THU0180 Time to Biologic Therapy Driven by Rheumatoid Arthritis Disease Activity and Severity
Background In patients with early rheumatoid arthritis (RA), aggressive treatment of disease activity with non-biologic disease modifying anti-rheumatic drugs (nbDMARDs) and biologics is recommended in order to reduce the long-term consequence of inflammation (1). We sought to estimate time from use...
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| Veröffentlicht in: | Annals of the rheumatic diseases 2014-06, Vol.73 (Suppl 2), p.243-244 |
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| creator | Harrold, L.R. Greenberg, J.D. Bao, Y. Grant, S. Kremer, J.M. Reed, G. Florentinus, S. Karki, C. Lacerda, A.P. Ganguli, A. |
| description | Background In patients with early rheumatoid arthritis (RA), aggressive treatment of disease activity with non-biologic disease modifying anti-rheumatic drugs (nbDMARDs) and biologics is recommended in order to reduce the long-term consequence of inflammation (1). We sought to estimate time from use of first nbDMARD to first biologic initiation in RA patients, as well as investigate factors associated with biologic initiation. Methods We identified early RA patients (disease duration 10) at nbDMARD initiation. The median time between first nbDMARD and first biologic was 4.24 years.In univariate analyses, factors associated with time to biologic initiation include patient age (HR 0.98, 95% CI 0.97-0.99), private insurance (HR 1.50, 95% CI 1.18-1.90), moderate/high disease activity with low disease activity the reference (HR 2.01, 95% CI 1.27-3.17), greater disability (mHAQ; HR 1.47, 95% CI 1.08-2.00) and year of enrollment/diagnosis (HR 1.23, 95% CI 1.12-1.3). In multivariable models, only moderate/high disease activity (HR 1.02, 95% CI 1.01-1.04) and patient age (HR 0.98, 95% CI 0.98-0.99) were associated with time to biologic. Conclusions In this real world cohort of RA patients, biologic therapy was started on average 4 ¼ years after initiation of a nbDMARD. Higher disease activity and younger patient age were associated with a reduced time to biologic initiation. References Singh JA, Furst DE, Bharat A, et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic |
| doi_str_mv | 10.1136/annrheumdis-2014-eular.1161 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1777975469</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4008708061</sourcerecordid><originalsourceid>FETCH-LOGICAL-b1859-780e2bf48142159b4a9438c87ad649704daaf39ef0a3f7ed4b82273caa134e793</originalsourceid><addsrcrecordid>eNqVkM1OwzAQhC0EEqXwDpZ6Dtix6x9xKi1QpEpIkJ4tJ9lQV01S7KRSblx4UZ6EhHLgymm1OzM70ofQhJJrSpm4sVXlN9CWuQtRTCiPoN1Z32uCnqAR5UL1Z0FO0YgQwiKuhTxHFyFs-5UoqkbIJMs1oYp8fXwmrgTc1PjO1bv6zWU42YC3-w4vvDtAhdMOvwxltqldjme-2XjXuIAXLoANgGdZ4w6u6bCtcvwKB-jl7hKdFXYX4Op3jtH64T6ZL6PV8-PTfLaKUqqmOpKKQJwWXFEe06lOudWcqUxJmwuuJeG5tQXTUBDLCgk5T1UcS5ZZSxkHqdkYTY5_975-byE0Zlu3vuorDZVSajnlYnDdHl2Zr0PwUJi9d6X1naHEDETNH6JmIGp-iJqBaJ8Wx3Rabv8V_Ab1iYJh</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1777975469</pqid></control><display><type>article</type><title>THU0180 Time to Biologic Therapy Driven by Rheumatoid Arthritis Disease Activity and Severity</title><source>BMJ Journals - NESLi2</source><creator>Harrold, L.R. ; Greenberg, J.D. ; Bao, Y. ; Grant, S. ; Kremer, J.M. ; Reed, G. ; Florentinus, S. ; Karki, C. ; Lacerda, A.P. ; Ganguli, A.</creator><creatorcontrib>Harrold, L.R. ; Greenberg, J.D. ; Bao, Y. ; Grant, S. ; Kremer, J.M. ; Reed, G. ; Florentinus, S. ; Karki, C. ; Lacerda, A.P. ; Ganguli, A.