AB0394 Long Term Efficacy of Rheumatoid Arthritis (RA) Patients with Adequate Responses to Methotrexate (MTX) on Maintenance of Function and Structure: 3-Year Study Results

Background To achieve comprehensive disease control (CDC; defined as simultaneous achievement of DAS28 Objectives To compare 161 patients who showed adequate responses to methotrexate (MTX) (MTX group) with 96 patients treated with adalimumab (ADA) + MTX to inadequate response to MTX (MTX-IR) (ADA group) about the effects on functional and structural outcomes for 3 years. Methods Grip strength, CDR and CDC rates and patients9 proportions with structural remission (ΔmTSS ≤0.5), clinical relevant radiographic progression (CRRP; ΔmTSS >3) and rapid radiographic progression (RRP; ΔmTSS>5) were measured in MTX group (n=161, mean disease duration: 4.4 years) or ADA group (n=96, mean disease duration: 8.5 years) every year, for 3 years. Results There was no significant difference in clinical remission rates (DAS28-ESR Conclusions It was demonstrated that grip strength gradually decreased from 1 year after initiation of MTX treatment even in the patients who were managed RA disease for 3 years with MTX alone, while ADA treatment to MTX-IR patients improved grip strength time dependent manner, which was supported by the significantly better inhibitory effect on radiographic progression with higher CDC and CDR rates over 3 years in ADA group than those in MTX group. In summary, from our study in site, it is suggested ADA treatment by defining the patients who would better to start the treatment with biologics as early as possible, based on the concept of Treat To Target, would be a key for patients to achieve higher therapeutic goals. References Aletaha D et al, Ann Rheum Dis. 2010;69(9):1580-8. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.3957