THU0209 Disease Activity and Structural Damage-Related Differences in Functional Disability in Early and Established Rheumatoid Arthritis

Background A measure of functional impairment, the Health Assessment Questionnaire Disability Index (HAQ), consists of a reversible disease activity-related component (ACT-HAQ) and a joint damage component that increases with time (DAM-HAQ). Objectives To assess baseline ACT-HAQ and DAM-HAQ and response to treatment in early and established rheumatoid arthritis (RA) patients (pts). Methods PREMIER was a 2-year (yr) randomized, double-blind (DB), controlled phase 3 study in methotrexate (MTX)-naive pts with RA duration post hoc analysis, HAQ and modified Total Sharp Score (mTSS) were assessed at baseline (BL), and wk 24 or 26 in pts treated with ADA 40 mg every other wk+MTX or PBO+MTX. DAM-HAQ was calculated, DAM-HAQ=0.01*mTSS; ACT-HAQ=HAQ – DAM-HAQ. 1 Results Mean disease duration was 0.8 yrs in PREMIER, 0.4 yrs in OPTIMA, and 11 yrs in DE019. At baseline (BL), HAQ scores were indicative of substantial functional disability (table); ACT-HAQ scores improved at wk 26 in all studies. In established RA pts (DE019), DAM-HAQ accounted for almost 50% of the BL HAQ, reflecting the extent of pre-existing joint damage in pts with long-standing RA. In both early and established RA pts, joint damage did not progress with 26 wks of treatment as reflected by the DAM-HAQ. In clinical responders (DAS28 Conclusions In both early and established RA pts, baseline disease activity measured by the HAQ indicated substantial functional impairment. In early RA pts, disease activity is an important determinant of the HAQ, while structural damage is the primary component of the HAQ in established RA pts. In both early RA and established RA, ACT-HAQ improved dramatically on appropriate therapy, with the extent of improvement greater with ADA+MTX therapy. References Smolen JS, et al. Ann Rheum Dis 2010;69:1058–64. Acknowledgements AbbVie Inc funded the studies (NCT00195663, PREMIER; NCT00420927, OPTIMA; NCT00195702, DE019). AbbVie was responsible for the study designs, research, analysis, data collection, interpretation of data, and writing, reviewing, and approving of the publication. Medical writing support was provided by Kathleen V. Kastenholz, PharmD, MS, of AbbVie. Disclosure of Interest J. Smolen Grant/research support from: AbbVie, Amgen, Astra-Zeneca, BMS, Celgene Centocor-Janssen, Glaxo, Lilly, Pfizer (Wyeth), MSD (Schering-Plough), Novo-Nordisk, Roche, Sandoz, UCB, Consultant for: AbbVie, Amgen, Astra-Zeneca, BMS, Celgene Centocor-Janssen, Glaxo, Lilly, Pfizer (Wyeth), MSD (Schering-Plough), Novo-Nordisk, Roche, Sandoz, UCB, A. Kavanaugh Grant/research support from: AbbVie, Amgen, Astra-Zeneca, BMS, Celgene, Centocor-Janssen, Pfizer, Roche, UCB, Consultant for: AbbVie, Amgen, Astra-Zeneca, BMS, Celgene, Centocor-Janssen, Pfizer, Roche, UCB, D. van der Heijde Grant/research support from: AbbVie, Amgen, AstraZeneca, BMS, Centocor, Chugai, Daiichi, Eli Lilly, GSK, Janssen Biologica, Merck, Novartis, Novo Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, UCB, Vertex, Consultant for: AbbVie, Amgen, AstraZeneca, BMS, Centocor, Chugai, Daiichi, Eli Lilly, GSK, Janssen Biologica, Merck, Novartis, Novo Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, UCB, Vertex; Director of Imaging Rheumatology BV, S. Florentinus Shareholder of: AbbVie, Employee of: AbbVie, S. Rathmann Shareholder of: AbbVie, Employee of: AbbVie Inc, H. Kupper Shareholder of: AbbVie, Employee of: AbbVie Deutschland GmbH & Co. KG, E. Keystone Grant/research support from: AbbVie, Amgen, AstraZeneca, BMS, Centocor, Genzyme, Merck, Novartis, Pfizer, Roche, UCB, Consultant for: AbbVie, AstraZeneca, Biotest, BMS, Centocor, Genentech, Merck, Nycomed, Pfizer, Roche, UCB, Speakers bureau: AbbVie, Amgen, BMS, Janssen, Merck, Pfizer, Roche, UCB