SAT0112 Guideline-based care improves outcomes that matter to patients: tighter control, less suffering, and greater well-being over the past decade in canadian ra patients

Background Best practice recommendations can increase the quality of care and improve clinical outcomes, however, the impact of guideline-based care on outcomes that matter most to early RA patients before and after implementation of treat to target (T2T) recommendations has not been evaluated. Objectives: We compared changes over the first year of treatment in outcomes valued most by RA patients: 1) in relation to disease activity; and 2) prior (2007-10) and subsequent (2011-16) to the release of T2T and Canadian RA Recommendations. Methods: Data included early RA adults enrolled in CATCH ( C anadian Early A r T hritis C o H ort) between 2007-16 who met 1987/2010 RA criteria with active disease at enrolment. Treatment was at the discretion of the rheumatologist and cohort investigators met annually to discuss ways to improve outcomes. We compared changes in DAS28, pain (0-10), fatigue (0-10), patient global (0-10), and HAQ-DI at 6 and 12 months prior to and after the release of guidelines using Cochran-Armitage trend tests and regression. Results: The sample included 1942 adults who were mostly female (72%) with a mean (SD) age of 55 (15), 2 (2) comorbidities, and symptom duration of 6 (3) months. At enrollment, almost all (95%) were in DAS28 moderate disease activity [MDA; 42%] or high disease activity [HDA; 53%], and were initially treated with csDMARDS (92%) and MTX (75%). CDAI, DAS28 and PROs by DAS28 disease levels are shown in the Table. Conclusions: Results from this large country-wide study suggest that T2T results in better disease control in the first year of RA with similar improvements in pain, fatigue, and disability--symptoms that patients identify as important--resulting in greater overall well-being. These data offer additional evidence supporting the importance of early identification and rapid control of RA to improve long-term outcomes and QOL. Acknowledgements: Sponsors: Amgen u0026 Pfizer-Founding sponsors 2007+; UCB, AbbVie 2011+; Medexus 2013+; Eli Lilly, Sanofi- Genzyme 2016+; Merck 2017+; BMS 2011-2014, Hoffmann-LaRoche, Janssen 2011-2016 Disclosure of Interest: None declared