</creatorcontrib><description>Background In patients with early rheumatoid arthritis (RA), aggressive treatment of disease activity with non-biologic disease modifying anti-rheumatic drugs (nbDMARDs) and biologics is recommended in order to reduce the long-term consequence of inflammation (1). We sought to estimate time from use of first nbDMARD to first biologic initiation in RA patients, as well as investigate factors associated with biologic initiation. Methods We identified early RA patients (disease duration <1 year) within a national disease-based registry (CORRONA) with visits between 1/1/06 to 10/1/12. Survival analyses were performed using Kaplan-Meier curves estimating time from nbDMARD initiation to first biologic initiation. Median times to first biologic initiation were calculated. Cox proportional hazards models examined factors at nbDMARD initiation associated with time to biologic initiation including age, gender, baseline disease activity based on the clinical disease activity index [CDAI], insurance, disability (using the modified Health Assessment Questionnaire [mHAQ]) and prior nbDMARD use. We adjusted for clustering of patients by physician using the sandwich estimator for variance. Results There were 2403 nbDMARD initiators who met inclusion criteria. Most were female (71.5%) with a mean age of 56.1 yrs, mean mHAQ of 0.5 and mean CDAI 19.9 with 73.8% having moderate or high disease activity (CDAI >10) at nbDMARD initiation. The median time between first nbDMARD and first biologic was 4.24 years.In univariate analyses, factors associated with time to biologic initiation include patient age (HR 0.98, 95% CI 0.97-0.99), private insurance (HR 1.50, 95% CI 1.18-1.90), moderate/high disease activity with low disease activity the reference (HR 2.01, 95% CI 1.27-3.17), greater disability (mHAQ; HR 1.47, 95% CI 1.08-2.00) and year of enrollment/diagnosis (HR 1.23, 95% CI 1.12-1.3). In multivariable models, only moderate/high disease activity (HR 1.02, 95% CI 1.01-1.04) and patient age (HR 0.98, 95% CI 0.98-0.99) were associated with time to biologic. Conclusions In this real world cohort of RA patients, biologic therapy was started on average 4 ¼ years after initiation of a nbDMARD. Higher disease activity and younger patient age were associated with a reduced time to biologic initiation. References Singh JA, Furst DE, Bharat A, et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis care & research. May 2012;64(5):625-639. Acknowledgements The CORRONA RA registry has been supported through contracted subscriptions in the last two years by Abbvie, Amgen, AstraZeneca, Genentech, Horizon Pharma, Eli Lilly, Novartis, Pfizer, Vertex and UCB. The design, study conduct, and financial support for the study was provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the abstract. Disclosure of Interest : L. Harrold Grant/research support: CORRONA, J. Greenberg Shareholder of: CORRONA, Consultant for: AstraZeneca, Pfizer, Employee of: CORRONA, Y. Bao Shareholder of: AbbVie, Employee of: AbbVie, S. Grant Employee of: Statistical Center for HIV/AIDS Research & Prevention at Fred Hutchinson Cancer Research Center, J. Kremer Shareholder of: CORRONA, Employee of: CORRONA, G. Reed Employee of: CORRONA, S. Florentinus Shareholder of: AbbVie, Employee of: AbbVie, C. Karki Employee of: CORRONA, A. P. Lacerda Shareholder of: AbbVie, Employee of: AbbVie, A. Ganguli Shareholder of: AbbVie, Employee of: AbbVie DOI 10.1136/annrheumdis-2014-eular.1161</description><identifier>ISSN: 0003-4967</identifier><identifier>EISSN: 1468-2060</identifier><identifier>DOI: 10.1136/annrheumdis-2014-eular.1161</identifier><identifier>CODEN: ARDIAO</identifier><language>eng</language><publisher>Kidlington: Elsevier Limited</publisher><ispartof>Annals of the rheumatic diseases, 2014-06, Vol.73 (Suppl 2), p.243-244</ispartof><rights>2014, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Copyright: 2014 (c) 2014, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b1859-780e2bf48142159b4a9438c87ad649704daaf39ef0a3f7ed4b82273caa134e793</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://ard.bmj.com/content/73/Suppl_2/243.2.