AB0665 FACTORS INFLUENCING ATTAINMENT OF LOW DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS PATIENTS DEVIATING FROM TREAT-TO-TARGET STRATEGY
Authors: Y. J. Song, S. K. Cho, J. Y. Han, S. B. Lee, H. R. Park, H. W. Kim, E. Nam, S. W. Lee, Y. K. Sung
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> While Treat-to-Target (T2T) is a widely endorsed approach for managing rheumatoid arthritis (RA), instances arise where the strategy is not strictly adhered to, considering patient preferences and clinical characteristics. <h3>Objectives:</h3> This study aimed to investigate the proportion of RA patients achieving low disease activity (LDA) despite not following the T2T strategy and to identify contributing factors. <h3>Methods:</h3> Data were extracted from a multicenter prospective observational study involving RA patients initiating targeted therapy in Korea from April 2020 to July 2023. Emphasizing patients persisting with initial targeted therapy despite not attaining LDA at week 24, they were categorized into LDA and high disease activity (HDA) groups at week 48. Baseline characteristics were compared, and a multivariable logistic regression model was employed to identify factors associated with LDA at week 48. <h3>Results:</h3> Out of the 456 RA patients undergoing targeted therapy, 213 individuals (46.7%) were included in the analysis, with 96 categorized in the LDA group and 117 in the HDA group. Despite no notable differences in demographics and medication usage, patients in the HDA group presented with a higher prevalence of comorbidities and elevated DAS28-ESR levels at both enrollment and week 24. In the multivariable analysis, it was observed that patients with more comorbidities (Hazard Ratio [HR] 0.40, 95% Confidence Interval [CI] 0.22–0.73) and those with seropositive RA (HR 0.15, CI 0.03–0.70) were less likely to achieve LDA at week 48. Additionally, substantial reductions in both DAS28-ESR (HR 2.42, CI 1.27–4.60) and HAQ-DI (HR 2.70, CI 1.46–5.01) between enrollment and week 24 were associated with an increased likelihood of attaining LDA at week 48. Notably, the absence of non-steroidal anti-inflammatory drugs (NSAIDs) usage at week 24 was also linked to achieving LDA at week 48, with a HR of 2.15 (CI 1.06–4.38). <h3>Conclusion:</h3> This study highlights a noteworthy finding that a significant number of RA patients can achieve LDA even when not strictly adhering to the T2T strategy. Key determinants contributing to this positive outcome encompass lower comorbidity levels, seronegative RA, substantial reduction in disease activity between enrollment and week 24, and the cessation of NSAIDs at week 24. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> This research was supported by a grant of the Korea Health Technology R&amp;D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health &amp; Welfare, Republic of Korea (grant number: HI19C0481, HC19C0052). <h3>Disclosure of Interests:</h3> Yeo-Jin Song: None declared, Soo-Kyung Cho: None declared, Jung-Yong Han: None declared, Soo-Bin Lee: None declared, Ha-Rim Park: None declared, Hye Won Kim: None declared, Eunwoo Nam: None declared, Sang Won Lee: None declared, Yoon-Kyoung Sung YKS has received research grants from Bristol-Myers Squibb, Eisai, Pfizer, and JW Pharmaceutical.