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FRI0025 Compliance with Treat to Target Recommendations & Its Impact on Control of Rheumatoid Arthritis – Interim Results of A UK Multicentre Audit
  1. M. Buch1,
  2. D. O'Reilly2,
  3. T. Sheeran3,
  4. S. Keidel4,
  5. P. Emery1
  6. on behalf of T2T Initiative Group
  1. 1Leeds Teaching Hospitals NHS Trust, Leeds
  2. 2Department of Rheumatology, West Suffolk NHS Foundation Trust, Bury St Edmonds
  3. 3Mid Staffordshire NHS Foundation Trust, Cannock
  4. 4Medical Affairs, AbbVie Ltd, Maidenhead, United Kingdom


Background Based on a strong evidence base that pre-determined treatment targets & tight control improve outcomes, 2010 recommendations on treating to target aim to improve rheumatoid arthritis (RA) management [1].

Objectives This prospective audit assess compliance with these recommendations & disease activity outcomes in a large group of UK NHS rheumatology centres. We present 6-month interim results from early centres joining the audit.

Methods Newly diagnosed patients with RA were recruited at presentation to rheumatology clinics from April 2012 for 1 year follow up from diagnosis. Data on disease history, management & outcomes are collected at each visit. Correlations between recommendation compliance & change in 6 month DAS28 score were calculated for this interim analysis.

Results By December 2013, 813 patients in 38 centres were included. 152 patients [48 (32%) male] from 19 centres had evaluable data, with both baseline & 6 month DAS28 scores available. Mean (standard deviation, SD) age at diagnosis was 59.4 (14.6) years, & mean (SD) time from onset of persistent symptoms to first clinic visit was 0.49 (1.4) years. Mean (SD) DAS28 score at baseline was 4.69 (1.63) &at 6 months 3.09 (1.43) (p<0.0001). 59 (39%) achieved DAS28<2.6 & 18 (12%) DAS28 2.6-3.2 at 6 months. Table 1 shows % compliance with the recommendations & correlation between % compliance & improvement in DAS28 score. Negative values show where compliance was related to improvement in outcome. Patients who were informed of their treatment target or who had a DAS28 score at each visit had a greater improvement in DAS28 score at 6 months than those whose management did not comply with these recommendations (correlation significance p=0.03 & p=0.02 respectively).

Conclusions 39% of patients achieved clinical remission at 6 months. Informing patients of treatment targets &formal measurement of disease activity at each visit were associated with the greatest improvement in DAS28 score. The correlations in these interim results show association between compliance with recommendations &improved RA outcomes. Not necessarily causative, these associations are signals that further work to increase compliance with treat to target recommendations may be worthwhile. This project is ongoing &further results will be presented in due course.


  1. Smolen et al. Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis 2010;69:631–637

Acknowledgements pH Associates, Marlow, Buckinghamshire

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.3126

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