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://ard.bmj.com/content/73/Suppl_2/243.2.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3194,23570,27923,27924,77371,77402</link.rule.ids></links><search><creatorcontrib>Harrold, L.R.</creatorcontrib><creatorcontrib>Greenberg, J.D.</creatorcontrib><creatorcontrib>Bao, Y.</creatorcontrib><creatorcontrib>Grant, S.</creatorcontrib><creatorcontrib>Kremer, J.M.</creatorcontrib><creatorcontrib>Reed, G.</creatorcontrib><creatorcontrib>Florentinus, S.</creatorcontrib><creatorcontrib>Karki, C.</creatorcontrib><creatorcontrib>Lacerda, A.P.</creatorcontrib><creatorcontrib>Ganguli, A.</creatorcontrib><title>THU0180 Time to Biologic Therapy Driven by Rheumatoid Arthritis Disease Activity and Severity</title><title>Annals of the rheumatic diseases</title><description>Background In patients with early rheumatoid arthritis (RA), aggressive treatment of disease activity with non-biologic disease modifying anti-rheumatic drugs (nbDMARDs) and biologics is recommended in order to reduce the long-term consequence of inflammation (1). We sought to estimate time from use of first nbDMARD to first biologic initiation in RA patients, as well as investigate factors associated with biologic initiation. Methods We identified early RA patients (disease duration <1 year) within a national disease-based registry (CORRONA) with visits between 1/1/06 to 10/1/12. Survival analyses were performed using Kaplan-Meier curves estimating time from nbDMARD initiation to first biologic initiation. Median times to first biologic initiation were calculated. Cox proportional hazards models examined factors at nbDMARD initiation associated with time to biologic initiation including age, gender, baseline disease activity based on the clinical disease activity index [CDAI], insurance, disability (using the modified Health Assessment Questionnaire [mHAQ]) and prior nbDMARD use. We adjusted for clustering of patients by physician using the sandwich estimator for variance. Results There were 2403 nbDMARD initiators who met inclusion criteria. Most were female (71.5%) with a mean age of 56.1 yrs, mean mHAQ of 0.5 and mean CDAI 19.9 with 73.8% having moderate or high disease activity (CDAI >10) at nbDMARD initiation. The median time between first nbDMARD and first biologic was 4.24 years.In univariate analyses, factors associated with time to biologic initiation include patient age (HR 0.98, 95% CI 0.97-0.99), private insurance (HR 1.50, 95% CI 1.18-1.90), moderate/high disease activity with low disease activity the reference (HR 2.01, 95% CI 1.27-3.17), greater disability (mHAQ; HR 1.47, 95% CI 1.08-2.00) and year of enrollment/diagnosis (HR 1.23, 95% CI 1.12-1.3). In multivariable models, only moderate/high disease activity (HR 1.02, 95% CI 1.01-1.04) and patient age (HR 0.98, 95% CI 0.98-0.99) were associated with time to biologic. Conclusions In this real world cohort of RA patients, biologic therapy was started on average 4 ¼ years after initiation of a nbDMARD. Higher disease activity and younger patient age were associated with a reduced time to biologic initiation. References Singh JA, Furst DE, Bharat A, et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis care & research. May 2012;64(5):625-639. Acknowledgements The CORRONA RA registry has been supported through contracted