Do Rheumatoid Arthritis Patients Have a Higher Risk for Sleep Apnea?

Objective.Patients with rheumatoid arthritis (RA) have an increased risk for developing cardiovascular disease (CVD) compared to subjects in the general population. The development of CVD has also been linked to chronic sleep apnea. The purpose of this study was to examine the risk for sleep apnea in patients with RA compared to subjects without RA.Methods.We recruited RA patients and non-RA subjects who were age and sex matched from the same population. These persons completed the Berlin Sleep Questionnaire, which evaluated their level of risk (high or low) for sleep apnea. In addition, there were 3 subscales evaluating snoring, fatigue, and relevant comorbidities [i.e., high blood pressure and obesity [body mass index (BMI) ≥ 30 kg/m2)]. Chi-squared tests were used for comparisons.Results.The study population consisted of 164 patients with RA and 328 patients without RA. Age, sex and BMI were similar for both groups. There was no difference in snoring (p = 0.31) or in the comorbidities subscale (p = 0.37). However, RA patients reported more fatigue (38%) than subjects without RA (13%; p < 0.001). Overall, the risk for sleep apnea was significantly higher for the RA patients (50%) than the non-RA subjects (31%; p < 0.001).Conclusion.Patients with RA may be at a higher risk for sleep apnea compared to non-RA subjects. This apparent risk difference may be attributed to reports of fatigue in RA patients, which may be associated with sleep apnea or RA disease itself.

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Abstract 631: Evaluation of Risk Factors for Cardiovascular Disease in Rheumatoid Arthritis

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.35.suppl_1.631 ◽

2015 ◽

Vol 35 (suppl_1) ◽

Author(s):

Vitor M Rocha ◽

Maria Guadalupe B Pippa

Keyword(s):

Rheumatoid Arthritis ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Total Cholesterol ◽

Normal Population ◽

Control Group ◽

American College Of Rheumatology ◽

Increased Risk ◽

Systemic Inflammatory Disease

Backgroung: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease, that appear to be responsible for 50% of mortality for thrombotic events such as Myocardial Infarction (MI) and Ischemic Stroke (SI) in RA patients. Occur approximately a decade earlier in these patients compared with the normal population. Objectives: To determine the risk of developing cardiovascular disease in patients with Rheumatoid Arthritis according to the classification criteria of the American College of Rheumatology. Methods: To assess the risk of cardiovascular diseases we studied 78 patients diagnosed with Rheumatoid Arthritis. For this we used the criteria of the risk score of Acute Coronary Disease in 10 years according to the Framingham Heart Study. A control group consisted of 21 patients with osteoarthritis and fibromyalgia was also assessed using the same criteria, where age, sex, systolic blood pressure values, total cholesterol, cholesterol HDL, presence of smoking and diagnosis of diabetes, were scored. Results: Patients with rheumatoid arthritis had a mean disease duration of 12.8 years (SD=7.4), age 58.6 years (SD=10.3) and the control group 59.3 years (SD=10,0). The old values of total cholesterol, HDL, blood pressure and being with Diabetes Mellitus showed positive correlations with the Cardiovascular Risk, and Blood Pressure in the index this correlation was stronger (r=+0.593) in Rheumatoid Arthritis and age (r=+0.702) in the control group. The Global Cardiovascular Risk in each group were considered low (7,8 points to Rematoid Artrhrits and 9,3 points to the control group). Conclusion: The results showed no increased risk of cardiovascular disease when compared to control group. Remember that control group fact be constituted by a larger number of diabetics, which likely impact these results.

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430 Relation of blood pressure to coronary artery calcium and mortality

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.243 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

I J Cho ◽

J H Lee ◽

S Y Choi ◽

E J Chun ◽

S H Park ◽

...

Keyword(s):

