AB0610 EARLY RHEUMATOID ARTHRITIS AND THYROID DYSFUNCTION: A 20-YEARS FOLLOW-UP STUDY IN BULGARIA

Background:

Rheumatoid arthritis is systemic autoimmune disease with progressive development leading to disabilities. The presence of thyroid autoantibodies and thyroid autoimmune disease has been known for more than six decades. The co-existence of thyroid autoimmune disease and RA may lead to more severe clinical manifestations and worse joint damage.

Objectives:

This study aims to evaluate the prevalence of antithyroid autoantibodies and their association with the presence or later appearance of autoimmune thyroid disease (ATD) in patients with early rheumatoid arthritis (RA), as well as to find a possible relationship between RA activity, thyroid disorder, and severity of radiographic joint changes at the onset and long-term tracing of RA patients.

Methods:

We observed 210 patients with early RA in the period from 2000 to 2021. We assessed 126 healthy controls for anti-thyroid antibodies. Al1 RA patients were examined at entry to the study and later at regular intervals in the course of 15 years for disease activity, the presence of anti-thyroglobulin (anti-Tg) and anti-thyroid peroxidase (anti-TPO) antibodies. Erosion grade and joint space narrowing (JSN) of hands and feet were read.

Results:

At entry to the study, anti-Tg autoantibodies were found solely in 5% RA patients and anti-TPO antibodies were presented solely in 9,44% RA patients. Both antibodies were detected in 13,89% of RA patients'- significantly higher than the controls. In the beginning clinical and subclinical findings for ATD were more frequent in RA patients compared to controls. During the follow-up, RA patients showed statistically higher incidence of anti-Tg and anti-TPO serum antibodies. Erosions Sharp score, joint space narrowing (JSN) and total Sharp score compared between RA patients with and without thyroid disease showed no statistical difference in the severity of the radiographic joint damage at entry in the study and during follow-up. RA patients with thyroid disease had significantly higher JSN Sharp score in a 5 years duration of RA than the ones without thyroid disorder.

Conclusion:

RA patients are at risk for development of anti-Tg and anti-TPO antibodies. The presence of thyroid disease in early RA patients does not influence the course of RA clinical activity. RA patients with thyroid disease have more severe joint space narrowing.

REFERENCES:

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Acknowledgements:

NIL.

Disclosure of Interests:

None declared.