Search

Background The lack of efficacy of biological therapies in rheumatic patients causes a change of treatment, usually to another biological therapy. A significant number of studies have been published in relation to the reasons that cause this inefficacy, (1,2,3); however, no studies have evaluated the involvement of the weight and lipid profile of patients in this process. Objectives To analyze the influence of weight and lipid profile in the relapse and change of biological therapy. Methods Retrospective-descriptive study. Rheumatic patients in treatment with biological therapies were recruited from January 2016 to December 2018. Sociodemographic data were collected (age and sex), along with anthropometric variables (weight, height, waist circumference and hip perimeter), toxic habits, comorbidities and variables related to the treatment. Associations between variables were analyzed using a Chi-square and T student. P-values Results Two hundred and nine patients were enrolled, of which 80 (38.3%) were male and 129 (61.7%) were female. The mean age (SD) was 48.9 12.8 years. One hundred and twenty patients (57.4%) suffered rheumatoid arthritis, 35 (16.7%) spondylitis, 29 (13.9%) psoriatic arthritis and 10 (4.8%) spondyloarthritis. One hundred and fifty-three (73.2%) had not switches of biological therapy, 51 (24.4%) switched of biological therapy once and 5 (2.4%) three or more times. Statistically significant differences were found in the obese males who switched of biological therapy in relation to obese males who not switched (35.6% vs. 11.1%). Accordingly, the percentage of patients with hyperlipemia that switched of biological therapy was significantly higher than those who did not (29.4% vs. 13.1%). The years of evolution and diagnosis we also involved, so that patients with more years of evolution and more years from the diagnosis had a higher percentage of switched (p = 0.006 IC 95% -17.22, - 0.96 and p = 0.042 -18, 32; -037 respectively). Conclusion Being obese male and with hyperlipidemia could be a risk factor that would condition the lack of response to a biological therapy and thus the need of switching to another. References [1] Glintborg B1, stergaard M, Krogh NS, Tarp U, Manilo N, Loft AG, Hansen A, Schlemmer A, Fana V, Lindegaard HM, Nordin H, Rasmussen C, Ejstrup L, Jensen DV, Petersen PM, Hetland ML. Clinical response, drug survival and predictors thereof in 432 ankylosing spondylitis patients after switching tumour necrosis factor α inhibitor therapy: results from the Danish nationwide DANBIO registry. Ann Rheum Dis. 2013Jul;72(7):1149-55. doi: 10.1136/annrheumdis-2012-201933. Epub 2012 Aug 31. [2] Navarro-Compn V, Plasencia-Rodrguez C, de Miguel E, Diaz Del Campo P, Balsa A, Gratacs J. Switching biological disease-modifying antirheumatic drugs in patients with axial spondyloarthritis: results from a systematic literature review. RMD Open. 2017 Oct 10;3(2):e000524. doi: 10.1136/rmdopen-2017-000524. eCollection 2017. [3] Ganzetti G, Campanati A, Bettacchi A, Brandozzi G, Brisigotti V, Bugatti L, Cataldi I, Filosa G, Giacchetti A, Lemme G, Morresi L, Nicolini M, Postacchini V, Ricotti G, Rosa L, Simonacci M, Offidani A. Switching from a biological therapy to another biologic agent in psoriatic patients: the experience of PsOMarche group. G Ital Dermatol Venereol. 2018 Feb;153(1):5-10. doi: 10.23736/S0392-0488.16.05463-8. Epub 2016 Nov 15. Disclosure of Interests Rocio Segura: None declared, Maria del Carmen Abalos-Aguilera: None declared, Alejandra M. Patio-Trives: None declared, juan vacas: None declared, Joaquin Sosa: None declared, Celestino Gil: None declared, Maria del Rosario Navarro: None declared, Mara del Carmen Castro Villegas Paid instructor for: MSD, Abbvie, Pfizer, Janssen, Lilly, Roche, Rafaela Ortega Castro: None declared, Jerusalem Calvo Gutierrez: None declared, Desiree Ruiz: None declared, Montserrat Romero-Gmez: None declared, Ladehesa Pineda Lourdes: None declared, Alejandro Escudero Contreras: None declared, Eduardo Collantes-Estvez Consultant for: UCB Pharma, MSD, AbbVie, Novartis, Janssen, Font Ugalde Pilar: None declared, Luis Jurado: None declared