Blood Pressure ◽

Coronary Artery ◽

Diastolic Blood Pressure ◽

Coronary Artery Calcium ◽

Multicenter Observational Study ◽

J Curve ◽

Increased Risk ◽

All Cause Mortality ◽

Study Population ◽

Artery Disease

Abstract Background Diastolic blood pressure has a J-curve relation with coronary heart disease and death, but it is debating whether a J-curve association exists in general population. We aimed to assess the relation of blood pressure to mortality, and whether their association is interacted with presence of high coronary artery calcium (CAC). Methods The KOICA registry is a retrospective, multicenter observational study designed to investigate the effectiveness and prognostic value of CAC score for primary prevention of cardiovascular disease in asymptomatic Korean adults. The association between CAC score and blood pressure was assessed. Patients were divided into 2 groups according to the baseline CACS (> 300 and ≤ 300), and all-cause mortality was assessed. Results The study population composed 48903 subjects with a mean age of 54 ± 9. There were 425 (0.9%) deaths during follow-up. At baseline, SBP (systolic blood pressure) more than 110 mmHg and DBP (diastolic blood pressure) more than 80 mmHg was associated with increased risk for CACS > 300. In patients with baseline CACS ≤ 300, all-cause mortality was increased in patients with SBP of 110-119 mmHg (HR 1.47, p = 0.023), 130-139 mmHg (HR 1.72, p = 0.002) and ≥ 140 mmHg (HR 1.47, p = 0.042) compared to SBP of 120-129 mmHg, whereas DBP did not predict all-cause mortality. In contrast, SBP was not associated to all-cause mortality in patients with CACS > 300, whereas DBP < 60 mmHg (HR 3.53, p =0.018) and 70-79 mmHg (HR 2.21, p = 0.042) was associated with increased risk for all-cause mortality compared to DBP of 80-89 mmHg. Conclusion Low DBP was associated with increased risk for all-cause mortality in subjects with high CAC score, suggesting high-risk for coronary artery disease. However, this J-curve relation was not shown in the population with low CAC score.

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Risk of Obstructive Sleep Apnea and Its Association with Cardiovascular and Noncardiac Vascular Risk in Patients with Rheumatoid Arthritis: A Population-based Study

The Journal of Rheumatology ◽

10.3899/jrheum.170460 ◽

2017 ◽

Vol 45 (1) ◽

pp. 45-52 ◽

Cited By ~ 5

Author(s):

Katelynn M. Wilton ◽

Eric L. Matteson ◽

Cynthia S. Crowson

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Medical Information ◽

Statistical Significance ◽

Vascular Events ◽

Obstructive Sleep ◽

Increased Risk ◽

Large Joint

Objective.To define the incidence of obstructive sleep apnea (OSA) in patients with rheumatoid arthritis (RA) and determine whether OSA diagnosis predicts future cardiovascular disease (CVD) and noncardiac vascular events.Methods.Medical information pertaining to RA, OSA, CVD, and vascular diagnoses was extracted from a comprehensive medical record system for a geographically defined population of 813 patients previously diagnosed with RA and 813 age- and sex-matched comparator subjects.Results.The risk for OSA in persons with RA versus comparators was elevated, although not reaching statistical significance (HR 1.32, 95% CI 0.98–1.77; p = 0.07). Patients with RA were more likely to be diagnosed with OSA if they had traditional risk factors for OSA, including male sex, current smoking status, hypertension, diabetes, dyslipidemia, and increased body mass index. Features of RA disease associated with OSA included large joint swelling and joint surgery. Patients with RA with decreased renal function were also at higher risk of OSA. The increased risk of overall CVD among patients with RA who have OSA was similar to the increased CVD risk associated with OSA in the comparator cohort (interaction p = 0.86). OSA diagnosis was associated with an increased risk of both CVD (HR 1.9, 95% CI 1.08–3.27), and cerebrovascular disease (HR 2.4, 95% CI 1.14–5.26) in patients with RA.Conclusion.Patients with RA may be at increased risk of OSA secondary to both traditional and RA-related risk factors. Diagnosis with OSA predicts future CVD in RA and may provide an opportunity for CVD intervention.

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Hypertension burden and the risk of new-onset atrial fibrillation: a nationwide population-based study

EP Europace ◽

10.1093/europace/euab116.508 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

SR Lee ◽

CS Park ◽

EK Choi ◽

HJ Ahn ◽

KD Han ◽

...

Keyword(s):

