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Abstract Number: 1206

Associations of Vascular and Bone Status in Anti-TNF-treated Rheumatoid Arthritis and Ankylosing Spondylitis Patients

Anita Pusztai1, Attila Hamar2, Monika Czókolyová2, Katalin Gulyás2, Ágnes Horváth2, Edit Végh2, Zsófia Pethő2, Szilvia Szamosi2, Emese Balogh2, Nóra Bodnár2, Ágnes Szentpétery3, Harjit Bhattoa2, György Kerekes2, Balázs Juhász2, Éva Szekanecz2, Katalin Hodosi2, Andrea Domján2, Sándor Szántó2, Hennie Raterman4, Willem Lems5, Zoltán Szekanecz2 and Gabriella Szűcs2, 1University of Debrecen Faculty of Medicine, Department of Rheumatology, Debrecen, Hungary, 2University of Debrecen, Debrecen, Hungary, 3Uppsala University Hospital, Uppsala, Sweden, 4Northwest Clinics, Alkmaar, Netherlands, 5Amsterdam Rheumatology and Immunology Centre, Amsterdam, Netherlands

Meeting: ACR Convergence 2020

Keywords: osteoporosis, rheumatoid arthritis

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Session Information

Date: Sunday, November 8, 2020

Title: RA – Treatments Poster III: PROs, Biomarkers, Systemic Inflammation & Radiographs

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Cardiovascular (CV) disease and osteoporosis (OP) have become increasing challenges in the ageing population, even more in patients with inflammatory rheumatic diseases, such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Both diseases have been associated with generalized and localized bone loss, accelerated atherosclerosis, increased CV morbidity and mortality. 

Bone and vascular biomarkers and parameters along with the effect of one-year anti-TNF therapy on these markers were assessed in order to determine correlations between vascular pathophysiology and bone metabolism in RA and AS.

Methods: Fifty-three patients including 36 RA patients treated with etanercept (ETN) or certolizumab pegol (CZP) and 17 AS patients treated with ETN were included in a 12-month follow-up study. Bone and vascular markers were assessed by ELISA. Bone density was measured by DXA and quantitative CT (QCT). Flow-mediated vasodilation (FMD), common carotid intima-media thickness (IMT) and pulse-wave velocity (PWV) were assessed by ultrasound. Data on the effects of vascular markers on bone and bone effects on vasculature had undergone statistical analysis.

Results: We found a great number of correlations between vascular and bone surrogate markers. Both univariable and multivariable analyses suggested that osteoprotegerin (OPG) may positively determine FMD, parathyroid hormone (PTH) may be a determinant of PWV and sclerostin (SOST) may influence IMT at different time points. QCT total and trabecular BMD inversely correlated with IMT and IMT was also inversely associated with QCT total BMD. Baseline vitamin D3 (VITD3) inversely affected PWV. Some biomarkers at baseline also significantly determined other parameters at later time points. Moreover, one-year biologic treatment combined with baseline levels of different bone biomarkers may predict changes of IMT upon therapy. According to the multivariate analyses, systemic inflammation (C-reactive protein) or disease activity, as well as their change between baseline and 12 months may significantly influence the interrelationship between certain bone and vascular biomarkers.

Conclusion: In our study of anti-TNF treated RA and AS patients, vascular and bone parameters showed numerous correlations. Some bone markers may predict vascular status after one-year treatment and vice versa. Systemic inflammation and arthritic disease activity may influence the associations between bone and vascular biomarkers.


Disclosure: A. Pusztai, None; A. Hamar, None; M. Czókolyová, None; K. Gulyás, None; �. Horváth, None; E. Végh, None; Z. Pethő, None; S. Szamosi, None; E. Balogh, None; N. Bodnár, None; �. Szentpétery, None; H. Bhattoa, None; G. Kerekes, None; B. Juhász, None; �. Szekanecz, None; K. Hodosi, None; A. Domján, None; S. Szántó, None; H. Raterman, None; W. Lems, None; Z. Szekanecz, Pfizer, 1; G. Szűcs, None.

To cite this abstract in AMA style:

Pusztai A, Hamar A, Czókolyová M, Gulyás K, Horváth �, Végh E, Pethő Z, Szamosi S, Balogh E, Bodnár N, Szentpétery �, Bhattoa H, Kerekes G, Juhász B, Szekanecz �, Hodosi K, Domján A, Szántó S, Raterman H, Lems W, Szekanecz Z, Szűcs G. Associations of Vascular and Bone Status in Anti-TNF-treated Rheumatoid Arthritis and Ankylosing Spondylitis Patients [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/associations-of-vascular-and-bone-status-in-anti-tnf-treated-rheumatoid-arthritis-and-ankylosing-spondylitis-patients/. Accessed .
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