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THU0184 Predictive Marker for the Long-Term Discontinuation of Infliximab in Rheumatoid Arthritis with Clinical Remission
  1. M. Yamasaki
  1. Shin-Yokohama Yamasaki Clinic, Yokohama, Japan

Abstract

Background Patients who achieved disease remission continuously, biologic DMARDs are able to start tapering. But the predictive markers to stop biologic DMARDs were not well known.

Objectives To assess the clinical characteristics of rheumatoid arthritis (RA) patients treated with infliximab (IFX) and achieved long-term discontinuation of infliximab with clinical remission.

Methods Efficacy was evaluated by DAS28CRP. Analyze the clinical parameters between patients with more than 2 year discontinuation of IFX and the others.

Results 52 (7 men, 45 women, average age 52.4 years old) of RA patients were treated with IFX and enrolled in this study. Overall remission rate was 51.9%. However there were no significant differences between patients with remission and without remission in combination therapy with or without MTX, duration of disease before using IFX and initial DAS28 score, MMP-3 ratio (MMP-3 at initial/MMP-3 at 5th IFX) was the only predictive marker at the start of IFX therapy for the discontinuation of IFX with clinical remission (4.71±5.18 vs1.15±0.57, p=0.0279). Assessing the clinical parameters at the final treatment with IFX, there were significant differences between patients with remission and without remission in DAS28CRP (1.30 vs. 2.54, p=0.016). ROC analysis was performed and the cut off point was DAS28CRP=2.08 (AUC0.94) to detect patient with long-term discontinuation of IFX.

Conclusions MMP-3 ratio was the predictive marker to achieve clinical remission with IFX. DAS28CRP less than 2.08 was also as predictive marker to achieve long-term discontinuation of IFX in RA with clinical remission.

Disclosure of Interest : None declared

DOI 10.1136/annrheumdis-2014-eular.4147

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