POS0108 REMISSION OR NOT REMISSION? THAT’S THE QUESTION, BUT WHAT’S THE ANSWER? - ILLUMINATING ON REMISSION IN ORDINARY OUTPATIENT CLINICAL RHEUMATOID ARTHRITIS PATIENTS

Background A recent meta-analysis by Ferreira et al. (2020) has questioned the validity of using Patient Global Assessment (PGA) to define remission in Boolean criteria (4-variable remission, 4vR) [1]. This is because PGA, which presumptively reflects a patient’s perception disease activity, influenced both inflammatory and non-inflammatory mechanisms, thus questioning PGA-related definitions when treating patients target anti-inflammatory drugs. Further, impact PGA differs various algorithms developed rheumatoid arthritis (RA). Objectives study aims examine rates applying different an outpatient cohort RA illuminate on remission. Methods Data were obtained during 2019 from followed at clinic Southern Norway. The composite activity scores simple index (SDAI), clinical (CDAI), score with 28 joint count C-reactive peptide (DAS28(3) DAS28(4)), as well 4vR without 3-variable (3vR) used Cut-off values for CDAI, SDAI, DAS28 are ≤2.8, ≤3.2, ≤2.6, respectively. attained ≤10, (CRP) ≤10 mg/L, SJC28 ≤1, TJC28 while 3vR CRP ≤1 [2]. Remission also calculated cut-offs ≤20, 30, 40, 50, 60, 70, 80, 90. Results In Figure 1, proportion DAS28(3), DAS28(4), 3vR, presented. 73% 67% 37% 38% 23% 4vR, 65% 3vR. When comparing remissions rate SDAI CDAI lie between cut-off ≤20 ≤30, all lies beyond ≤90. 1. 502 Conclusion Our data highlights that there great variation definitions, DAS28(3) having highest (73%) original lowest (23%) rate. While may still have swollen joints, no tender joints normal not achieve even minor elevation above ten, only reflect mechanisms. We question value where large ordinary practice treat Further studies warranted should be Is it time paradigm shift focus more objective than subjective measures reflecting status aiming daily practice? References [1]Ferreira RJO, Welsing PMJ, Jacobs JWG, Gossec L, Ndosi M, Machado PM, Revisiting use excluding patient global assessment: individual 5792 patients. Ann Rheum Dis. 2020. [2]Felson DT, Smolen JS, Wells G, Zhang B, van Tuyl LH, Funovits J, American College Rheumatology/European League Against Rheumatism provisional definition trials. Arthritis Rheum. 2011;63(3):573-86. Acknowledgements To patients, nurses, doctors who contributed collection Disclosure Interests None declared