FRI0065 PATIENT-REPORTED PALINDROMIC SYMPTOMS IN EARLY RHEUMATOID ARTHRITIS: RESULTS FROM THE CANADIAN EARLY ARTHRITIS COHORT
Authors: Leah Ellingwood, Orit Schieir, Marie-France Valois, Susan J. Bartlett, Louis Bessette, Carol Hitchon, Gilles Boire, Glen Hazlewood, Edward Keystone, Diane Tin, Carter Thorne, Vivian Bykerk, Janet Pope
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The frequency and characteristics of patients with Palindromic Rheumatism (PR) (transient acute attacks of articular inflammation) prior to early rheumatoid arthritis (ERA) are unknown. <h3>Objectives</h3> To compare ERA patients who did versus did not report a history of transient episodes of joint inflammation preceding RA diagnosis. <h3>Methods</h3> Study participants were patients with ERA or suspected RA (symptoms &lt;1 year; 83% met 2010 ACR/EULAR criteria) enrolled in the Canadian Early ArThritis CoHort (CATCH) between April 2017 to March 2018 who completed a questionnaire on prior inflammatory joint symptoms that “come and go”. Chi-square and t-tests were used to compare characteristics in patients with versus without a reported history of prior palindromic symptoms. Simple, and multivariable logistic regression with backward selection (p&lt;0.2) were used to determine crude and adjusted predictors of palindromic symptoms. <h3>Results</h3> 154 ERA patients were included; 66% were female and mean (sd) age was 54 (15) years. 54% had previous joint pain and swelling prior to their current episode; 42% endorsed prior episodic joint pain and swelling, approximately half of whom (20% of total, N=31) reported transient joint symptoms for over six months. Patients reporting previous palindromic symptoms were more often female, seropositive, had more comorbidities, and lower swollen joints and baseline CDAI (p&lt;0.05). In multivariable regression, female sex, higher income, seropositivity, back or spine issues, and lower CDAI were associated with history of palindromic symptoms (Table 1). <h3>Conclusion</h3> Half of ERA patients self-reported transient episodes of inflammatory arthritis prior to being diagnosed with RA. They are more likely female, seropositive, with higher income and lower disease activity. <h3>Acknowledgement</h3> The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016 and Merck Canada since 2017. Previously funded by Hoffmann-LaRoche and Janssen Biotech from 2011-2016,UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. <h3>Disclosure of Interests</h3> Leah Ellingwood: None declared, Orit Schieir: None declared, Marie-France Valois: None declared, Susan J. Bartlett Consultant for: Pfizer, UCB, Lilly, Novartis, Merck, Jansen, Abbvie, Louis Bessette Grant/research support from: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Consultant for: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Speakers bureau: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Carol Hitchon: None declared, Gilles Boire Grant/research support from: Investigator-initiated studies: Amgen, Abbvie, BMS, Eli Lilly, Merck, Novartis, Pfizer, Consultant for: Advisory boards: Amgen, BMS, Celgene, Eli Lilly, Pfizer, Speakers bureau: Merck, BMS, Pfizer, Glen Hazlewood: None declared, Edward Keystone Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, F. Hoffmann-La Roche Inc, Gilead, Janssen Inc, Lilly Pharmaceuticals, Pfizer Pharmaceuticals, Sanofi-Aventis, Consultant for: AbbVie, Amgen, AstraZeneca Pharma, Biotest, Bristol-Myers Squibb Company, Celltrion, Crescendo Bioscience, F. Hoffmann-La Roche Inc, Genentech Inc, Gilead, Janssen Inc, Lilly Pharmaceuticals, Merck, Pfizer Pharmaceuticals, Sandoz, UCB., Speakers bureau: Amgen, AbbVie, Bristol-Myers Squibb Canada, F. Hoffmann-La Roche Inc., Janssen Inc., Merck, Pfizer Pharmaceuticals, Sanofi Genzyme, UCB, Diane Tin: None declared, Carter Thorne Grant/research support from: Investigator-initiated studies: Amgen, Pfizer. RCTs: Abbvie, Celgene, CaREBiodam, Novartis, Pfizer, Consultant for: Advisory board: Abbvie, Amgen, Celgene, Lilly, Medexus/Medac, Merck, Novartis, Pfizer, Sanofi. Consultant: Abbvie, Centocor, Janssen, Lilly, Medexus/Medac, Pfizer, Speakers bureau: Medexus/Medac, Vivian Bykerk Grant/research support from: Mallinckrodt, BMS, Crescendo Biosciences, Sanofi/Regeneron., Consultant for: Amgen, Pfizer, UCB, Scipher, Sanofi/Genzyme/Regeneron, Janet Pope Consultant for: Eli Lilly and Company