AB0795 DYNAMIC CHANGES IN QUANTITATIVE INDICES OF BODY COMPOSITION BY DUAL-ENERGY X-RAY ABSORPTIOMETRY IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS ON DIFFERENT THERAPEUTIC REGIMENS

Background: A redistribution of body fat (abdominal obesity) is quite common in RA patients. Such parameters as body mass index (BMI) and waist circumference do not distinguish or quantify fat and lean (muscle) mass. For that purpose, dual-energy X-ray absorptiometry (DXA) is usually used. Objectives: to compare quantitative body composition in patients with early RA at baseline and after 24 weeks of therapy with different regimens. Methods: The study included 37pts (31 women /6 men) with early RA (ACR/EULAR criteria, 2010), 57 [46.5, 62,0] years old, naive to treatment with glucocorticoids and disease-modifying anti-rheumatics (DMARDs). Pts were seropositive for IgM RF (76%) and anti-CCP (92%), with highly active RA (DAS28 5,5 [5,1; 6,0]; SDAI 32,4 [22,4; 42], CDAI 29,0 [19,7; 39,5]) scores, and median disease duration of 6.0 [5,5;15.5] months. Methotrexate (MTX) 10 [10-15] mg/week subcutaneously was initiated in all included patients as first line therapy for 12 weeks. By this time point therapy was reviewed in 19 patients (51%) due to MTX inefficacy and adalimumab (ADA) at 40 mg once every 2 weeks was added on top of MTX. DXA scan (HOLOGIC, USA) was used to measure body composition at baseline and after 6mths of treatment with the protocol assessing total body, body fat and lean muscle mass. Results: Based on therapeutic regimens at week 24 all study subjects were divided into 2 groups: Group I (n=18) receiving MTX monotherapy, Group II (n=19) – the combination of MTX and ADA (Table 1). Group I patients had lower body weight, lean and fat mass vs patients from Group II (62 kg vs. 73.7 kg; 40.6 kg vs. 49.7 kg; 21.0 kg vs. 25.8 kg, respectively (p Conclusion: In general, RA patients on treatment tend to gain weight by week 24. Patients who failed on MTX monotherapy by week 24 and were switched to combination therapy had higher fat mass at baseline. Mediations used for RA treatment produce multidirectional effects on quantitative parameters of body composition: MTX monotherapy triggers some increase of lean mass, while combination of MTX and bDMARD results in weight gain and increase of total and fat mass. These data need to be confirmed in large-scale studies with longer follow-up period. Disclosure of Interests: None declared