AB0587 EFFECT OF FISH INTAKE ON PATIENTS WITH RHEUMATOID ARTHRITIS USING BIOLOGICS OR JANUS KINASE INHIBITORS: A JOINT RESEARCH IN JAPAN AND SPAIN
Authors: M. Tarumi, O. Amengual, M. Navidad Fuentes, M. Yasuda, Y. Kosumi, S. Takeyama, M. Yoshimura, K. Ninagawa, K. Aso, R. Hisada, M. Kono, Y. Fujieda, M. Kato, R. Cáliz Cáliz, T. Atsumi
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> In recent years, the advent of molecular targeted therapies including TNF inhibitors and IL-6 inhibitors or janus kinase inhibitors (JAKi), have contributed to dramatic progress in the treatment of rheumatoid arthritis (RA). With these therapeutic advancements, many patients have experienced favourable outcomes; however, disease control remains challenging for some patients. Diet and nutrition are considered environmental factors that can affect the course of RA and the response to pharmacotherapy. Intake of fish rich in n-3 polyunsaturated fatty acids (n-3 PUFA) has been suggested to relate with the clinical course of RA. Notably, both Japanese diets and Mediterranean diets are known for their high fish consumption. <h3>Objectives:</h3> This study aims to assess the relationship between the intake of fish rich in n-3 PUFA and treatment response in RA patients living in Japan or in Spain. <h3>Methods:</h3> This retrospective cross-sectional study included RA patients receiving molecular targeted therapy including biologics or JAKi at Hokkaido University Hospital in Sapporo, Japan and Virgen de las Nieves University Hospital in Granada, Spain. From April 2021 to March 2023, patients answered to the brief-type self-administered diet history questionnaire (BDHQ) and detailed fish frequency questionnaire (DFFQ). At Hokkaido University Hospital, 218 patients with RA were registered, of which 205 were eligible after excluding cases with insufficient disease activity assessment in the electronic medical records and incomplete questionnaire responses. At Virgen de las Nieves University Hospital, 117 patients with RA were registered, with 74 included after excluding 43 patients. The patients who responded to molecular targeted therapy (Responder group) were defined as cases with Disease Activity Score 28 (DAS28)-ESR &lt; 2.6 and DAS28-CRP &lt; 2.4, and the control group was the non-Responders. The association of patient characteristics, the amount, and frequency of fish intake in the Responder and non-Responder group was evaluated using chi-squared tests, Fisher's exact test, and contributing factors to the Responder group were assessed using multivariate logistic regression analysis. <h3>Results:</h3> Among the 205 Japanese RA patients, 162 were female, with a median age of 67 years. Of them, 87% were treated with biologics and 13% with JAKi. The Responder group criteria were met in 59%. The estimated daily intake of n-3 PUFA was higher in the Responder group (2.49 g/day [Q1-Q3 1.82-3.23] vs. non-Responder group: 1.99 g/day [Q1-Q3 1.33-2.94], p = 0.04). Moreover, a higher frequency of fish intake rich in n-3 PUFA, at least once a week, was seen in the Responder group (30% vs. non-Responder group: 14%, p = 0.01). Multivariate logistic regression analysis indicated that consuming n-3 PUFA at least once a week was an independent factor contributing to favourable outcomes in the Responder group (p = 0.04, Odds Ratio [OR] 2.50, 95% Confidence Interval [CI] 1.06-5.88). Among the 74 Spanish RA patients, 58 were female, with a median age of 60 years. 96% were treated with biologics, and 4% with JAK inhibitors. 36% met the Responder group criteria. No significant differences were found between the Responder and non-Responder groups in the estimated daily intake of n-3 PUFA (1.29 g/day [Q1-Q3 1.13-1.90] vs. non-Responder group: 1.70 g/day [Q1-Q3 1.12-2.61], p = 0.11) or the frequency of fish consumption rich in n-3 PUFA (26% vs. non-Responder group: 25%, p = 1.00). <h3>Conclusion:</h3> In the Japanese population, the frequency of consumption of fish rich in n-3 PUFA has been suggested to potentially affect treatment response in patients with RA undergoing molecular targeted therapies. However, this association was not observed in the Spanish population. These findings indicate that the impact of fish consumption on treatment outcomes may vary across ethnicities. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> Acknowledgements: NIL.to Ms. Y. Ikea and S. Kumagai for their enriching support on the nutritional properties of fish. Supported by the Kakenhi C grant number 20K11597 from the Japan Society for the Promotion of Science. <h3>Disclosure of Interests:</h3> <b>None declared.</b>