AB0352 Osteoprotegerin, Disease Severity and Established Cardiovascular Disease in Rheumatoid Arthritis: A CASE Control Study
Authors: R. Lopez-Mejias, B. Ubilla, A. Corrales, J.L. Hernandez, F. Genre, I. Ferraz-Amaro, L. Tsang, J. Llorca, R. Blanco, C. Gonzalez-Juanatey, M.A. Gonzalez-Gay, P.H. Dessein
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Osteoprotegerin (OPG) may participate in the pathophysiology of rheumatoid arthritis (RA) (1). Recently reported evidence further supports a potential involvement of OPG in endothelial activation and subclinical atherosclerosis in RA (2). <h3>Objectives</h3> We determined whether osteoprotegerin (OPG) concentrations are independently related to established cardiovascular disease (CVD) amongst patients with rheumatoid arthritis. <h3>Methods</h3> OPG concentrations were measured by an enzyme-linked immunosorbant assay in 151 (54 with CVD) RA patients and 62 age and sex matched control subjects without CVD. Concentrations of the endothelial activation marker angiopoietin 2 were also evaluated in a subgroup of 85 RA participants. Relationships were assessed in mixed regression models. <h3>Results</h3> In RA patients, age, rheumatoid factor and anti-cyclic citrullinated peptide antibody positivity, joint erosion status and body mass index were associated with OPG concentrations (partial R (<i>P</i>)=0.175 (0.03), 0.323 (&lt;0.0001), 0.217 (0.008), 0.159 (0.05) and -0.277 (0.0009)), respectively. Median (interquartile range) OPG concentrations increased from 6.38 (3.46-9.31) to 7.07 (5.04-10.65) and 8.64 (6.00-11.52) in controls and RA patients without and with CVD, respectively (<i>P</i>=0.0002). In potential confounding or/and mediating characteristic adjusted analysis, OPG concentrations remained lower in controls compared to RA patients without CVD (<i>P</i>=0.04) and in the latter compared to those with CVD (P=0.03). OPG concentrations related independently to those of angiopoietin 2 in RA patients with but not without CVD (partial R (<i>P</i>)=0.537 (0.001) and 0.060 (0.7)). <h3>Conclusions</h3> OPG concentrations are associated with disease severity and CVD prevalence in RA patients. OPG may contribute to the link between RA severity and enhanced cardiovascular risk. <h3>References</h3> Ziolkowska M et al. High levels of osteoprotegerin and soluble receptor activator of nuclear factor κB ligand and their normalization alter anti-tumor necrosis factor α treatment. Arthritis Rheum 2001;46:1744-53. Dessein PH et al. Independent relationship of osteoprotegerin concentrations with endothelial activation and carotid atherosclerosis in patients with severe rheumatoid arthritis. J Rheumatol 2014 (in press). <h3>Acknowledgements</h3> This study was supported by grants from "Fondo de Investigaciones Sanitarias" PI06/0024, PS09/00748 and PI12/00060 (Spain). This work was also partially supported by RETICS Program, RD08/0075 and RD12/0009/0013 (RIER) from "Instituto de Salud Carlos III" (ISCIII) (Spain). Research performed by Patrick Dessein was supported by the South African Medical Research Council (grant number MRC2008_DES) and the National Research Foundation. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2516