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FRI0356 Studies on Ageing and the Severity of Radiographic Joint Damage in Rheumatoid Arthritis
  1. L. Mangnus1,
  2. H.W. van Steenbergen1,
  3. E. Lindqvist2,
  4. E. Brouwer3,
  5. M. Reijnierse4,
  6. T.W. Huizinga1,
  7. P.K. Gregersen5,
  8. E. Berglin6,
  9. S. Rantapää-Dahlqvist6,
  10. D. van der Heijde1,
  11. A.H. van der Helm-van Mil1
  1. 1Department of rheumatology, Leiden University Medical Center, Leiden, Netherlands
  2. 2Department of rheumatology, Lund university, Lund, Sweden
  3. 3Department of rheumatology, University Medical Center Groningen, Groningen
  4. 4Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
  5. 5Feinstein Institute for Medical Research and North Shore–LIJ Health System, Manhasset, New York, United States
  6. 6Department of rheumatology, University Hospital, Umea, Sweden

Abstract

Background The western population is ageing. It is unknown whether age at diagnosis affects the severity of Rheumatoid Arthritis (RA), we therefore performed the present study.

Methods 1,875 RA-patients (7,219 radiographs) included in five European and North-American cohorts (Leiden-EAC, Wichita, Umeå, Groningen and Lund) were studied on associations between age at diagnosis and joint damage severity. In 698 Leiden RA-patients with 7-years follow-up it was explored if symptom duration, anti-citrullinated-peptide-antibodies (ACPA), swollen joint count (SJC) and C-reactive-protein (CRP) mediated the association of age with joint damage. Fifty-six other RA-patients of the EAC-cohort underwent baseline MRIs of wrist, MCP and MTP-joints; MRI-inflammation (RAMRIS-synovitis plus bone marrow edema) was also evaluated in mediation analyses. Linear regression and multivariate normal regression models were used.

Results Analysis on the five cohorts and the Leiden-EAC separately revealed 1.026-fold and 1.034-fold increase of radiographic joint damage per year increase in age (β=1.026, 1.034, both p<0.001); this effect was present at baseline and constant over time. Age correlated stronger with baseline erosion-scores compared to joint space narrowing (JSN)-scores (r=0.38 versus 0.29). Symptom duration, ACPA, SJC and CRP did not mediate the association of age with joint damage severity. Age was significantly associated with the MRI-inflammation-score after adjusting for CRP and SJC (β=1.018, p=0.027). The association of age with joint damage (β=1.032, p=0.004) decreased after also including the MRI-inflammation-score (β=1.025, p=0.021), suggesting partial mediation.

Conclusions RA-patients presenting at higher age have more severe joint damage; this might be partially explained by more severe MRI-detected inflammation at higher age.

Disclosure of Interest None declared

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