AB0041 EVALUATING DISEASE ACTIVITY AND CARDIOVASCULAR RISK USING BIOMARKERS IN FAMILIAL MEDITERRANEAN FEVER PATIENTS
Authors: G. Yaz Aydin, R. C. Kardaş, İ. Vasi, M. C. Altinsoy, A. Erden, H. Küçük, Ö. Gülbahar
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Familial Mediterranean Fever (FMF) is an autoimmune disease characterized by recurrent fevers and aseptic serositis attacks. Persistent subclinical inflammation during remission may impact the disease prognosis and severity. The development of amyloidosis, a severe complication, can lead to organ dysfunction. The objective is to objectively measure disease damage and severity in FMF patients, crucial for assessing its relevance to atherosclerosis and cardiovascular diseases. <h3>Objectives:</h3> This study aims to investigate potential biomarkers that can predict cardiovascular risk and disease damage in FMF patients. It involves analyzing serum levels of biomarkers (suPAR, sST2, oxidized LDL, TMAO, and NLRP3) and their correlations with clinical and laboratory parameters, disease activity-damage scoring systems (ADDI, ISSF), and the cardiovascular risk scoring index (SCORE2). <h3>Methods:</h3> Consecutive FMF patients above 18 years of age followed in the Gazi University outpatient rheumatology clinic between January and September 2023 were included in this study. Demographic information, smoking habits, family history, education, and relevant laboratory findings are recorded. Subgroups are categorized based on the disease's clinical history and laboratory findings. Scores (SCORE2, ISSF, ADDI) are calculated during outpatient visits, and laboratory data are obtained from the hospital information management system. <h3>Results:</h3> 104 FMF patients and 46 healthy volunteers were inlcuded in the study. The majority of FMF patients were female (61.5%), with an average age of 38.9±12.6 years. The most common comorbidity among FMF patients was hypertension (24%). Among 104 FMF patients, 65 do not exhibit colchicine resistance, while 39 show resistance. The median suPAR levels are found to be statistically significantly different between the two groups, with 0.85 ng/mL (IQR: 1.49) for those without colchicine resistance and 1.58 ng/mL (IQR: 2.82) for those with resistance (p=0.036). The median ADDI score was 0 (IQR: 2). There was a significant positive correlation between ADDI scores and serum suPAR and sST2 levels (τ=+0.230, p=0.004; τ=+0.172, p=0.030, respectively). The median ISSF score was 2 (IQR: 3). Patients were categorized based on ISSF scores into two groups: mild (≤2 points) and moderate-severe (&gt;2 points). The serum suPAR levels were found to be statistically significantly different between these groups, with lower levels in the mild group (p=0.026). No significant correlation was found between creatinine, albuminuria, proteinuria levels, and serum oxLDL and NLRP3 levels. However, positive correlations were observed between suPAR and creatinine, albuminuria, and proteinuria levels (τ=+0.196, p=0.005; τ=+0.151, p=0.046; τ=+0.166, p=0.020, respectively). Positive correlations were also found between sST2 and albuminuria and proteinuria levels (τ=+0.217, p=0.004; τ=+0.191, p=0.007), and a correlation near significance was noted between sST2 and creatinine levels (τ=+0.127, p=0.065). Patients were categorized into three SCORE2 categories based on risk: low-medium (&lt;2.5%), high (2.5–7.5%), and very high (&gt;7.5%) levels. Median (IQR) suPAR values for low-medium, high and very high groups were 0.75 (1.5), 1,63 (1.9) and 2.7 (5.7) respectively (P=0.01). Median (IQR) sST2 values were 1.3 (1.85), 1.85 (2.88) and 4.8 (7.96) respectively (P=0.003, Figures 1 and 2). <h3>Conclusion:</h3> suPAR and sST2 biomarkers show positive correlations with albuminuria and proteinuria, suggesting early detection possibilities for patients at risk of severe kidney failure, especially due to amyloidosis. Key findings include suPAR's association with ADDI and ISSF algorithms, and sST2's link to ISSF. Both biomarkers correlate positively with each other and with SCORE2. Routine evaluation of these biomarkers in clinical practice could be a significant step in determining disease course and personalizing treatment strategies. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>