Session: (0965–0992) Epidemiology & Public Health Poster II
0987: Risk Factors and Predictors of Disease Activity in Rheumatoid Arthritis and Psoriatic Arthritis: Data from the Mexican Adverse Events Registry (BIOBADAMEX)
Colegio Mexicano de Reumatología Mexico City, Federal District, Mexico
Disclosure information not submitted.
Vijaya Rivera Terán1, David Vega Morales2, Miguel Angel Saavedra Salinas3, Iris Colunga4, Sandra Carrillo Vazquez5, Dafhne Miranda Hernández6, Sergio Durán Barragán7, Erick Adrián Zamora Tehozol8, Daniel Xavier Xibillé Friedman9, Angel Alejandro Castillo Ortiz10, Sandra Sicsik Ayala11, Fedra Irazoque Palazuelos5, Julio César Casasola Vargas12, Angelica Peña13, Omar Eloy Muñoz Monroy14, Azucena Ramos Sánchez2, Luis Valdés Corona15, Javier Merayo-Chalico16, Estefania Torres Valdez13, Aleni Paz Viscarra15, Samara Mendieta Zerón17 and Deshiré Alpízar Rodríguez1, 1Colegio Mexicano de Reumatología, Mexico City, Mexico, 2Instituto Mexicano del Seguro Social, Monterrey, Mexico, 3IMSS, Mexico City, Mexico, 4Hospital Universitario UANL, Monterrey, Mexico, 5Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico, 6Instituto Mexicano del Seguro Social, Mexico City, Mexico, 7Consulta Privada, Guadalajara, Mexico, 8Centro Médico Pensiones, Mérida, Mexico, 9Práctica Privada, Cuernavaca, Mexico, 10Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mérida, Mexico, 11Instituto Mexicano del Seguro Social, Torreón, Mexico, 12Instituto de Seguridad Social del Estado de México y Municipios, Mexico City, Mexico, 13Instituto Mexicano del Seguro Social, Querétaro, Mexico, 14Hospital Central Militar, Mexico City, Mexico, 15Práctica Privada, Mexico City, Mexico, 16Reumátika, Centro de Vanguardia en Reumatología de la Ciudad de México, Mexico City, Mexico, 17Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico
Background/Purpose: Genetic, demographic, clinical, and immunological factors have been related with the response to treatment in inflammatory rheumatic diseases, such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Among them, obesity and smoking are two potentially modifiable risk factors. Obesity has been associated with persistent activity of the disease and a lower response to TNF inhibitors. Active smoking is associated with disease severity and lower response to conventional treatment. The aim of this study is to evaluate the association of baseline characteristics, particularly obesity, smoking and disease activity in patients with RA and psoriatic PsA using data from the Mexican Adverse Events Registry (BIOBADAMEX).
Methods: In this case-control study from an inception cohort from BIOBADAMEX we included all patients with RA and PsA diagnosis registered from 2016 to April 2023. We compared the clinical characteristics between RA and PsA. Patients were divided in 2 groups: those with remission/low disease activity and those with moderate/high disease activity, patients without disease activity registered were excluded. Sociodemographic, clinical, and treatment characteristics were compared between groups. Chi square and Mann Whitney U tests to analyze differences between the groups. Multivariate model was used to analyze disease activity associated variables.
Results: A total of 818 patients were included, 748 with RA and 70 with PsA. When comparing both groups, we found that PsA patients had higher BMI (29.4 vs 26.7, p = 0.001), lower disease duration (9.7 vs 14.2, p = 0.001) and lower use of steroids (17.1 vs 39.6, p = 0.001). Variables like gender, age, smoking, disease activity, comorbidities were similar (Table 1). When we compared RA patients with remission/low activity and moderate/high activity (Table 2), we found that moderate/high activity patients had lower smoking habit (6.1 vs 9.4, p = 0.007), lower disease duration (13.2 vs 16.1, p = 0.002), and lower use of previous biologic (36.1 vs 62.3, p = 0.001). Comparison between PsA patients with remission/low activity and moderate/high activity (Table 3) showed lower smoking frequency in moderate/high activity (5.3 vs 28, p = 0.03). For the adjusted multivariable analysis, we included age, sex, BMI, smoking, disease duration and previous use of biologic therapy. In RA patients we found that longer disease duration (p = 0.03) and previous use of biologic (p = 0.001) were associated with lower risk of disease activity. In PsA patients we found that smoking habit (p = 0.007) was associated with lower risk of disease activity.
Conclusion: In Mexican RA and PsA patients enrolled in BIOBADAMEX, we found that most of the patients have BMI >25. However, higher BMI did not show an association with disease activity. Further studies comparing BMI levels and activity, as well as comparing Mexican BMI with other regions will be conducted. On the other hand, we found that smoking was associated with lower disease activity, especially in PsA patients. This finding correlates with the Choi HK study where smokers had slower radiographic progression. This finding needs further investigation.
V. Rivera Terán: None; D. Vega Morales: None; M. Saavedra Salinas: None; I. Colunga: None; S. Carrillo Vazquez: None; D. Miranda Hernández: None; S. Durán Barragán: None; E. Zamora Tehozol: None; D. Xibillé Friedman: None; A. Castillo Ortiz: None; S. Sicsik Ayala: None; F. Irazoque Palazuelos: None; J. Casasola Vargas: None; A. Peña: None; O. Muñoz Monroy: None; A. Ramos Sánchez: None; L. Valdés Corona: None; J. Merayo-Chalico: None; E. Torres Valdez: None; A. Paz Viscarra: None; S. Mendieta Zerón: None; D. Alpízar Rodríguez: GlaxoSmithKlein(GSK), 12, Scientific Advisor.