SAT0092 LOW SERUM LEVEL OF VITAMIN D AT TIME OF DIAGNOSIS IS ASSOCIATED WITH HIGHER ONE-YEAR REMISSION RATE IN PATIENTS WITH NEWLY DIAGNOSED RA, TREATED AGGRESSIVELY DURING FOLLOW-UP: POST-HOC ANALYSES OF THE CIMESTRA TRIAL

Background Vitamin D is often low in Rheumatoid Arthritis(RA), and immunomodulatory properties of vitamin D might be associated with disease-course in RA.(1) Objectives To evaluate association between baseline vitamin D metabolites and one-year remission, in newly diagnosed, treatment-naive RA patients, aggressively treated during follow-up. Methods The CIMESTRA-cohort comprises 160 newly diagnosed RA patients, treated aiming at remission with methotrexate and intraarticular steroid, further randomized 1:1 to ciclosporine or placebo-ciclosporine.(2) A total of 158 patients had vitamin D metabolites measured at time of diagnosis. Dietary vitamin D supplementation was recommended in accordance with the national guidelines. Serum vitamin Dtotal (sum of 25OHD2 and 25OHD3) and 1,25(OH)2D at time of diagnoses were measured by LC-MS/MS or RIA. Dtotal were dichotomized at 50 nmol/l, and 1,25(OH)2D categorized in tertiles. Primary outcome was remission (DAS28-CRP ≤ 2.6) after one year. Associations were calculated using logistic regression, presented as Odds Ratios with 95% Confidence Intervals (95%CIs). Adjustment of analyses included sex, age, symptom duration prior to diagnosis, DAS28-CRP and season of diagnosis. Results In univariate analyses, neither Dtotal nor 1,25(OH)2D at time of diagnosis predicted remission at year one. In adjusted analysis, Dtotal Conclusion Low Dtotal at time of diagnosis is associated to increased odds for achieving remission at year one in early, treatment naive RA patients, treated aggressively during follow-up. References [1] Jeffery LE, et al. Vitamin D in rheumatoid arthritis-towards clinical application. NatRevRheumatol. 2015. [2] Hetland ML, et al. Combination treatment with methotrexate, cyclosporine, and intraarticular betamethasone compared with methotrexate and intraarticular betamethasone in early active rheumatoid arthritis: an investigator-initiated, multicenter, randomized, double-blind, parallel-group, placebo-controlled study. Arthritis Rheum. 2006;54:1401-9. Acknowledgement Soren Moller, biostatistician at OPEN, Odense, for statistical support Disclosure of Interests Mette Herly Grant/research support from: Pfizer Denmark, unrestricted grant, used for salary. The Danish Rheumatism Association, patient association, 6 months salary as part of PHD study, Speakers bureau: The Danish Rheumatism Association, patient association, speakers Fee 500 Euro, Kristian Stengaard-Pedersen: None declared, Peter Vestergaard Speakers bureau: Amgen, Eli Lilly, Novartis, MSD, Servier, Robin Christensen Grant/research support from: AbbVie Inc, and the Oak Foundation, Speakers bureau: Roche, Mikkel Ostergaard Grant/research support from: Abbvie, Celgene, Centocor, Merck, Novartis, Consultant for: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, and UCB, Speakers bureau: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, and UCB, Peter Junker: None declared, Merete L. Hetland Grant/research support from: BMS, MSD, AbbVie, Roche, Novartis, Biogen, Pfizer, Consultant for: Eli Lilly, Speakers bureau: Orion Pharma, Biogen, Pfizer, CellTrion, Merck, Samsung Bioepis, Kim Horslev-Petersen Grant/research support from: AbbVie during the conduct of the study, Torkell Ellingsen: None declared