AB0376 Rapamycin induces remission in patients with newly diagnosed rheumatoid arthritis
ANNALS OF THE RHEUMATIC DISEASES(2018)
Abstract
Background Rheumatoid arthritis (RA) is an autoimmune disease characterised by chronic inflammation of the joints. We found that there was an imbalance between Th17 and Treg cells in the patients with active refractory RA, reduced absolute number of Treg cells was found in these patients. Objectives To observe the medium-term curative effect of rapamycin in the treatment of 25 cases newly diagnosed rheumatoid arthritis. Methods Collecting 25 patients of newly diagnosed rheumatiod arthritis, which accorded with RA diagnosis standard of ACR in 1987. The patients were treated with rapamycin at a dose of 0.5 mg every 2 days for 24 weeks, then we observed the change of clinical improvement and immunological assessments after 24 weeks. Results There was 25 patients enrolled. After rapamycin treatment for 24 weeks, the mean DAS28 of them was decreased from 5.36 [1.42] to 3.45 [1.29](p=0.001). The absolute number of Treg CD4+CD25+Foxp3+ cells significantly higher than baseline (30.24 [14.44],46.64 [27.54],p=0.025). The absolute number of Th17 cells was not significantly different (6.40 [4.46],7.03 [5.60],pu003e0.05), and the same as the ratio of Th17/Treg cells (0.25 [0.18],0.19 [0.16]),pu003e0.05). Meanwhile, the mean dose of prednisone was decreased form 11.25 mg/d to 9.6 mg/d. Conclusions Rapamycin could induce the balance of Th17 cells and Treg cells, especially up-regulate the absolute number of Treg cells, thus induce remission in patients with newly diagnosed RA. Disclosure of Interest None declared
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Key words
rheumatoid arthritis,rapamycin
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