FRI0036 VALIDATION OF RISK SCORES FOR PREDICTING PROGRESSION IN INDIVIDUALS “AT RISK OF RHEUMATOID ARTHRITIS”
Authors: L. Duquenne, J. Nam, K. Mankia, L. Garcia-Montoya, A. DI Matteo, P. Emery
Journal: Annals of the Rheumatic Diseases (2020)

<h3>Background:</h3> Composite scores for risk of progression were described in 2015 in a cohort of 100 anti-cyclic citrullinated peptide (anti-CCP) + individuals at risk of developing Inflammatory Arthritis (IA) (1). The first score, designed for primary care, was based on anti-CCP and rheumatoid factor (RF) titres, small joints tenderness and early morning stiffness (EMS). A second score developed for secondary care added power Doppler presence (PD+) and/or at least one allele positive for the shared epitope (SE+). <h3>Objectives:</h3> To validate previous data by scoring risk factors in a new cohort of 394 individuals. <h3>Methods:</h3> Individuals at risk of developing IA selected by a positive anti-CCP test and a new musculoskeletal symptom have been followed in a single-centre prospective observational cohort since 2008. The previous risk score was derived from 100 patients. With the same recruitment and follow-up pathways, the next 394 consecutive participants were studied (full data were available for 373 patients for secondary care model). Participants followed for less than 10 weeks without progression were excluded. <h3>Results:</h3> Participants from both cohorts were similar in terms of age and sex. Although the mean time to progression is comparable, there were significantly more participants with a high titre anti-CCP test in the 2015 cohort (Table 1). Cox multivariable analysis showed similar Hazard Ratios (HR) of progression in both groups (Table 2) confirming the high predictive value of high CCP/RF titre, early morning stiffness duration, power doppler presence and shared epitope. High risk of progression individuals identified by the secondary score were eight times more likely to develop IA (HR = 8.290, CI = 3.763-18.264, p&lt;0.001), 50% of them had progressed at 2 years (Figure 1). <h3>Conclusion:</h3> These data from a new large cohort confirm the validity previous Leeds Risk Scores for Primary and Secondary care, and the fidelity of the risk factors over time to predict progression. <h3>References:</h3> [1]Rakieh C, Nam JL, Hunt L, Hensor EM, Das S, Bissell LA, et al. Predicting the development of clinical arthritis in anti-CCP positive individuals with non-specific musculoskeletal symptoms: a prospective observational cohort study. Annals of the rheumatic diseases. 2015;74(9):1659-66. <h3>Disclosure of Interests:</h3> Laurence Duquenne: None declared, Jacqueline Nam: None declared, Kulveer Mankia: None declared, Leticia Garcia-Montoya: None declared, Andrea Di Matteo Grant/research support from: the publication was conducted while Dr. Di Matteo was an ARTICULUM fellow, Paul Emery Grant/research support from: AbbVie, Bristol-Myers Squibb, Merck Sharp &amp; Dohme, Pfizer, Roche (all paid to employer), Consultant of: AbbVie (consultant, clinical trials, advisor), Bristol-Myers Squibb (consultant, clinical trials, advisor), Lilly (clinical trials, advisor), Merck Sharp &amp; Dohme (consultant, clinical trials, advisor), Novartis (consultant, clinical trials, advisor), Pfizer (consultant, clinical trials, advisor), Roche (consultant, clinical trials, advisor), Samsung (clinical trials, advisor), Sandoz (clinical trials, advisor), UCB (consultant, clinical trials, advisor)