Session Information
Title: Rheumatoid Arthritis - Clinical Aspects: Novel Biomarkers and Other Measurements of Disease Activity
Session Type: Abstract Submissions (ACR)
Background/Purpose: Osteoprotegerin (OPG), RANKL, and DKK-1 act as regulators of bone resorption and formation. The uncoupling of bone remodelling that occurs in rheumatoid arthritis (RA) originates generalized bone loss and joint erosions.
Our aims are: 1) In patients with RA, to determine the serum levels of OPG, RANKL and DKK-1 and its relationship with radiological progression in hands. 2) To assess their relations with the activity and disability parameters of RA.
Methods: From a previous study in which we had radiographs of hands and frozen sera from all patients (T0), we selected the ones controlled since the diagnosis of the disease in an Early Arthritis Clinic of a university hospital through a strategy of tight control. They came back to make radiographs of hands and collection of sera (T1). Study variables were: 1) Demographics: age, sex, body mass index (BMI); 2) RA history: duration, RF, anti-CCP antibodies; 3) Disease activity: mean DAS28 and CRP between T0 and T1; 4) Disability: mean HAQ; 5) RA treatment; 6) Serum levels of OPG, RANKL and DKK-1; and 7) Sharp-van der Heijde Index (SHI) of hands, analyzing together and separately erosions (SHI-Ero) and joint space (SHI-Spa).
Results: Ninety-seven patients (60 women) were included with a mean age of 53 ± 14 years and a mean BMI of 25.9 ± 4.9 kg/m2. At T0, mean RA duration was 1.6 ± 1.5 years. Sixty-one percent of the patients had RF + and 62%, anti-CCP antibodies +. Mean DAS28 was 2.61 ± 0.96; CRP, 5.9 ± 7.1 mg/L; and HAQ, 0.330 ± 0.331. Seventy-six percent of the patients had low activity (DAS28 < 3.2) and 23%, moderate activity (DAS28 ≥ 3.2 and < 5.1); only one patient presented high activity (DAS28: 5.21). Mean time between T0 and T1 was 3.3 ± 1.5 years.
|
|
SHI |
SHI-Ero |
SHI-Spa |
OPG pmol/L |
RANKL* pmol/L |
OPG/RANKL* |
DKK-1 pmol/L |
|
T0 |
5.2 ± 7.1 |
0.8 ± 2.3 |
4.5 ± 5.9 |
3.9 ± 1.8 |
0.3 ± 0.3 |
53.5 ± 55.1 |
29.9 ± 11.0 |
|
T1 |
7.8 ± 10.9 |
1.4 ± 3.7 |
6.3 ± 8.1 |
4.1 ± 2.2 |
0.4 ± 0.4 |
29.7 ± 39.4 |
26.4 ± 18.9 |
* RANKL levels were below the limit of detection in 82 (T0) and 72 (T1) patients.
Mean annual progression of SHI was 0.9 ± 2.2; SHI-Ero, 0.2 ± 0.6, and SHI-Spa, 0.7 ± 1.7. The annual progression of SHI, SHI-Ero and SHI-Spa correlated with CRP levels (p < 0.01) and with the titer of anti-CCP antibodies; SHI-Spa progression correlated also with age (p < 0.05). We found no relation between SHI and OPG, RANKL or DKK-1.
Patients whose ISH worsened (48%) were older and had higher BMI and RA activity than patients in which ISH didn’t worsen (52%).
Conclusion: The progression of radiological damage in a series of RA patients controlled in an Early Arthritis Clinic is dependent on the activity of the disease and the titer of anti-CCP antibodies. Serum levels of OPG, RANKL and DKK-1 do not seem useful to predict progression of radiographic damage.
Disclosure:
C. Gómez-Vaquero,
None;
I. Martín-Esteve,
None;
J. Ivorra,
None;
J. A. Narvaez,
None;
J. Hernandez Gañan,
None;
P. Alia,
None;
J. Narváez,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/determinants-of-radiological-progression-in-rheumatoid-arthritis-relationship-with-serum-levels-of-opg-rankl-and-dkk-1/