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AB0355 Anti-Rheumatic Therapy Reduces Syndecan-1 Shedding in Rheumatoid Arthritis (RA)
  1. I. Hollan1,
  2. T.T. Vuong2,
  3. T.M. Reine2,
  4. G. Hjeltnes3,
  5. T. Lyberg4,
  6. S. Agewall4,
  7. A. Wiik5,
  8. K. Mikkelsen1,
  9. Ø. T. Førre2,
  10. S.O. Kolset2
  11. on behalf of Feiring Heart Biopsy Study Network
  1. 1Lillehammer Hospital for Rheumatic Diseases, Lillehammer
  2. 2University of Oslo, Oslo
  3. 3Innlandet Hospital Trust, Lillehammer
  4. 4Oslo University Hospital, Oslo, Norway
  5. 5Statens Serum Institut, Coepenhagen, Denmark


Background Intact glycocalyx is of importance for healthy endothelial function. Changes in the endothelial glycocalyx, characterized by increased levels of circulating syndecan-1, might be related to accelerated atherosclerosis in RA.

Objectives To examine the effect of anti-rheumatic treatment on serum syndecan-1 levels.

Methods From the Norwegian observational PSARA study, we selected 32 patients starting with methotrexate (MTX) and/or anti-tumor necrosis factor (anti-TNF) treatment due to active RA. S-syndecan-1 was measured by ELISA at baseline and after 6 weeks of the treatment.

Results The mean age of the patients was 59±8 years, and 27% were men. 12 patients received MTX and 20 received MTX and anti-TNF. S-syndecan-1 significantly decreased during the treatment (49±52 ng/ml vs. 45±50 ng/ml, p=0.047). The difference was independent of age, sex and DAS28. The s-syndecan-1 reduction was greater in the MTX than MTX+anti-TNF group (10±13 vs. 1±1 ng/ml, p=0.048).

Conclusions Anti-rheumatic treatment reduces s-syndecan-1 in RA. Thus, a glycocalyx ameliorating effect may contribute to the reduction of cardiovascular morbidity due to anti-rheumatic treatment. In theory, the greater reduction of s-syndecan-1 in the MTX than in the combined group might be due to differences in patient population (less severe RA and a shorter disease duration in patients treated with MTX compared to anti-TNF). Interestingly, although MTX is considered a less potent anti-rheumatic drug than anti-TNF, it may have an important cardioprotective effect caused by its protective effect on glycocalyx etc. This effect might be at least partially independent of its anti-inflammatory properties.

Disclosure of Interest None declared

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