AB0490 Evaluation of inhibitory factor of radiographic progression by iguratimod add-on therapy in rheumatoid arthritis patients with inadequate responses to disease-modifying anti-rheumatic drugs

Background Iguratimod (IGU) is one of csDMARDs (Conventional synthetic Disease modified anti-rheumatoid arthritis drug) for RA patients in Japan. It was reported to suppress the production of inflammatory cytokines by inhibiting NFkB pass-way. IGU add-on therapy was efficient in patients with RA who were previously designated MTX-monotherapy inadequate responders (MTX-IR). The efficacy of IGU add-on therapy in bDMARDs (Biological DMARD)-IR patients was also reported. In this study, we showed disease activity and safety, and showed also radiographic evaluation for the first time by adding IGU. Objectives To obtain DAS28-ESR and adverse event data about adding IGU on RA patients with poor response to csDMRADs and/or bDMARDs in single-centre, open label and retrospective study. Furthermore, to show the radiological evaluation after one year. Methods Clinical and radiographic efficacy was assessed by disease activity score of 28 joints (DAS28) ESR (n=68) and the modified total Sharp score (mTSS) (n=44), respectively. We evaluated which factors are important in determining a prognosis of clinical response and mTSS. For safety, adverse events (AE) were investigated on all patients (n=89). Results 89 RA patients were recruited, and male was 28% (n=25). Mean age was 61.5 years old and mean of disease duration was 87 months. Main csDMARDs were MTX (72%). The mean dose of MTX was 7 mg/week (The average dose in Japan). Observational period was 13 months (range, 1 to 30). DAS28-ESR changed from 4.3±1.1 to 3.6±1.2 after adding IGU for 6 months (p Conclusions Adding IGU to csDMARDs with poor response in RA patients is effective, but AE should be considered. Radiographic progression by Iguratimod might be inhibited in early phase of RA. Disclosure of Interest None declared