FRI0124 FACTORS ASSOCIATED WITH PERSISTENT DRUG-FREE REMISSION IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

Background: Persistent drug-free remission of RA is a condition that is close to “cure” of the disease. However, long-term drug-free remission is considered to be rare and very challenging to reach. Also, little data are available that report how often persistent drug-free remission can be achieved and what kind of clinical characteristics are associated with such state. Objectives: To evaluate factors associated with persistent drug-free remission in patients with rheumatoid arthritis Methods: We analyzed the long-term observational follow-up phase of the randomized controlled RETRO (REduction of Therapy in RA Patients in Ongoing Remission) study on tapering and stopping of DMARDS in RA patients in stable remission (DAS28-ESR Results: All 141 patients being in the long-term observational follow-up phase of the RETRO study for at least 1 year were analyzed. Among them DMARDs were initially continued (Control, n=38), tapered (Taper, n=50) or stopped (Taper/Stop n=53). 19/141 patients were lost to follow-up and the worst case scenario was assumed that all of them did not reach persistent drug-free remission. Median time after study entry (Q1-Q3) was 69 (37-96) months as by December 2018. Overall number of patients in drug-free remission was 34/141 (24.1%), 10/38 (26%) in the control group, 6/50 (12%) in the taper group and 18/53 (34%) in the taper/stop group. After adjustment for baseline risk factors in the likelihood to reach persistent drug-free remission between the groups (OR:0.76, 95%CI: 0.29-1.99) was highly uncertain. Positive ACPA (OR: 3.38, 1.01 – 11.31) and erosive-state (3.05, 1.32 – 7.06) at baseline were associated with a lower likelihood to reach persistent drug-free remission. Conclusion: These data show that persistent drug-free remission can be reached in a subset of RA patients following a structured DMARD tapering approach after being in stable long-term DMARD control.