THU0264 In Early Rheumatoid Arthritis (Espoir Cohort), Serum CCL19 Level is Associated with Disease Activity, Autoantibody Secretion and 3-Year Radiographic Progression: Data from the Espoir Cohort
Authors: J.E. Gottenberg, R. Seror, A. Baillet, N. Rincheval, G. Alsaleh, A. Pichot, T. Schaeverbeke, A. Cantagrel, B. Combe, X. Mariette
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> The interferon (IFN) signature has mainly been studied in established rheumatoid arthritis (RA), and was associated with poor response to rituximab. Serum levels of CCL2 (Monocyte Chemotactic Protein 1, MCP-1), CXCL10 (Interferon gamma –inducible 10 kDa Protein, IP-10) and CCL19 (Macrophage Inflammatory Protein 3 beta, MIP-3beta) are associated with an interferon (IFN) gene signature and disease activity in systemic lupus. <h3>Objectives</h3> The objectives of the study were to assess the association between the IFN serum signature, disease activity, autoantibody secretion, radiographic progression and rapid initiation of a biologic DMARD in early RA. <h3>Methods</h3> Serum levels of CCL2, CXCL10, and CCL19 were assessed in the ESPOIR cohort composed of 813 patients with early arthritis (more than 6 weeks and less than 6 months) not treated with steroid or DMARD. RA was defined according to ACR/EULAR 2010 criteria. An elevated level of each chemokine was defined as a value greater than the mean + 2DS value of the control population (88 sex and age-matched subjects). Patients with at least 2 out of 3 IFN-regulated chemokines were defined to have an IFN-high score. <h3>Results</h3> Among the 813 patients included in the ESPOIR cohort, 641 patients had RA according to ACR/EULAR 2010 criteria. Elevated levels of CCL2, CXCL10, CCL19 were observed in 1.9% of early RA patients vs 0.6% of patients with other early arthritides (<i>P</i>=0.5), 49.4 vs 38.2% (P=0.01) and 23.3 vs 7.1% (P&lt;0.0001), respectively. An IFN-high score was observed in 15.1% of RA patients vs 2.9% of patients with other early arthritides (P&lt;0.0001). Among the 641 patients with RA according to ACR/EULAR 2010 criteria, CXCL10 and CCL19 were significantly correlated with DAS28 at enrollment (r=0.22 and r=0.16, respectively,<i>P</i>&lt;0.0001 for both) whereas CCL2 was not. Patients with RF or anti-CCP autoantibodies only had elevated levels of CCL19 (315.5[142.6-631.6] vs 214.4 [101.2-443.0] pg/ml, <i>P</i>&lt;0.0001 and 332.6 [161.1-645.8] vs 214.5 [96.4-447.6] pg/ml, <i>P</i>&lt;0.0001) whereas they had similar CCL2 and CXCL10 levels. RF and anti-CCP positivity were not associated with IFN-high score. Radiographic progression at 3 years (increase of total Sharp score greater than 5) was only associated with increased levels of CCL19 (<i>P</i>=0.05) but not with CCL2 or CXCL10, or with IFN-high score. Initiation of a biologic DMARD within the first year after enrollment was only significantly associated with increased levels of CCL19 (391.8 [197.3-548.6] vs 263.1[166.4-533.8] pg/ml, <i>P</i>=0.03<i>).</i> <h3>Conclusions</h3> In early RA, serum CCL19 level is associated with disease activity, autoantibody secretion and 3-year radiographic progression. Patients with a high-IFN serum signature represent 15% of patients with early RA, with a rather good prognosis since high-IFN serum signature was not associated with autoantibody secretion, radiographic progression, or rapid initiation of a biologic DMARD treatment of RA. <h3>Disclosure of Interest</h3> : None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.4239