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THU0375 Amyloidosis: Something to Keep in Mind When Dealing with Patients on Biologic Treatment and Persistent Inflamations
  1. F.C. Ileana1,
  2. D. Patricia1,
  3. A. Melania1,
  4. S. Bogdan2,
  5. G. Carmen3,
  6. R. Simona1
  1. 1Rheumatology Clinic
  2. 2Surgical Clinic II
  3. 3Morphopathology Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania

Abstract

Background AA amyloidosis is a life threatening clinical complication of chronic inflammatory diseases such as rheumatoid arthritis (RA). The persistence of inflammatory syndrome in patients with RA treated with anti-TNFα agents could be caused by many factors; amyloidosis may be one of them.

Objectives We evaluated the frequency of secondary amyloidosis in patients with RA treated with anti-TNFα agents.

Methods This single-center longitudinal study included 144 RA patients with anti-TNFα treatment. The study was conducted between June 2011 and October 2013. All patients were clinically and biologically evaluated. In some patients with ESR>20mm/h we performed biopsy of abdominal fat to appreciate the existence of amyloidosis using special stain. Infections, malignancies and other sign of active disease were excluded in the study group.

Results The fat biopsy was performed at 34 of RA patients. AA amyloidosis was identified at 11 patients (32.3%). Proteinuria was found in 4/11 (36.36%), none of them had renal insufficiency. The mean age in RA patients with AA amyloidosis was 58.8 years and disease duration was 14.06 years. Most of the patients (63.63%) with AA + were treated with infliximab. All of the patients were treated with DMARDs, methotrexat alone or in combination was used in 86% of patients AA+. In the group with AA+, colchicine was included in the therapy.

We found statistically significant differences between the 2 groups (with or without amyloidosis) and they were recorded as CRP value (p<0.02), VASpatient (p<0.02) and ESR value (p<0.04).

Conclusions Secondary amyloidosis could be considered as factor responsible for the persistent inflammatory syndrome in patients with RA treated with anti-TNFα agents. Administration of colchicine in the group of patients with amyloidosis has improved their clinical status. Proteinuria was found in a small number of patients.

Disclosure of Interest : None declared

DOI 10.1136/annrheumdis-2014-eular.5918

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