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Rheumatoid arthritis - comorbidity and clinical aspects
THU0116 European multicentre pilot survey to assess vitamin d and clinical status in rheumatoid arthritis patients
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  1. M Cutolo1,
  2. J Vojinovic2,
  3. A Tincani3,
  4. S Soldano1,
  5. L Andreoli3,
  6. F Dall'Ara3,
  7. F Salaffi4,
  8. R Ionescu5,
  9. K Simic Pasalic6,
  10. I Balcune7,
  11. I Ferraz-Amaro8,
  12. M Tlustochowicz9,
  13. I Butrimiene10,
  14. E Punceviciene10,
  15. N Toroptsova11,
  16. S Grazio12,
  17. J Morovic-Vergles13,
  18. P Masaryk14,
  19. K Otsa15,
  20. M Bernardes16,
  21. V Boyadzhieva17,
  22. A Sulli1
  1. 1Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Genoa, Italy
  2. 2Clinical Centre, Medical Faculty, University of Nis, Nis, Serbia
  3. 3Rheumatology and Clinical Immunology Unit, University of Brescia, Brescia
  4. 4Clinical Rheumatology, Università Politecnica delle Marche, Ancona, Italy
  5. 5Division of Rheumatology, University of Medicine and Pharmacy, Bucharest, Romania
  6. 6Institute of Rheumatology, University of Belgrade, Belgrade, Serbia
  7. 7Division of Rheumatology, Paula Stradina Clinical Hospital, Riga, Latvia
  8. 8Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain
  9. 9Department of Internal Medicine and Rheumatology, Military Institute of Medicine, Warszawa, Poland
  10. 10Centre of Rheumatology, Vilnius University Hospital, Vilnius, Lithuania
  11. 11Department of Epidemiology and Genetics of Rheumatic Diseases, Institute of Rheumatology, Moscow, Russian Federation
  12. 12University Department for Rheumatology, Physical and Rehabilitation Medicine, Clinical Hospital Centre Sisters of Mercy
  13. 13Division of Clinical Immunology and Rheumatology, University of Zagreb, Zagreb, Croatia
  14. 14National Institute of Rheumatic Diseases, Piestany, Slovakia
  15. 15Department of Rheumatology, Tallinn Central Hospital, Tallin, Estonia
  16. 16Rheumatology Department of São João Hospital Center, University of Porto, Porto, Portugal
  17. 17Clinic of Rheumatology, University Hospital St. Iv. Rilski, Sofia, Bulgaria

Abstract

Background Vitamin D (25(OH)D) deficiency seems a distinct risk factor influencing prevalence and severity of several autoimmune diseases. Several studies suggest that low serum concentrations of vitamin D are frequent in rheumatoid arthritis (RA) patients, and an inverse relationships have been reported between 25(OH)D serum concentrations and disease activity or disability.

Objectives European multicentre cross-sectional study to collect data on vitamin D serum concentrations in RA patients from different countries, and to investigate the relationship with disease activity, disability and quality of life in a large population.

Methods The survey involved 625 RA patients (mean age 55±11 years, mean disease duration 11±9 years) and 276 age and sex-matched healthy subjects from 13 European countries. Serum samples for 25(OH)D measurement were collected during winter time (December-March) and analyzed in a central laboratory using chemiluminescence immunoassay (DiaSorin). Thirty-six percent of RA patients were treated with vitamin D analogues. Patient past medical history, Rheumatoid Arthritis Impact Diseases (RAID) score, Health Assessment Questionnaire (HAQ) and DAS28-CRP were also collected. Statistical analysis was performed by non parametric tests.

Results Mean serum concentration of 25(OH)D was found significantly lower in RA patients (17.6±9.7 ng/ml) when compared to matched controls (18.9±9.4 ng/ml) (p=0.01), Several statistically significant differences between European countries were observed (possibly linked to different latitude, sun exsposure and dietary habits) (see figure). Vitamin D deficiency (<20 ng/ml) was found in almost 66% of RA patients, and severe deficiency (<10 ng/ml) was detected in almost 25% of them; insufficiency (between 20 and 30 ng/ml) was found in 27% of RA patients. Only 6% of the RA patients were found within the normal concentrations (>30 ng/ml). Male and female RA patients showed similar 25(OH)D values. Negative statistically significant correlations were found between 25(OH)D serum concentrations and RAID (p=0.05) HAQ (p=0.04) and DAS28-CRP (p<0.001) scores in the RA patients group.

Figure

Conclusions This European survey add new evidences that vitamin D insufficiency/deficiency is frequent in RA patients with statistically significant differences between several countries. Vitamin D serum concentrations negatively correlate with the clinimetric indexes for disease activity, disability and quality of life in the present cohort of RA European patients.

Disclosure of Interest None declared

https://doi.org/10.1136/annrheumdis-2017-eular.5977

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