AB0284 Relationship of biomarkers, ultrasound (US) signs of joint damage and radiographic progression in patients with rheumatoid arthritis(RA). (12th June 2018) - Alekseeva, O.
Abstract : Background: Rheumatoid arthritis (RA) is a chronic inflammatory immune-mediated disease, based on the imbalance of biomarkers, leading to the appearance of inflammatory changes in the joints, the progression of bone and cartilage destruction. Objectives: to identify the relationship between cytokines, their dynamic changes, ultrasound (US) signs and radiologic progression in 12 month prospective study in patients RA. Methods: 35 patients (median age 55.0 [48.0; 64.0] years) with early RA use MTX and/or biologic therapy in accordance with the treat-to-target concept. Serum cytokine concentrations were determined using the xMAP multiplexing technology baseline, 3 and 6 months after the start of therapy. US with grey scale (GS), power Doppler (PD) and destructive changes (erosion), according to the criteria of OMERACT, were performed baseline, 3, 6, 9 and 12 months after the start of therapy. We analysed absolutely levels and theirs changes(Δ). X-ray examination was conducted baseline and at 12 month of therapy with an assessment of X-ray changes by Sharp van der Heijde scores (ΔSHS). Results: Levels of proinflammatory cytokines (IL1β, IL6, IL12, IL15, TNFα) decreased by 3 month. Significant differences in PD-group at the end of observation were revealed only for IL6 and TNFα, and with X-ray progression – for Δ IL17 level at 6 month. At baseline a positive correlation was found between PD and levels of IL1β (r=0.34), IL6 (r=0.42). We found correlation between PD at 12 month and ΔIL1β by 6 month, ΔTNFα by 3 month. In the PD-group concentration of IL6 baseline was significantly higher: 75.2 (37.9; 101.7) vs 38.7 (19.2; 59.6); by 6 month level of TNFα in this group also higher: 67.6 (34.3;125.5) vs 38.8 (21.9; 67.2). Radiographic progression was detected in 6 of 35 RA patients; this group was with PD and destructive change by US was significantly higher. We found correlation between ΔIL17 and ΔFGF levels at 3 month with PD at 3 month: r=0.57 p=0.001 and r=0.52 p=0.004, respectively. Also we found significantly correlation between ΔIL17 and ΔFGF at 3 month and ΔIL17 at 6 month with the X-ray examination: the sum of erosions, the sum of the narrowing of the joints and the total score (for IL17 at 3 month r=0.43 p=0.01, r=0.51 p=0.0018, r=0.52 p=0.001, respectively, for the FGF at the 3 month r=0.37 p=0.03, r=0.41 p=0.014, r=0.41 p=0.014, respectively, for IL17 at 6 month r=0.38 p=0.024, r=0.39 p=0.019, r=0.4 p=0.016, respectively). Conclusions: The revealed relationship of active synovitis by US, X-ray progression and biomarkers of inflammation in RA confirm the role of ultrasound as a method of independent evaluation of the course and outcomes of the disease. Disclosure of Interest: None declared