovascular diseases), RA activity scores (DAS28, SDAI), and SLADAI-2K. No association was found between macrophage activation and levels of ESR, RF, ACCP, CRP, ANA, and anti-dsDNA.Conclusion:No differences in macrophage activation were found in RA and SLE pts. Macrophage activation was independent of age, sex, traditional risk factors, and ARD-related parameters. A study on a larger number of pts will clarify the link between macrophage activation and autoimmune disorders.This work was supported by the Russian Science Foundation (Grant № 21-15-00225).Disclosure of Interests:None declared

Predictors of atherosclerosis in rheumatoid arthritis

VASA ◽  
2012 ◽  
Vol 41 (5) ◽  
pp. 353-359 ◽  
Author(s):  
Ahmad ◽  
Garg ◽  
Dhar ◽  
Srivastava ◽  
Biswas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Disease Duration ◽  
Early Stage ◽  
Subclinical Atherosclerosis ◽  
Disease Onset ◽  
Intima Media Thickness ◽  
Qt Dispersion ◽  
Control Group ◽  
Age And Sex

Background: Atherosclerosis is emerging as an important complication of rheumatoid arthritis (RA), with coronary artery disease being projected as the major cause of mortality in these patients.This study was undertaken to evaluate the presence of subclinical atherosclerosis and to identify the risk factors of atherosclerosis in patients with RA. Patients and methods: All consecutive in- and out-patients of rheumatoid arthritis (n = 100) irrespective of the disease duration were included in the study. A group of 100 age and sex matched controls were also studied. Increased carotid intima media thickness (beyond the 75th percentile for age and sex), presence of plaques, ankle brachial pressure index and QT dispersion were deemed as non-invasive measures of atherosclerotic burden. Results: Fifty patients (50.0 %) with RA had evidence of subclinical atherosclerosis as compared to the control group (n = 11, 11 %); plaques were observed in 26 patients. Eighteen (36 %) of these developed this evidence within 1 - 5 years of disease onset. Low HDL levels among the conventional risk factors and advanced patient age, longer disease duration, greater number of involved joint areas, steroid use and indices of inflammation in particular in RA, were associated with subclinical atherosclerosis. Sustained inflammation was observed throughout the sub-group with atherosclerosis irrespective of the disease duration. Conclusions: RA is a pro-atherogenic state with the process of atherosclerosis initiated in the early stage of the disease. Besides the traditional risk factors, sustained inflammation contributes to atherogenesis.

scholarly journals SAT0026 HIGHER LEVELS OF NATURAL ANTI-PHOSPHORYLCHOLINE ANTIBODIES ARE ASSOCIATED WITH LOWER RISK OF INCIDENT CARDIOVASCULAR EVENTS IN YOUNGER PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 943.1-943
Author(s):  
S. Ajeganova ◽  
M. Andersson ◽  
J. Frostegård ◽  
I. Hafström
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Lower Risk ◽  
Atherosclerotic Disease ◽  
Rank Test ◽  
Favourable Effect ◽  
The European Union ◽  
Younger Patients ◽  
Early Ra ◽  
Traditional Risk Factors

