THU0073 HAVE THE CLINICAL CHARACTERISTICS OF RHEUMATOID ARTHRITIS AT PRESENTATION BECOME MILDER OVER TIME? RESULTS FROM A NATIONWIDE STUDY OVER THREE DECADES IN SWEDEN

Background The course of rheumatoid arthritis (RA) has become milder during the last decades, which could at least partly be attributed to major advances in the pharmacological treatment of the disease and the implementation of “treat to target”-strategies (1,2). It has also been suggested that RA is already milder at presentation (3) Objectives To investigate whether the clinical status, markers of inflammation, functional status, and patient and evaluator reported disease activity measures in patients with newly diagnosed RA, have improved over the recent decades. Methods Baseline data on all DMARD-naive patients with early RA ( Results A total of 6559 early RA patients were included. Over the study period of 23 years the majority of the patients were women (68%), and the mean age at inclusion increased from 57,4 to 59,1 years. Results are summarised in Table 1. Mean CRP, ESR, TJC and SJC all decreased significantly between the two time periods compared, which was also the case for HAQ. In contrast, mean pain, PtGA and EGA increased significantly between the time periods. Furthermore, time from symptom onset to inclusion was shorter 2011-2014. Conclusion In Swedish patients with early RA, baseline joint counts and inflammatory markers improved over the last three decades. This could partly be explained by shorter symptom duration at diagnosis but also suggests that, at onset, RA might be an inherently milder disease today. However, pain and patient’s global assessment and evaluator’s global assessment of disease activity increased over the same period of time, possibly indicating changes in both patients’ and evaluators’ expectations for management of early RA today References [1] Gwinnutt, et al. Arthritis Rheumatol. 2017; 69:1566–75. [2] Matsumoto, et al. J Rheumatol. 2017; 44:1575–82. [3] Diffin, et al. J Rheumatol. 2014; 41:1590–9. Disclosure of Interests Jon Einarsson: None declared, Tor Olofsson: None declared, Olafur Palsson: None declared, Johan K Wallman Consultant for: Consultant for AbbVie, Celgene, Eli Lilly, Novartis, and UCB Pharma., Meliha C Kapetanovic: None declared