subscriptions in the last two years by Abbvie, Amgen, AstraZeneca, Genentech, Horizon Pharma, Eli Lilly, Novartis, Pfizer, Vertex and UCB. The design, study conduct, and financial support for the study was provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the abstract. Disclosure of Interest : L. Harrold Grant/research support: CORRONA, J. Greenberg Shareholder of: CORRONA, Consultant for: AstraZeneca, Pfizer, Employee of: CORRONA, Y. Bao Shareholder of: AbbVie, Employee of: AbbVie, S. Grant Employee of: Statistical Center for HIV/AIDS Research & Prevention at Fred Hutchinson Cancer Research Center, J. Kremer Shareholder of: CORRONA, Employee of: CORRONA, G. Reed Employee of: CORRONA, S. Florentinus Shareholder of: AbbVie, Employee of: AbbVie, C. Karki Employee of: CORRONA, A. P. Lacerda Shareholder of: AbbVie, Employee of: AbbVie, A. Ganguli Shareholder of: AbbVie, Employee of: AbbVie DOI 10.1136/annrheumdis-2014-eular.1161</description><issn>0003-4967</issn><issn>1468-2060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqVkM1OwzAQhC0EEqXwDpZ6Dtix6x9xKi1QpEpIkJ4tJ9lQV01S7KRSblx4UZ6EhHLgymm1OzM70ofQhJJrSpm4sVXlN9CWuQtRTCiPoN1Z32uCnqAR5UL1Z0FO0YgQwiKuhTxHFyFs-5UoqkbIJMs1oYp8fXwmrgTc1PjO1bv6zWU42YC3-w4vvDtAhdMOvwxltqldjme-2XjXuIAXLoANgGdZ4w6u6bCtcvwKB-jl7hKdFXYX4Op3jtH64T6ZL6PV8-PTfLaKUqqmOpKKQJwWXFEe06lOudWcqUxJmwuuJeG5tQXTUBDLCgk5T1UcS5ZZSxkHqdkYTY5_975-byE0Zlu3vuorDZVSajnlYnDdHl2Zr0PwUJi9d6X1naHEDETNH6JmIGp-iJqBaJ8Wx3Rabv8V_Ab1iYJh</recordid><startdate>201406</startdate><enddate>201406</enddate><creator>Harrold, L.R.</creator><creator>Greenberg, J.D.</creator><creator>Bao, Y.</creator><creator>Grant, S.</creator><creator>Kremer, J.M.</creator><creator>Reed, G.</creator><creator>Florentinus, S.</creator><creator>Karki, C.</creator><creator>Lacerda, A.P.</creator><creator>Ganguli, A.</creator><general>Elsevier Limited</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope></search><sort><creationdate>201406</creationdate><title>THU0180 Time to Biologic Therapy Driven by Rheumatoid Arthritis Disease Activity and Severity</title><author>Harrold, L.R. ; Greenberg, J.D. ; Bao, Y. ; Grant, S. ; Kremer, J.M. ; Reed, G. ; Florentinus, S. ; Karki, C. ; Lacerda, A.P. ; Ganguli, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b1859-780e2bf48142159b4a9438c87ad649704daaf39ef0a3f7ed4b82273caa134e793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harrold, L.R.</creatorcontrib><creatorcontrib>Greenberg, J.D.</creatorcontrib><creatorcontrib>Bao, Y.</creatorcontrib><creatorcontrib>Grant, S.</creatorcontrib><creatorcontrib>Kremer, J.M.</creatorcontrib><creatorcontrib>Reed, G.</creatorcontrib><creatorcontrib>Florentinus, S.</creatorcontrib><creatorcontrib>Karki, C.</creatorcontrib><creatorcontrib>Lacerda, A.P.</creatorcontrib><creatorcontrib>Ganguli, A.</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><jtitle>Annals of the rheumatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harrold, L.R.</au><au>Greenberg, J.D.</au><au>Bao, Y.</au><au>Grant, S.</au><au>Kremer, J.M.</au><au>Reed, G.</au><au>Florentinus, S.</au><au>Karki, C.</au><au>Lacerda, A.P.</au><au>Ganguli, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>THU0180 Time to Biologic Therapy Driven by Rheumatoid Arthritis Disease Activity and Severity</atitle><jtitle>Annals of the rheumatic diseases</jtitle><date>2014-06</date><risdate>2014</risdate><volume>73</volume><issue>Suppl 2</issue><spage>243</spage><epage>244</epage><pages>243-244</pages><issn>0003-4967</issn><eissn>1468-2060</eissn><coden>ARDIAO</coden><abstract>Background In patients with early rheumatoid arthritis (RA), aggressive treatment of disease activity with non-biologic disease modifying