AB0402 Rituximab may delay the movement of rheumatoid arthritis patients on cardiorenal continuum: results from a prospective observational single-centre cohort study

Abstract

BackgroundSimilarities in risk factors, initial stages, progression and final stage of both atherosclerotic cardiovascular disease (CVD) and chronic kidney disease (CKD) allowed formulating a concept of cardiorenal continuum.1 CVD and CKD remain the main causes of mortality in rheumatoid arthritis (RA) patients.2,3ObjectivesWe aimed to evaluate the effects of rituximab biologic therapy on cardiorenal continuum of RA patients.MethodsBiologics-naïve RA patients (n=50; age 55.1±10.3) were followed up for 72 months after commencing and continuing rituximab therapy (1–10 standard courses) compared with 30 control RA patients (age 53.2±9.8).ResultsAt year 6, rituximab patients have fewer incidences of hypertension, anxiety/depression, atherosclerosis and diastolic dysfunction than control patients (Table).Table 1.Cardiorenal continuum features of rheumatoid arthritis patients (%)FeaturesRituximab groupControl groupPR-C 1 year, n=503 years, n=476 years, n=311 year, n=303 years, n=266 years, n=16 Risk factorsHypertension50.038.325.840.038.550.0p6=0.032p6–1=0.028Dyslipidaemia44.036.238.740.046.250.0>0.05Pre-diabetes52.036.241.933.334.656.3>0.05Metabolic syndrome12.06.43.210.07.712.5>0.05Diabetes mellitus4.000000>0.05Anxiety/depression83.241.535.380.073.168.8p3=0.009p3–1=0.006p6–1<0.001p6=0.008Initial stagesAtherosclerosis32.021.312.940.034.637.5p6=0.02p6–1=0.048Left ventricular hypertrophy8.04.306.77.70>0.05Diastolic dysfunction48.038.322.646.750.056.3p6=0.04p6–1=0.022Albuminuria8.000006.3>0.05Kidney impairment6.02.1013.300>0.05ProgressionAngina6.0003.300>0.05Chronic kidney disease16.08.59.713.400>0.05End stageMyocardial infarction/stroke000000>0.05Heart failure2.000000>0.05Acute/chronic renal failure000000>0.05Death0012.9000>0.05There were no significant differences in frequencies of other risk factors, signs of asymptomatic multiorgan damage and cases of established heart, cerebrovascular and renal diseases/complications.ConclusionsRituximab may be effective in delay of the movement of RA patients on cardiorenal continuum. The clinical implications of rituximab for cardiorenal correlations in RA patients need to be confirmed in large-scale clinical outcome trials.References Sarnak MJ, Levey AS. Cardiovascular disease and chronic renal disease: a new paradigm. Am J Kidney Dis 2000;35(4, Suppl. 1):117–31.Avina-Zubieta JA, Choi HK, Sadatsafarvi M, et al. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum 2008;59:1690–7.Gullick NJ, Scott DL. Co-morbidities in established rheumatoid arthritis. Best Pract Res Clin Rheumatol 2011;25:469–83. Disclosure of InterestNone declared