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BackgroundA regular monitoring of structural damage in patients with rheumatoid arthritis (RA) is necessary to adjust the treatment. However, the rhythmicity of new radiographs to assess the structural damage is not codified. There is no biomarker able to reflect structural damage.ObjectivesOur study aimed to assess the relationship between the modified Sharp score and the platelet to lymphocyte ratio.MethodsWe performed a cross-sectional study including 53 patients with RA. A cell blood count was performed for each patient, and PLR was calculated. Modified Sharp score and its components (erosion score and joint space narrowing score) were evaluated using the radiograph of hands and feet.Statistical analysis was performed using SPSS (Statistical Package for Social Sciences).ResultsOf the 53 patients, 39 were female (Sex Ratio: 2.8). The mean age was 53.9 ± 12.7 years. The mean age of the onset of the disease was 43.8±13.5 years. The mean disease duration was 10.1 ± 8.2 years. The mean DAS 28-ESR score was 4.64 ± 1.23.The mean value of PLR was 161.62 ± 86.59. The mean modified Sharp score was 46.33 ± 37.74. Thirty-two percent of patients had a modified Sharp score greater than 50. The mean scores of joint erosion and joint space narrowing were 12.76 ± 15.05 and 33.57 ± 25.80.Modified Sharp score was correlated to the PLR (r: 0.501; p Moreover, joint space narrowing score and joint erosion score were correlated to the PLR (r: 0.558; p Patients with a modified Sharp score ≥ 50 had a higher PLR (203.12 ± 101.71 versus 142.33 ± 74.07).As shown in Figure 1, the ability of PLR to distinguish patients with a modified Sharp score ≥ 50 was good with an AUC of 0.704 (p= 0.021) with a cut-off of 130.5 (sensitivity=75%, specificity=65.7%).Figure 1.ROC curve assessing the ability of PLR to distinguish patients with a modified Sharp score ≥ 50ConclusionOur study showed that the modified Sharp score correlated with PLR, which ​​can be useful to distinguish patients with severe structural damage with a cut-off of 130.5. This finding suggests that this ratio is a reliable marker to reflect radiographic joint damage.Disclosure of InterestsNone declared

Background:The tight control strategy is recommended in rheumatoid arthritis to tailor treatment for patients. This strategy requires regular monitoring of both disease activity and structural damage. However, radiographic assessement cannot be performed frequently and the modified Sharp score is rarely evaluated in current practice. Besides, no biomarker was able to mirror structural damage (1).Objectives:Our study aimed to assess the relationship between the modified Sharp score and the inflammatory ratios (platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), fibrinogen to albumin ratio (FAR) and CRP to albumin ratio (CAR)).Methods:We performed a cross-sectional study including 53 patients with rheumatoid arthritis (RA). A cell blood count, fibrinogen and an albumin blood test were measured for each patient. Inflammatory ratios were also measured (PLR, NLR, LMR, FAR, and CAR). Modified Sharp score and its components (erosion score and joint space narrowing score) were evaluated using the radiograph of hand and foot.Patients with infectious or hematological diseases were excluded from the study.Statistical analysis was performed using SPSS (Statistical Package for Social Sciences).Results:Of the 53 patients, 39 were female (Sex Ratio: 2.8). The mean age was 53.9 ± 12.7 years. The mean disease duration was 10.1 ± 8.2 years.The average age of the onset of the disease was 43.8±13.5 years.The mean DAS 28-ESR score was 4.64 ± 1.23. Forty three patients had a score higher than 3.2 (patients with moderate or high disease activity).The mean values of PLR, NLR, LMR, FAR and CAR were 161.62 ± 86.59, 2.84 ± 2.39, 4.99 ± 3.23, 0.12 ± 0.06 and 1.15 ± 1.38.The mean scores of joint erosion and joint space narrowing were respectively 12.76 ± 15.05 and 33.57 ± 25.80. The mean modified Sharp score was 46.33 ± 37.74.There was a positive correlation between modified Sharp score and following ratios: PLR (r: 0.501; p -3), NLR (r: 0.302; p:0.031), FAR (r: 0.300; p:0.030), CAR (r:0.286; p:0.042).Moreover, a positive correlation between joint space narrowing score and these ratios was identified: PLR (r: 0.558; p -3), NLR (r: 0.428; p:0.002), FAR (r: 0.371; p:0.007), CAR (r:0.387; p:0.005).Joint erosion score correlated with PLR (r: 0.299; p:0.033).No correlation was found between LMR and radiographic score.Conclusion:Our study showed that the modified Sharp score correlated with PLR, NLR, FAR and CAR in patients with RA. This finding suggests that these ratios could be used as inexpensive and reliable markers to reflect radiographic joint damage.Longitudinal studies are necessary to confirm our results.References:[1]Syversen SW, Landewe R, Van Der Heijde D, Bathon JM, Boers M, Bykerk VP, et al. Testing of the OMERACT 8 draft validation criteria for a soluble biomarker reflecting structural damage in rheumatoid arthritis: a systematic literature search on 5 candidate biomarkers. J Rheumatol. 2009;36(8):1769-84.Disclosure of Interests:None declared