SAT0090 Three out of Every Four Patients with Dmard-Naive Early Rheumatoid Arthritis Meet DAS28 Remission at 12 Months in Finland
Authors: T. Rannio, J. Asikainen, P. Hannonen, T. Yli-Kerttula, P. Ekman, L. Pirilä, L. Kuusalo, M. Mali, M. Puurtinen-Vilkki, S. Kortelainen, J. Paltta, K. Taimen, M. Kauppi, K. Laiho, S. Nyrhinen, H. Mäkinen, P. Isomäki, T. Uotila, K. Aaltonen, H. Kautiainen, T. Sokka
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Finnish national combination treatment trials [1,2] have demonstrated excellent outcomes in patients with early rheumatoid arthritis (RA) including 90% of patients reaching 28-joint Disease Activity Score (DAS28) remission. Whether similar results are reached in clinical praxis is not known. <h3>Objectives</h3> To assess what proportion of patients with dmard-naïve early rheumatoid artritis (RA) reach DAS28 remission over one year and remission variability across clinics in Finland <h3>Methods</h3> Patients with dmard-naïve inflammatory arthritis diagnosed as new early RA were recruited. Comparison among sites were made in proportion of patients in 28-joint Disease Activity Score with 3 variables (DAS28–3) remission. Repeated measures were analyzed using mixed models approach with appropriate distribution and link function. <h3>Results</h3> 611 patients were recruited at 5 sites: 67% female; the mean age (SD) at diagnosis was 57 (16) years; respective 71% and 68% were RF and AntiCCP positive; 23% had radiographic erosions. A total of 506 (83%) fulfilled the ACR/EULAR 2010 classification criteria for RA for further analyses. DAS28–3 remission was met by 68% and 75% at 3 and 12 mo, respectively. Clinic had no effect in remission when adjusted for confounders (Figure 1). At baseline, a total of 68% used MTX based combination therapy, and 31% used triple therapy with methotrexate, hydroxychloroquine and sulphasalazine. In multivariate analysis, the only independent predictors of DAS28–3 remission at 12 mo were lower baseline DAS28–3 (odds ratio 0.6, 95% confidence interval 0.4–0.7, <i>P</i>&lt;0.001) and triple therapy as the initial treatment (odds ratio 1.8, 95% confidence interval 1.0–3.3, <i>P</i>=0.048). <h3>Conclusions</h3> Three out of every four dmard-naïve early RA patients are in remission in Finland after 1 year of diagnosis. High remission rates were achieved with use of csDMARDs in combinations for majority of patients. Treatment with triple therapy is a predictor of DAS28–3 remission also in real-life rheumatology settings. <h3>References</h3> Möttönen T, Hannonen P, Leirisalo-Repo M, Nissilä M, Kautiainen H, Korpela M, et al. Comparison of combination therapy with single-drug therapy in early rheumatoid arthritis: A randomised trial. FIN-RACo trial group. Lancet 1999; 353:1568–73 Leirisalo-Repo M, Kautiainen H, Laasonen L, Korpela M, Kauppi MJ, Kaipiainen-Seppänen O, et al. Infliximab for 6 months added on combination therapy in early rheumatoid arthritis: 2-year results from an investigator-initiated, randomised, double-blind, placebo-controlled study (the NEO-RACo Study). Ann Rheum Dis 2013;72:851–7 <h3>Acknowledgement</h3> We would like to thank study nurses. This study was supported by Pfizer. <h3>Disclosure of Interest</h3> None declared