FRI0147 Analysis of radiographic joint destruction in the patients with rheumatoid arthritis who have withdrawn, spaced and continued biologics after achieving sustained remission from local biologics registry. (12th June 2018)

• Record Type: Journal Article
• Authors: Takakubo, Y.; Nagai, J.; Oki, H.; Naganuma, Y.; Yang, S.; Ito, J.; Suzuki, Y.; Sasaki, K.; Takagi, M.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 617
• Page End: 618
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.2016
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Increasing of remission reached by biologics agents in early and established RA patients 1, 2 . Data on withdrawn, spacing or reducing of biologics (BIO) medication after sustained remission are limited 3, 4 . After withdrawn, spacing or reducing, it is less known to be influenced the radiographic destruction of the joints. Objectives: To retrospectively analyse the joint destruction using modified Total Sharp Score (mTSS) in RA patients in sustained remission, either withdrawing, spacing and continuing BIO. Methods: Local prefectural (ZAO) registry which is open-labelled BIO cohort study has registered 356 RA patients. RA Patients were enrolled into this study if they maintained in DAS remission (DAS28-ESR<2.6) more than one year after starting BIO. ΔmTSS1 was estimated between starting BIO and withdrawn or spacing or reaching remission in each group, ΔmTSS2 between the beginning of withdrawn or spacing, or reaching remission in continuing group and latest follow-up or flare-up. Results: 40 RA patients (32 female) using BIO was fulfilled in the criteria of this study in ZAO registry. Of 40 RA Patients, 10 has withdrawn BIO, 15 has spaced and 15 has continued it after maintain DAS remission more than one year. Mean age was 43, 55, 54 year-old, mean RA affiliation 4.6, 15.3, 9.1 years before BIO and mean duration of remission 6.2, 7.6, 7 years, mean dosage of MTX and PSL was 7.7, 6, 5 mg/week and 1.1, 3, 4 mg/day, respectively. ΔmTSS1 and ΔmTSS2 was +2.4 and+4.5 in withdrawn group, +3.6 and+0.9 in spacing group, +0.2 and −1.4 in continuing group, respectively (figure 1, p <0.05 ). Five cases in withdrawing group had resumed BIO because of flare-up of their disease activity. Conclusions: Several studies reported the potential of BIO withdrawing, spacing or reducing in the patients with RA who reached remission 3), 5) . All cases in spacing and withdrawing group have shown DAS28–4ESR<2.6 in this study, however, 50% (5/10 cases) in withdrawing group have re-flare and shown the radiological joint destruction. Spacing or reducing of BIO may have potential to maintain the remission of RA and prevent the joint destruction. Withdrawing of BIO after even sustained deeper remission may be difficult to keep real remission. References: [1] O'Dell JR. Arthritis Rheum2002;46:283–85. [2] Smolen JS, et al. Ann Rheum Dis2017;76:960–77. [3] Tanaka Y, et al: Ann Rheum Dis2015;74:389–95. [4] Takeuchi T, et al: Ann Rheum Dis2014;73:536–43. [5] Fautrel B, et al. Ann Rheum Dis2016;75:59–67. Acknowledgements: Disclosure of Interest: None declared