OP0154 Clinical and radiological outcomes of four disease activity driven treatment strategies: 8-year results of the best study:

Objectives To compare clinical and radiological outcomes of 8 years targeted treatment with four treatment strategies in recent onset rheumatoid arthritis (RA) patients. Methods Patients (n=508) with recent onset RA were randomized to 4 treatment strategies: 1. sequential monotherapy, 2. step-up combination therapy, 3. initial combination with prednisone, 4. initial combination with infliximab. Treatment was DAS≤2.4 steered, with measurements every three months: DAS >2.4: next treatment step; DAS ≤2.4 during ≥6 months: taper to maintenance dose, next if DAS Results After 8 years, 347 patients were still in follow-up. A DAS ≤2.4 was achieved in 79% of these and 52% were in remission (DAS Conclusions After 8 years DAS≤2.4 targeted treatment, radiological damage is still very low and following initial improvement (earlier with initial combination therapy than with initial monotherapy), functional ability was maintained in all groups without deterioration over time. A stabilization of the percentages of patients in clinical remission and in drug-free remission was observed. Disclosure of Interest M. van den Broek Grant/Research support from: Dutch College of Health Insurances, Centocor inc and MSD (formerly Schering Plough), L. Dirven: None Declared, N. Klarenbeek: None Declared, M. van Krugten: None Declared, H. Ronday: None Declared, P. Kerstens: None Declared, T. Huizinga: None Declared, W. Lems: None Declared, C. Allaart: None Declared