AB0294 PERSISTENCE WITH ABATACEPT VERSUS TUMOR NECROSIS FACTOR-INHIBITORS FOR RHEUMATOID ARTHRITIS COMPLICATED BY POSITIVE ANTI-CYCLIC CITRULLINATED PEPTIDE/RHEUMATOID FACTOR OR OTHER POOR PROGNOSTIC FACTORS

Background: Rheumatoid arthritis (RA) and spondyloarthritis (SA) are two heterogeneous diseases but both being major causes of disability in our practice. Biologic treatments have changed miraculously the course of these diseases in the past two decades. Objectives: To determine severity factors in RA and SA patient newly treated with biologics. Methods: A survey using results of the Tunisian registry BINAR including ten rheumamtology centers was conducted. Adults of 18 years or more were included. Only those meeting the ACR/EULAR 2010 critera for RA or the ASAS 2009 criterea for SA and treated with biologics for 2 years or less were included. Results: Two hundred and ninety-eight patientd were enrolled including 111 males and 187 females (sexe ratio H/F of 0.6. The mean age was 49.1 years ± 14.1. The mean disease duration was 6.7 years ± 3.5 for RA and 6.5 years ±3.6 for SA. All patients were prescribed biologics for poor response under NSAIDS or conventional DMARDS. Smoking was reported in 17.7% patients. High disease activity defined as a DAS 28 VS score>5,1 in RA and was reported in 36% of cases. HAQ>2 was present in 14.3%, erosive forms were reported in 73.1% of cases. Rheumatoid factor (RF) and anti cetrullinated peptide antibodies were highly positive (>3x normal rates) in 71,2% and 62.4% of cases respectively. As for AS, active disease was defined by ASDAS CRP or ASDAS VS>2,1 or BASDAI>4 and was reported in 39%, 39.8% and 56.9 % of cases respectively. The functional score BASFI>4 was reported in 54.5% of cases. On the whole, a coxitis was noted in 48.8% of cases and extra articular manifestations (EAM) were present in 59.3 % of cases. Statistical analysis for SA patients didn’t show an association between active disease (ASDAS>2,1 and different parameters (genre (p=0.205), smoking (p=0.120), inflammation in biology (p=0.481), uveitis (p=0.241) and the presence of coxitis (p=0.375)). Nevertheless, RA patients with severe disease were more likely men (p= Conclusion: It’s important to determine clinical, biological and radiographic factors in RA and SA patients as well as activity scores in order to recognize patients potentially at risk of poor progression and for better therapeutic management and biologic treatment may have an influence on these factors. References: [1]Wagner E, Ammer K, Kolarz G, Krajnc I, Palkonyai E, Scherak O, et al. Predicting factors for severity of rheumatoid arthritis: a prospective multicenter cohort study of 172 patients over 3 years. Rheumatol Int. 1 sept 2007;27(11):1041‑8. Disclosure of Interests: None declared