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FRI0194 Treatment with anti-tumor necrosis factor (TNF) biologics to human t-lymphotropic virus type 1 (HTLV-1) positive patients with rheumatoid arthritis (RA): a case-control study
  1. S. Miyauchi1,
  2. K. Umekita1,
  3. T. Hidaka2,
  4. Y. Hashiba2,
  5. T. Kawaguchi1,
  6. M. Matsuda1,
  7. K. Kubo1,
  8. S. Ueno1,
  9. N. Kusumoto1,
  10. I. Takajo1,
  11. Y. Kai2,
  12. Y. Nagatomo1,
  13. A. Okayama1
  1. 1Department Of Internal Medicine, Rheumatology, Infectious Diseases And Laboratory Medicine, University of Miyazaki
  2. 2Institute of Rheumatology, Zenjinkai Shimin-no-Mori Hospital, Miyazaki, Japan

Abstract

Objectives To see whether the clinical features and responses to anti-TNF of HTLV-1 positive patients with RA are different from those of HTLV-1 negative patients.

Methods The clinical features and response to anti-TNF were compared between 10 female HTLV-1 positive RA patients and 20 age-matched female HTLV-1 negative patients, who were diagnosed based on the 1987 ACR criteria for RA. Therapeutics response was evaluated using the EULAR improvement criteria.

Results Significantly higher baseline level of C-reactive protein (CRP) was observed in HTLV-1 positive patients than in HTLV-1 positive patients (P = 0.003). The value of disease activity score in 28 joints (DAS28) and the levels of erythrocyte sedimentation rate (ESR) tended to be higher in HTLV-1 positive patients. The discontinuation rate of anti-TNF was higher in HTLV-1 positive patients 6 months after the beginning of treatment than in HTLV-1 negative patients (30 % v.s 0 %, respectively). Most of reason for discontinuation was inefficacy of anti-TNF. EULAR response rate in 3 months of the treatment was worse in HTLV-1 positive patients than in HTLV-1 positive patients. The levels of CRP, ESR and the value of DAS28 remained to be significantly higher in carrier RA than non-carrier RA. There is no development of lymphoma or myelopathy during 2-years observation period in HTLV-1 positive patients.

Conclusions The result of this small study suggested that HTLV-1 positive RA patients have high inflammation and resistance to the treatment with anti-TNF. Further study with larger number of cases is necessary to confirm these data.

Disclosure of Interest None Declared

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