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AB0190 Treat To Target Strategy versus Routine Care in Patients with Early Rheumatoid Arthritis
  1. G.H. Brinkmann1,2,
  2. E.S. Norli2,3,
  3. T.K. Kvien2,
  4. A.J. Haugen1,
  5. L. Grøvle1,
  6. H. Nygaard4,
  7. D.M. Soldal5,
  8. A. Wierød6,
  9. H.C. Gulseth7,
  10. M.D. Mjaavatten2,
  11. E. Lie2
  1. 1Østfold Hospital Trust, Moss
  2. 2Diakonhjemmet Hospital, Oslo
  3. 3Martina Hansen Hospital, Bærum
  4. 4Lillehammer Hospital for Rheumatic Diseases, Lillehammer
  5. 5Hospital of Southern Norway Trust, Kristiansand
  6. 6Veste Viken Hospital Trust, Drammen
  7. 7Betanien Hospital, Skien, Norway

Abstract

Background The treat to target (T2T) strategy has provided good results in clinical trials and is part of current management recommendations, but real life data are still needed to support the implementation of T2T in clinical practice.

Objectives To investigate 2-year outcomes (DAS28 and EQ-5D) in early RA before and after implementation of the T2T monitoring and treatment strategy.

Methods Pts in the Norwegian Very Early Arthritis Cohort (NOR-VEAC) were included from 2010 through 2015 and treated according to T2T with visits at baseline, 3, 6, 9, 12 months and then every 6 months plus monthly visits until DAS28<2.6. We compared this group of pts to pts included in the NOR-DMARD register during 2006–2009 who were treated according to routine care at the time and followed up at 3,6,12 months and then yearly after start of each new DMARD regime. Both groups had a clinical diagnosis of RA (<1 year), were DMARD naive and started DMARD treatment at baseline. We studied DMARD use, DAS28 and EQ-5D during 2-yr follow-up.

Results The current analyses included 252 pts from NOR-VEAC (mean (SD) age 54 (14) yrs, 65% females, 73% seropos, duration of joint swelling median (25,75 perc) 97 (57,168) days) and 586 pts from NOR-DMARD (mean (SD) age 55 (13) yrs, 67% females, 74% seropos, median (25,75 perc) 4 (0,67) days since diagnosis). 2-yr follow-up data were available in 56%/67% of pts in NOR-VEAC/NOR-DMARD. Methotrexate monotherapy was the dominant initial DMARD treatment in both groups (93% in NOR-VEAC vs 87% in NOR-DMARD). Proportions of pts achieving remission (DAS28<2.6) at 1 and 2 yrs were higher in NOR-VEAC than in NOR-DMARD (64% vs 42% and 69% vs 50%, respectively, both p<0.001).Table 1 shows DAS28 and EQ-5D values at BL, 1 and 2 yrs in the NOR-VEAC-and NOR-DMARD cohorts as well as DMARD use during follow-up. 25% vs. 17% of those with 2-yr follow-up data used biologic DMARDs over 2 yrs, p=0.06.

Comparison of disease outcomes after 1 and 2 years and DMARD use during follow-up in the NOR-VEAC- and NOR-DMARD cohorts

Conclusions Pts treated according to the T2T strategy achieved lower DAS28 scores and higher (better) EQ-5D scores during follow-up despite similar baseline values. The differences in DMARD use between cohorts were relatively small, however there is a trend towards more use of biologic DMARD in the T2T cohort.

Disclosure of Interest G. H. Brinkmann: None declared, E. Norli: None declared, T. Kvien Grant/research support from: AbbVie, BMS, MSD, Pfizer, Roche and UCB, Consultant for: AbbVie, BMS, Boehringer Ingelheim, Celgene, Celltrion, Eli Lilly, Hospira, Merck-Serono, MSD, Novartis, Orion Pharma, Pfizer, Roche, Sandoz, UCB, Speakers bureau: AbbVie, BMS, Boehringer Ingelheim, Celgene, Celltrion, Eli Lilly, Hospira, Merck-Serono, MSD, Novartis, Orion Pharma, Pfizer, Roche, Sandoz,UCB, A. Haugen: None declared, L. Grøvle: None declared, H. Nygaard: None declared, D. Soldal: None declared, A. Wierød: None declared, H. Gulseth: None declared, M. Mjaavatten: None declared, E. Lie Consultant for: AbbVie, Bristol-Myers Squibb, Hospira, Pfizer, UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb

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