TREAT TO TARGET PATHWAY (T2T) IN INFLAMMATORY ARTHRITIS-DESIRABLE RESULTS? AND IF CERTAIN GROUPS RESPOND TO TREATMENT BETTER?

Background There is established evidence that treat to target strategy in inflammatory arthritis helps achieve early remission rates or low disease activity. This approach is more effective for improved outcomes at no additional costs and more likely to achieve rapid and sustained disease control. It is important to aim for early diagnosis to limit the structural damage that occurs with prolonged inflammation. Commencing disease modifying anti-rheumatic drugs (DMARD) therapy and glucocorticoids as early as possible and titrating therapy as appropriate improves clinical outcomes. Objectives Aim of this study was to analyse ACR20 response within different subgroups of inflammatory Arthritis patients enrolled in Treat to Target program. Methods Data collection was performed by assessing electronic medical records of 374 inflammatory arthritis patients who participated in Treat to Target pathway for inflammatory arthritis between 2014 to 2020. In total 374 patients were enrolled in treat to target inflammatory pathway led by Rheumatology ANP with consultant supervision. Majority of the patients had diagnosis of Rheumatoid arthritis as per ACR/Eular criteria. 213(51%) were seropositive RF+, 83(19.9%) were seronegative RF-, 44(10.5%) were diagnosed as psoriatic arthritis, and 34(8.1%) were labelled as undifferentiated inflammatory arthritis. In terms of age and gender, 158(42%) were under 50, and 216(58%) were aged 50 and over, majority females 207(55%). Smoking status 118(32%) current, 211(56%) never, 45(12%) ex-smokers. DMARD started at baseline was Methotrexate only and Starting dose was 15mg for all patients. 326(88%) were on oral methotrexate and only 48(12%) were on SC form between weeks 1-20. ACR 20,50,70 responses were analysed for these subgroups with majority (61%) seen at week 6 for their visit 1 after starting T2T pathway while all patients seen by week 20. Results ACR 20,50 and 70 responses were calculated for all subgroups enrolled in T2T program. The results showed that ACR 20 response rate was same among patients aged under and over 50(67% responders), ACR 50 (38.3%) responders and ACR 70 (20.1%) responders. There was no significant difference in ACR 20 response among females and males (66.9% response) both groups. In terms of seropositivity, 75% responded to treatment in RF+ group vs 60% in RF-group. Higher response rates were seen among not current smokers vs active smokers(70%vs65%). ACR 20 response was greater in patients on Sc form of methotrexate. Overall, 65 % achieved remission within 15 months of starting T2T pathway while remaining achieved low disease activity. Further analysis and discussion will follow. Conclusion Treat to target strategy in inflammatory arthritis are consistent with real world data in achieving early response rates with methotrexate (ACR responses) and specific subgroups within T2T cohort respond better to treatment. Disclosure of Interests None declared