POS0554 CLINICAL CHARACTERISTICS OF PATIENTS WITH RHEUMATOID ARTHRITIS IN PRE-DIFFICULT-TO-TREAT STATUS

Background Patients with rheumatoid arthritis (RA) who have a difficult-to-treat condition (D2T RA) are often burden to both patients and rheumatologists. Objectives The aim of this study was determine the risk factors for failure treat in refractory conditions find them relevant prevention. Methods RA were treated under treat-to-target (T2T) strategy more than one year picked up. Their background characteristics such as sex, age, disease duration, anti-citrullinated polypeptide antibodies titer (ACPA), collected, their simplified activity index (SDAI) score, Health Assessment Questionnaire Disability Index (HAQ) pain score measured visual analog scale (PS), EuroQol 5th-dimensions (EQ5D) monitored every three months. Sharp/van der Heijde (SHS) calculated annually. Difficult-to-treat status determined according EULAR definition D2T [1], pre-D2T follows: (Category-1) history kind action biologic or targeted synthetic modifying anti-rheumatic drug (b/tsDMARD) switched another b/tsDMARD other mechanism (Category-2) following status; mean SDAI recent months exceeded 11 (MDA), consecutive administration glucocorticoid steroid no less 7.5mg prednisolone equivalent (GCS), rapid radiographic progression 5 SHS last time (RRP), decrease EQ5D -0.2 6 (dEQ5D). recruited when Category-1 -2 matched treating, results observation each category. When second d/tsDMARD failed until patient Category-1, judged “failure”, “success”. Category-2 continued observation, escaped from category, Risk items treating evaluated category using binary logistic regression analysis. Results A total 47 491 recruited. In patients, female 83.0% age 71.3. Mean HAQ PS, at (baseline) 15.5, 0.457, 40.1, 0.811, 72.9, respectively. Numbers first 32 TNF inhibitors, 8 IL-6 abatacepts, 1 JAK inhibitor. after 13 inhibitors 19 THF inhibitor, whereas 3 2 inhibitor failure, 4 abatacept failure. these, success counted 18 29. Significant higher ACPA, baseline (p<0.05). There significant difference between drugs. numbers 455 MDAs, 20 GCSs, 17 RRPs, 9 dEQ5Ds. 315 140 MDA, 16 GCS, 0 RRP, 7 dEQ5D, PS dEQ5D (p<0.01). Conclusion Clinical besides important preventing fall-in D2T_RA. However, most weighted factor control falling MDA status. Tight is overriding factor. References [1]Nagy G, et al. Ann Rheum Dis 2021;80:31-5. Disclosure Interests None declared.