ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1529

Serum Levels of P-Glycoprotein Are Associated with Disease Activity in Rheumatoid Arthritis

Edsaul Emilio Perez-Guerrero1, Jorge Ivan Gamez-Nava2, Ernesto German Cardona-Muñoz3, Jose Francisco Muñoz-Valle4, Paulina Hernandez-Cuervo1,5, David Bonilla-Lara6,7, Ana Miriam Saldaña-Cruz8, Nicte Selene Fajardo-Robledo9, Silvia Elena Totsuka-Sutto10, Ana Rosa Rincon-Sanchez7, David Cardona-Muller3 and Laura del Carmen Gonzalez-Lopez6, 1Unidad de Investigación Biomédica 02 (Unidad de Investigación en Epidemiología Clínica), UMAE, Hospital de Especialidades Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Jalisco, Mexico, 2Unidad de Investigación Biomédica 02 (Unidad de Investigacion en Epidemiología Clínica), UMAE, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituo Mexicano del Seguro Social, Guadalajara, Mexico, 3Departamento de Fisiología, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Jalisco, Mexico, 4Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, Universidad de Guadalajara, Guadalajara, Mexico, 5Programa de Doctorado en Ciencias de la Salud Pública, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara. Guadalajara, Jalisco, México., Guadalajara, Mexico, 6Departamento Medicina Interna-Reumatología, Instituto Mexicano del Seguro Social, Hospital General Regional 110, Jalisco, Mexico, 7Doctorado en Farmacología, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Jalisco, Mexico, 8Centro Universitario de Investigación Biomédica. Universidad de Colima, Colima, Mexico, 9Laboratorio de Investigación y Desarrollo Farmacéutico, Universidad de Guadalajara, Centro Universitario de Ciencias Exactas e Ingenierias, Jalisco, Mexico, 10Unidad de Investigación Cardiovascular, CUCS, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords:

Session Information

Date: Monday, November 14, 2016

Title: Rheumatoid Arthritis – Clinical Aspects - Poster II: Co-morbidities and Complications

Session Type: ACR Poster Session B

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

Background/Purpose:  Patients with rheumatoid arthritis (RA) exert a wide variety of therapeutic responses to disease controlling anti-rheumatic drugs (DMARDs). P-glycoprotein (P-Gp) is involved in treatment resistance in some chronic diseases. Although, to date there is lack information to identify if high levels of P-gp are associated with low therapeutic response to s-DMARDs. The aim of the present study is analyze the association between serum P-Gp levels with the severity of disease activity despite treatment with DMARDs in RA.

Methods:  We included in this cross-sectional study eighty-one patients with RA treated for at least six months with DMARD. Patients were assessed for disease activity (DAS-28), type of DMARD, as well as other drugs currently used for the treatment of their disease and other clinical characteristics. Serum P-Gp levels were measured by ELISA.

Results:  The patients had a mean age of 57±10, the frequency of synthetic DMARDs received by the patients were methotrexate 59%, sulfasalazine 38%, leflunomide 30%, azathioprine 14%, chloroquine 14%, d-penicillamine 3%; whereas anti-TNF agents were received by 11% (etanercept 9%, adalimumab 1%, infliximab 1%) and rituximab 4%. Overall, patients with RA had higher serum P-Gp levels compared with controls 153 ± 187 versus 31 ± 29 ng/mL; respectively, p<0.0001). Patients with moderate or severe disease activity had higher serum P-Gp levels compared with patients with low-disease activity or remission (201 ± 207 versus 109 ± 156 ng/mL; respectively, p=0.028). Serum P-Gp levels were correlated with DAS-28 (r=0.26, p=0.018). There were no differences observed between patients with biologic agents vs patients with synthetic DMARDs in the serum P-Gp levels (228 ± 200 vs. 140 ± 183 ng/mL; p=0.14). P-Gp levels were independent of methotrexate utilization (p=0.5). After adjusting for age, disease duration and biologic agents’ utilization, the serum P-Gp levels remain associated with moderate or severe disease activity in the logistic regression analysis (p=0.021, using forward conditional method)

Conclusion:  Higher serum P-Gp levels are associated with the severity of disease activity despite treatment with DMARDs in RA. These serum levels can be used as biomarkers in patients with a non-therapeutic response. Further longitudinal studies should demonstrate if these levels can be predictive of failure to therapeutic response.

Disclosure: E. E. Perez-Guerrero, None; J. I. Gamez-Nava, None; E. G. Cardona-Muñoz, None; J. F. Muñoz-Valle, None; P. Hernandez-Cuervo, None; D. Bonilla-Lara, None; A. M. Saldaña-Cruz, None; N. S. Fajardo-Robledo, None; S. E. Totsuka-Sutto, None; A. R. Rincon-Sanchez, None; D. Cardona-Muller, None; L. D. C. Gonzalez-Lopez, None.

To cite this abstract in AMA style:

Perez-Guerrero EE, Gamez-Nava JI, Cardona-Muñoz EG, Muñoz-Valle JF, Hernandez-Cuervo P, Bonilla-Lara D, Saldaña-Cruz AM, Fajardo-Robledo NS, Totsuka-Sutto SE, Rincon-Sanchez AR, Cardona-Muller D, Gonzalez-Lopez LDC. Serum Levels of P-Glycoprotein Are Associated with Disease Activity in Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/serum-levels-of-p-glycoprotein-are-associated-with-disease-activity-in-rheumatoid-arthritis/. Accessed .

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