Background:The increased cardiovascular (CV) risk in rheumatoid arthritis (RA), especially in seropositive RA, is not fully explained by traditional risk factors. Immuno-inflammatory mechanisms and autoantibodies could be involved in the pathogenesis of atherosclerotic disease. Recent studies have suggested that anti-phosporylcholine antibodies (anti-PC) of IgM subclass counteract the generation of senescent and IL-17+ T-cells, have atheroprotective effects and may play a role in formation and stabilization of atherosclerotic plaque.Objectives:To investigate the association between IgM anti-PC antibodies with cardiovascular (CV) morbidity in patients with RA in age and sex groups and by serostatus.Methods:The study population was derived from the BARFOT early RA cohort, recruited in 1994-1999. The outcome was CV events i.e. AMI, angina pectoris, coronary intervention, ischemic stroke and TIA tracked through the Swedish Hospital Discharge and the National Cause of Death Registries. The RA-disease measures and traditional risk factors were assessed according to the protocol. Sera collected at inclusion and the 2-year visit were analyzed with ELISA to determine levels of anti-PC IgM (Athera CVDefine kit, Athera Biotechnologies AB). The Kaplan-Meier estimates and Cox proportional-hazards regression models were applied. Analysis were stratified by median level of IgM anti-PC and performed within strata of age, sex and RA-autoantibodies.Results:In all, 654 patients with early RA, 68% women, mean (SD) age 55(14.7) years, DAS28 5.2(1.3), 60% RF-positive and 60% ACPA-positive without prevalent CVD were included in this analysis. The level of IgM anti-PC at baseline was median (IQR) of 60.9(36.4-94.9) and at 2 years 56.0(32.3-84.2) U/ml. During follow-up of > 10 years, 141 incident CV events (21.6%) were registered. The levels of anti-PC both at inclusion and after 2 years of observation were lower in participants who experienced CV event than in those who did not, p=0.020 and p=0.012.The CV event-free survival differed between patients with levels of anti-PC above median compared with those with levels below, p=0.003 by log-rank test. The risk for incident CV event showed a 0.6-fold hazard (95% CI, 0.4-0.8) among patients with higher anti-PC levels as compared with those with lower levels, p=0.003. In the age groups, the risk for incident CV event was lower in patients aged <55 years at inclusion than in those who were older, hazard ratio (HR) 0.40 (0.17-0.94), p=0.036. This result persisted when adjusted for sex and all traditional risk factors, HR 0.36 (0.14-0.92), p=0.032. Also, the risk for incident CV events was lower in patients with higher anti-PC levels in females, HR 0.61 (0-39-0.45), and double RF- and ACPA- negative patients, 0.44 (0.21-0.90), in crude analyses.The favourable effect of anti-PC at baseline and the CV outcome was not observed in ages >55 years, males, ACPA+ and RF+ patients. There were no significant association between anti-PC level at 2 years and outcome.Conclusion:These results suggest that higher levels of IgM anti-PC are associated with a lower risk of incident CV events over 10 years in younger patients. The favourable atheroprotective effect of IgM anti-PC may be a part of explanation of lower risk of atherosclerotic disease in younger persons, females and in those with seronegative RA.Acknowledgments :6th Framework Program of the European Union (grant LSHM-CT-2006-037227 CVDIMMUNE)Disclosure of Interests:Sofia Ajeganova: None declared, Maria Andersson: None declared, Johan Frostegård Grant/research support from: Unconditional competitive grant from Amgen, related only to PCSK9, not the topic of this abstract, Ingiäld Hafström: None declared

scholarly journals AB0243 THE SHORT DISEASE DURATION IS ASSOCIATED WITH WORSE MOOD DISORDER IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1422.3-1422
Author(s):  
Y. Geng ◽  
T. Gao ◽  
Z. Zhang
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Mood Disorder ◽  
Mood Disorders ◽  
Disease Duration ◽  
Depression And Anxiety ◽  
Early Ra ◽  
Short Disease Duration ◽  
The Status ◽  
Independent Risk Factors

