Ab0459 relationship Between Fish Consumption and Response to Treatment With Molecular Targeted Therapies in Patients With Rheumatoid Arthritis

Abstract

BackgroundThe use of molecular targeted therapies has improved the clinical course and quality of life of patients with rheumatoid arthritis (RA); however, a percentage of patients experience treatment failure (non-responders), which is a particular challenge for clinicians. Diet and nutrients are potential environmental factors that are likely to influence the course and the response to pharmacological therapies in RA. The Mediterranean diet or omega-3 polyunsaturated fatty acids (n-3 PUFAs) supplementation have been shown to have a favorable effect on the reduction of RA symptom. A higher intake of fish, the main source of PUFAs, was associated with lower disease activity in RA patients. Several factors have been identified that may affect treatment response in RA; however, the effect of fish consumption on treatment response in RA patients has not been clarified.ObjectivesTo explore the relationship between fish consumption and response to targeted therapies in RA patients with two dietary patterns characterized by high fish consumption.MethodsThe study is a collaborative international cross-sectional retrospective study involving RA patients on treatment with biologics or Janus kinase inhibitors (JAKi) attending Hokkaido University Hospital (Japan) or Hospital Virgen de las Nieves (Spain). Patients complete a brief-type self-administered diet history questionnaire (BDHQ) and a detailed food frequency questionnaire (DFFQ) to assess fish consumption in the previous month. At study entry, qualified rheumatologists assessed RA disease activity. Demographic, clinical/laboratory data were collected retrospectively from the medical records. Descriptive analysis was performed in each cohort.ResultsOne-hundred-twenty-four Japanese RA patients, 100 females, median age at entry 66 yrs [IQR 54-72], median disease duration 12 yrs [IQR 7-20] were included. One-hundred-seven (86%) patients were on biologics and 17 (14%) on JAKi, median treatment duration of 4 yrs [IQR 1-7]. Concomitant treatment with conventional synthetic disease modifying anti rheumatic drugs (csDMARDs) and glucocorticoids were reported in 84% and 53% of patients, respectively. Ninety-six (77%) patients were responders to treatment defined as disease activity score 28 (DAS28)-ESR <3.2 and DAS28-CRP <2.7. All patients had fish consumption in the last month and 82% reported intake of n-3 PUFA rich fish (fatty fish) (<1 time/week 33%, ≧1 time/week 49%). A higher estimated daily intake of n-3 PUFAs from fish was found in the responder group compared to the non-responder group [median grams, 1.01 (IQR 0.47-1.44) vs 0.51 (IQR 0.34-1.14), p=0.044]. The Spanish cohort comprised of 62 RA patients, 47 females, median age at entry 58 yrs [IQR 49-66], median disease duration 12 yrs [IQR 5-21]. Fifty-nine (95%) patients were on biologic therapies and three (5%) on JAKi, median treatment duration of 3 yrs [IQR 1-8]. Concomitant treatment with csDMARDs and glucocorticoids were reported in 38% and 42% of patients, respectively. Thirty-four (55%) patients were responders to treatment. All patients had consumption of fish in the last month and 77% had consumed fatty fish (<1 time/week 31%, ≧1 time/week 46%). No difference in estimated intake of n-3 PUFAs from fish was observed in this cohort.ConclusionFish consumption may have a positive effect on the response to treatment of Japanese RA patients receiving targeted therapy.ReferencesNIL.AcknowledgementsAcknowledgements to Ms. Y. Ikea and S. Kumagai for their enriching support on the nutritional properties of fish. Supported by the Kakenhi C grant number 20K11597 from the Japan Society for the Promotion of Science.Disclosure of InterestsNone Declared.