Session Information
Title: Rheumatoid Arthritis - Clinical Aspects (ACR): Comorbidities, Treatment Outcomes and Mortality
Session Type: Abstract Submissions (ACR)
Background/Purpose
The purpose of the study was to describe prevalence and components (c) of MetS in a cohort of early RA, to compare it with data from matched controls and to investigate MetS impact on disease activity.
Methods
The study population was a prospective cohort of early RA (95% satisfying 2010 ACR/EULAR criteria) initiated in 2004. At baseline, 2 months-apart for the first 2 years and thereafter at least six-months-apart, patients had complete medical evaluations that included height, weight and blood pressure, standardized rheumatic evaluations and assessments of comorbidity and treatment; at 6 months fixed intervals, fasting serum glucose (GLU), triglycerides (TRG), HDL-Cholesterol (HDL) and acute reactant-phase were performed. Data from a local database of healthy controls randomly selected and matched were used.
MetS was defined according to 3 sets of criteria (ATP-III, AHA/NHLBI, IDF) and body mass index (BMI) ≥30 was used as a surrogate of the waist circumference criteria-c. Sustained remission (SR) was defined according to ACR/EULAR 2012 criteria and lasting ≥ 6 months.
The study was approved by the internal review board. Written informed consent was obtained.
Appropriated statistics was used. All statistical tests were 2-sided and evaluated at the 0.05 significance level.
Results
Up to March 2014, 162 patients were included in the cohort, of whom 160 had complete baseline data; they were more frequently middle-aged females (142 �Š, [mean±SD] years of age: 38.1±12.8), RF+ (81.3%), ACCP+ (83.8%) and had high disease activity; comorbid conditions were present in 82 patients (51.3%). Patients were treated with conventional DMARDs.
Prevalence of MetS at the baseline evaluation varied (depending on the criteria applied) from 11.3% to 17.5% in RA patients and was similar to that in controls (vs. 13.8% to 18.8%). Distribution of MetS c varied from 64-100% for BMI-c, 93-96% for TRG-c, 94-96% for HDL-c, 21-22% for systolic blood pressure-c and from 28-54% for GLU-c.
During follow-up (69.2±36.8 months), 108 patients had at least ≥ 1 sustained remission state at (median) 14 months of study entry and remained in remission for 16 months; of them, 20.4% had MetS and no differences were seen between patients with/without MetS regarding remission related outcomes.
Up to last follow-up, 39 patients (34.5%) developed incidental MetS (out of 113 baseline MetS-free patients). Annual incidental rate decreased after the third year of follow-up. Patients who developed incidental MetS were older, more frequently menopause females, had higher BMI, had more cumulative disease activity and disability previous incidental MetS and developed more frequently erosive disease than their counterparts. In the Cox regression analysis, cumulative DAS28 (OR: 1.81, 95% CI: 1.346-2.433, p=0.000) and baseline BMI (OR: 1.131, 96% CI: 1.035-1.236, p=0.007) were the only predictors for incidental MetS (X²=28.8%).
Conclusion
MetS prevalence in a cohort of early RA patients was similar to that from matched controls and varied from 11 to 18%. Cumulative disease activity and higher BMI were risk factors for incidental Mets. Disease activity control in RA patients may additionally impact comorbid conditions.
Disclosure:
F. Parra-Salcedo,
None;
I. Contreras-Yáñez,
None;
D. Elías-López,
None;
C. A. Aguilar-Salinas,
None;
V. Pascual-Ramos,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-metabolic-syndrome-mets-on-rheumatoid-arthritis-disease-activity/