AB0315 HYPERURICEMIA AS A FACTOR INTERRELATED WITH COMORBIDITY AND TREATMENT RESULTS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

BackgroundUric acid (UA) is a risk factor of cardiovascular comorbidity in total population [1,2]. However, data about role of hyperuricemia (HU) in rheumatoid arthritis (RA) are limited.Objectivesto evaluate the interrelations between HU and disease activity, comorbidity, treatment results in patients (pts) with RA.MethodsThree age and sex matched groups of the pts were formed on the base of Saint-Petersburg rheumatological register (01JAN 2011 - 31DEC2021): group of RA pts with HU (n=292, criteria EULAR2010), group of RA pts without HU (n=292), and group of pts with gouty arthritis (GA, n=300). HU registered if patient had serum level of UA ≥360 µmol/l in ≥3 tests in absence of GA. Pts with secondary HU excluded. RA activity was measured with DAS28. Statistics was performed with SPSS 2020.ResultsDemographic, clinical characteristics, RA treatment in both RA groups were comparable, however decrease of DAS28 during 6-month RA treatment in RA pts with HU was lower than in RA with absence of HU, Table 1.Table 1.Clinical, laboratory characteristics, and treatment efficacy in RA and GAParameterRA with HU (n=292)RA without HU (n=292)GA (n=300)Age (Mean±SD), years60.53±12.4758.07±13.2457.7±11.85Female, n (%)253 (86,64)282 (96.57)275 (91.67)Duration of clinical manifestation, years (mean±SD)3.56±1.584.13±1.753.42±2.12ESR, mm/h (mean±SD)29.25±14.6728.22±14.3930.14±14.43C-reactive protein, mg/l (mean±SD),21.10±20.8823.69±29.9322.48±21.496 months decrease of DAS28 (mean±SD)1.09±0.281.48±0.35*NAMedicamental ULT, n (%)25NA100Efficacy of ULT, n (%)68 (23.29)NA160 (53.33)ESR – Erythrocyte Sedimentation Rate; ULT – urate-lowering treatment; DAS28 – Disease activity score; NA – not applicable; intergroup difference with p<0.001.Presence of the HU in RA pts was associated with increased comorbidity as compared with age, sex and activity matched RA pts without HU, and with GA, Figure 1.Figure 1.Comorbidity in pts with RA without and with HU, and in GA pts.Intergroup difference of comorbidities between pts with RA without and with HU or with GA is significant with p <0.000. Intergroup difference between RA with HU and GA is significant with p<0.01.AH - arterial hypertension, AF - atrial fibrillation, HC – hypercholesterolemia, Ob – obesity, DM - diabetes mellitus type 2, CL – cholelithiasis, NAFLD - non-alcoholic fatty liver disease, UL – urolithiasis, CKD – chronic kidney disease (st.1-4).ULT was administered to pts with RA and HU 4 times less frequently than to pts with GA. The effectiveness of ULT in RA and HU is two times lower than in GA.Conclusion1) HU negatively affects the decrease of RA activity. 2) HU in RA is associated with increased comorbidity 3) ULT is assigned to pts with RA and HU 4 times less frequently than to pts with GA and is ineffective in 76.71% of cases.Additional research is needed to evaluate the influence of UAs’ serum levels’ normalization as factor that could improve results of RA treatment and comorbidity.