THU0172 Improvement of disease activity in a 5-year cohort of rheumatoid arthritis patients treated under treat to target recommendations and a multispeciality care model receiving conventional dmard therapy. (15th June 2017)

• Record Type: Journal Article
• Authors: Santos-Moreno, P; Gomez, D; Castillo, E; Giraldo, R; Ballesteros, G; Villarreal, L; Bello, J; Buitrago-Garcia, D
• Is Part Of: Annals of the rheumatic diseases. Volume 76(2017)Supplement 2
• Page Start: 266
• Page End: 267
• Publication Date: 2017-06-15
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2017-eular.5592
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Treat to Target (T2T) strategy becomes from the need to develop therapeutic targets and tools to achieve defined outcomes in rheumatoid arthritis (RA), this strategy has become recognized as a standard of good practice embodying the principle that rapid attainment of remission, or low disease activity, can halt joint damage and maintain good quality of life. Objectives: The aim of this study was to describe global change in Disease Activity Score 28 (DAS28) using T2T strategy for a 5 year period in patients with conventional DMARD therapy in a large cohort of patients from a Colombian specialized in RA center with multidisciplinary care model (MCM). Methods: A descriptive dynamic cohort study was performed. Records of patients using conventional DMARD treatment from specialized in RA center were reviewed; those patients were followed-up under T2T standards. Clinical follow-up was according to DAS28 as follows: every 3–5 weeks (DAS28 >5.1), every 7–9 weeks (DAS28 ≥3.1 and ≤5.1), and every 11–13 weeks (DAS28 <3.1). Therapy had to be adjusted with DAS28 >3.2 unless patient's conditions don't permit it. MCM model means that every patient is seen by the other specialties involved in care as a minimum three times a year. We divided patients in three groups: low disease activity (LDA), moderate disease activity (MDA) and severe disease activity (SDA) patients. Descriptive epidemiology was done, percentages and averages were calculated; the median of each variable was analyzed using t-Student assuming normality for DAS28 distribution and the level activity disease was analyzed using Pearson's statistics. Results: We included 1443 patients, 84% were women and 16% were men. Mean age was 62±11 years; mean DAS28 at beginning was 4.0±1; regarding disease activity 57% were in moderate disease activity and 17% in severe disease activity. While at 5 year follow up mean DAS was 2.92±0.65, 48% achieved remission, 30% low disease activity, with decrease to 20% in moderate disease activity and 2% in severe disease activity. Conclusions: There is a significant improvement of DAS28 in a cohort of RA patients receiving only conventional DMARDs therapy, treated and followed under T2T strategy recommendations and a MCM model. Disclosure of Interest: None declared