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The objective of this study is to correlate the patient-driven tool Routine Assessment of Patient Index Data 3 (RAPID-3) with other common tools used in daily practice to measure disease activity in rheumatoid arthritis (RA).One hundred nineteen RA patients according to 1987 American College of Rheumatology criteria who consecutively attended a RA outpatient clinic between August and December 2015 were evaluated. Data was stored in an electronic form that included demographic information, comorbidities, concomitant medication, and laboratory results. The disease activity was determined by tender and swollen joint count, pain and disease activity visual analog scales (VAS), disease activity score 28 (DAS28), Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI), and multidimensional health assessment questionnaire (MDHAQ). Correlations between RAPID-3 and other disease activity tools were assessed. Mean age was 61 ± 13.8 years with a median disease duration of 14 years (IQR 5-21), 77% were females. Median scores were MDHAQ 0.5 (IQR 0.1-1.2), DAS 28 3.8 (IQR 2.7-5.1), and RAPID-3 12.3 (IQR 6-19). A strong correlation was obtained between RAPID-3 and DAS 28 (r 0.719, p < 0.001), CDAI (r 0.752, p < 0.001), and SDAI (r 0.758, p < 0.001). RAPID-3 had a high correlation with tools regularly used for disease activity assessment of RA patients in daily practice. The ease of its application favors routine use as it does not require laboratory results and joint counts.

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Background. Clinical, laboratory, and radiologic parameters are used for diagnosis and classification of spondyloarthritis (SpA). Magnetic resonance imaging (MRI) of sacroiliac (SI) joints is being increasingly used to detect early sacroiliitis. We decided to evaluate the interobserver agreement in MRI findings of SI joints of SpA patients between a local radiologist, a rheumatologist, and an expert radiologist in musculoskeletal diseases. Methods. 66 MRI images of the SI joints of patients with established diagnosis of SpA were evaluated. Agreement was expressed in Cohen's kappa. Results. Interobserver agreement between a local radiologist and an expert radiologist was fair (κ = 0.37). Only acute findings showed a moderate agreement (κ = 0.45), while chronic findings revealed 76.5% of disagreement (κ = 0.31). A fair agreement was observed in acute findings (κ = 0.38) as well as chronic findings (κ = 0.38) between a local radiologist and a rheumatologist. There was a substantial agreement between an expert radiologist and a rheumatologist (κ = 0.73). In acute findings, a 100% agreement was achieved. Also chronic and acute plus chronic findings showed high levels of agreement (κ = 0.73 and 0.62, resp.). Conclusions. Our study shows that rheumatologists may have similar MRI interpretations of SI joints in SpA patients as an expert radiologist.

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BackgroundMethotrexate (MTX) as monotherapy or in combination, is the most commonly Disease-Modifying-AntiRheumatic-Drug (DMARDs) used in rheumatoid arthritis (RA). About 40% of patients do not respond to treatment or have adverse effects. The genetic variability could be responsible for this phenomenon. Different studies suggest associations between polymorphisms in the enzymes involved in the metabolic pathway of MTX with alterations in the efficacy and toxicity.ObjectivesDetermine the polymorphisms of the enzymes involved in MTX metabolism in a group of Colombian patients.Methods400 patients with RA over 18 years old, diagnosed according to the ACR/EULAR classification criteria, who consecutively attended an outpatient RA clinic between March 2015 and December 2016 were included. MTX efficacy was defined by DAS28 score ≥3.2, liver toxicity by elevation of transaminases above three times the normal value, Haematological toxicity by: leukocytes<4,000, Hb <9.5, platelets<150,000, renal toxicity: creatinine >1.5. The single nucleotide polymorphisms (SNPs) studied were MTHFR C677T, MTHFR A1298C, ATIC C347G, RFC1 G80A, FPGS-AG and DHFR-CT and were identified by the technique of polymerase chain reaction in real time (RT-PCR).ResultsThe mean age of patients was 60.7±13.9 years, the duration of the disease was 13.2±10.9 years and 76% were women. A significant increase in the frequency of MTHFR C677T and A1298C SNPs (p=0.05 and p=0.048) were found in the responding patients compared to non-responders. The DHFR-CT and the ATIC C347G SNPs were significantly increased in patients with any toxicity to MTX (p=0.0095 and p=0.005 respectively). We did not find a significant difference between the polymorphisms studied with any specific toxicity.Abstract AB0004 – Table 1 Polymorphisms nActivity (%)Remission (%) OR-95%(IC)p MTHFR C677CCCCTT3448126318937 (20)152 (80)15544 (28)111 (72) 1.62 (1.0–2.68) 0.05MTHFR A1298AATT38131269219172 (79)47 (21)162140 (86)22 (14) 1.74 (1.01–3.02) 0.048DHFRCCTT394233 (58.3)161 (25.8)225131 (58.2)91 (40.5)16595 (57.6)68 (41.2) 1.03(0–68–1.55) 0.484FPGSAAGG400137 (34.3)263 (65.7)22574 (32.9)151 (67.7)16557 (34.5)108 (65.5) 1.92 (0.69–1.41) 0.406Abstract AB0004 – Table 2ConclusionsThe Colombian population has similar statistical data compared to the global studies regarding the association of SPNs with the efficacy and toxicity of methotrexate, however the polymorphisms associated with inefficiency in the literature are not replicated in our data. These SNPs could be established as biomarkers to the methotrexate response in terms of efficacy and toxicity in our Colombian population with RA.Reference[1] Fan H, Li Y, Zhang L, Li W. Lack of association between MTHFR A1298C polymorphism and outcome of methotrexate treatment in rheumatoid arthritis patients: Evidence from a systematic review and meta-analysis. Int J Rheum Dis2017;20(5):526–40.Disclosure of InterestNone declared