ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2323

The Effect of Biologic Therapies on Serum Metabolic Biomarkers in Patients with Psoriatic Arthritis

Keith Colaco1, laura bumbulis2, Vinod Chandran1, Richard Cook3, Dafna Gladman4 and Lihi Eder5, 1University of Toronto, Toronto, ON, Canada, 2University of Waterloo, Waterloo, ON, Canada, 3University of Waterloo, Waterloo, Canada, 4University of Toronto, Toronto Western Hospital, Toronto, ON, Canada, 5University of Toronto, Women’s College Hospital and Department of Medicine, Toronto, ON, Canada

Meeting: ACR Convergence 2024

Keywords: , , ,

Session Information

Date: Monday, November 18, 2024

Title: SpA Including PsA – Diagnosis, Manifestations, & Outcomes Poster III

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: Biologic therapies, such as tumor necrosis factor-alpha inhibitors (TNFi) and interleukin-17 inhibitors (IL-17i) may affect the cardio-metabolic profile of patients with psoriatic arthritis (PsA). We aimed to assess the short-term effects of TNFi and IL-17i on serum metabolites in patients with PsA, and determined whether these metabolite changes differed across the two drug classes.

Methods: A nested cohort study was conducted among participants with available serum samples from a longitudinal PsA cohort who initiated TNFi or IL-17i therapy. Serum samples prior to initiation of therapy, and three to six months after initiation of therapy, were used to quantify 64 metabolic biomarkers using a Nuclear Magnetic Resonance targeted metabolomics panel, which comprised lipid particles, apolipoproteins, fatty acids, amino acids and various other low-molecular metabolites. T-tests were used to compare differences in metabolite levels before versus after therapy within each drug class. Linear mixed effects models assessed the effect of each drug class on changes in metabolite levels adjusting for age, sex, lipid lowering drugs, diabetes, hypertension and menopause.

Results: A total of 176 treatment periods (163 patients) were analyzed between 2013 and 2021 (mean age 51 ± 12.6 years, 45.5% female) (Table 1). Among users of TNFi, levels of alanine, glycine, citrate and creatinine significantly increased post-treatment, whereas levels of glycoprotein acetyls (GlycA), a marker of systemic inflammation, decreased (Figure 1).  Among users of IL-17i, concentrations of citrate significantly increased post-treatment, whereas alanine, glycine, histidine, GlycA and creatinine decreased. When comparing biomarkers between classes of medications, post- and pre-treatment levels differed significantly for alanine, glycine, histidine, citrate, GlycA and creatinine. In linear mixed effects models adjusted for age and sex involving TNFi users, levels of alanine (Estimate [EST] 0.034; 95% confidence interval [CI] 0.008, 0.06), glycine (EST 0.029; 95% CI 0.02, 0.04), phenylalanine (EST 0.006; 95% CI 0.001, 0.01), citrate (EST 0.008; 95% CI 0.005, 0.01)  and creatinine (EST 3.87; 95% CI 0.41, 7.4) increased post-treatment, whereas acetate (EST −0.03; 95% CI −0.03,−0.02) and GlycA (EST −0.05; 95% CI −0.09,−0.01) decreased (Table 2). In models adjusted for age and sex involving IL-17i users, changes were observed among fewer biomarkers, with low-density lipoprotein (LDL) particle size (EST 0.04; 95% CI 0.009, 0.07) increasing post-treatment, and levels of histidine (EST−0.005; 95% CI −0.008,−0.003) and acetone (EST −0.005; 95% CI −0.009,−0.001) decreasing. 

Conclusion: TNFi and IL-17i appear to differentially affect the serum metabolic profile of patients with PsA. Treatment with TNFi was associated with more changes in metabolite profiles than IL-17i, including changes associated with systemic inflammation (GlycA) and amino acids. The implication of these changes on long-term cardio-metabolic risk needs further research.

Supporting image 1

Table 1 – Baseline characteristics of the study population.

Supporting image 2

Table 2 – Estimated differences between post- and pre-treatment levels of metabolite biomarkers on linear mixed effects models for treatment periods involving TNF inhibitors and IL_17 inhibitors. Only biomarkers with statistically significant (p<0.05) estimates for at least one model are included.

Supporting image 3

Figure 1 – Estimated differences between post- and pre-treatment levels of metabolite biomarkers based on t-tests. Only biomarkers with statistically significant (p<0.05) differences for at least one class of medication are included.

Disclosures: K. Colaco: None; l. bumbulis: None; V. Chandran: AbbVie/Abbott, 1, 5, AstraZeneca, 12, Spousal employment, Bristol-Myers Squibb(BMS), 1, Eli Lilly, 1, Janssen, 1, Novartis, 1, UCB, 1; R. Cook: None; D. Gladman: AbbVie, 2, 5, Amgen, 2, 5, AstraZeneca, 2, BMS, 2, Celgene, 2, 5, Eli Lilly, 2, 5, Galapagos, 2, 5, Gilead, 2, 5, Janssen, 2, 5, Novartis, 2, 5, Pfizer, 2, 5, UCB, 2, 5; L. Eder: AbbVie, 2, 5, 6, Bristol-Myers Squibb (BMS), 2, Eli Lilly, 2, 5, Fresenius Kabi, 5, Johnson & Johnson, 2, 5, Novartis, 1, 5, Pfizer, 5, 6, UCB, 5, 6.

To cite this abstract in AMA style:

Colaco K, bumbulis l, Chandran V, Cook R, Gladman D, Eder L. The Effect of Biologic Therapies on Serum Metabolic Biomarkers in Patients with Psoriatic Arthritis [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/the-effect-of-biologic-therapies-on-serum-metabolic-biomarkers-in-patients-with-psoriatic-arthritis/. Accessed .

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