Background:Rheumatoid arthritis (RA) is commonly associated with mood disorders, especially depression and anxiety. But the status of mood disorders in RA patients with different courses is unknown.Objectives:The aims of this study were to investigate the frequencies of depression and anxiety in patients with early RA and non-early RA, and further to identify the risk factors for mood disorders.Methods:Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were applied to all enrolled RA patients to assess their corresponding status of anxiety and depression. Besides clinical assessment, power Doppler and grey-scale ultrasound of 22 joints were also performed. The status of mood disorder was studied in early RA patients compared to non-early RA patients. Multivariate regression was used to identify the risk factor for mood disorders.Results:201 RA patients were enrolled, with 76 early RA (disease duration≤2 years) and 125 non-early RA (disease duration > 2 years) patients. Mood disorder (depression and/or anxiety) was found in 20.9% (42/201) patients. Depression was more often observed in early RA patients than non-early RA patients (26.3% vs. 14.4%,P=0.036). The similar trend for anxiety was observed also in early RA patients compared to non-early RA patients, although the difference was insignificant (13.2% vs. 5.6%,P=0.062). Multivariate logistic regression analysis showed that disease duration (OR 0.991 [95% CI 0.985-0.998]), rheumatoid factor concentration (OR 2.697 [95% CI 1.165-6.241]), Health Assessment Questionnaire Disability Index (HAQ-DI) (OR 1.045 [95% CI 1.001-1.091]) and grey-scale synovitis score (GS score) (OR 1.092 [95% CI 1.032-1.156]) were independent risk factors for predicting depression in RA. Disease duration (OR 0.983 [95% CI 0.970-0.997]), HAQ-DI (OR 1.069 [95% CI 1.002-1.141]) and GS score (OR 1.073 [95% CI 1.005-1.141]) were independent risk factors for predicting anxiety in RA patients.Conclusion:Mood disorders were almost doubled in frequency in early RA patients than non-early RA patients. RA Patients with short disease duration, high HAQ-DI and high GS score were more likely to be in depression and anxiety. More attention is needed to the psychological status of RA patients, especially those at an early stage, with poor physical function and severe synovitis.References:[1]Sturgeon JA, Finan PH, Zautra AJ. Affective disturbance in rheumatoid arthritis: psychological and disease-related pathways. Nat Rev Rheumatol 2016;12(9):532-42.[2]Bacconnier L, Rincheval N, Flipo RM, et al. Psychological distress over time in early rheumatoid arthritis: results from a longitudinal study in an early arthritis cohort. Rheumatology (Oxford) 2015; 54(3): 520-7.Acknowledgments:The authors thank all the colleagues in our department.Disclosure of Interests:None declared

Effect of Dietary Education on Cardiovascular risk Factors in Rheumatoid Arthritis Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Rahil Taheri ◽  
Shahram Molavynejad ◽  
Parvin Abedi ◽  
Elham Rajaei ◽  
Mohammad Hosein Haghighizadeh
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Statistical Tests ◽  
Intervention Group ◽  
Serum Levels ◽  
Control Group ◽  
Dietary Education

Aim: The aim of this study was to investigate the effect of dietary education on cardiovascular risk factors in patients with rheumatoid arthritis. Method: In this randomized clinical trial, 112 patients with rheumatoid arthritis were randomly assigned into two groups, intervention and control. Dietary education was provided for the intervention group in 4 sessions; anthropometric measurements, serum levels of RF, triglycerides, cholesterol, HDL, LDL, and fasting blood sugar were measured before and three months after intervention. Data was analyzed using SPSS software and appropriate statistical tests. Results: The mean of total cholesterol (p <0.001), triglycerides (p = 0.004), LDL (p <0.001), systolic blood pressure (p = 0.001), diastolic blood pressure (p = 0.003), FBS and BMI (p <0.001) were decreased significantly in the intervention group after education compared the control group. Conclusion: Traditional care for rheumatoid arthritis patients is not enough. Patients need more education in order to improve their situation.

scholarly journals SAT0077 CARDIOVASCULAR RISK ASSESSMENT WITH CAROTID ULTRASONOGRAPHY IN ADDITION TO THE TRADITIONAL CARDIOVASCULAR RISK FACTORS IN RHEUMATOID ARTHRITIS PATIENTS: A CASE CONTROL STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 973-973
Author(s):  
R. Gonzalez Mazario ◽  
J. J. Fragio-Gil ◽  
P. Martinez Calabuig ◽  
E. Grau García ◽  
M. De la Rubia Navarro ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Disease Duration ◽  
Case Control Study ◽  
Case Control ◽  
Healthy Controls ◽  
Carotid Ultrasonography ◽  
Control Study

