THU0247 What is More Predictive of Achieving Remission at 12 Months: the Percentage of Baseline Improvement or the Actual Disease State Achieved?

Background The aim of rheumatoid arthritis (RA) treatment is to optimize symptom control and, when possible, achieve sustained remission. Therefore, identification of clinical signs predicting future remission is valuable to clinical decision making. One question faced by clinicians is whether the achievement of a lower disease activity value or a higher rate of change of disease activity is indicative of better future disease outcomes. Objectives To determine whether change in disease activity measures or the actual values achieved at 6 months were more predictive of remission at 12 months in RA patients treated with infliximab (IFX) in a real-world, clinical practice setting. Methods BioTRAC is an ongoing, prospective registry of patients initiating treatment for RA with IFX or golimumab as first biologics or after having been treated with a biologic for Results 436 patients were included with mean age of 56.1 yrs and disease duration of 10.4 yrs. With respect to 12-month DAS28 remission, a stronger association was observed with the actual DAS28 score compared to the percent improvement in DAS28 at 6 months. The Wald statistic for the percent change and actual value of DAS28 at 6 months was 5.38 and 46.88, respectively, while the change in log-likelihood was 4.98 (P=0.026) and 61.64 (P For SDAI remission at 12 months, the respective Wald values for percent change and actual value at 6 months were 0.075 and 18.28 and log-likelihood changes were 0.07 (P=0.788) and 24.08 (P Conclusions These results demonstrate that the actual disease outcome value achieved at 6 months is a stronger predictor of remission at 12 months than the percent change in disease activity. These findings suggest that the treatment target in a real-world setting should be set as specific endpoints and not as change over time. Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.4443