AB0265 Clinical predictor factors associated with sustained disease activity among patients with early rheumatoid arthritis. (12th June 2018)

• Record Type: Journal Article
• Authors: Gonzalez Alvarez, M.G.; Molina, J.; Nuño, L.; Navarro-Compán, V.; Villalba, A.; Peiteado, D.; Bogas, P.; Balsa, A.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1313
• Page End: 1313
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.3543
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: In patients with rheumatoid arthritis (RA), low disease activity (DA) overtime is associated with favourable outcomes. However, the progression of the disease is faster during the first years. Therefore, it is desirable to identify patients with a high probability of sustained DA in an early stage. Objectives: To identify clinical predictor factors at diagnosis associated with sustained DA after 12 months of follow up in patients with early RA. Methods: Baseline (at diagnosis) and 12 months follow-up data from an early arthritis clinic was analysed. At both visits, demographic, clinical, laboratory and treatment data were collected and clinical DA was assessed using DAS28 and SDAI. For this study, patients with RA according to physician's diagnosis were selected. Sustained DA at 12 months was defined as DAS28 >3.2 and SDAI>11. Univariate and multivariable logistic regression models were employed to identify which factors are associated with sustained DA. Results: In total, 566 patients were included. Out of these, 75.8% were women, 74.7% Caucasian, 77.7% RF +and 65.9% ACPA+. Mean (SD) age was 54 17 years and mean symptoms duration was 16 15 weeks. Regarding treatment, 89.8% patients received methotrexate as first line treatment and 81.1% received glucocorticoids. At baseline, 88.8% had moderate-high DA according to DAS28 (>3.2) and 77.6% with SDAI (>11). After one year of follow-up, 34% (DAS28) and 30.9% (SDAI) remained with moderate-high DA. Univariable logistic regression analysis results are shown in table 1. Sustained DA was significantly associated with baseline index and its individual components, HAQ, and GCs used for both indexes definitions, with smoking and MTX use for DAS28 definition and RF +for SDAI definition. In the multivariable analysis, sustained DA at 12 months remained significantly associated only with baseline DAS28 (OR 1.34; p<0.05) for DAS28 definition and with RF (OR 2.6; p=0.02), HAQ (OR 1.06; p<0.01) and use of glucocorticoids (OR 2.1; p<0.05) for SDAI definition. Conclusions: One out of three patients with RA maintains DA 12 months after diagnosis. The predictors for this status depend on the index employed: DAS28 at baseline is the best predictor for sustained disease activity when using DAS28-definition. Conversely, positive RF, impaired functionality and the need of glucocorticoids at baseline are associated with the SDAI-definition. Disclosure of Interest: None declared