Background The correct indication of the suspension of treatment with FAMES and biological therapy in pediatric patients, in the presence of a mild infectious disease or vaccination is a common problem in children’s rheumatology. In patients with juvenile idiopathic arthritis (JIA), joint or extra-articular clinical reactivation during these “pauses” is not uncommon, however, there are not enough studies in the pediatric population to show the influence of treatments on the immune system., and therefore, that justify this clinical practice. Objectives To analyze the levels of T, B and NK lymphocyte subpopulations in patients diagnosed with JIA treated with FAMES and biological therapy. Methods A descriptive and cross-sectional study in which 39 patients from the Pediatric Rheumatology Unit of the Reina Sofia University Hospital were recruited, diagnosed with JIA according to the ILAR 2001 criteria. The patients were divided into four groups: 8 controls in clinical remission without treatment, 17 in treatment with DMARD in monotherapy, 7 in biological treatment in monotherapy and 7 in treatment with DMARD-biological. Patients with systemic JIA were excluded because they had a pathogenic mechanism different from the rest of the JIA categories. By flow cytometry, the levels of CD3, CD4, CD8 and CD19 cells were measured for acquired immunity and from NK for innate, the CD4/CD8 index was also calculated. Results The mean age of the 39 patients was 10 ± 5.7 years, 29 were girls (74.3%), 4 patients had arthritis related to enthesitis, 16 patients had oligoarticular involvement ANA +, 6 subjects polyarticular involvement FR- and 13 they were psoriatic arthritis. Although no statistically significant differences were found when contracting cellular levels among the 4 groups evaluated, it was observed that the group treated with DMARD monotherapy had the highest percentage of children with alterations in cellular levels CD3, CD4, CD8 and CD19 (41.17% of the patients of the group); the group treated in monotherapy with biological treatment (28%) presented alteration in the levels of CD8 and CD19 and the group treated in combination of DMARD and biological (14.28%) in CD19. On the other hand, the NK cells and the CD4/CD8 index were not altered in any of the groups. Only 6 cases of serious infections were registered in patients in combination therapy (DMARD-biologic) who had received corticosteroids by clinical activity. There were no statistical differences between patients who had received corticosteroids and those who did not. Conclusion Patients in treatment with DMARD monotherapy had a tendency to decrease cellular levels. On the other hand, alterations in innate immunity or CD4/CD8 index were not observed. Disclosure of Interests None declared

Funder: Europeo de Desarrollo Regional de la Unión Europea, Funder: Rheumatic Diseases Network, OBJECTIVE: To analyze the relationship between complement component 3 (C3) and the prevalence of cardiometabolic risk factors and disease activity in the rheumatic diseases having the highest rates of cardiovascular morbidity and mortality: rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). METHODS: This is a cross-sectional study including 200 RA, 80 PsA, 150 axSpA patients and 100 healthy donors. The prevalence of cardiometabolic risk factors [obesity, insulin resistance, type 2 diabetes mellitus, hyperlipidemia, apolipoprotein B/apolipoprotein A (apoB/apoA) and atherogenic risks and hypertension] was analyzed. Serum complement C3 levels, inflammatory markers and disease activity were evaluated. Cluster analysis was performed to identify different phenotypes. Receiver operating characteristic (ROC) curve analysis to assess the accuracy of complement C3 as biomarker of insulin resistance and disease activity was carried out. RESULTS: Levels of complement C3, significantly elevated in RA, axSpA and PsA patients, were associated with the prevalence of cardiometabolic risk factors. Hard clustering analysis identified two distinctive phenotypes of patients depending on the complement C3 levels and insulin sensitivity state. Patients from cluster 1, characterized by high levels of complement C3 displayed increased prevalence of cardiometabolic risk factors and high disease activity. ROC curve analysis showed that non-obesity related complement C3 levels allowed to identify insulin resistant patients. CONCLUSIONS: Complement C3 is associated with the concomitant increased prevalence of cardiometabolic risk factors in rheumatoid arthritis and spondyloarthritis. Thus, complement C3 should be considered a useful marker of insulin resistance and disease activity in these rheumatic disorders.