AB0263 Impact Evaluation of A Doses Optimization Strategy for Biological Products in Structural Damage Measured by Low-Field MRI in Rheumatoid Arthritis Patients

Background Currently it is recommended to optimize doses of biologics in RA patients who have maintained the therapeutic goal of remission for at least 6 months (1). Questions remain about the potential impact of these strategies on structural damage (2–4). Studies show that patients in clinical remission have synovitis detected by sensitive imaging studies such as magnetic resonance imaging (MRI) (5). Objectives The aim of this pilot study was to determine the percentage of patients who did not appear or increase the degree of synovitis evaluated by MRI after drug dose reduction at 6 months. Methods Observational, longitudinal, prospective study, which included patients with rheumatoide arthritis who are being treated with biologics and are in a state of clinical remission, defined as DAS28 Results A total of 16 patients were included. Of these, 10 (62.5%) received etanercept, 2 tocilizumab (12.50%) and 4 adalimumab (25%). The mean disease duration before starting biological therapy was 4.5 years (1-17). The mean DAS28 at starting biological therapy was 5.3 (3,6-9). All patients with etanercept increased range of 7 to 10 days, except one patient dose reduced to 25 mg every 7 days. In 68% of patients no increase in the degree of synovitis was found. The disease activity and imaging data are shown in Table 1. No statistically significant differences in the disease activity before and after reduction (p 0.1) were found. However, differences between basal RAMRIS synovitis, at 3 months and at 6 months (p 0.019) were found. Conclusions In selected RA patients who are in permanent clinical remission, dose optimization may be an effective strategy that does not involve an increase in clinical activity, however, implications on structural outcome must be evaluated. References Smolen JS, et al. Ann Rheum Dis 2010;69:964-75. Brocq O, et al. Joint Bone Spine 2009;76:350-55. Saleem B, et al. Ann Rheum Dis 2010;69:1636-42. Tanaka Y, et al. Ann Rheum Dis 2020;69:1286-91. Brown AK, et al. Arthritis Rheum 2006;54(12):3761-73. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5669