AB0234 Comparing Activity Among RA Patients: Are There Differences Between Patients Treated with Biologic or Synthetic Dmards?

BackgroundThe emergence of biological DMARDs have been a major change for the treatment of Rheumatoid Arthritis (RA) patients. The RA therapeutic algorithm includes: synthetic DMARD monotherapy, synthetic DMARD combination and biologic DMARDs. Since biological DMARDs have proved to be extremely effective, it would seem that those patients not receiving these biologic DMARDs could be treated suboptimally.ObjectivesTo assess whether there are differences in clinical activity among RA patients with treated with biologic DMARDs or synthetic DMARDs in Ra specialist clinicMethodsConsecutive patients treated with both biologic or synthetic DMARDs seen in a RA specialized clinic were included. Clinical activity using different composite indices (DAS28-ESR, DAS28-CRP, RAPID3, SDAI and CDAI) was assessed.Outcomes among patients treated with synthetic or biologic DMARDs were compared. Composite indices were compared in both quantitative and qualitative values. Qualitative status were defined as: Remission, Low activity disease, Medium Activity disease or High Activity disease by each of these indices.Results312 values of 154 patients (average of 2.02 per patient) were obtained.Patient characteristics: 78% women, mean age (SD) 59 (13), average time of evolution (DE) 11 (10) years. 79 patients (51.3%) treated with biologic DMARDs.The table shows the number of patients, age, disease duration, corticosteroid use quantitative value from each index, expressed in its mean (SD) and percentage of patients in remission or low activity disease for each of index.Biologic DMARDsSynthetic DMARDspN7975Age, years (mean (SD))58,7 (12,2)59,8 (15,5)NSSex (% female)78,5%78,7%NSEvol, years (mean (SD))14,9 (11,3)6,8 (6,6)0,001Corticoids %46,4%63,8%0,002Qualitative indices DAS28-ESR3,0 (1,2)3,3 (1,2)0,02 DAS28-CRP2,5 (1,0)2,7 (1,1)0,12 SDAI7,7 (7,0)8,5 (7,6)0,36 CDAI7,1 (6,8)8,1 (7,7)0,24 RAPID38,6 (0,5)8,5 (0,6)0,86Quantitative indices: REM+LAD (%) DAS28-ESR63,1%47,0%0,02 DAS28-CRP77,8%71,1%0,18 SDAI74,1%70,7%0,51 CDAI73,9%70,3%0,47 RAPID339,3%40,7%0,79ConclusionsNo significant clinical differences among patients treated with biologic DMARDs or synthetic DMARDs were observed reflecting T2T strategy. In the only index that significant differences (DAS28-ESR) were found, these differences were not clinically relevant.The use of T2T strategy should lead to a similar control in RA patients regardless of treatment provided, as this study shows.Disclosure of InterestNone declared