THU0168 How Low Should You Go? Towards Personalized Treatment Targets for Disease Activity in RA

Background Prevention of joint damage is a main goal of treatment in Rheumatoid Arthritis (RA). However, not all patients have the same risk for joint damage during the course of disease. This is partly dependent on the level of disease activity over time, but also on three main prognostic factors at baseline: presence of anti-CCP, elevated ESR and presence of erosions. Therefore, in establishing a treatment target to prevent joint damage, the presence of these risk factors may be taken into account. A differentiation can be made in the one-size-fits-all treatment target of clinical remission and individualized treatment targets can be defined. Objectives To define DAS treatment targets for the prevention of joint damage for four different baseline risk profiles, based on the presence of anti-CCP, increased ESR and erosions. Methods Data were used from year 0 to 3 of patients of the Nijmegen Early RA cohort. Presence or absence of the three main prognostic factors anti-CCP, high ESR and erosions at baseline was combined in an individual risk profile, with a risk score of 0 to 3, representing the number of risk factors. Joint damage progression was assessed with the Ratingen score at 0 and 3 years and the Disease Activity Score (DAS) was calculated every 3 months. Logistic regression models were used for analyses. Based on the probability for joint damage progression after 3 years, treatment targets were defined for each risk profile. A probability cut point of