Rheumatoid Arthritis Patients On Persistent Moderate Disease Activity On Biologics Have Adverse 5-years Outcome Compared To Persistent Low-remission Status Yet They Represent A Heterogeneous Group: Lower-moderate Has Better Functionality And Fewer Serious Adverse Events Than Higher-moderate Subgroup

Abstract Background The long-term outcome of rheumatoid arthritis (RA) patients who in clinical practice, exhibit persistent moderate disease activity (pMDA) despite treatment with biologics has not been adequately studied. Herein, we analyzed the 5-year outcome of the pMDA group and assessed for within-group heterogeneity. Methods We included longitudinally-monitored RA patients from the Hellenic Registry of Biologic Therapies with persistent (cumulative time ≥50% of a 5-year period) moderate (pMDA, 3.20.22 (p=0.029) and lower average DAS28 during the first trimester since treatment initiation (p=0.001), independently predicted grouping into pRLDA. Conclusions In clinical practice, RA patients with pMDA while on bDMARDs have adverse long-term outcome compared to lower disease activity status, while heterogeneity exists within the pMDA group in terms of 5-year functionality and SAEs. Targeted studies to better characterize pMDA subgroups are needed, in order to assist clinicians in tailoring treatments.