OP0211 A Preliminary Investigation of “Treat-to-Target” Criteria Using BSAS, RAPID3 and Physician Global in Behcet’s Syndrome

Background We had developed a PRO measure for Behcet Syndrome (BS) BSAS (Behcet Syndrome Activity Scale), for use as an outcome measure in order to determine need for treatment changes, leading to more aggressive treatment and possible “treating to target” criteria Objectives To determine if change in treatment is associated with changes in the BSAS, physician global, (MDGL) and RAPID3 scores. Methods All BS patients seen at the center completed an MDHAQ, and a BSAS. Treatment changes defined as first line (colchicine, hydroxychloroquine, low dose prednisone), second line (azathioprine, cyclosporine, methotrexate, mycophenolate mofetil) and third line (biologic agents-TNF inhibitor) were identified and then the predictive value of change in therapy with BSAS, RAPID3 and MDGL were estimated using general linear mixed models. Results 544 patients (female 74%, mean disease duration 4.9 years, age 35) over 1474 observations (average 3.5 observations per patient) were analyzed. BSAS quantified more differences than MDGL and RAPID3, identifying significant changes between no therapy and first line, third line, combination of first and second and all three (Table). All three outcomes were able to distinguish between no therapy and use of combination of first and second line therapies as well as usage of all three. Image/graph Conclusions BSAS was the measure most strongly and commonly associated with therapy changes. Both MDGL and RAPID3 were more predictive of later level treatment changes where as BSAS was also useful early on with lower levels of disease activity. A patient outcome measure such as BSAS may be useful in documenting treatment responses in Behcet syndrome patients in routine care and may be developed further as a “treat to target” tool for BS. Disclosure of Interest None Declared