AB0225 THE NATURAL COURSE OF EARLY RA WITH LATE ONSET IN EVERYDAY CLINICAL PRACTICE ACCORDING TO THE RUSSIAN RA PATIENT REGISTER OREL

Background: The opinion about the severity and prognosis of rheumatoid arthritis (RA) with late onset balanced between more favorable and more severe over various periods of rheumatology development. We studied this group of patients according to the Russian RA Patient Register OREL. Objectives: To study clinical, laboratory and radiological characteristics in patients with early RA with late onset of the disease (50 years and older) who are DMARD (disease modifying antirheumatic drugs), biological DMARD and glucocorticoid (GC) (systemic administration) – naive. Methods: All patients were included in the OREL register in the period from 01.01.2014 to 12.31.2018. There were 151 patients in the study (M:41, W:110; average age 60 ± 7.0 years). There were 73 patients (48%) with the duration of RA up to 3 months, 45 (30%) - 4-6 months, 33 (22%) - 7-12 months. The ratio of men and women was only 1: 2.8 (50 -64 years = 1:3.8; 64 years and older = 1: 1.8). Results: 99/151 (66%) patients had high disease activity (according to DAS-28), 52/151 (34%) – medium activity. 22/151 (15%) patients had II functional class (FC), 103 (68%) – III FC, 26 (17%) – IV FC. Table 1 illustrates that with an increase in the duration of the disease, a gradual increase in the frequency of detection of radiological erosion in the hands and distal parts of the feet is noted: 1.5 - 3 months - 33/73 (45%) patients; 4-6 months - 22/45 (49%) patients and in the period 7-12 months - 23/33 (70%) patients. The frequency of RF and AСPA detection in non-erosive patients, in all patients with radiological erosion and in patients with advanced stages only (III and IV) was 67% (RF) -78% (ACPA), 75% -90% and 100% -100%, respectively. Conclusion: Everyday clinical practice (OREL register) shows that in patients aged 50 years and older with early clinical stage of RA who are naive about the treatment of DMARD, biological DMARD and GC, the detection of RF, ACPA and erosive changes in the joints are often observed in the onset of the disease. RF and ACPA are markers of early joint destruction. Disclosure of Interests: None declared