SAT0227 Rheumatoid arthritis patients treated with a low-dose and short-term glucocorticoid were satisfied with earlier improvement and reported decreased anxiety regarding adverse events.
Authors: E. Torikai, D. Suzuki, M. Suzuki, Y. Matsuyama
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> At EULAR 2017, we reported that the treatment of early rheumatoid arthritis (RA) patents by a low-dose and short-term glucocorticoid therapy (low and short GC) enabled earlier improvement and didn't worsen the rate of new complications. Currently, in RA treatment, subjective assessment of patients as well as objective assessment of doctors is gaining more importance<sup> (1)</sup>. What do patients think about the risks of low and short GC? Does low and short GC improve patients' satisfaction? <h3>Objectives:</h3> In this study, we investigated the change in each factor of the disease activity index (DAI) and patients' expectation of and anxiety regarding low and short GC through a questionnaire. <h3>Methods:</h3> We include 96 Japanese patients with RA and &lt;2-years disease duration. Patients were treated with a T2T strategy; if the disease activity was not improved within 3 months, their DMARDs were replaced with alternatives or additional DMARDs were added. We classified patients into two groups: those treated with DMARDs alone (N group; 35 females, 10 males) and those treated with &amp;x2266;5 mg/day GC for a maximum of 1 year along with DMARDs (GC group; 40 females, 11 males). The mean ages of the N and GC groups were 56.3 and 60.9 years, respectively. In the GC group, the mean GC dose was 2.46 mg/day. No significant differences were observed between the groups regarding MTX or Biologics agent use rates. We evaluated changes in the number of swollen joints and tender joints, DAS28-CRP score, CRP and VAS of pain for 3 years and compared each factor of DAI between both groups. We then asked them by a questionnaire what was beneficial from the therapies and how much paid attention to the adverse events. <h3>Results:</h3> There were no significant differences in all factors of DAI at baseline between the groups. At 1 month after treatment, there were significant differences in the improvement rate of VAS, CRP and DAS28-CRP score in the GC group compared with the N group. However, no significant difference was observed between the groups at &amp;x2267;3 months after treatment (figure 1). In the questionnaire (figure 2), pain improvement was the most expected effect from the treatment (89%), and early therapeutic effect was the second (80%) in the GC group. The pain improvement and the early therapeutic effect were significantly higher in the GC group than in the N group. The patients in both groups equally recognized the reduction in arthritis, morning stiffness, fatigue and the recovery of activities of daily living (ADL). Anxiety regarding adverse events was eliminated in the GC group as GC administration was restricted to a low dose for a short term. Almost identical results were obtained from the two groups. <h3>Conclusions:</h3> The treatment of early RA patients with low and short GC enables earlier improvement of disease activity, particularly VAS and CRP. Patients also reported that low and short GC were an improvement effect from the early stage, particularly regarding pain and anxiety about adverse events. These data confirm that the treatment with low and short GC in RA patients leads to improved patient satisfaction. <h3>Reference</h3> 1) Vibeke Strand, et al. J Rheumatol2015. <h3>Disclosure of Interest:</h3> None declared