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THU0191 (2020)
HAS THE DOSE OF METHOTREXATE IN RHEUMATOID ARTHRITIS BEEN OPTIMIZED BEFORE INITIATING BIOLOGICAL TREATMENT? RESULTS OF AN ALGERIAN MULTICENTER STUDY
R. Benaziez1, F. Mechid2, M. Bercache1, I. Bencharif3, H. Ayed4, S. Slimani5, N. Bahaz1, S. Lefkir6, F. Rahal7, F. Hanni8, A. Abi Ayad9, C. Makhloufi-Dahou1
1University Hospital Center of Babeloued, Algiers, Algeria
2University Hospital Center of Babeloued, Rheumatology, Algiers, Algeria
3University Hospital Center of Constantine, Constantine, Algeria
4University Hospital Center of Annaba, Annaba, Algeria
5Liberal Rheumatologist, Batna, Algeria
6University Hospital Center of benimessous, Benimessous, Algeria
7Public Hospital Establishment of Benaknoun, Benaknoun, Algeria
8Public Hospital Establishment of Benaknoun, Benaknoun, Algeria
9University Hospital Center of Ain Naadja, Ainnaadja, Algeria

Background: Methotrexate (MTX) is the gold standard treatment for rheumatoid arthritis (RA). The international guidelines recommend optimizing its dose before the introduction of a biologic treatment in cases where it is well tolerated1.


Objectives: The objective of this study is to evaluate the dose of MTX before the initiation of biological treatment in RA patients with MTX ineffectiveness.


Methods: This is a multicenter, cross-sectional, prospective study including adults RA, over a period of 6 months (January-June 2019). We collected the following data: sex, age, comorbidities (diabetes, hypertension), rate of RF and ACPA, dose of MTX, rate of patients on corticosteroids, Disease Activity Score (DAS 28-vs), Health Assessment Questionnaire (HAQ) and SHARP Score.


Results: Number of patients: 239 (187 women / 52 men); average age: 48.3 years (19 - 81); average duration of the disease: 13.6 ± 8.2 years. Comorbidities: arterial hypertension (14,6 %) - diabetes (13 %),The RF were positive in 59.8%. The average value of ACPA is 228.76 ± 287.08 IU / L, positive in 73% case. The average DAS28vs is 4.77 ± 1.46 (0.77 - 12.26). The average modified SHARP 111.67 ± 98.16 (0-448), the average HAQ is 1.13 ± 0.82 (0 - 2.87). 86.7% of patients are under corticosteroids.Only 18.5% of patients had a dose of MTX between 20 and 25 mg / week. the remaining 82% of patients the average dose of MTX was 14 mg / week (10-18.5).


Conclusion: These results suggest that the dose of MTX was not optimized before the initiation of biotherapy in the majority of patients with RA.


REFERENCES:

[1]Smolen JS, Landewé R, Bijlsma J , et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update Annals of the Rheumatic Diseases 2017;76:960-977.

[3]Claire Daiena, Charlotte Huac, Cécile Gaujoux-Viala, et al. Update of French society for rheumatology recommendations for managing rheumatoid arthritis. Joint Bone Spine 86 (2019) 135–150

[2]Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care Res. 2016 Jan;68(1):1-25.


Disclosure of Interests: None declared

Citation: Ann Rheum Dis, volume 79, supplement 1, year 2020, page 311
Session: Rheumatoid arthritis - non biologic treatment and small molecules (Poster Presentations)