P075 Changes of metabolic biomarker levels upon anti-tnf therapy in rheumatoid arthritis. (21st February 2018) - Pusztai, A
Abstract : Introduction: Rheumatoid arthritis (RA) has been associated with cardiovascular disease and metabolic syndrome. Numerous pro-inflammatory cytokines (e.g. TNF-α, IL-1, IL-6) are released, which cytokines cause increased reactive oxygen species (ROS) production and thereby contribute to the increased lipid peroxidation and reduction of many antioxidants. These processes not only lead to the deterioration of joints and other tissues but may also contribute to comorbidities, such as atherosclerosis. Objectives: The aim of this study was to assess the effects of anti-TNF therapy on different metabolic markers, such as PON1 (paraoxonase 1), arylesterase, chemerin and adiponectin. We also investigated whether these biomarkers correlated with various demographic, clinical and laboratory markers. Methods: We treated 37 RA patients with either etanercept (ETN) or certolizumab pegol (CZP) in a 12 month follow-up study. Assessments were performed at baseline, and 3, 6 and 12 months after treatment initiation. Serum chemerin and adiponectin concentrations were measured by commercially available ELISA kits (R and D System, MN and USA). PON1 and arylesterase activities were measured by spectrophotometry. In addition, age, disease duration, disease activity (DAS28), CRP, anti-CCP, IgM rheumatoid factor and plasma lipid levels were also assessed. Arterial flow-mediated vasodilation (FMD), carotid intima-media thickness (cIMT) and arterial pulse-wave velocity (PWV) were assessed by ultrasound. Results: Anti-TNF treatment resulted in a significant decrease in the levels of chemerin (p<0.001) and adiponectin (p<0.007) after 12 months. There were no significant changes in the levels of other metabolic biomarkers. We found the following correlations between the baseline values: the PON1 levels correlated with the age of patients (R=0.466, p=0.004). The adiponectin correlated with the disease activity (R=0.385, p=0.030), HDL-C (R=0.417, p=0.012) and the triglyceride levels (R=0.481, p=0.003). The total cholesterol correlated with the PWV (R=0.449, p=0.021) and the levels of the LDL-C (R=0.911, p<0.001). The baseline triglyceride correlated with the IgM rheumatoid factor (R=0.343, p=0.021); and the levels of LDL-C correlated with the PWV values (R=0.444, p=0.023). Conclusions: Metabolic factors, such as certain adipokines, PON1 and arylesterase may play a role in oxidative stress and atherosclerosis associated with RA. Anti-TNF treatment may affect adipokine levels. Acknowledgements: The work is supported by the GINOP-2.3.2-15-2016- 00015/I-KOM TEAMING project. Disclosure of interest: None declared