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  • THU0165 Obesity as one of the commodities was the robustest prediction factors for post therapeutic clinical remission of rheumatoid arthritis with short disease duration – results from kansai consortium for well-being of rheumatic disease patients

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THURSDAY, 14 JUNE 2018
Rheumatoid arthritis – comorbidity and clinical aspects
THU0165 Obesity as one of the commodities was the robustest prediction factors for post therapeutic clinical remission of rheumatoid arthritis with short disease duration – results from kansai consortium for well-being of rheumatic disease patients
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  1. K. Murakami1,
  2. M. Hashimoto2,
  3. K. Murata2,
  4. W. Yamamoto2,3,
  5. R. Hara4,
  6. M. Katayama5,
  7. A. Ohnishi6,
  8. K. Akashi6,
  9. S. Yoshida7,
  10. K. Nagai7,
  11. Y. Son8,
  12. H. Amuro8,
  13. T. Hirano9,
  14. K. Ebina10,
  15. K. Nishitani2,
  16. M. Tanaka2,
  17. H. Ito11,
  18. K. Ohmura1,
  19. T. Mimori1
  1. 1Department of Rheumatology and Clinical Immunology
  2. 2Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto
  3. 3Department of Health Information Management, Kurashiki Sweet Hospital, Kurashiki
  4. 4The Center for Rheumatic Diseases, Nara Medical University, Nara
  5. 5Department of Rheumatology, Osaka Red Cross Hospital, Osaka
  6. 6Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe
  7. 7Department of Internal Medicine (IV), Osaka Medical College, Takatsuki
  8. 8First Department of Internal Medicine, Kansai Medical University, Hirakata
  9. 9Department of Respiratory Medicine, Allergy and Rheumatic Disease
  10. 10Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka
  11. 11Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan

Abstract

Background A part of rheumatoid arthritis (RA) patients are resistant to clinical remission (CR) irrespective of therapies. In addition to known risk factors, systemic organ complications are assumed to interfere with CR.

Objectives To extract the predictive comorbidities of clinical response of disease activities.

Methods In Kansai consortium for well-being of rheumatic disease patients (ANSWER) cohort, which was the real world cohort of clinical database of rheumatic diseases, RA patients within 3 years of disease duration were included and followed. Using logistic regression analysis, background factors at the initial visit were extracted in order to predict CR after 1 year (1 year-non CR).

Results 651 patients met in the inclusion criteria were under the analysis. Of those, 245 (37.6%) cases were resulted in 1 year-non CR. The average scores of DAS28-CRP at first visit and one year later was 3.51 and 2.02, respectively. Logistic regression analysis revealed that DAS28-CRP at first visit (OR 1.42/unit, 95% CI 1.24–1.63), concomitant use of methotrexate (MTX) or biologic disease modifying rheumatic drugs (bDMARDs) (OR 2.04, 95% CI 1.41–2.96) and body mass index (BMI) (OR 1.07/unit, 95% CI 1.02–1.12) were significant predictive factors of 1 year-non CR, but not in the case with gender, age, disease duration, hypertension, diabetes, dyslipidemia, lung diseases, heart diseases, digestive tissue diseases, history of malignancy nor concomitant autoimmune diseases. Using propensity score matching (1:1) stratified by gender, age, disease duration, concomitant use of MTX or bDMARDs and DAS28-CRP at baseline, the 49 pairs were matched between obese (defined as body mass index (BMI) over than 28) and non-obese patients. In these cohort, mean score of DAS28-CRP after 1 year was significantly higher in obese patients than in non-obese patients (2.63 and 2.18, respectively, see the figure 1).


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Conclusions In these early arthritis cohort, obese patients tend to remain higher disease activities even considering with gender, age and therapeutic management, although validation studies should be added to confirm these findings.

Acknowledgements None.

Disclosure of Interest None declared

https://doi.org/10.1136/annrheumdis-2018-eular.1680

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