anti-rheumatic drugs (nbDMARDs) and biologics is recommended in order to reduce the long-term consequence of inflammation (1). We sought to estimate time from use of first nbDMARD to first biologic initiation in RA patients, as well as investigate factors associated with biologic initiation. Methods We identified early RA patients (disease duration <1 year) within a national disease-based registry (CORRONA) with visits between 1/1/06 to 10/1/12. Survival analyses were performed using Kaplan-Meier curves estimating time from nbDMARD initiation to first biologic initiation. Median times to first biologic initiation were calculated. Cox proportional hazards models examined factors at nbDMARD initiation associated with time to biologic initiation including age, gender, baseline disease activity based on the clinical disease activity index [CDAI], insurance, disability (using the modified Health Assessment Questionnaire [mHAQ]) and prior nbDMARD use. We adjusted for clustering of patients by physician using the sandwich estimator for variance. Results There were 2403 nbDMARD initiators who met inclusion criteria. Most were female (71.5%) with a mean age of 56.1 yrs, mean mHAQ of 0.5 and mean CDAI 19.9 with 73.8% having moderate or high disease activity (CDAI >10) at nbDMARD initiation. The median time between first nbDMARD and first biologic was 4.24 years.In univariate analyses, factors associated with time to biologic initiation include patient age (HR 0.98, 95% CI 0.97-0.99), private insurance (HR 1.50, 95% CI 1.18-1.90), moderate/high disease activity with low disease activity the reference (HR 2.01, 95% CI 1.27-3.17), greater disability (mHAQ; HR 1.47, 95% CI 1.08-2.00) and year of enrollment/diagnosis (HR 1.23, 95% CI 1.12-1.3). In multivariable models, only moderate/high disease activity (HR 1.02, 95% CI 1.01-1.04) and patient age (HR 0.98, 95% CI 0.98-0.99) were associated with time to biologic. Conclusions In this real world cohort of RA patients, biologic therapy was started on average 4 ¼ years after initiation of a nbDMARD. Higher disease activity and younger patient age were associated with a reduced time to biologic initiation. References Singh JA, Furst DE, Bharat A, et al. 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis care & research. May 2012;64(5):625-639. Acknowledgements The CORRONA RA registry has been supported through contracted subscriptions in the last two years by Abbvie, Amgen, AstraZeneca, Genentech, Horizon Pharma, Eli Lilly, Novartis, Pfizer, Vertex and UCB. The design, study conduct, and financial support for the study was provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the abstract. Disclosure of Interest : L. Harrold Grant/research support: CORRONA, J. Greenberg Shareholder of: CORRONA, Consultant for: AstraZeneca, Pfizer, Employee of: CORRONA, Y. Bao Shareholder of: AbbVie, Employee of: AbbVie, S. Grant Employee of: Statistical Center for HIV/AIDS Research & Prevention at Fred Hutchinson Cancer Research Center, J. Kremer Shareholder of: CORRONA, Employee of: CORRONA, G. Reed Employee of: CORRONA, S. Florentinus Shareholder of: AbbVie, Employee of: AbbVie, C. Karki Employee of: CORRONA, A. P. Lacerda Shareholder of: AbbVie, Employee of: AbbVie, A. Ganguli Shareholder of: AbbVie, Employee of: AbbVie DOI 10.1136/annrheumdis-2014-eular.1161</abstract><cop>Kidlington</cop><pub>Elsevier Limited</pub><doi>10.1136/annrheumdis-2014-eular.1161</doi><tpages>2</tpages></addata></record> |
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| title | THU0180 Time to Biologic Therapy Driven by Rheumatoid Arthritis Disease Activity and Severity |
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