P116 Systematic review of the prevalence of foot disease activity in patients classed in disease activity score-28 remission

Abstract Background/Aims The disease activity score-28 (DAS-28) is commonly used in rheumatoid arthritis (RA) to identify people remission, low, moderate and high guide medical management. DAS-28 omits foot joints recent research suggests that this may place with at risk of poor outcomes. However, little known concerning the prevalence amongst RA who are considered be remission according DAS-28. aim review was estimate patients classed remission. Methods Databases included search were MEDLINE, CINAHL, AMED HSNAE. Keywords including “Rheumatoid arthritis”, “disease score”, “remission”, “foot joint”, “ankle “clinical examination”, “ultrasound” “synovitis” synonyms using MeSH terms comprised strategy. Studies which reported review. Participants diagnosed RA, from clinical examination (CE), or musculoskeletal ultrasound (MSUS) assessments. Methodological quality studies independently assessed by two researchers Joanna Briggs Institution critical appraisal tool (JBI PCAT). Results subject narrative synthesis Preferred Reporting Items for Systematic Reviews Meta Analyses statement. Of 44 screened eligibility, 7 a further 2 met inclusion criteria identified reference lists included. A total 933 participants (mean age range 44-63 years) took part across 9 studies. Five MSUS (B-mode synovial hypertrophy/power Doppler) while 4 (tenderness/swelling) synovitis. Significant variation apparent ankle sites method scoring presence disease. For synovitis one more assessed, hypertrophy detected B-mode ranged 23.4-88.6% (4 studies, n = 687). Synovitis affecting metatarsophalangeal joint (MTPJ) power Doppler present 7.5% (1 study, 125). clinically any 35-43% (3 542). Joint tenderness 1 MTPJs 6.3% 187). generally high, ranging 7-9/9. Conclusion but heterogeneous approaches assessment adopted making comparisons difficult. results suggest common as These ongoing problems functional radiographic Disclosure K. McIlwaine: None. G.J. Hendry: Grants/research support; Currently receiving NIHR HTA funding.