AB0918 Patient-reported outcomes improvement in the russian cohort of early periferal psoriatic arthritis patients treated according to treat-to-target strategy (OPEN-LABEL REMARCA STUDY)
Authors: E.E. Gubar, E.Y. Loginova, S.I. Glukhova, T.V. Korotaeva, E.L. Nasonov
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Psoriatic arthritis (PsA) has a significant impact on patients' (pts) mood and quality of life. Patient reported outcome (PRO) measures are an important component to assessing disease impact and therapy response in PsA pts. There is limited data concerning the influence of T2T strategy on PROs. <h3>Objectives</h3> To assess the effect of tight control T2T strategy on the PROs dynamics over 1 year (yr) period. <h3>Methods</h3> 78 pts (M/F–39/39) with early PsA according to CASPAR criteria were included; mean age 36.5±10.7 years, disease duration 12.2±10.3 mo. Disease activity indexes (DAS)=4. 0±1.4, DAS28=4.2±1.1. Pts underwent standard clinical examination of PsA activity. At baseline all pts were treated with MTX (s/c). The dose of MTX was escalated by 5 mg eow from 10 mg/wk to 20–25 mg/wk. If the patient did not achieve minimal disease activity (MDA) or remission after 3 mo of MTX mono-therapy, combination therapy with MT +adalimumab 40 mg s/c eow was started. At baseline and after 1 year. of therapy the following PROs were analysed: trends in fatigue (according to FACIT) and in RAPID3 were studied in 64 pts, trends in patient's global disease activity (PGA) and in patient's pain VAS were studied in 78 pts, trends in levels of anxiety and depression (HADS) were studied in 49 pts. The data acquired was analysed with the use of Spearman's correlation. <h3>Results</h3> After 1 year of therapy, there was a significant improvement in the following scores: anxiety changed from 5.7±3.1 to 4.3±3.2, (p=0.003), fatigue from 35.3±9.6 to 41.3±9.9 (p&lt;0.001), RAPID3 from 13.4±5.1 to 6.2±5.2 (p&lt;0.001), PGA from 56.0±17.8 to 18.9±17.1 (p&lt;0.001), pain from 53.7±18.6 to 16.9±16.6 (p&lt;0.001). Depression scores had also changed though not significantly: from 3.8±3.0 to 3.2±3.1 (p=0.235). The dynamics of anxiety and depression indexes correlated with the dynamics of fatigue (r=0.64 and r=0.39, accordingly), as well as dynamics of FACIT and RAPID3 indexes (r=0.36). Correlation of the dynamics of RAPID3 indexes with DAS (r=0.45) and DAS28 (r=0.41) activity reduction was found. Association of RAPID3 dynamics with the achievement of remission according to DAS (p&lt;0.001) and DAS28 (p&lt;0.001) was detected. Interrelation between RAPID3 dynamics and the achievement of MDA (p&lt;0.001) was found. Correlation between dynamics of anxiety and depression indexes and the reduction of tender joint count (TJC) (r=0.38 and r=0.36, accordingly) was found. There is correlation between the dynamics of fatigue indexes and TJC, swollen joint count (SJC) and PGA (r=0.30, r=0.25 and r=0.35, accordingly). Dynamics of RAPID3 correlated with TJC and SJC dynamics (r=0.33, r=0.25), as well as with PGA and pain dynamics (r=0.49 and r=0.58). PGA and pain dynamics correlated with TJC and SJC dynamics (r=0.34 and r=0.26; r=0.43 and r=0.39, accordingly). <h3>Conclusions</h3> The T2T strategy in the Russian cohort of peripheral early PsA pts demonstrated the improvement of PROs indexes and decrease in PsA activity. Interrelation between the improvement of psychological status according to PROs (anxiety, depression and fatigue) and improvement in joint status (TJC and SJC) was found. RAPID3 is a reliable tool for evaluating patient's status: RAPID3 indexes correlate with the achievement of MDA and DAS/DAS28 remission. <h3>Disclosure of Interest</h3> None declared