AB0822 VITAMIN D (25OHD) IN PATIENTS WITH CHRONIC RHEUMATIC DISEASESRECEIVING TREATMENT WITH ADALIMUMAB. DESCRIPTIVE STUDY OF A COHORT
Authors: Boris Anthony Blanco Cáceres, Paula García Escudero, Javier Arostegui Lavilla, Mayra Nathali Rivas Zavaleta, Marta González Fernández
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Patients with chronic rheumatic diseases (CRD) have lower levels of 25OHD, inverse correlation has been describe and greater severity between the different CRD with 25OHD deficit. Most scientific societies recommend levels&gt; 30 ng/mL. Patients with refractary disease to conventional therapy have a higher inflammatory load, require optimal levels of 25OHD and often needs biological disease-modifying antirheumatic drugs (bDMARD) in order to prevent structural damage. <h3>Objectives</h3> The aim of this study was to describe the epidemiological, clinical and therapeutic characteristics of patients receiving Adalimumab (ADL) in which 25OHD levels were determined in 2018. <h3>Methods</h3> Transversal, retrospective study in a hospital setting. We analyzed data from patients included in a study to determine levels of ADL, in whom the serum level of 25OHD was determined at least once during the last year. Among 104 patients, 74 with 25OHD determination were included. <h3>Results</h3> Seventy-four patients selected, 45.9% were men and 54.1% women. The mean age was 54.9 years (SD ± 13.6). 41.9% (31) had Rheumatoid Arthritis, 36.5% (27) Spondyloartrhitis, 17.6% (13) Psoriatic Arthritis and 4.1% (3) Juvenile Idiopathic Arthritis. 35.1% (26) had deficit (&lt;20 ng/mL) of 25OHD, 31.1% (23) insufficiency (20-30 ng/mL) and only 33.8% (25) optimal levels (&gt;30 ng/mL). The 62.2% (46) of the patients received oral supplementation, of these 67.4% maintained levels &gt;20 ng/mL and 32.6% &lt;20 ng/mL. 37.8% (28) did not receive supplementation, despite this 60.7% within this group had levels &gt;20 ng/mL. No statistical differences were found regarding vitamin D deficit and oral supplementation (p&gt; 0.05). 13.5% (10) of the patients also had Osteoporosis (OP); in this group 6 had deficit of 25OHD, 1 insufficiency and only 3 optimal levels, all of them received 25OHD supplementation. No differences between the groups in relation to the DMARD treatment. <h3>Conclusion</h3> Vitamin D levels were determined in 71.2% of patients and not in all of them as it would be advisable. Among the patients with 25OHD determination, 62.2% received oral supplementation, however only 33.8% of the patients reached optimal levels (&gt; 30 ng/mL) without statistical differences regarding supplementation. 13.5% of the patients who received supplementation also had OP. Despite the weakness of the study in terms of design and sample, most patients did not reached optimal levels of 25OHD; we can assume that it is necessary to obtain levels of 25OHD &gt;30 ng/mL in all patients, with adequate supplementation if necessary due to the positive effects known in CRD. <h3>References</h3> [1] Fernandes S1, Etcheto A2, van der Heijde D3, Landewé R4, van den Bosch F5, Dougados M2, Moltó A2. Vitamin D status in spondyloarthritis: results of the ASAS-COMOSPA international study. Clin Exp Rheumatol. 2018Mar-Apr;36(2):210-214 [2] Lin J1, Liu J1, Davies ML2, Chen W1. Serum Vitamin D Level and Rheumatoid Arthritis Disease Activity: Review and Meta-Analysis. PLoS One. 2016Jan11;11(1):e0146351 [3] Dawson-Hughes B1, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GE, Josse RG, Lips P, Morales-Torres J, Yoshimura N. IOF position statement: vitamin D recommendations for older adults. Osteoporos Int. 2010Jul;21(7):1151-4. [4] Bischoff-Ferrari HA1, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006Jul;84(1):18-28. <h3>Disclosure of Interests</h3> None declared