AB0430 Subjective assessments of patients with rheumatoid arthritisreported that bio-holiday therapy brought them financial and psychological improvements
Authors: E. Torikai, D. Suzuki, M. Suzuki, Y. Matsuyama
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> At EULAR 2016 and 2017 we reported that it is possible to maintain disease activity, radiographic progression, physical function, and bone metabolism status in rheumatoid arthritis (RA) patients with clinical disease activity index (CDAI) remission using the biologic agents (Bio)-holiday therapy. Currently, in RA therapy, subjective assessment of patients as well as objective assessment of doctors is becoming more important<sup> (1)</sup>. How does the patient think about Bio-holiday therapy? <h3>Objectives</h3> We conducted questionnaire survey in RA patients with CDAI remission who underwent Bio-holiday therapy or Bio-continue therapy to evaluate the benefits of their therapies and to clarify the number of patients concerned about flare-up. <h3>Methods</h3> The first and second survey comprised 9 and 11 questions, respectively; each provided predefined answers. In the first survey, we questioned 85 RA patients in CDAI remission: those treated with any DMARDs. We asked them about the expected elements of RA treatment. In the second survey, we questioned two groups of patients with CDAI remission; those treated with Bio-continue after achieved CDAI remission (BC group: n=26) and those treated with Bio-holiday therapy after achieved CDAI remission (BH group: n=28). We asked them by a questionnaire what was expected from the treatment effect and how much they felt anxiety about the activity of daily life (ADL) deterioration, RA flare-up and treatment costs. For Bio-holiday therapy, patients with CDAI remission were treated with golimumab or tocilizumab. Bio was discontinued if they achieved CDAI remission. Patients were treated with Bio within 3 months after falling out of CDAI remission. They could be taken off Bio again when they reached CDAI remission. <h3>Results</h3> In the first survey (figure 1), pain improvement and inexpensive treatment were the most and the second expected treatment effect, respectively. In the second survey (Figure 2), for questions regarding expectation from RA treatment effect, the patients reported that the most beneficial points was pain improvement and the second one was the active daily living without difficulty. Patients in both groups equally recognised reduction in pain and recovery of activities of daily living, which are important for patients with CDAI remission. Interestingly, improvement of emotional depression is the higher in BH group than in BC group. For question regarding anxiety, the high medical expense was the most anxious point. Anxiety regarding high medical expenses in BH group was lower than that in BC group. Anxiety regarding flare-up was equal to that in BC group as patients were assured of retreatment with Bio in case of a flare-up. <h3>Conclusions</h3> Patients in both groups were equally satisfied with the improvement of their disease activity and progression of ADL. Reduction of the anxiety regarding treatment costs and flare-up in Bio-holiday therapy also helped to improve psychological aspects. Therefore, we recommended Bio-holiday therapy for RA patients with CDAI remission. <h3>Reference</h3> [1] Vibeke Strand, et al. J Rheumatol2015. <h3>Disclosure of Interest</h3> None declared