FRI0076 Low Disease Activity or DAS-Remission as Treatment Target in Early Rheumatoid Arthritis Patients

Background It is unknown what the optimum treatment target for early rheumatoid arthritis (RA) patients is. Objectives To assess which treatment target, low disease activity or disease activity score (DAS)-remission is more effective in early RA patients. Methods The BeSt study included early (≤2 years symptom duration) active (≥6 of 66 swollen joints, ≥6 of 68 tender joints, and either erythrocyte sedimentation rate ≥28 mm/hour or a visual analogue scale global health score ≥20mm) RA (1987 criteria) patients to compare 4 treatment strategies, targeted at DAS≤2.4. In arm 3 treatment started with a combination of methotrexate (MTX), sulfasalazine and a tapered high dose of prednisone. In the IMPROVED study, early arthritis patients started with MTX and a tapered high dose of prednisone, with subsequent treatment options aiming at DAS-remission ( Results At baseline IMPROVED patients had a significantly lower mean±SD DAS compared to BeSt patients (4.1±0.7 vs 4.4±0.9, p=0.012) and a shorter median (IQR) symptom duration (17 (8–28) vs 23 (15–53) weeks, p 2 to 1.8±1.0, functional ability improved from 1.5±0.6 to 0.5±0.6, 72% of patients achieved DAS≤2.4 and 53% were in DAS-remission. At year 1, DAS was decreased by 2.5 in IMPROVED and 2.4 in BeSt compared to baseline, to 1.6±1.0 and 2.0±0.9, p=0.004, and more IMPROVED patients than BeSt patients had achieved DAS Predictive factors for DAS Conclusions Although the treatment target was less often achieved for DAS Disclosure of Interest G. Akdemir: None declared, I. M. Markusse: None declared, A. A. Schouffoer: None declared, P. B. de Sonnaville: None declared, B. A. Grillet: None declared, P. J. Kerstens: None declared, W. F. Lems: None declared, T. W. Huizinga: None declared, C. F. Allaart Grant/research support from: Year 1 of the IMPROVED study was sponsored by Abbott. The BeSt study was designed by the investigators and supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. Data collection, trial management, data analysis and preparation of the manuscript were performed by the authors.