SAT0181 Effect of anti-il-6 therapy on serum levels of metabolic syndrome-related biomarkers in rheumatoid arthritis patients
Authors: F. Genre, S. Remuzgo-Martínez, R. López-Mejías, V. Mijares, J. Calvo-Alen, R. Blanco, J. Llorca, S. Castañeda, Á. M. González-Gay
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Metabolic syndrome (MeS) is a pathologic state that encompasses metabolic anomalies such as hyperglycemia, dyslipidemia, obesity and hypertension and that, apart from being a cardiovascular risk factor, it has been associated with chronic inflammatory diseases such as rheumatoid arthritis (RA)<sup>1,2</sup>. Ghrelin and retinol binding protein-4 (RBP-4) are two biomarkers associated with MeS, and are also linked to different cardiometabolic risk factors. In this regard, it is known that ghrelin exerts an anti-inflammatory role, while RBP-4 has a pro-inflammatory role<sup>2</sup>. <h3>Objectives:</h3> Since a beneficial effect on endothelial function has been reported for anti-IL-6 therapy<sup>3</sup>, we aimed to evaluate the effect of a single infusion of anti-IL-6 on the serum levels of ghrelin and RBP-4 in patients with RA. <h3>Methods:</h3> Ghrelin and RBP-4 levels were measured in serum samples from 50 Spanish individuals with RA that fulfilled the 2010 classification criteria<sup>4</sup>, and that were under treatment with the anti-IL-6 monoclonal antibody Tocilizumab. Patients with diabetes mellitus or plasma glucose levels &gt;110 mg/dL were excluded. Blood samples were taken in the fasting state, immediately before (time 0) and after (time 60 minutes) Tocilizumab infusion. <h3>Results:</h3> A significant increase in serum levels of ghrelin was observed after a single infusion of Tocilizumab (mean±standard deviation: 72.99±58.43 pg/mL versus 134.02±225.93 pg/mL, before and after Tocilizumab infusion, p=0.04). Serum levels of RBP-4 were not affected by the administration of Tocilizumab (mean±standard deviation: 23.48±13.99 μg/mL versus 20.90±15.54 μg/mL, before and after Tocilizumab infusion, p=0.42). <h3>Conclusions:</h3> Our results show that ghrelin levels increase after a single infusion of Tocilizumab, supporting the hypothesis that IL-6 blockade has a rapid beneficial effect on factors associated with MeS and cardiovascular risk in RA patients. Hence, long-term treatment with anti-IL-6 may reduce the risk of developing cardiovascular disease in RA. <h3>References</h3> [1] Best Pract Res Clin Rheumatol2016;30(5):851–869. [2] Biomed Res Int2014;2014:860651. [3] Atherosclerosis2011;219:734–36. [4] Arthritis Rheum2010;62:2569–81. <h3>Acknowledgements:</h3> FG is a recipient of a Sara Borrell post-doctoral fellowship from the Instituto de Salud Carlos III (ISCIII)(Spain), co-funded by European Social Fund (ESF,"Investing in your future") (CD15/00095). SR-M is supported by funds of the RETICS Program (RIER) RD16/0012/0009 (ISCIII, co-funded by the European Regional Development Fund, ERDF). RL-M is a recipient of a Miguel Servet type I programme fellowship from the ISCIII, co-funded by ESF (CP16/00033). VM is supported by funds of a Miguel Servet type I programme (CP16/00033)(ISCIII, co-funded by ERDF). <h3>Disclosure of Interest:</h3> None declared