AB0187 PREVALENCE, RISK FACTORS, AND TREATMENT MODALITIES OF ATLANTOAXIAL DISLOCATION IN RHEUMATOID ARTHRITIS

Background: Cervical spine involvement is common in patients with rheumatoid arthritis (RA). The most abnormality atlantoaxial dislocation (AAD). It may lead to severe neurological symptoms and even death. Currently, there a lack of consensus on the best approach treatment. Objectives: We investigated prevalence risk factors for AAD RA, as well its relationship treatment modalities. Methods: conducted cross-sectional study including 224 RA. All fulfilled 2010 American College Rheumatology/European League Against Rheumatism RA classification criteria. Radiographs cervical included lateral views taken flexion, extension, neutral position neck, anteroposterior odontoid projection view. Patients were divided into two groups: (G1) group (G2) without ADD. compared clinical, radiological, laboratory findings between groups, treatments used: Steroid therapy, classic biologic disease-modifying anti-rheumatic drugs ( DMARDs ). Structural joint damage was assessed Sharp/van der Heijde radiographic method. Functional impairment using Health Assessment Questionnaire (HAQ). used Statistical Package Social Sciences (SPSS) 22.0 analyze results. level statistical significance set at 0.05. Results: ADD present 16% cases (n=36). Female predominance noted, sex ratio 0.25 (p=0.530). mean age 58±12 years, no significant difference groups (p=0.146). disease duration significantly higher G1 (11.5 ± 10.5 years versus 5.9 6.3, p=0.004). A noticeable immunopositivity found: factor (RF) 86.1% 67.5% G2 (p=0.025). Anti-citrullinated protein antibodies (ACPA) 64.8% (p=0.012). found activity by DAS28-VS (5.8±1.3 5.3±1.6 G2,p=0.027). associated more structural damage: erosions (121.1±60.9 61.8±56.5 G2,p<10 -3 ), joints space narrowing (77.4±47.4 38.7±40 G2, p<10 score (190.2±103.1 100.1±90.6 Hip frequent (22.2% 9.4% p=0.038). HAQ (1.8±0.7 1.2±1, p=0.002). Seventy-five percent had received methotrexate 82.3% (p=0.301). therapy longer (24.6±23.5 18±24 months, p=0.015). dose cumulative methotrexate: 13.2±3.5 g/week 11.8±4.4 (p=0.048), 6.5±6.8 4.8±8.5 (p=0.025), respectively. Thirty-five corticosteroids 25% (p=0.217). steroid therapy: 17.8 + 20.2 13.3 24.3 months (p=0.22). cortico steroids similar 6.9±4.3 mg/day 5.7±4.6 (p=0.132). total G1: There other DMARDs: Sulfasalazine (p=0.182) leflunomide (p=0.276). No observed under 24.1% 17% (p=0.725). Conclusion: be asymptomatic. Immunopositive seem have frequently ADD, those high damage. modalities do not appear affected AAD; however, doses methotrexate. Given nature our study, it difficult confirm connection two. Further studies are needed. Disclosure Interests: None declared