Atrial Fibrillation ◽

Blood Pressure ◽

Population Based ◽

Total Study Population ◽

Funding Sources ◽

Increased Risk ◽

Burden Scale ◽

History Of ◽

Study Population ◽

Stage 1

Abstract Funding Acknowledgements Type of funding sources: None. Background The association between the cumulative hypertension burden and the development of atrial fibrillation (AF) is unclear. Purpose We aimed to investigate the relationship between hypertension burden and the development of incident AF. Methods and Results: Using the Korean National Health Insurance Service database, we identified 3,726,172 subjects who underwent four consecutive annual health checkups between 2009 and 2013, with no history of AF. During the median follow-up of 5.2 years, AF was newly diagnosed in 22,012 patients (0.59% of the total study population, 1.168 per 1,000 person-years). Using the BP values at each health checkup, we determined the burden of hypertension (systolic blood pressure [SBP] ≥130 mmHg or diastolic blood pressure [DBP] ≥80 mmHg), stratified as 0 to 4 per the hypertension criteria. The subjects were grouped according to hypertension burden scale 1 to 4: 20% (n = 742,806), 19% (n = 704,623), 19% (n = 713,258), 21% (n = 766,204), and 21% (n = 799,281). Compared to normal people, subjects with hypertension burdens of 1, 2, 3, and 4 were associated with an 8%, 18%, 26%, and 27% increased risk of incident AF, respectively. On semi-quantitative analyses with further stratification of stage 1 (SBP 130-139 mmHg or DBP 80-89 mmHg) and stage 2 (SBP ≥140 mmHg or DBP ≥90 mmHg) hypertension, the risk of AF increased with the hypertension burden by up to 71%. Conclusions Both a sustained exposure and the degree of increased blood pressure were associated with an increased risk of incident AF. Tailored blood pressure management should be emphasized to reduce the risk of AF. Abstract Figure.

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Association between high blood pressure and long term cardiovascular events in young adults: systematic review and meta-analysis

BMJ ◽

10.1136/bmj.m3222 ◽

2020 ◽

pp. m3222 ◽

Cited By ~ 2

Author(s):

Dongling Luo ◽

Yunjiu Cheng ◽

Haifeng Zhang ◽

Mingchuan Ba ◽

Pengyuan Chen ◽

...

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Young Adults ◽

Confidence Interval ◽

Cardiovascular Events ◽

Meta Analysis ◽

Risk Difference ◽

Normal Blood ◽

Normal Blood Pressure ◽

Increased Risk

AbstractObjectiveTo evaluate and quantify the future risk of cardiovascular events in young adults with high blood pressure.DesignSystematic review and meta-analysis.Data sourcesMedline, Embase, and Web of Science were searched from inception to 6 March 2020. Relative risks were pooled using a random effects model and expressed with 95% confidence intervals. Absolute risk difference was calculated. Dose-response relations between blood pressure and individual outcomes were assessed by a restricted cubic spline model.Eligibility criteria for selecting studiesStudies were selected that investigated the adverse outcomes of adults aged 18-45 with raised blood pressure. The primary study outcome was a composite of total cardiovascular events. Coronary heart disease, stroke, and all cause mortality were examined as secondary outcomes.ResultsSeventeen observational cohorts consisting of approximately 4.5 million young adults were included in the analysis. The average follow-up was 14.7 years. Young adults with normal blood pressure had increased risk of cardiovascular events compared with those with optimal blood pressure (relative risk 1.19, 95% confidence interval 1.08 to 1.31; risk difference 0.37, 95% confidence interval 0.16 to 0.61 per 1000 person years). A graded, progressive association was found between blood pressure categories and increased risk of cardiovascular events (high normal blood pressure: relative risk 1.35, 95% confidence interval 1.22 to 1.49; risk difference 0.69, 95% confidence interval 0.43 to 0.97 per 1000 person years; grade 1 hypertension: 1.92, 1.68 to 2.19; 1.81, 1.34 to 2.34; grade 2 hypertension: 3.15, 2.31 to 4.29; 4.24, 2.58 to 6.48). Similar results were observed for coronary heart disease and stroke. Generally, the population attributable fraction for cardiovascular events associated with raised blood pressure was 23.8% (95% confidence interval 17.9% to 28.8%). The number needed to treat for one year to prevent one cardiovascular event was estimated at 2672 (95% confidence interval 1639 to 6250) for participants with normal blood pressure, 1450 (1031 to 2326) for those with high normal blood pressure, 552 (427 to 746) for those with grade 1 hypertension, and 236 (154 to 388) for those with grade 2 hypertension.ConclusionsYoung adults with raised blood pressure might have a slightly increased risk of cardiovascular events in later life. Because the evidence for blood pressure lowering is limited, active interventions should be cautious and warrant further investigation.

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Methylmalonic acid, vitamin B12, renal function, and risk of all-cause mortality in the general population: results from the prospective Lifelines-MINUTHE study

BMC Medicine ◽

10.1186/s12916-020-01853-x ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Ineke J. Riphagen ◽

Isidor Minović ◽

Dion Groothof ◽

Adrian Post ◽

Manfred L. Eggersdorfer ◽

...

