AB0236 WHAT FACTORS ARE ASSOCIATED WITH THE EVOLUTION TOWARDS RHEUMATOID ARTHRITIS, USE OF BIOLOGICAL THERAPY AND DEVELOPMENT OF CARDIOVASCULAR EVENTS IN A COHORT OF PATIENTS WITH UNDIFFERENTIATED ARTHRITIS?
Authors: Jerusalem Calvo Gutierrez, Rafaela Ortega Castro, Clementina López-Medina, Ladehesa Pineda Lourdes, María del Carmen Castro Villegas, Alejandro Escudero Contreras, Eduardo Collantes Estevez
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Objectives</h3> To describe the clinical-demographic characteristics and behaviour over time (12, 24 and 60 months) of a cohort of Undifferentiated Arthritis (UA), as well as to analyze which factors are associated with the evolution towards Rheumatoid Arthritis (RA), use of Biological Therapy (BT) and the development of Cardiovascular Disease (CVD). <h3>Methods</h3> Ambispective cohort study of patients with UA evaluated longitudinally from January 2009 to 2019. We analyzed baseline clinical and laboratory variables and a Multivariate Logistic Regression was performed to determine the factors associated with RA development after 5 years of follow-up. To analyze what factors were associated with the use of BT and the presence of CVD chi-square or Fisher's test were used for binary variables, and U-Mann Whitney for continuous variables. <h3>Results</h3> 180 patients were included, 55% were women, with an average age of 49.3 (SD 16.1) years. The average duration of symptoms before the first visit was 6.9 (SD 9.9) months. 47.2% were FR+, 41% ACPA+, 20.6% HLA-DRB1 shared epitope. At the end of follow-up: 33.3% evolved to RA, 17.2% remained as palindromic rheumatism, 25% were diagnosed other chronic rheumatic diseases, 21.1% remitted spontaneously and 3.3% remained as UA. Of the 60 AR, 37 were diagnosed in the first year, 13 at second and 10 at 5 years of follow-up. During follow-up, 13 patients with RA started BT, and 12 patients presented CVD (7 of them died). Table 1 identifies the factors associated with the development of RA. The MLR identified <b>ACPA +, OR (95% CI) = 10.69 (4.43 - 25.78), and the HLA-DRB1 shared epitope OR (95% CI) = 9.18 (2.96 - 28.48) p &lt;0.001</b> as factors associated to the development of AR. We failed to identify factors associated with the use of BT, possibly due to the sample size. The factors associated with the development of CVD, where only the use of glucocorticoids as a factor associated with the presence of CVD shows statistical significance. <h3>Conclusion</h3> 1) Useful clinical and laboratory characteristics have been identified to predict which patients are at risk of developing persistent arthritis. 2) HLADRB1 shared Epitope and ACPA are predictive factors of evolution to RA. 3) Possibly the continued use of glucocorticoids, even at low doses, may be related to the development of long-term CVD <h3>Disclosure of Interests</h3> Jerusalem Calvo Gutierrez: None declared, Rafaela Ortega Castro: None declared, Clementina López-Medina: None declared, Ladehesa Pineda Lourdes: None declared, María del Carmen Castro Villegas Paid instructor for: MSD, Abbvie, Pfizer, Janssen, Lilly, Roche, Alejandro Escudero Contreras: None declared, Eduardo Collantes Estevez: None declared