A SUBSTANTIAL PROPORTION OF PATIENTS FAILING TO ACHIEVE DAS28 OR ACR20 RESPONSE AT 12 WEEKS OF DMARD THERAPY EXHIBIT IMPROVEMENT IN CORE SET MEASURES. RESULTS FROM AN EARLY ARTHRITIS COHORT

Background: DAS/ACR composite indices have been used in trials to guide treatment decisions RA. Patients (pts) who fail to achieve $Δ $DAS28 ≥1.2 or ACR20 are considered inadequate responders. However many clinicians use various measures of disease activity to individualize treatment Objectives: To determine and compare the clinical improvement in individual core set measures in pts determined as inadequate responders using composite measures of disease activity Methods: Pts with early RA who were enrolled and prospectively followed in the Canadian Early Arthritis Cohort (CATCH) were studied. Pts receiving DMARD therapy for 3 months who failed to achieve $Δ $DAS28≥0.6, $Δ $DAS28≥1.2 or ACR20 were examined for 20 and 30% improvement in their disease activity measures. Results: 416 pts with ≥3 months of follow-up with available data to calculate composite measures were included for analysis (74% female, mean age 53). Baseline mean DAS28, disease duration (mo), SJC and TJC were 5.1, 6.1, 8.2 and 9.2 respectively. These pts had a 51% improvement in SJC, 49% in TJC, 38% in pt global and 45% in physician global. Of 416 pts, 197 (47%) failed to achieve ACR20, 212 (51%) failed to achieve ΔDAS28 ≥1.2 and 142 (34%) failed to achieve ΔDAS28 ≥0.6. A substantial proportion of pts failing to achieve DAS28 or ACR20 after 3 months of treatment exhibited a >20 or 30% improvement in core set measures (Table1). Pt derived outcomes improved less compare to physician derived outcomes. Disease activity measureΔDAS <1.2ΔDAS <0.6Not achieved ACR20 % pt with% pt with% pt with% pt with% pt with% pt with ≥20% Imp≥30% Imp≥20% Imp≥30% Imp≥20% Imp≥30% Imp SJC514443375045 TJC474037304641 Patient global393034272520 Pain scale373032252319 Physician global484039294034 HAQ423337273024 ESR332523153427 Conclusions: A substantial proportion of pts who fail to achieve ACR20, ΔDAS28 ≥1.2 or even ΔDAS ≥0.6 after 3 months DMARD therapy may still exhibit significant improvement in their clinical disease activity measures. These findings should be considered when making treatment decisions in real world clinical settings. A substantial proportion of patients who fail to achieve ACR20, ΔDAS28 ≥1.2 or even ΔDAS ≥0.6 after 3 months DMARD therapy may still exhibit significant improvement in their clinical disease activity measures. These findings should be considered when making treatment decisions in real world clinical settings. Disclosure of Interest: P. Akhavan: None Declared, V. Bykerk Grant/Research support from: reearch grant from Amgen, Abbott, Pfizer, UCB, Roche, Y. Sun: None Declared, G. Boire: None Declared, C. Thorne: None Declared, J. Pope: None Declared, C. Hitchon: None Declared, B. Haraoui: None Declared, D. Ferland: None Declared, E. Keystone: None DeclaredCitation: Annals of the Rheumatic Diseases, volume 70, supplement 3, year 2011, page 649Session: Rheumatoid arthritis – prognosis, predictors and outcome (Poster Presentations )