SAT0158 The assessment of safety and efficacy of using self-monitoring of disease activity via web portal in the management of patients with rheumatoid arthritis
Authors: G. Bagirova, E. Lygina, S. Iakushin, A. Vorobyev
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> According to the Treat-to-Target guidelines for the RA, the main goal of treatment is remission or, alternatively, a lower activity of the disease. However, persistent remissions and preservation of working capacity are observed in no more than 5–6% of cases. As a result of the analysis of possible causes of the strategy's lack of efficacy, it seemed to us urgent to create and approve the method of managing RA patients via the "Web portal for self-monitoring of rheumatoid arthritis activity". <h3>Objectives:</h3> Maximally quickly identify the exacerbation of the disease and timely strengthen the therapy, for more rapid achievement of remission or low disease activity. <h3>Methods:</h3> The authors created an interactive web portal for self-monitoring of RA activity. The patient management model using this method is that a patient conducts a monthly self-evaluation of the disease activity and transmits this information to his treating doctor in a remote manner via the web portal. The doctor receives information about the patient9s health as quickly as possible. In case of worsening and in the absence of any dynamics, according to the patient, he was invited to the center, where this information was verified by a doctor and, if necessary, correction of therapy was made. If, in the patient9s opinion, there was an improvement, he did not come to clinic, but continued therapy. During the management of patients with RA using this method (1 year) initially and further regularly clinical, laboratory and radiological monitoring of efficacy and safety was conducted. Currently, 30 women with RA, age 57 (38; 71), who completed the 6-month treatment period, are included in the study. All patients underwent a clinical examination, hand and feet X-ray, laboratory tests and assessment of the RA activity by DAS28 index. Initially, all patients were trained by a rheumatologist to carry out a self-assessment of tender and swollen joints according to the original author9s technique "Structured curriculum for teaching RA patients self-monitoring of disease activity". <h3>Results:</h3> During 6 months, there was a positive dynamics of the course of the disease, the activity of the RA by DAS 28 decreased. Initially, 5 patients (16.7%) had high DAS activity, 24 – moderate (80%), 1- low (3.3%). After 6 months of treatment 8 patients (26.7%) had low activity, 22 (73.3%) achieved remission. The mean value of the DAS 28 index at the time of inclusion was 3.99 (2.46; 5.78) and after 6 months of management 2.175 (0.79; 4.31), a statistically significant decrease (Wilcoxon T-test = 5). Initially, all patients received methotrexate at an average dose of 12.9 mg (10 mg; 30 mg), at 6 months of follow-up, the average dose was 14.6 mg (10 mg; 25 mg). An increasing the dose of methotrexate was required in 11 (36.6%) patients. Analysis of clinical and laboratory parameters did not reveal statistically significant deviations. <h3>Conclusions:</h3> The 6-month period of patient management via the "web portal for self-monitoring of rheumatoid arthritis activity" proved the possibility of achieving remission and low disease activity in all patients. <h3>Disclosure of Interest:</h3> None declared