1254 - No Change in Arterial Stiffness After 6 Months of Abatacept Treatment in Rheumatoid Arthritis

Monday, November 7, 2011: 9:00 AM-6:00 PM
Hall F2 - Poster Hall (McCormick Place West)
Sylvain Mathieu1, Bruno Pereira2, Emilie Rabois1, Anne Tournadre1, Jean Jacques Dubost1 and Martin Soubrier2, 1CHU Gabriel Montpied, Clermont-Ferrand, France, 2CHU CLERMONT-FERRAND, Clermont-Ferrand, France
Presentation Number: 1254

Background/Purpose: The excess cardiac risk found in rheumatoid arthritis (RA) has been attributed to biological inflammation. Effective control of inflammation and disease activity may be of benefit in reducing cardiovascular risk in RA patients.

Method: and Objectives: To investigate the effects of 24 weeks of abatacept treatment in active RA on arterial stiffness measured by augmentation index (AIx) and pulse wave velocity (PWV) and on traditional cardiovascular risk factors (lipid profile, blood pressure).

Result: Twenty-one patients, of whom 17 (81.0%) were female; with a mean age of 65.2 ± 13.7 years and a mean disease duration of 21.5 ± 10.0 years, were included. Of the 21 RA patients, 10 (47.6%) had positive rheumatoid factors, 16 (76.2%) had positive anti-CCP antibody, and 90.5 % (n=19) were erosive. Sixteen patients (76.2%) were non-responders to anti-TNF alpha treatments.

After 6 months of abatacept treatment, no change was observed in PWV and AIx (PWV: 8.5 ± 3.8 m/s at baseline, 9.3 ± 3.0 at 6 months; p=0.07 and AIx: 31.4 ± 10.7 % at baseline, 31.6 ± 9.1 at 6 months; p=0.97). A significant increase in levels of HDL cholesterol (1.64 ± 0.45 mmol/l at baseline, 1.93 ± 0.62 at 6 months; p=0.01) and a decrease in atherogenic index (total cholesterol/HDL cholesterol), but not to a level of significance (3.14 ± 0.79 at baseline, 2.89 ± 0.96 at 6 months, 3.37 ± 1.03 at one year; p=0.14), were obtained. We found no modification in levels of total cholesterol (4.91 ± 0.99 mmol/l at baseline, 5.22 ± 0.86 at 6 months; p=0.33), LDL cholesterol (2.65 ± 0.65 mmol/l at baseline, 2.70 ± 0.63 at 6 months; p=1.0) or triglycerides (1.17 ± 0.53 mmol/l at baseline, 1.31 ± 0.73; p=0.72). No change was found in levels of blood pressure. DAS28 ESR (5.1 ± 1.0 at baseline, 3.5 ± 1.3 at 6 months; p<0.001) and DAS28 CRP (4.8 ± 0.9 at baseline, 3.4 ± 1.2 at 6 months; p<0.001) were significantly improved. We found a significant decrease in parameters of biological inflammation, significant for ESR (35.7 ± 38.9 mm/h at baseline, 26.6 ± 28.1 at 6 months; p=0.04) but not for CRP (21.5 ± 36.1 mg/l at baseline, 11.8 ± 15.1 at 6 months; p=0.61).

Conclusion: This study shows that arterial stiffness was not improved after 6 months of abatacept therapy. This lack of improvement might be due to insufficient decrease in biological inflammation in these 21 RA patients. However, the treatment did have a beneficial effect on lipid profile and so it would be interesting to have an assessment over a longer period.


Keywords: abatacept, arteriosclerosis and rheumatoid arthritis (RA)

Disclosure: S. Mathieu, None; B. Pereira, None; E. Rabois, None; A. Tournadre, None; J. J. Dubost, None; M. Soubrier, None.