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FRI0212 The relationship between anti-tnf therapy use and metabolic syndrome in patients with ankylosing spondylitis

Background Ankylosing spondylitis (AS) is an inflammatory disease associated with accelerated atherosclerosis and the presence of metabolic syndrome (MetS) features. TNF-α is considered as one of the factors responsible for favouring insulin resistance and dyslipidemia, which are important features of the metabolic syndrome. Objectives In this study, we aimed to investigate the relationship between anti-TNF therapy and metabolic syndrome rate in patients with ankylosing spondilitis (AS). Methods AS patients who visited the outpatient rheumotology clinic between 2016 February and May were included in to the study. Systolic and diastolic blood pressures, body mass index (BMI), waist-hip circumference were measured. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fasting blood sugar, cholesterol panel were evaluated. MetS was defined by abdominal obesity, elevated blood pressure, elevated glucose, high triglycerides and reduced high-density lipoprotein cholesterol according to National Cholesterol Education Program’s Adult Treatment Panel III report (NCEP ATP III) criteria. Duration of disease and use of anti-TNF was recorded. Bath Ankylosing Spondylitis Functional Index (BASFI) – Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) measurements were performed to assess the disease activity and functional capacities. Patients were divided into two groups as anti-TNF treated and anti-TNF naive. For comparisons between groups statistical analyses included descriptive statistics, t- tests and one-way ANOVA. Results A total of 223 patients were analysed. Of the total 223 patients, 78 (35%) were receiving anti-TNF therapy. Age distribution was similar in between groups. In the group receiving anti-TNF therapy, the number of male patients was higher (75.6% vs. 58.6%) and the duration of disease was longer (145.2±90.8 vs 103.3±97.1). Serum lipid levels, glucose, ESR, CRP, BASFI, BASDAI measurements, BMI and blood pressures were not significantly different in between the groups. MetS was present in 26 (33.3%) of 78 patients receiving anti-TNF and 29 (20%) of 145 patients in anti-TNF naive group. The effect of TNF-α inhibitor use on MetS was independent from the gender. Conclusions Patients with AS who received anti-TNF therapy were found to have a higher incidence of MetS than those who did not. Suppression of the catabolic effect of inflammation with treatment may have been effective in this result. Disclosure of Interest None declared