AB0339 HYPERURICEMIA AMONG A MOROCCAN POPULATION WITH RHEUMATOID ARTHRITIS
Authors: Lehraiki Meriem, Ouafae Hammou, Azzouzi Hamida, Ichchou Linda
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Rheumatoid arthritis (RA) is a known cause of cardiovascular disease (CVD). Several studies suggest that serum uric acid (SUA) is significantly associated with CVD in RA. However, the association between SUA and inflammation remains controversial. <h3>Objectives</h3> The aim of the present study is to determine the prevalence of hyperuricemia in RA patients, to assess its association with inflammation and to evaluate whether disease modifying anti rheumatic drugs (DMARDs) have a hypouricemiant effect. <h3>Methods</h3> We have conducted a cross-sectional study over four months in our department of rheumatology. A total of 204 RA patients receiving DMARDs in their treatment were enrolled. All patients fulfilled the RA ACR-EULAR criteria. SUA and inflammatory markers were studied. Hyperuricemia was defined as SUA&gt;70mg/L for males and &gt;60mg/L for females. Data analysis was carried out using the SPSS 20 Software. Univariate and multivariate regressions were performed to identify the impact of hyperuricemia in RA patients. <h3>Results</h3> The mean age was 51.76±12.84 and the mean age at RA diagnosis was 42.5 ± 15.23. Fourteen patients (6.9%) had hyperuricemia and the average rate of SUA was 41.99 ± 11.85 mg/L. All patients were taking Methotrexate, 34% received also Sulfasalazine, 6.4% Hydroxychloroquine and 77% steroids. Males and post-menopausal women had significantly higher SAU levels (p&lt;0.001 and p&lt;0.0001, respectively). Univariate analysis showed a positive relationship between SUA levels and age (p=0.004), gender (p=0.002), age at RA diagnosis (p=0.03), smoking (p=0.046), use of alcohol (p=0.025), high body mass index (BMI) (p=0.012), elevated blood pressure (p&lt;0.0001), dyslipidaemia (p&lt;0.001) and high doses of steroids (p=0.001). The association between RA and gout was noted in one case. We found no correlation between inflammation, DMARDs, CVD and SUA. In multivariate regression In multivariate analysis adjusted for age, gender, BMI and steroids maintained a significant correlation with SAU. <h3>Conclusion</h3> The prevalence of hyperuricemia is low in our RA patients and similarly gout remains infrequent. However, RA patients must be screened for hyperuricemia. There is growing evidence that higher doses of steroids can cause hyperuricemia. Practitioners should be aware that these patients are at risk of having high SUA levels as well as more traditional cardiovascular risk factors. Thus, appropriate preventive interventions in these patients should be introduced. <h3>References</h3> [1] J.-Y. Choe, S.-K. Kim. Association between serum uric acid and inflammation in rheumatoid arthritis: Perspective on lowering serum uric acid of leflunomide. Clin Chim Acta. 2015Jan1;438:29-34. [2] Kuo D, et al. Hyperuricemia and incident cardiovascular disease and noncardiac vascular events in patients with rheumatoid arthritis. International Journal of Rheumatology, 2014 Aug 17;523897-7. [3] Zaragoza-García O, et al. Hypertriglyceridemic waist is associated with hyperuricemia and metabolic syndrome in rheumatoid arthritis patients. Diabetes Metab Syndr. 2019 Jan - Feb;13(1):722-729. <h3>Disclosure of Interests</h3> None declared