AB0467 Maintenance Therapy with Chloroquine of Low Activity Rheumatoid Arthritis Patients
Authors: M.P. Ivanova, H.I. Batolska
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Objectives</h3> This study investigates the effectiveness of the maintenance therapy with 250 mg chloroquine daily of low activity rheumatoid arthritis patients who were previously threated with synthetic and biological disease-modifying antirheumatic drugs (SBDMARDs) or with disease modifying antirheumatic drugs (DMARDs). <h3>Methods</h3> The study covered 81 patients aged between 42-73 with low activity rheumatoid arthritis: DAS28 &lt;3,2. The patients were split in two groups: group A of 39 patients stops medical treatment and group B of 42 patients starts maintenance therapy with 250 mg chloroquine daily. Every quarter DAS28 was calculated. Inclusion criteria: All patients meet 1987 ACR criteria (The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis) and/or are positive anti- CCP antibody. All patients were previously threated during the acute stage of rheumatoid arthritis with one of the following medicines or a combination of them: Leflunomid, Methotrexat, Sulfasalazin, Infliximab, glucocorticoids (GCs) for a period from 6 to 15 months until low activity of the disease was reached: DAS28 &lt;3,2. Exclusion criteria: moderate to high activity of rheumatoid arthritis patients DAS28 &gt;3,2, patients with early stage rheumatoid arthritis, patients not willing to consult a specialist once a month. <h3>Results</h3> During the first quarter no exacerbation of the disease was observed in any patients from group A and group B. During the second quarter there is an exacerbation in 5 (12.82%) patients from group A and there was no exacerbation in any patient from group B. During the third quarter there is an exacerbation in 24 (61.54%) patients from group A and in 1 (2.38%) patient from group B. During the fourth quarter there was an exacerbation in 37 (94.87%) patients from group A and 3 (7.14%) patients from group B. During the fifth quarter all 39 (100%) patients from group A and 6 (14.28%) patinets from group B are in an acute stage. After 15 months all patients with rheumatoid arthritis who were not under treatment and only 6 (14.28%) from patients under maintenance therapy are again with high activity of rheumatoid arthritis DAS28 &gt;5,2. Comparing the obtained values, a very significant statistical difference (p&gt;0.001) was noticed. During the first quarter only 6 (15.38%) patients from group A are with moderate activity rheumatoid arthritis and all patients from group B are with low activity of the disease. During the second quarter 17 (43.59%) patients from group A and 5 (11.9%) from group B are with moderate activity. During the third quarter 14 (35.89%) from group A and 7 (16.67%) from group B are with moderate activity. During the fourth quarter 2 (5.13%) patients from group A and 8 (19.05%) patients from group B are with moderate activity. During the fifth quarter all patients from group A are with high activity of rheumatoid arthritis and 8 (19.05%) are with moderate activity. Comparing the obtained values, a very significant statistical difference (p&gt;0.001) was noticed. <h3>Conclusions</h3> After the treatment with biological disease-modifying antirheumatic drugs (SBDMARDs) or with disease modifying antirheumatic drugs (DMARDs) of rheumatoid arthritis patients was stopped for a period from 6 to 15 months, the symptoms of the disease return. If the patients are treated with 1 tablet of 250 mg chloroquine daily, the disease may remain with low or medium activity for longer period. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.1092