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AB0467 Maintenance Therapy with Chloroquine of Low Activity Rheumatoid Arthritis Patients
  1. M.P. Ivanova1,
  2. H.I. Batolska2
  1. 1Ministry of Interior Medical Institute (MVR), Sofia
  2. 2Medical University Pleven, Pleven, Bulgaria

Abstract

Objectives This study investigates the effectiveness of the maintenance therapy with 250 mg chloroquine daily of low activity rheumatoid arthritis patients who were previously threated with synthetic and biological disease-modifying antirheumatic drugs (SBDMARDs) or with disease modifying antirheumatic drugs (DMARDs).

Methods The study covered 81 patients aged between 42-73 with low activity rheumatoid arthritis: DAS28 <3,2. The patients were split in two groups: group A of 39 patients stops medical treatment and group B of 42 patients starts maintenance therapy with 250 mg chloroquine daily. Every quarter DAS28 was calculated.

Inclusion criteria: All patients meet 1987 ACR criteria (The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis) and/or are positive anti- CCP antibody. All patients were previously threated during the acute stage of rheumatoid arthritis with one of the following medicines or a combination of them: Leflunomid, Methotrexat, Sulfasalazin, Infliximab, glucocorticoids (GCs) for a period from 6 to 15 months until low activity of the disease was reached: DAS28 <3,2.

Exclusion criteria: moderate to high activity of rheumatoid arthritis patients DAS28 >3,2, patients with early stage rheumatoid arthritis, patients not willing to consult a specialist once a month.

Results During the first quarter no exacerbation of the disease was observed in any patients from group A and group B. During the second quarter there is an exacerbation in 5 (12.82%) patients from group A and there was no exacerbation in any patient from group B. During the third quarter there is an exacerbation in 24 (61.54%) patients from group A and in 1 (2.38%) patient from group B. During the fourth quarter there was an exacerbation in 37 (94.87%) patients from group A and 3 (7.14%) patients from group B. During the fifth quarter all 39 (100%) patients from group A and 6 (14.28%) patinets from group B are in an acute stage. After 15 months all patients with rheumatoid arthritis who were not under treatment and only 6 (14.28%) from patients under maintenance therapy are again with high activity of rheumatoid arthritis DAS28 >5,2. Comparing the obtained values, a very significant statistical difference (p>0.001) was noticed.

During the first quarter only 6 (15.38%) patients from group A are with moderate activity rheumatoid arthritis and all patients from group B are with low activity of the disease. During the second quarter 17 (43.59%) patients from group A and 5 (11.9%) from group B are with moderate activity. During the third quarter 14 (35.89%) from group A and 7 (16.67%) from group B are with moderate activity. During the fourth quarter 2 (5.13%) patients from group A and 8 (19.05%) patients from group B are with moderate activity. During the fifth quarter all patients from group A are with high activity of rheumatoid arthritis and 8 (19.05%) are with moderate activity. Comparing the obtained values, a very significant statistical difference (p>0.001) was noticed.

Conclusions After the treatment with biological disease-modifying antirheumatic drugs (SBDMARDs) or with disease modifying antirheumatic drugs (DMARDs) of rheumatoid arthritis patients was stopped for a period from 6 to 15 months, the symptoms of the disease return. If the patients are treated with 1 tablet of 250 mg chloroquine daily, the disease may remain with low or medium activity for longer period.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.1092

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