The clinical effectiveness of INB in both PROs and disease-activity measures was comparable to INX during the first year of switching, with no immediate safety signals. Subjective reasons (negative expectations) may play a role among discontinuations of biosimilars. Larger patient numbers and longer follow-up are necessary for confirming this clinical experience.

Objective Frequent monitoring of patients with early rheumatoid arthritis (RA) is required for achieving good outcomes. This study was undertaken to investigate the influence of text message (SMS)–enhanced monitoring on early RA outcomes. Methods We randomized 166 patients with early, disease‐modifying antirheumatic drug–naive RA to receive SMS‐enhanced follow‐up or routine care. All patients attended visits at 0, 3, and 6 months, and a follow‐up visit at 12 months. Treatment was at the physicians’ discretion. The intervention included 13 SMSs during weeks 0–24 with questions concerning medication problems (yes/no) and disease activity (patient global assessment [PtGA], scale 0–10). Patients were contacted if response SMSs indicated medication problems or PtGA exceeded predefined thresholds. Primary outcome was 6‐month Boolean remission (no swollen or tender joints and normal C‐reactive protein levels). Quality of life (QoL; measured by the Short Form 36 survey) and Disease Activity Score in 28 joints (DAS28) were assessed. Results Six and 12‐month follow‐up data were available for 162 and 157 patients, respectively. In the intervention group, 46% of the patients (38 of 82) reported medication problems and 49% (40 of 82) reported text message PtGAs above the alarm limit. Remission rates at 6 months (P = 0.34) were 51% in the intervention group and 42% in the control group. These rates were 57% and 43% at 12 months (P = 0.17) in the intervention and control groups, respectively. The respective mean ± SD DAS28 scores for the intervention and control groups were 1.92 ± 1.12 and 2.22 ± 1.11 at 6 months (P = 0.09); and 1.79 ± 0.91 and 2.08 ± 1.22 at 12 months (P = 0.28). No differences in QoL were observed. Conclusion The study did not meet the primary outcome despite a trend favoring the intervention group. This may be explained by the notably high overall remission rates.

Only a small proportion of patients would have been eligible for RCTs, and the efficacy of TNF inhibitors assessed in them cannot be generalized directly into Finnish routine health care.

Background According to a common consensus, remission/low disease activity is the treatment target in RA. Recommendations to reach the target are surprisingly different: ACR recommendations include a combination of conventional DMARDs for RA but EULAR recommendations strictly suggest a conventional monotherapy and addition of a biologic agent if needed. In many countries, it is not possible to adhere to EULAR recommendations due to high expenses of biologic agents to patients and society. Objectives To study whether treatment target was reached, which medications were used and how much medications cost, in patients with RA in two Nordic rheumatology clinics in 2010. Methods Design: Cross sectional observational clinical data of all patients with RA seen in 2010. Setting: Two Nordic county hospital rheumatology units: Kristiansand, Norway (NOR), and Jyväskylä, Finland (FIN), which both serve a population of about 275,000. Treatment philosophy is to reach remission in both clinics. Patients: All consecutive 1140 patients with RA in NOR and 1240 in FIN. Measures: All data were collected as an infrastructure of the clinic using an identical monitoring system to facilitate clinical decision making. Measures included patient demographic measures, clinical characteristics, disease activity, functional status, and treatments. Annual costs of medications to the society were calculated per 100 patients, using an assumption that a patient is taking current medications for one year. Results Patient populations from NOR and FIN were similar according to age (61 vs. 60), gender (69% vs. 71%F), disease duration (10 vs. 11 years), and prevalence of rheumatoid factor and anti-citrullinated antibodies (Table). Disease activity was low and patients’ functional status well reserved in both clinics. Almost twice as many patients in NOR than in FIN (33% vs 17%) used biologic agents. A combination of conventional anti-rheumatic drugs was currently used by <1% of patients in NOR and by 37% of patients in FIN. Estimated annual costs of medications per 100 patients were 508,000€ in NOR and 280,000€ in FIN. NOR (N=1140)FIN (N=1240)p CCP or RF positive, %69%71%ns SJC28 (0-28), mean1.91.1<0.001 TJC28 (0-28), mean2.51.3<0.001 ESR, mean1914<0.001 CRP, mean8.06.30.008 DAS28 (0-9.4), mean3.12.6<0.001 DAS28-remission, %35%54%<0.001 MHAQ (0-3), mean0.490.41<0.001 Pain (0-100), mean3630<0.001 Biologics now, %33%17%<0.001 Combination of MTX+SSZ/HCQ, %0.8%37%<0.001 Annual medication costs/100pts, €507.889279.796 Conclusions Treatment target of remission/low disease activity and good functional status were seen in patients with RA using expensive and less-expensive anti-rheumatic drugs. This observation may be encouraging to rheumatologists in countries where expensive medications cannot be used. Disclosure of Interest None Declared