Session Information
Session Title: Rheumatoid Arthritis - Clinical Aspects: Novel Biomarkers and Other Measurements of Disease Activity
Session Type: Abstract Submissions (ACR)
Background/Purpose
Intact glycocalyx is of importance for healthy endothelial function. Changes in the endothelial glycocalyx, characterized by increased levels of circulating syndecan-1, might be related to accelerated atherosclerosis in RA. The aim of this study was to examine the level of serum (s-) syndecan-1 in patients with RA, and the effect of anti-rheumatic treatment on the s-syndecan-1 levels.
Methods
We selected 32 patients with active RA from the Norwegian observational PSARA study. Due to clinical decision, the patients should start either with methotrexate or methotrexate (MTX) and anti-tumor necrosis factor (TNF) regimen. The patients were examined before the treatment initiation (visit 1) and after 6 weeks (visit 2) of the treatment. S-syndecan-1 was measured by ELISA.
Results
The mean age of the patients was 59±8 years, and 27% were men. 12 patients recieved MTX and 20 recieved MTX and anti-TNF treatment. S-syndecan-1 levels significantly decreased from visit 1 (49 ± 52 ng/ml) to visit 2 (45±50 ng/ml), p=0.047. The difference was independent of age, sex and difference in DAS28. The s-syndecan-1 reduction was greater in the MTX than MTX and anti-TNF group (10 ± 13 vs. 1 ± 1 ng/ml), p=0.048.
Conclusion
Anti-rheumatic treatment reduces s-syndecan-1 in RA. Thus, a glycocalyx ameliorating effect may contribute to the reduction of cardiovascular morbidity and mortality due to anti-rheumatic treatment. In theory, the greater reduction of s-syndecan-1 in the MTX than in the combined group might be due to differences in patient population, as patients starting with MTX are likely to have a less severe RA, with a shorter disease duration, than those starting with anti-TNF. Interestingly, although MTX is considered as a less potent anti-rheumatic drug than anti-TNF, it may have a protective effect on glycocalyx, which may explain its cardioprotective effect observed in previous studies. This effect might be at least partially independent of its anti-inflammatory properties.
Disclosure:
I. Hollan,
None;
G. Hjeltnes,
None;
T. Lyberg,
None;
S. Agewall,
None;
A. Wiik,
None;
K. Mikkelsen,
None;
T. Førre,
None;
T. T. Vuong,
None;
S. O. Kolset,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/anti-rheumatic-therapy-decreases-syndecan-1-shedding-in-rheumatoid-arthritis-ra/