THU0146 DAS28-REMISSION IS ASSOCIATED WITH AN INCREASE OF FINGER JOINT SPACE WIDTH IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

Background:The reduction of finger joint space width in patients with rheumatoid arthritis (RA) is associated with joint destruction. Anti-TNF treatment with certolizumab pegol is an effective therapy in RA-patients. The computer-assisted joint space analysis is a new computer based technique to measure joint space width on hand radiographs.Objectives:The aim of this post-hoc analysis of the data set used in the RAPID 1 trial was to quantify finger joint space width of RA patients treated with Certolizumab pegol in Association to DAS28-remission.Methods:The post-hoc analysis includes 297 patients. These patients were treated with certolizumab pegol 200 mg (every two weeks) plus methotrexate and certolizumab pegol 400 mg (every two weeks) plus methotrexate. All patients underwent x-rays of the hand at baseline and week 52 as well as the quantification of finger joint space width of the metacarpal-phalangeal articulations (MCP) using the computer-assisted joint space analysis (Version 1.3.6; Sectra; Sweden). The joint space distance is expressed as mean joint space width of the MCP joints I to V (JSD-MCP total). Remission was defined with a Disease Activity Score 28 < 2.6.Results:The group with DAS28-remission (DAS28 < 2.6) presented a significant joint space increase with 3.3 % for JSD-MCP total from 0.152 ± 0.033 cm (baseline) to 0.157 ± 0.033 cm (week 52) treated with certolizumab pegol 200 mg as well as with 3.9 % for JSD-MCP total from 0.152 ± 0.031 cm (baseline) to 0.158 ± 0.032 cm (week 52). For the patients without DAS28-remission (DAS28 > 2.6) under the treatment with certolizumab pegol 400 mg a non-significant change of JSD-MCP total from 0.145 ± 0.034 cm (baseline) to 0.144 ± 0.036 cm (week 52) was observed. A similar result was evaluated for the certolizumab pegol 200 mg group (JSD-MCP total: 0.146 ± 0.037 cm [baseline] to 0.143 ± 0.037 cm [week 52]).Conclusion:The study highlights that patients treated with certolizumab pegol plus methotrexat and a DAS-Remission showed an increase of joint space width of the metacarpal-phalangeal articulations which is potentially associated with reparative effects of the cartilage under the anti-TNF treatment with certolizumab pegol.