FRI0569 Remission and Low Disease Activity Matrix Tool: Results in Real-World Rheumatoid Arthritis Patients under Golimumab
Authors: D. Rosa-Gonçalves, R. Fonseca, F. Aguiar, T. Martins-Rocha, M. Bernardes, L. Costa
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Cost-effectiveness of treatments in rheumatoid arthritis (RA) is of growing importance thus, the ideal is to have a tool that help us to select patients most likely to respond to biotechnological drugs. <h3>Objectives</h3> To assess the relationship between predicted disease states and the observed amount of improvement applying the remission and low disease activity (LDA) matrix tool presented by MSD as a poster at EULAR 2015<sup>1</sup> to our patients receiving golimumab (GLM). <h3>Methods</h3> We identified RA patients who had done GLM as first biological therapy in our hospital. Demographic and clinical data at baseline and at 6 months were collected. The calculation of remission or LDA rates at 6 months of GLM treatment was made based on the proposed prediction matrix tool. Patients were divided into 2 groups by their predicted remission rate at 6 months: lowest chance if &lt;30% and greatest if ≥30%. Thereafter, we compared the amount of improvement in DAS28-4v, tender joint count (TJC), HAQ and Patient Global Assessment of Disease Activity Visual Analog Scale (PGA-VAS) scores observed in each group during 6 months of treatment with GLM. <h3>Results</h3> At our hospital, 239 patients with RA are under biological therapy. Of these, 20 had GLM as the first biological agent. Most patients were females (n=16, 80%) and mean age (SD) at start of biological therapy was 50 (11.8) years. Most were non-smoking (n=15, 78.9%). Only 2 patients had rheumatoid factor and anti–citrullinated protein antibodies negative and mean disease duration was 9.5 (5.6) years. The mean of DAS28 4v was 5.71 (1.16). At 6 months we found that only one patient had inactive disease, the remaining showed moderate (n=12) or high (n=4) disease activity; 6 patients did not have EULAR response. When we applied the matrix tool, we found that in these cases only three and one case had less than 20% predicted rate of remission and LDA, respectively. We observe that patients with lowest chance of remission had greater improvement in DAS28-4v, TJC, HAQ, and PGA-VAS scores than those with highest chance, during 6 months of treatment: 1.80 vs 0.54, 8.13 vs 0.27, 0.44 vs 0.26 and 19.63 vs 15.91, respectively (p&lt;0.05 only for DAS28-4v and TJC). We found 9 cases (45%) of drug discontinuations at 6 months, 8 of which for primary failure and 1 for adverse event (at 1 month). Of the patients that remained under GLM at 6 months, 9 remained beyond 12 months of treatment, 4 of which have achieved remission. <h3>Conclusions</h3> The application of the remission and LDA matrix tool in our sample showed contradictory results with regard to the predictive ability of remission or LDA rate at 6 months. On the other hand, our results reinforce that EULAR response may be a more appropriate goal of treatment than LDA or remission in a subgroup of patients. <h3>References</h3> Vastesaeger N, et al. EULAR 2015 (SAT0360) <h3>Disclosure of Interest</h3> None declared