Background:Cardiovascular disease (CV) is the most frequent cause of death in rheumatoid arthritis (RA) patients. It is well known that RA acts as an independent cardiovascular risk factor.Objectives:To assess the CV risk in RA patients using carotid ultrasonography (US) additionally to the traditional CV risk factors.Methods:A prospective transversal case control study was performed, including adult RA patients who fulfilled ACR/EULAR 2010 criteria and healthy controls matched according to CV risk factors. Population over 75 years old, patients with established CV disease and/or chronic kidney failure (from III stage) were excluded. The US evaluator was blinded to the case/control condition and evaluated the presence of plaques and the intima-media thickness. Statistical analysis was performed with R (3.6.1 version) and included a multivariate variance analysis (MANOVA) and a negative binomial regression adjusted by confounding factors (age, sex and CV risk factors).Results:A total of 200 cases and 111 healthy controls were included in the study. Demographical, clinical and US data are exposed in table 1. Not any difference was detected in terms of CV risk factors between the cases and controls. In both groups a relationship between age, BMI and high blood pressure was detected (p<0.001).Table 1.Table 2.RA basal characteristicsDisease duration (years)16,98 (11,38)Erosions (X-Ray of hands/feet)163 (81,5%)Seropositive (RF/anti-CCP)146 (73%)Extra-articular symptoms44 (22%)Intersticial difusse lung disease10 (5%)Rheumatoid nodules14 (7%)Prednisone use103 (51,5%)Median dose of Prednisone last year (mg)2,34 (2,84)sDMARDsMethotrexate104 (52%)Leflunomide29 (14,5%)Hydroxycloroquine9 (4,5%)bDMARDs89 (44,5%) TNFi41 (20,5%) Abatacept15 (7,5%) IL6i22 (11%) RTX11 (5,5%)JAKi26 (13%) Baricitinib11 (5,5%) Tofacitinib15 (7,5%)DAS 28-ESR3,1 (2,3, 3,9)SDAI7,85 (4,04, 13,41)HAQ0,88 (0,22, 1,5)RF (U/mL)51 (15, 164,25)Anti-CCP (U/mL)173 (22, 340)Patients showed higher intima-media (both right and left) thickness compared to controls (p<0.006). Moreover it was also related to the disease duration and DAS28 score (p<0.001). A higher plaque account was noted in cases(p<0.004) and it was also related to the disease duration (p<0.001).Conclusion:RA implies a higher CV risk. Traditional CV risk factors explains only partially the global risk. These findings support that RA acts as an independent cardiovascular risk factor.Disclosure of Interests:None declared

scholarly journals SAT0047 RISK FACTORS FOR THE POSTOPERATIVE DELAYED WOUND HEALING IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH A BIOLOGICAL AGENT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 954.3-954
Author(s):  
S. Okita ◽  
H. Ishikawa ◽  
A. Abe ◽  
S. Ito ◽  
A. Murasawa ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Wound Healing ◽  
Retrospective Study ◽  
Nutritional Status ◽  
Disease Activity ◽  
Disease Duration ◽  
Foot And Ankle ◽  
Delayed Wound Healing ◽  
Chugai Pharmaceutical