Keyword(s):

Renal Function ◽

Vitamin B12 ◽

Methylmalonic Acid ◽

Vitamin B12 Deficiency ◽

Endogenous Production ◽

Increased Risk ◽

B12 Deficiency ◽

Study Population ◽

Age And Sex

Abstract Background Methylmalonic acid (MMA) is best known for its use as a functional marker of vitamin B12 deficiency. However, MMA concentrations not only depend on adequate vitamin B12 status, but also relate to renal function and endogenous production of propionic acid. Hence, we aimed to investigate to what extent variation in MMA levels is explained by vitamin B12 and eGFR and whether MMA levels are associated with mortality if vitamin B12 and eGFR are taken into account. Methods A total of 1533 individuals (aged 60–75 years, 50% male) were included from the Lifelines Cohort and Biobank Study. Individuals were included between 2006 and 2013, and the total follow-up time was 8.5 years. Results Median [IQR] age of the study population was 65 [62–69] years, 50% was male. At baseline, median MMA concentration was 170 [138–216] nmol/L, vitamin B12 290 [224–362] pmol/L, and eGFR 84 [74–91] mL/min/1.73 m2. Log2 vitamin B12, log2 eGFR, age, and sex were significantly associated with log2 MMA in multivariable linear regression analyses (model R2 = 0.22). After a total follow-up time of 8.5 years, 72 individuals had died. Log2 MMA levels were significantly associated with mortality (hazard ratio [HR] 1.67 [95% CI 1.25–2.22], P < 0.001). Moreover, we found a significant interaction between MMA and eGFR with respect to mortality (Pinteraction < 0.001). Conclusions Only 22% of variation in MMA levels was explained by vitamin B12, eGFR, age, and sex, indicating that a large part of variation in MMA levels is attributable to other factors (e.g., catabolism, dietary components, or gut microbial production). Higher MMA levels are associated with an increased risk for mortality, independent of vitamin B12, eGFR, and sex. This association was more pronounced in individuals with impaired renal function.

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Abstract 466: Obstructive Sleep Apnea And Its Association With Endothelial Function, Oxidative Stress, Inflammation, Metabolic Profile, Blood Pressure And Sympathetic Activity In Obese Individuals

Hypertension ◽

10.1161/hyp.64.suppl_1.466 ◽

2014 ◽

Vol 64 (suppl_1) ◽

Author(s):

Luciene S Araújo ◽

Julia F Fernandes ◽

Debora C Valença ◽

Maria de Lourdes G Rodrigues ◽

Nathalia F Gomes ◽

...

Keyword(s):

Oxidative Stress ◽

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Endothelial Function ◽

Metabolic Profile ◽

Neck Circumference ◽

Obstructive Sleep ◽

Increased Risk ◽

Hs Crp

Background: Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease (CVD). Several of the proposed mechanisms for the development of CVD in OSA are similar to those proposed for the increased risk of CVD in obesity, being difficult to determine the influence of OSA on these pathogenic mechanisms in obese individuals. Objectives: The purpose of this study was to evaluate the relationship of OSA with endothelial function, oxidative stress, inflammatory biomarkers, metabolic profile, sympathetic nervous system activity and blood pressure (BP) in obese individuals. Methods: In this cross-sectional study, were included 53 obese adults (28 women). Sleep study was performed with Watch-PAT200® and the diagnosis of OSA was made when apnea-hipopnea index (AHI) ≥5 events/h (n=33). All participants underwent evaluation of: body adiposity, BP, plasma catecholamines, high sensitivity C-reactive protein (hs-CRP), adiponectin, malondialdehyde, glucose, insulin, lipid profile and endothelial function (Endo-PAT 2000®). Results: Mean age (39.6 ± 1.5 vs. 32.5 ± 2.1y) and percentage of male participants (61% vs. 25%) were significantly higher in participants with OSA than in those without OSA (p=0.01). In univariate analysis participants with OSA compared with those without OSA exhibited higher values of neck circumference (40.98 ± 0.63 vs. 38.65 ± 0.75 cm, p=0.02), glucose (92.54 ± 1.97 vs. 80.2 ± 1.92 mg/dL, p=0.0001), noradrenaline (0.16±0.02 vs. 0.12±0.03 ng/mL, p=0.02) and systolic BP (126.05 ± 1.61 vs. 118.16 ± 1.86 mmHg, p=0.003). After adjustment for confounders, only glucose and hs-CRP were significantly higher in OSA patients. In correlation analysis, after controlling for confounders, AHI was associated with neck circumference (r=0.31,p=0.03) and hs-CRP (r=0.30,p=0.04), while minimum O2 saturation was associated with neck circumference (r=-0.31,p=0.03), insulin (r=-0.29,p=0.04) and HOMA-IR (r=-0.30,p=0.04). Conclusion: The present study suggests that in obese individuals OSA is associated with inflammation and worse glycemia; higher AHI correlates with increased central adiposity and inflammation; and lower oxygen saturation is related with insulin resistance.

