SAT0365 Inflammation and Calcium Supplementation Increase the Risk of Death in Patients with RA: A 15-Year Longitudinal Study in 609 Patients from the Oslo RA Register. (9th June 2015) - Provan, S.A.
Abstract : Background: Disease activity and inflammation are established predictors of increased mortality in patients with rheumatoid arthritis (RA). Objectives: To investigate whether osteoporosis and use of calcium supplementationswere associated with death from cardiovascular disease in RA. Methods: Patients in the Oslo RA register (ORAR) were examined and BMD measured in 1996. Biomarkers were analysed consecutively. A trained study-nurse recorded patient medication and assessed 28-tender and 28-swollen joint counts. Disease activity was calculated as DAS28. The cohort was linked to the Norwegian Cause of Death registry on Dec 31st, 2010, and we examined all-cause mortality as well as death from cardiovascular disease (Primary cause of death: Acute myocardial infarction, angina, atherosclerotic heart disease, hypertension, cerebral infarction, heart failure or stroke) We analysed all-cause mortality and death from CVD as endpoints in separate Cox regression models with hazard ratio (HR) and 95% confidence intervals (95% CI). Initially, baseline variables were analysed separately, adjusted for age and sex. Variables with a p-value of ≤0.1 were then included into a multivariable model and further excluded using backwards selection with a cut-of p-value of 0.05. Robustness of the final model was assessed by re-entering excluded variables. Results: 609 patients, mean 53.6 years (range 20-70) were examined in 1996/1997. During the period of observation 162 patients had died, while 447 were still alive at time of censoring, 7414 observed patient-years. In 43 (7%) patients CVD was the primary cause of death. Results from the univariate analyses in are presented in the table . In the final multivariate model of all-cause mortality; increased baseline ESR (HR 1.02, 95% CI 1.01-1.03 p<0.001), calcium supplementation (1.68, 1.07-2.62 p=0.02) and osteoporosis (1.56, 1.07-2.29 p=0.02) remained associated with higher mortality. In the final multivariate model of death from CVD; increased ESR (1.03, 1.01-1.04 p<0.001) and calcium supplementation (3.03, 1.49-6.15 p=0.002) remained associated with higher mortality. Conclusions: Increased baseline inflammation and calcium supplementation were associated with increased all-cause mortality and risk of primary atherosclerotic death in this longitudinal study of a representative cohort of RA patients. Disclosure of Interest: None declared