116. Association Between Levels of Serum Hepatocyte Growth Factor and Joint Replacement of the Hip or Knee in Rheumatoid Arthritis

Abstract

Background: RA is a chronic inflammatory disease of the synovial joints leading to progressive joint destruction, functional impairment and, in severe cases, the need for joint replacement. There is a need to identify which of these patients are more likely to need a joint replacement in order to plan both clinically and economically for patient care. Previous research has identified several biomarkers that may be associated with inflammation and disease activity in RA. Hepatocyte growth factor (HGF) is a pleiotropic cytokine that regulates cell growth, cell motility and tissue regeneration. Expression of HGF has been reported in the synovium of patients with RA and may be associated with disease activity. The objective of our study was to investigate the association between levels of HGF and total joint replacement of the hip and knee in patients with RA. Methods: Data were collected from 412 RA patients with established disease who were followed prospectively. The mean (S.D.) age of the cohort was 61 (10.8) years with a disease duration of 11(4.8) years and 279 (67.7%) of the cohort were female. Clinical indices of disease severity were recorded including whether each patient had undergone hip or knee replacement. Of the 412 patients enrolled, 209 have reached 5 year follow-up (50.7%). Serum levels of HGF at recruitment were quantified using a fluorescent bead-based assay system (Luminex) and at the 5-year follow-up using enzyme-linked immunosorbent assays (ELISA). Associations between joint replacement and HGF levels were analysed using the Mann–Whitney U test for non-parametric data. Results: High levels of HGF were associated with joint replacement of the hip or knee at baseline and at 5-year follow-up. At baseline, significantly higher levels of serum HGF were found in patients who had previously had a hip or knee replacement (n1⁄463) compared with patients who had not received a joint replacement: median (IQR) HGF level (1502 (665) vs 1388 (554) pg/ml, P1⁄40.048). This association was significantly greater for knee replacement alone: median (IQR) HGF level (1610 (683) vs 1382 (548) pg/ml, P1⁄40.016). At 5-year follow-up, serum HGF levels were significantly higher in patients who had received a new hip or knee replacement since baseline (n1⁄433) compared with those who had not had these joints replaced: median (IQR) HGF level (1296 (1894) vs 1115 (862) pg/ml, P1⁄40.040). Conclusion: Joint replacement of the hip or knee in patients with RA is associated with high circulating levels of HGF and may reflect a role for HGF in joint damage. Disclosure statement: The authors have declared no conflicts of interest.