SAT0413 The trend of incidence rate, frequency, outcomes and hla phenotype of reactive arthritis and uveitis in japanese patients with bladder cancer following intravesical bcg therapy: a 20-year, two-centre retrospective study. (12th June 2018)

• Record Type: Journal Article
• Authors: Nakatani, Y.; Taniguchi, Y.; Inotani, S.; Nishikawa, H.; Karashima, T.; Yoshinaga, Y.; Terada, Y.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1067
• Page End: 1067
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.2878
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Intravesical instillation of Bacillus Calmette-Guerin (iBCG) is used as an effective immunotherapy of bladder cancer. However it may have, as adverse event, a reactive arthritis (ReA) and the frequencies are known as about 0.5% to 1% in Western countries. Objectives: To evaluate the trend of incidence rate, frequency and HLA phenotype of reactive arthritis (ReA), uveitis and other adverse events in Japanese patients with bladder cancer following iBCG therapy. Methods: The clinical findings of Japanese patients who received iBCG (n=555 [250 and 305 in Kochi Medical School Hospital and Kurashiki Medical Centre, respectively]) for bladder cancer from March 1997 to February 2017 were retrospectively assessed, with specific attention to patients with ReA and uveitis. HLA phenotypes of patients with ReA were also looked. Moreover, iBCG-induced ReA diagnosed from 1997 to 2007 were compared with that from 2007 to 2017. Finally, outcomes of ReA patients were also evaluated. Results: Patients' mean age was 72±10 years and male/female ratio was 438/117. Fever, haematuria, and dysuria were presented in 91/555 (16.4%), 121/555 (21.8%), and 196/555 (35.3%), respectively of all enrolled patients. Of the 555 cases, ReA and uveitis were revealed in 11/555 (2.0%) and 4/555 (0.7%). The protocol of iBCG therapy was stable over the 20 years. Notably, HLA-B27, -B35, -B39 and -B51 positivity was more frequent in ReA patients (9.1%, 36.3%, 36.3% and 63.6%, respectively) (p<0.05) than in healthy subjects without ReA (0.3%, 8.3%, 4.0% and 9.1%, respectively). All 4 cases with uveitis had ReA, and showed positive HLA-B27 (25%), -B39 (50%) and -B51 (25%). Moreover, the overall incidence of iBCG-ReA was not different between from 1997 to 2007 and 2007 to 2017. Finally, all ReA patients did not progress to chronic type and spondyloarthritis (SpA) as outcomes. Conclusions: The 2.0% iBCG-induced ReA frequency in Japanese patients exceeds that in Western countries, and its incidence has been stable and all ReA did not progress chronic type and SpA over the last 20 years. HLA phenotype, especially HLA-B51 and -B39 alleles in addition to -B27, may be a risk factor in iBCG-induced ReA in Japanese patients. Disclosure of Interest: None declared