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SAT0250 Cardiovascular Risk Predictors under Non-Tnf Biological DMARD Treatment. A 12-Month Longitudinal Study
  1. S.A. Provan,
  2. I.J. Berg,
  3. A.G. Semb,
  4. A. Mathiessen,
  5. H.B. Hammer,
  6. T.K. Kvien
  1. Rheumatology, Diakonhjemmet Hospital, Oslo, Norway

Abstract

Background Patients with rheumatoid arthritis (RA) have an increased level of cardiovascular (CV) risk markers.

Objectives To assess whether treatment with one of three biological DMARDs; Rituximab (Rit), Abatacept (Aba) or Tocilizumab (Toc) can reduce the level of CV risk markers in patients with RA.

Methods An open, observational, longitudinal study with study visits at baseline, 3, 6, and 12 months. Patients aged 18-80 years, fulfilling the ACR 1987 classification criteria for RA and starting on either Rit, Aba or Toc based on the decision of a rheumatologist, were included. CV risk was assessed by blood pressure and arterial stiffness measurements (pulse wave velocity (PWV) and augmentation index (AIx)).

Change in CVD risk markers over 3 months were compared using paired samples bivariate tests. Change over the 12 months follow-up in patients receiving Rit was assessed using mixed models repeated analyses.

Results 36 patients were included in the study and 4 patients were re-entered into the study after switching to either Toc or Aba prior to the 6 month follow-up. The final number included was 40, 24 patients receiving Rit, 5 Aba and 7 Toc. In the bivariate analyses of paired samples at 3 months DAS28 was significantly improved in the Rit and Toc groups. Only patients receiving Toc had a significant reduction in CRP, ESR and PWV at 3 months (Table 1).

Table 1.

Paired t-test over change at 3 months

Over the 12-month follow-up period patients in the Rit group showed a significant reduction in CRP, DAS28 and PWV (Fig. 1).

Figure 1.

Change in disease activity and CV risk markers in patients receiving Rituximab.

Conclusions Toc and Rit reduce PWV, a marker of CVD risk, in patients with RA. The reduction in PWV was apparent at 3 months for patients taking Toc and at 12 months for patients receiving Rit.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.3409

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