SAT0051 REMISSION IN RHEUMATOID ARTHRITIS PATIENTS: A CLUSTER ANALYSIS TO IDENTIFY AND CHARACTERIZE SUBPOPULATIONS OF PATIENTS

Background: Disease Activity Score (DAS) is a continuous measure of Rheumatoid Arthritis (RA) activity, used in clinical practice for monitoring disease progression and for documenting treatment response. According to EULAR, the clinical desired target is to achieve a remission state (or failing that, low disease activity). However, the population of RA patients in this state could be heterogenous. Objectives: To characterize the level of heterogeneity of RA patients in remission by identifying clusters based on the DAS28 components; and to describe inter and intra-class cluster demographic and clinical characteristics Methods: Patients from Hospital Clinico San Carlos cohort, stored in a departmental electronic health record from January 1st, 2000 to December 30th, 2018, diagnose with RA according ACR 1986/ 2010 criteria were eligible for this study. Only observations with a DAS28 Erythrocyte Sedimentation Rate (ESR) value Results: 812 patients with 1,431 observations were analyzed in this study. The joint aggregation level which showed a highest Silhouette width value (0.708) was the anatomic one. In this aggregation level, five dichotomous variables (presence of tenderness and/or swelling in right and/or left shoulder, elbow, wrist, knee and hand (including both metacarpophalangeal and proximal interphalangeal joints) and two continuous variables (ESR and GH) were used. Two clusters were found: the cluster A) with 1,305 observations and 742 patients and the B) with 126 observations and 115 patients. Cluster b) had a statistically significant higher DAS28-ESR value (higher number of tender and swollen joints, and higher GH, but lower ESR), longer follow-up time (6.5 vs. 4.7 years), higher VAS-pain score (10 vs. 2), and higher HAQ score (0.25 vs. 0.12). In addition, the proportion of patients treated with oral corticosteroids (63% s. 50%) and biological therapy (29% vs. 12%) was higher. Conclusion: We have identified two clinically distinct populations of RA patients in remission according to DAS28-ESR Disclosure of Interests: Alfredo Madrid Garcia: None declared, Dalifer Freites Nunez: None declared, Judit Font: None declared, Isabel Hernandez: None declared, Leticia Leon: None declared, Jose Ignacio Colomer: None declared, Isidoro Gonzalez-Alvaro Grant/research support from: Roche Laboratories, Consultant of: Lilly, Sanofi, Paid instructor for: Lilly, Speakers bureau: Abbvie, MSD, Roche, Lilly, Benjamin Fernandez: None declared, J Angel Jover: None declared, Lydia Abasolo: None declared, Luis Rodriguez Rodriguez: None declared