AB0249 Influence of autoantibodies profile on disease activity measurement in a colombian cohort of rheumatoid arthritis patients

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 1306
• Main Authors: Florez, J.B., Quintana, G., Mendez, P., Coral, P.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Autoantibodies; Citrulline; Diagnosis; Immunogenicity; Immunoglobulins; Methotrexate; Patients; Prognosis; Rheumatoid arthritis; Rheumatoid factor; Statistical analysis
• DOI: 10.1136/annrheumdis-2018-eular.7589
• ISSN: 0003-4967

BackgroundTraditionally, the role of Rheumatoid Factor (RF) and/or Anti-citrullinated antibodies (ACCP) presence have characterised for diagnosis and prognosis of Rheumatoid Arthritis (RA). However, Anti-nuclear antibodies (ANA) are not routinely measured for the diagnosis of the disease or RA prognosis establishment during first appointment. Recently, evidence showed that positive ANA titles could be considered as poor prognosis factor for RA, and also a higher probability of developing immunogenicity against biologic therapies.ObjectivesTo compare the disease activity measurement from a Colombian cohort of patients with RA, based on their auto-antibodies profile.MethodsThe study used a cohort of Colombian patients with RA. A database was developed using the information from the clinical records. The data included were: RF, ACCP, ANA, and the disease activity measured using DAS-28 ESR. Disease activity results were obtained in the following periods of time: 0, 3, 12, 24 and 36 months. Patients were classified based on the different autoantibody profiles (RF/ACCP/ANA:—, +–, -+-, –+, ++-, +-+, -++, +++). Mean DAS-28 ESR results from each period of time were calculated. Also mean weekly Methotrexate (MTX) dose was calculated for each profile. Mean differences between initial, and the follow-up period were calculated using Kruskal-Wallis test. Statistical analysis was made using STATA 12.0 software.Results635 patients with RA were included. 32% of them were men, and 68% were women. Mean age was 54.3 years. The most prevalent profile was +++with 118 patients, and the less frequent was +–. Patients with +++profile had the best response to treatment over time, but also they required more MTX dose. Less response during time was observed with +– profile, however the amount of patients from these group was relatively low. As it was expected,—profile patients required less weekly MTX dose (9.26 mg). It was interesting that patients with –+profile present a worst outcome based on DAS-28 activity, and less response to the treatment.ConclusionsResults from the study suggest the importance of including the measurement of ANA titles in the initial categorization and follow-up of patients with RA. The presence of ANA seems to have a worst prognosis. ANA co-existence with ACCP appear to have a worst outcome, compared to ++- or +-+profile. Auto-antibody profile in RA could direct the best therapeutic strategy for each patient. Validation of these results are required based on other cohorts.Reference[1] Sanmarti R, Gomez-Puerta JA. Biomarcadores en la artritis reumatoide. Reumatol Clin. 2011;6(S3):S25–S28.Disclosure of InterestNone declaredAbstract AB0249 – Table 1Auto-antibodies profile, disease activity by DAS-28 ESR (initial and follow-up to 3, 12, 24 and 36 months) and mean weekly MTX dose in a Colombian cohort of RA patientsPROFILE(FR/ACCP/ANA)DAS-28 (INITIALDAS-28 (3 MONTHS)NDAS-28 (12 MONTHS)NDAS-28 (24 MONTHS)NDAS-28 (36 MONTHS)NMEAN WEEKLY MTX DOSE (mg) —3.317.3072603730.1267188640.9367073*410.8593334*309.26+–3.375−0.29057157−0.58066676−0.264857270.17410.82-+-3.434.263663920.6267033*910.7705405*740.6138596*5714.01–+3.201.031481527−0.2926087230.1705263190.80384611310.2++-4.123.8346712**731.048**661.23**510.533816.19-++3.542.3822857560.5656604*530.71325*400.8733333*3314.91+-+4.6951.57*121.77*143.35962.03215.69+++4.118.6474576*1180.9343478**1151.196**861.25**6615.83*p<−0.05 **p<0.001