THU0270 ONLINE INTERACTION AND FREQUENT SELF-ASSESSMENTS PROMOTED TREAT-TO-TARGET FOR SLE VIA EMPOWERING PATIENTS: A COHORT STUDY FROM CHINA BY SMART SYSTEM OF DISEASE MANAGEMENT (SSDM)
Authors: J. Huang, Y. Wang, H. Wei, X. Wang, F. He, T. Xie, B. Wu, C. Zhao, H. Xiao, B. Wu, Y. Jia, F. Xiao, C. Bao
Journal: Annals of the Rheumatic Diseases (2020)

Background: Treating to target (T2T) is routine in RA, but no comparable standard has been defined for SLE. In 2015, the definition of Lupus Low Disease Activity State (LLDAS) was generated by Asia-Pacific Lupus Collaboration, and the preliminary validation demonstrated its attainment to be associated with improved outcomes in SLE. A SLEDAI-2K score lower than 4 is the main criteria for LLDAS. SSDM is an interactive mobile disease management application, including application systems for both the doctors and patients. Objectives: To evaluate the patterns of T2T and related influential factors among SLE patients after applying SSDM in real world. Methods: Patients were trained to master SSDM by healthcare professionals in clinics. The first assessment for SLEDAI-2K was performed as the baseline. Patients were required to perform repeated self-assessments after leaving the clinics. The data is synchronized to the SSDM of authorized rheumatologists. Based on the patients’ data, rheumatologists will provide medical advices to the patients. Results: From July 2015 to Jan 2020, 32,559 SLE patients enrolled in SSDM. The mean age is 36.35 years old and median disease duration is 3.85 years. Among them 1,937 SLE patients from 134 hospitals across China were followed up for more than 12 months, and the demographics were summarized in table 1. Table 1. Baseline\Final follow-up n % x &lt;= 4 % 5 &lt;= x &lt;= 9 % 10 &lt;= x &lt;= 14 % 15 &lt;= x % x &lt;= 4 1040 53.69% 820 78.85% 135 12.98% 50 4.81% 35 3.37% 5 &lt;= x &lt;= 9 357 18.43% 230 64.43% 60 16.81% 32 8.96% 35 9.80% 10 &lt;= x &lt;= 14 222 11.46% 120 54.05% 38 17.12% 40 18.02% 24 10.81% 15 &lt;= x 318 16.42% 156 49.06% 49 15.41% 47 14.78% 66 20.75% Total 1937 100% 1326 68.46% 282 14.56% 169 8.72% 160 8.26% The ratio of T2T achievers was 53.69% (1,040/1,937) at the baseline and improved significantly to 68.46% (1,326/1,937) after a 12-month follow-up, p&lt;0.01. Among T2T achievers at the baseline, 78.85% (820/1,040) maintained T2T, and 21.15% (220/1,040) relapsed. Of patients who didn’t achieve T2T at baseline, 56.41% (506/897) of the patients achieve T2T after 12-month follow-up. The impact of the online interaction and the frequency of self-assessment for SLEDAI-2K on T2T has been analyzed. Compared with 1,475 patients who didn’t interact online with their physicians through SSDM, 462 patients with online interaction achieved higher rate of T2T improvement (19.48% vs 13.29%, p&lt;0.05). The more frequent of the self-assessments being performed by patients, the higher improvement of T2T rate will be. The improvement rates of T2T in the subgroups which self-assessed with SSDM by quarterly, bimonthly and monthly were 8.56%, 16.14% and 23.24% respectively. The improvement rate (y) of T2T was positively correlated with the frequency of self-assessment for SLEDAI-2K(x) independently, r = 0.9998. (Figure 1) Conclusion: After proactive disease management via SSDM for more than 12 months, the rate of T2T in SLE patients increased significantly. Online interaction between patients and physicians contributed in promoting T2T improvement rate. The patients who performed more self-assessments through SSDM had higher probability of T2T achievement. SSDM is a valuable tool for long term SLE follow-up through empowering patients. References: Acknowledgments: SSDM was developed by Shanghai Gothic Internet Technology Co., Ltd. Disclosure of Interests: None declared