SAT0105 INFLUENCE OF RITUXIMAB ON DIASTOLIC FUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: L. Feiskhanova, S. Lapshina, O. Rybakova
Journal: Annals of the Rheumatic Diseases (2020)

Background: One of the drugs used in the treatment of rheumatoid arthritis (RA) is rituximab. Given the fact that the RA affects not only the joints, but, in addition to other organs, and the heart, our interest has caused the likelihood of the impact of rituximab on non-articular manifestations of rheumatoid arthritis, in particular, related to the cardiovascular system. Objectives: to study the effect of rituximab on the development of diastolic dysfunction of the heart in patients with RA. Methods: 98 patients with RA were examined, of which 28 patients took rituximab 1000 mg according to the scheme for 6-12 months and methotrexate up to 25 mg per week per os (1st group), and 70 patients – only methotrexate up to 25 mg per week at least 12 months (2nd group). They were held echocardiography with calculation of the E/a of mitral valve, E/a of tricuspid valve, end-diastolic size of left ventricle, electrocardiography with calculation of the dispersion of QT interval and vectorcardiography with determination of the areas of the P loop, QRS loop, T loop, and the maximum vector (MV), MV-azimuth and MV-lift. Results: the E/a of mitral and tricuspid valves in 1st group were higher than in 2nd group (p&lt;0.05). In 1st group, a correlation was found between the E/a of both valves and the MV-lift; and also between the dispersion of QT interval and the maximum vector (p&lt;0.05). Conclusion: in patients taking rituximab, there is a relationship between diastolic dysfunction, electrical instability of the ventricles and signs of electrophysiological remodeling. In addition, the use of rituximab is associated with a lower severity of diastolic dysfunction of both ventricles and a lower risk of life-threatening arrhythmias compared to the group that did not take this drug. References: [1]Singh J.A., Saag K.G., Shmerling R.H. et al. 2015 American College of Rheumatology Guidelinefor the Treatment of Rheumatoid Arthritis. Arthritis &amp; Rheumatology 2016. Vol.68(1). P. 1–26. DOI: https://doi.org/10.1002/art.39480 . [2]Davis J. M., Crowson C.S., Therneau T.M. et al. Five-Year Changes in Cardiac Structure and Function in Patients With Rheumatoid Arthritis Compared With the General Population // International journal of cardiology 2017. Vol. 240. P.379–385. DOI: https://doi.org/10.1016/j.ijcard.2017.03.108 . [3]Rein P., Mueller, R.B. Treatment with Biologicals in Rheumatoid Arthritis: An Overview // Rheumatology and Therapy 2017. Vol.4(2). P.247-261. DOI: https://doi.org/10.1007/s40744-017-0073-3 . [4]Smolen J.S, Goncalves J., Quinn M., et al. Era of biosimilars in rheumatology: reshaping the healthcare environment // Rheumatic &amp; Musculoskeletal Diseases 2019.Vol.5(1). DOI: http://dx.doi.org/10.1136/rmdopen-2019-000900 [5]Cohen M.D., Keystone E. Rituximab for Rheumatoid Arthritis // Rheumatology and Therapy 2015.Vol.2(2). P.99-111. DOI: https://doi.org/10.1007/s40744-015-0016-9 [6]Pierpont T.M., Limper C.B., Richards K.L. Past, Present, and Future of Rituximab-The World’s First Oncology Monoclonal Antibody Therapy // Frontiers in Oncology 2018.Vol.4(163). DOI: https://doi.org/10.3389/fonc.2018.00163 Disclosure of Interests: None declared