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Abstract Number: 398

Anti-Rheumatic Therapy Decreases Syndecan-1 Shedding in Rheumatoid Arthritis (RA)

Ivana Hollan1, Gunnbjørg Hjeltnes2, Torstein Lyberg3, Stefan Agewall3, Allan Wiik4, Knut Mikkelsen5, Øystein T. Førre6, Tram T. Vuong3 and Svein O. Kolset3, 1Rheumatology, Lillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway, 2Medicine, Innlandet Hospital Trust, Lillehammer, Norway, 3University of Oslo, Oslo, Norway, 4Clinical Biochem/Immunology, Statens Serum Institute, Copenhagen S, Denmark, 5Lillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway, 6Oslo University Hospital, Oslo, Norway

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Atherosclerosis, rheumatoid arthritis (RA) and treatment

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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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