Background:It has been suggested that perioperative use of biological disease-modifying anti-rheumatic drugs (bDMARDs) in rheumatoid arthritis (RA) patients carries risks for the surgical-site infection and the delayed wound healing (DWH); however, the risk of DWH with perioperative use of bDMARDs has not reached a general consensus.Objectives:This retrospective study aimed to investigate the risk factors associated with DWH after orthopedic surgery in RA patients treated with bDMARDs.Methods:We reviewed medical records of 277 orthopedic procedures for 188 RA patients treated with bDMARDs between from 2014 to 2017 in Niigata Rheumatic Center. As preoperative nutritional status assessment, we evaluated body mass index (BMI), prognostic nutritional index (PNI), and CONtrolling NUTritional status (CONUT). In addition, we evaluated DAS28-CRP, DAS28-ESR, face scale for pain, global health (GH), and Health Assessment Questionnaire-Disability Index (HAQ-DI) to assess the disease activity. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factor for DWH.Results:The major characteristics of the patients in 277 procedures were mean age of 63.2 years old and mean disease duration of 18.2 years. Surgical site were hand and wrist (145 procedures), foot and ankle (76), hip and knee (31), elbow and shoulder (24), and spine (1). Seventy-four patients were treated with tocilizumab, 62 with etanercept, 55 with golimumab, 49 with abatacept, 16 with infliximab, 15 with adalimumab, and 6 with certolizumab. According to nutritional assessment in PNI and CONUT, 63% (n=175) and 47% (n=130) were normal nourished patients, respectively.In 277 procedures, DWH were identified in 24 patients (8.6%). The following variables were significant in the univariate analyses: disease duration (OR 1.053; 95% CI 1.010–1.099; p=0.016), foot and ankle surgery (OR 7.091; 95% CI 2.130–23.603; p=0.001), tocilizumab (OR 0.286; 95% CI 0.093–0.881; p=0.029) (Table 1). These variables were entered into a multivariate model, and it was revealed that pre-operative use of tocilizumab (OR 0.265; 95% CI 0.074–0.953; p=0.042) and procedures in the foot and ankle (OR 6.915; 95% CI 1.914–24.976; p=0.003) were associated with an increased risk of DWH (Table 1).Conclusion:As previous study on tocilizumab described, the current retrospective study suggested that pre-operative use of tocilizumab and procedures in the foot and ankle were risk factors for DWH. Pre-operative disease activity and nutritional status were not independent risk factors for an increase in the prevalence of DWH.References:[1] Momohara S, Hashimoto J, Tsuboi H et al. Analysis of perioperative clinical features and complications after orthopaedic surgery in rheumatoid arthritis patients treated with tocilizumab in a real-world setting: Results from the multicentre tocilizumab in perioperative period (TOPP) study. Modern rheumatology. 2013, 23: 440-9.Disclosure of Interests:Shunji Okita: None declared, Hajime Ishikawa: None declared, Asami Abe: None declared, Satoshi Ito Speakers bureau: Abbvie,Eisai, Akira Murasawa: None declared, Keiichiro Nishida Grant/research support from: K. Nishida has received scholarship donation from CHUGAI PHARMACEUTICAL Co., Eisai Co., Mitsubishi Tanabe Pharma and AbbVie GK., Speakers bureau: K. Nishida has received speaking fees from CHUGAI PHARMACEUTICAL Co., Eli Lilly, Janssen Pharmaceutical K.K., Eisai Co. and AYUMI Pharmaceutical Corporation., Toshifumi Ozaki: None declared

scholarly journals Evaluation of nasal mucociliary clearance in rheumatoid arthritis: a comparative analysis using saccharin test

2017 ◽  
Vol 5 (11) ◽  
pp. 5026 ◽  
Author(s):  
Shelja Deswal ◽  
Jyoti Yadav ◽  
Mohit Deswal ◽  
Harpreet Singh
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Duration ◽  
Mucociliary Clearance ◽  
Systemic Disease ◽  
Unknown Etiology ◽  
Control Group ◽  
Ciliary Activity ◽  
Multisystem Disease ◽  
Organic Particles ◽  
Nasal Mucociliary Clearance

Background: Rheumatoid arthritis (RA) is a chronic multisystem disease of unknown etiology characterized by persistent inflammatory synovitis, usually involving peripheral joints in a symmetric distribution. RA is a systemic disease often associated with cutaneous and organ-specific extra-articular manifestations the mucociliary clearance system protects the lower respiratory system by trapping and removing inhaled pathogenic viruses and bacteria, in addition to nontoxic and toxic particulates (e.g., pollen, ash, mineral dust, mold spores, and organic particles), from the lungs. Effective clearance requires both ciliary activity and the appropriate balance of periciliary fluid and mucus.Methods: This was a case control study conducted in the Department of Physiology, Pt. B.D. Sharma PGIMS, Rohtak in 50 females of age group 30-50 years. Control group comprised of 25 healthy volunteer females while study group comprised of 25 rheumatoid arthritis female patients with disease duration of more than five years. Proven cases of RA (as per 1987 ACR criteria) were taken with disease duration of more than five years from Rheumatology clinic of Pt. B.D. Sharma PGIMS, Rohtak. Nasal mucociliary clearance time was evaluated by saccharin method.Results: The results of our study showed abnormal mucociliary clearance in rheumatoid arthritis patients.Conclusions: The study shows an abnormal mucociliary clearance in rheumatoid arthritis patients. Impairment of mucociliary clearance seems to be the result of qualitative and quantitative alterations in respiratory secretions.

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