THU0139 Impacts of Immediate Changes in Dmards on Outcomes in Rheumatoid Arthritis with Moderate-to-Severe Activity. (23rd January 2014)

• Record Type: Journal Article
• Authors: Kim, D.; Choi, C.-B.; Sung, Y.-K.; Cho, S.-K.; Park, S.-Y.; Choi, J.-Y.; Yoo, D.-H.; Lee, S.-S.; Lee, J.; Kim, J.; Lee, H.-S.; Kim, T.-H.; Yoon, B. Y.; Yoo, W.-H.; Choe, J.-Y.; Lee, S.-H.; Shim, S.-C.; Chung, W. T.; Hong, S.-J.; Lee, C. K.; Koh, E.; Jun, J.-B.; Bang, S.-Y.; Kim, S.-K.; Cha, H.-S.; Lee, J.; Bae, S.-C.
• Is Part Of: Annals of the rheumatic diseases. Volume 72:Supplement 3(2013)
• Page Start: A210
• Page End: A210
• Publication Date: 2014-01-23
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2013-eular.667
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: The importance of tight control is supported by solid clinical evidence. While treating RA with the aim of achieving remission or a low disease activity-as determined by disease activity score employing 28 joints count (DAS28) or the simplified and the clinical disease activity index (SDAI, CDAI) -is reasonable and important, this approach is not widely accepted in the clinical situation. Objectives: To identify the effects of tight control of rheumatoid arthritis (RA) on various disease outcomes in a large observational study. Methods: We selected 1900 RA patients with a baseline DAS28-ESR of more than 3.2 and who had 1 year of follow-up data. The patients were divided into two groups: (1) disease-modifying antirheumatic drugs (DMARDs)-changed group (patients who changed the types or amounts of their DMARDs) and (2) DMARDs-unchanged group (patients who maintained their DMARDs). We measured various disease outcomes, including the Health Assessment Questionnaire–Disability Index (HAQ-DI), DAS28-ESR, C-reactive protein (CRP), ESR, and global health assessments by both physicians and patients. The t -test was used to identify the effects of tight control of RA on various disease outcomes. Results: Patients in the DMARDs-changed group were younger, had a shorter disease duration, used less leflunomide, used more biologic agents. At baseline, they had higher DAS28-ESR (4.62±0.96 in DMARDs-changed group versus 4.42±0.90 in DMARDs-unchanged group, p<0.001), CRP (1.15±1.62 versus 0.81±1.14, p<0.001), global health assessment by both physician (34.05±20.00 versus 26.94±18.16, p<0.001) and patient (48.96±25.34 versus 46.18±24.74, p=0.016). In the comparison between baseline and the 1-year follow-up, the DMARDs-changed group showed greater improvements in HAQ-DI (–0.76±1.43 versus –0.59±1.22, p =0.006), CRP (–0.39±1.71 versus –0.11±1.37 mg/dl, p =0.001), and the global health assessment by a physician (–11.21±24.18 versus –8.10±19.20, p =0.002). Image/graph: Conclusions: Immediate changes in DMARDs according to disease activity can improve disease outcomes, especially DAS28-ESR, CRP, and the global health assessment by a physician. Disclosure of Interest: None Declared