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Abstract 120: Prevalence and Impact of Patent Foramen Ovale in Patients with Obstructive Sleep Apnea

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.36.suppl_1.120 ◽

2016 ◽

Vol 36 (suppl_1) ◽

Author(s):

Phillip Camp ◽

Abinash Achrekar ◽

Umar Malik ◽

Warren Laskey

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Patent Foramen Ovale ◽

Right Atrial ◽

Apnea Hypopnea Index ◽

Foramen Ovale ◽

Contrast Injection ◽

Obstructive Sleep ◽

Increased Risk ◽

Study Population

Introduction: It is well known that obstructive sleep apnea (OSA) prevalence increases as body mass index (BMI) increases. Lesser known is patent foramen ovale (PFO) is found in 12 to 35 percent of adults. Patients with OSA experience nocturnal apnea which result in hypoxemia, elevation of right atrial pressure, and an increase in right to left shunting and a theoretical increased risk of stroke. A few studies have suggested an association between the severity of OSA and a PFO. As such, OSA diagnosis and therapy may be tailored to address right-to-left shunting in these patients. If the prevalence of PFO in OSA patients is increased, it may be appropriate to include transthoracic echocardiography (TTE) testing as a component of routine evaluation of patients with OSA. Hypothesis: We hypothesize that patients with hypoxemia related to OSA are more likely to have a PFO with right-to-left shunting than those with less dramatic hypoxemia. We hope to determine the prevalence and clinical relevance of intra-cardiac shunting in patients with OSA by prospectively analyzing and correlating polysomnography and TTE findings. Methods: 80 patients with OSA were referred for TTE by the UNM Sleep Center. All patients underwent saline contrast TTE in the UNM echo lab. The prevalence of PFO in the general UNM echo population was calculated over the last year for comparison. Results: Of 80 patients with varying degrees of OSA, 12.5% had right to left shunting. PFO was not statistically associated with DI (Desaturation Index), nor any AHI (Apnea Hypopnea Index). The only statistically significant association was between OSA and BMI (p=0.013). BMI associated with DI and AHI was statistically significant (p=0.003 and p=0.005, respectively). Over the last year, 216 PFO’s were found from 1858 echo studies with contrast injection performed at UNM with a prevalence rate of 11.6%. Conclusions: In contrast to previous studies, there was no association between OSA of any severity and PFO in our study population. There was a statistically significant association between BMI and OSA, which is well established. Our study prevalence was found to be similar to the UNM general echo population as well, indicating that OSA patients within our study group were not as likely to have an associated PFO.

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Exposure to passive smoking and rheumatoid arthritis risk: results from the Swedish EIRA study

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2018-212973 ◽

2018 ◽

Vol 77 (7) ◽

pp. 970-972 ◽

Cited By ~ 12

Author(s):

Anna Karin Hedström ◽

Lars Klareskog ◽

Lars Alfredsson

Keyword(s):

Rheumatoid Arthritis ◽

Passive Smoking ◽

Population Based ◽

Rheumatoid Arthritis Risk ◽

Increased Risk ◽

Study Population ◽

Never Smokers ◽

Incident Cases ◽

Citrullinated Peptide ◽

Control Study

IntroductionSmoking has consistently been associated with increased risk of developing rheumatoid arthritis (RA). The aim of this study was to estimate the influence of passive smoking on the risk of developing anti-cyclic citrullinated peptide antibodies (ACPA)-positive and ACPA-negative RA.MethodsA population-based case–control study using incident cases of RA was performed in Sweden, and the study population in this report was restricted to include never-smokers (589 cases, 1764 controls). The incidence of RA among never-smokers who had been exposed to passive smoking was compared with that of never-smokers who had never been exposed, by calculating the OR with a 95% CI employing logistic regression.ResultsNo association was observed between exposure to passive smoking and RA risk (OR 1.0, 95% CI 0.8 to 1.2 for ACPA-positive RA, and OR 0.9, 95% CI 0.7 to 1.2, for ACPA-negative RA). No suggestion of a trend between duration of passive smoking and RA risk was observed.DiscussionsNo association was observed between exposure to passive smoking and RA risk, which may be explained by a threshold below which no association between smoke exposure and RA occurs.

