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AB0089 Histopathological change caused by biological treatment in rheumatoid arthritis synovial tissue
  1. A. Kubota1,
  2. T. Suguro1,
  3. A. Nakajima2,
  4. S. Masayuki1,
  5. S. Masato2,
  6. T. Kentaro1,
  7. T. Kazuaki1
  1. 1Toho Univeisity School Of Medicine, Department of Orthopaedic Surgery, Tokyo
  2. 2Departments of Orthopaedics and Rheumatology, Toho University Sakura Medical Center, Chiba, Japan


Background Multiple studies addressing the effects of biologics on the synovial tissue in rheumatoid arthritis (RA) patients have been reported. There are, however, few studies comparing histopathological changes in the synovial tissue in the same RA patients between before and after biologics treatment.

Objectives We examined biologics impacts on RA synovial tissues based on pathological findings in them collected during surgeries for the same patient before and after biological drug usage.

Methods Synovial tissues were collected from 34 RA joints before and after biologics. The average age and disease duration of the study subjects were 64.0 and 22.5, respectively. Synovial tissues were evaluated by hematoxylin. Histopathological changes in the synovial tissues were compared based on Rooney’s score, and presence or absence of fibrinoid degeneration and proliferation of villi in the subsynovial tissue. We examined correlation between pathological findings in RA synovium and disease activity under biologics. Disease activity was assessed by CDAI. We examined the Histopathological changes in the Remission, Low disease activity group (RL group) and Moderate disease activity (M group). Etanercept, Infliximab, Tocilizumab, Adalimumab and Abatacept was used as biological drug for 18, 6, 5, 3 and 2 joints respectively.

Results Rooney score between before and after biological usage improved from 28.4 to 12.0 showing significant difference. Significant improvement in Rooney score was observed in all items. Fibrinoid degeneration was observed in 29 cases (85.3%) and 6 cases (17.6%) before and after biologics treatment, respectively, demonstrating a significant reduction with biologics treatment. Proliferation of villi was observed in 32 cases (94.1%) and 11 (32.4%) before and after biologics treatment, respectively, demonstrating a significant reduction with biologics treatment. After biologics treatment, Rooney’s score in RL group and M group were 10.4 and 15.3, respectively, showing a statistically significant difference. In addition, the M group had significantly higher scores in lymphoid follicle and lymphocyte infiltration compared to the RL group.

Conclusions The study results demonstrated that biologics treatment significantly ameliorated inflammatory changes in the synovial lining layers and sublining layers. In addition, the results suggested that histopathological findings in the sublining layers reflected disease activity.

Disclosure of Interest None declared

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