THU0132 EVALUATION OF CARDIOVASCULAR RISK FACTORS IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH BIOLOGICAL AGENTS: 3-MONTH FOLLOW-UP
Authors: Giorgos Papamichail, Theodora Markatseli, Athanasios Georgiadis, Vasileios Xydis, Haralampos Milionis, Alexandros Drosos, Paraskevi Voulgari
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Systemic inflammation is an additional and independent predictor of cardiovascular disease (CVD) in rheumatoid arthritis (RA). It is worth mentioning that lipid levels, blood pressure and other major risk factors of CVD constitute a wide field of investigation in case of treatment with biological disease-modifying anti-rheumatic drugs (DMARDs). <h3>Objectives:</h3> The aim of this study is to assess the impact of biological agents on markers of CVD risk in patients with RA. <h3>Methods:</h3> This is a prospective, observational study which included biologic-naϊve RA patients treated with synthetic DMARDs, who had a negative history of CVD. Thirty-one patients and 31 healthy matched-controls (for gender, age and smoking) were compared for total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), triglycerides (TGs), Apolipoprotein A1 (ApoA1), Apolipoprotein B (ApoB) and Lipoprotein A (LpA). Additionally, an ultrasonographic measurement of intima-media thickness (IMT) of carotids was performed by an experienced sonographer to all patients in order to detect the presence of atherosclerosis at baseline. Furthermore, in a subgroup of 19 of these 31 RA patients, the parameters we previously reported (except for IMT) were compared between baseline and a 3-month follow up. We also compared disease activity indexes [disease activity score (DAS28), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)] at these predefined time-points. <h3>Results:</h3> As regards the demographic characteristics of 31 RA patients, the mean (SD) age was 54.7 (14.05) years, disease duration was 4.5 (1.3) years, there were 11 (35.5%) men and 20 (64.5%) women and 6 (31.6%) smokers. As far as the immunological profile of patients is considered, 17 (54.8%) were RF(+) and 8 (25.8%) ACPA(+). The comparison of the parameters between RA patients and matched-controls revealed an increased IMT in RA patients [0.9 (0.17) vs 0.6 (0.13) mm; p&lt;0.001], while the other parameters involving the lipid profile did not differ among the two groups. In the subgroup of 19 patients, there was a significant increase in mean(SD) HDL-C and ApoA1 levels from baseline to 3-month follow-up [55.3(15.44) vs 61.68(15.3) and 163.16(28.89) vs 173.11(29.65) respectively; p&lt;0.05)]. There was also a reduction in mean systolic blood pressure [137.89(14.36) vs 130.53(12.68); p&lt;0.05)], diastolic blood pressure [81.63(6.8) vs 77.63(6.09); p&lt;0.05)], ESR [25.53(18,57) vs 19.84(16.44); p&lt;0.05)] and DAS28 score [3.41(1.14) vs 2.62(1.12); p&lt;0.05)]. No statistically significant difference was found for the rest of parameters of lipids or inflammation markers. <h3>Conclusion:</h3> IMT measurement confirmed that patients with RA are at a higher risk of developing early atherosclerosis. The results of this study demonstrate an improvement of cardiovascular risk in RA patients treated with biological DMARDs via an increase in HDL-c and ApoA1 levels and a reduction of ESR and blood pressure measurements even from the first 3 months of treatment initiation. Long term studies are needed to determine the impact of biological agents on cardiovascular risk in RA. <h3>Acknowledgement:</h3> N/A Disclosure of Interests: None declared