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SAT0064 VACCINATION RATE AND RISK FACTORS FOR NON-VACCINATION IN RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL PROSPECTIVE MULTICENTRIC OBSERVATIONAL STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2723 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 965.2-965

Author(s):

C. Rempenault ◽

T. Barnetche ◽

M. Magnol ◽

B. Castagne ◽

M. Pugibet ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Observational Study ◽

Vaccination Rate ◽

University Hospitals ◽

Research Support ◽

Cross Sectional ◽

Vaccination Rates ◽

Increased Risk ◽

Chi Squared ◽

Patient’S Information

Background:Rheumatoid arthritis (RA) patients are at increased risk of infections, some of which could be prevented in part by vaccination (1). Influenza and pneumococcal vaccines are recommended in RA (2). However, vaccination coverage of these patients remains very low. Five years ago, we found in a previous study that vaccination rates in France were 55% for pneumococcal and 60% for influenza vaccines (3).Objectives:The aim of our study was to evaluate the vaccination rate among RA patients, compare it with our previous results, and identify factors associated with non-vaccination.Methods:We conducted a cross sectional multicentric observational study in the rheumatology departments of 5 university hospitals in France. Data were collected from December 2018 to July 2019. Outpatients and hospitalized adult patients with RA according to the ACR/EULAR 2010 criteria were included. Data were collected during a single visit through an anonymous questionnaire completed by the patients. Pearson Chi-squared analysis and multivariable logistic regression were used to compare characteristics of vaccinated versus non vaccinated patients.Results:584 patients (77.9% of women, mean age 61.8±12.6 years old) were included. 81.7% were RF and/or ACPA positive, with a mean RA duration of 15.7±10.5 years, 58.2% were treated with methotrexate (MTX), and 68.6% with a biologic. Vaccination rate against pneumococcal was 78.9% (versus 55% in 2013, p<0.0001) and 60.4% for influenza (versus 60% in 2013). The main reason for non-vaccination was absence of vaccine proposal (59.2%) for pneumococcal, and fear of vaccines (56.7%) for influenza. In the multivariate analysis, a higher level of education (OR [CI95] 4.4 [2.3-8.4], p<0.0001), a very good opinion on vaccination (2.1 [1.1-4.1], p=0.003), vaccination against influenza done (2.3 {1.3-4.2], p=0.006), and exposure to biologics (4.0 [2.2-7.4], p<0.0001) were associated with vaccination against pneumococcal. Age over 65 years old (2.0 [1.2-3.2], p=0.006), participation in a patients’ association (3.6 [1.4-8.9], p=0.006), vaccination against pneumococcal done (2.4 [1.3-4.5], p=0.004), exposure to biologics (2.1 [1.2-3.7], p=0.006), a good (3.3 [1.4-8.9], p=0.03) and a very good opinion on vaccination (6.6 [2.8-15.6], p<0.0001) were associated with vaccination against influenza.Conclusion:Vaccination rate against pneumococcal increased over the last 5 years but remained stable for influenza vaccine in French RA patients. This could be improved with patient’s information and education, especially in patients age under 65, biologic naïve and with a bad opinion about vaccination.References:[1] Doran MF, Crowson CS et al. Arthritis Rheum. 2002 Sep;46(9):2287–93.[2]van Assen S, Agmon-Levin N et al. Ann Rheum Dis. 2011 Mar;70(3):414–22.[3] Hua C, Morel J et al. Rheumatol Oxf Engl. 2015 Apr;54(4):748–50.Disclosure of Interests:Claire Rempenault: None declared, Thomas Barnetche: None declared, Marion Magnol: None declared, Benjamin Castagne: None declared, marine pugibet: None declared, Eleonore Berard: None declared, Marie-Elise Truchetet: None declared, Pascale Vergne-Salle: None declared, Anne Tournadre: None declared, Adeline Ruyssen-Witrand Grant/research support from: Abbvie, Pfizer, Consultant of: Abbvie, BMS, Lilly, Mylan, Novartis, Pfizer, Sandoz, Sanofi-Genzyme, Cédric Lukas: None declared

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