AB0354 Factors of the positive or negative answer on therapy with denosumab in women with rheumatoid arthritis and osteoporosis

Objectives To define a contribution of factors: anamnesis, clinical/laboratory markers, glucocorticoids (GC) intake, etc. on the response to therapy with denosumab in women with rheumatoid arthritis (RA) and osteoporosis (OP). Methods 66 postmenopausal women (mean age 59,6±7,4) with RA (mean duration 17,7±10,4 years) and OP received s/c denosumab 60 mg every 6 months pro 1 year. RF- positive were 72%, ACCP – 74% of patients. 34 (49%) continued GC. At baseline and after 12 months it was carried out the dual energy x-ray absorptiometry at 3 sites: lumbar spine (L1-L4), hip neck (HN) and distal forearm (DF) and x-ray of of hands and feet (Sharp/van der Heijde (SVH) score). After therapy it was noted the increase of BMD in L1-L4 and HN, a tendency to increase (p=0,0529) in DF. Positive dynamics (increase or stabilisation of BMD) was noted in 89% patients at L1-L4, 67% – at HN and 60% – at DF. The erosion score was increased in 12% (n=8) patients, the joint space narrowing score (JSN) – in 9% (n=6) (p=0.0117 and p=0.027, respectively). The Statistica 6.0 was used. Results Results of analysis of influence of statistically significant factors on the response to therapy in BMD showed that the negative response in L1–L4 is associated with GC intake (>3 months in anamnesis) (p=0,034) and the beginning of GC intake after menopause onset (p=0,023). In HN positive response is associated with higher concentration of the RF (initially and in dynamics) (p<0,05) and the beginning of menopause later than RA onset (p=0,024), the negative response – with GC intake (>3 months in anamnesis) (p=0,024). In DF positive response on therapy is associated with RF-positivity (p=0,02), the negative response back correlates with increase in erosion score and total SVH score: r=–0360 (p<0,05). In table 1 it is shown the most significant factors, which influence on SVH score dynamics (increase) after 12 months of denosumab therapy.Abstract AB0354 – Table 1 The factors which influence on SVH score increase (n=66), p<0.05. SVH score The score increase is associated with Erosion score - lower BMD in L1-L4 (at baseline and after treatment) - higher cumulative GC dose - back correlates with BMD increase in DF - back correlates with bone alkaline phosphatase (BAP) base level - correlates with increase in JSN Joint space narrowing score (JSN) - presence at patients in anamnesis a surgical menopause - lower value of BMD dynamics (%) in DF - correlates with increase in erosion score and total SVH score. Conclusions There was established that positive response on therapy with denosumab in BMD in NH and DF is associated with RF-positivity. The particular contribution to the negative response in L1-L4 and HN is associated with GC intake (previous intake more than 3 months in the anamnesis), purpose of the GC after menopause onset. There was note that the increase of erosion score is associated with either lower BMD in L1-L4 (at baseline and after treatment) or back correlation with BMD increase in DF. Also the higher cumulative GC dose and back correlation with BAP base level were observed at patients with increased erosion score. The only factors that we could reveal in patients with increased JSN score were surgical menopause in anamnesis and lower value of BMD dynamics (%) in DF after treatment. In general it was a direct correlation between erosion score and JSN score. Disclosure of Interest None declared