Santos Fernandes

AB1168 Touch study: technology and outcomes used in clinic in a day hospital

Background Patient reported outcomes PRO are a key element in the global evaluation of patients, especially those followed in a day hospital. The use of touchscreen computers is one of the new features in the day hospital of Instituto Português de Reumatologia. Objectives to evaluate the transition from paper to touchscreen computers technology of the PRO in use in Reuma.pt Methods We considered a step up model of comparison with 2 months intervals one before the use of the touchscreen computers, one two months after the introduction of touchscreen computers and a third after an intermediate evaluation (comparison between interval 0 and 1) of the results.A specific formation to physicians and nurses to be aware of missing data from non-total completion of the questionnaires was introduced between the first and second evaluation. The percentage of questionnaires totally completed by number of patients were obtained for every period and diagnosis Results 631 day hospital appointments were evaluated according to diagnosis and interval and the percentage was obtained (Table 1)Table 1. Results comparing questionnaires by diagnosis and intervals Paper interval 0 Interval 1 Interval 2 (Sept –Nov 15) (Nov 15- Jan 16) (Jan – Mar 16) AS N N Quest. Pct. N N Quest. Pct. N N Quest. Pct. BASDAI 95 95 100,00% 92 87 94,57% 93 92 98,92% BASFI 95 94 98,95% 92 89 96,74% 93 92 98,92% EQ5D 95 91 95,79% 92 85 92,39% 93 88 94,62% AsQol 95 88 92,63% 92 83 90,22% 93 85 91,40% SF-36 95 80 84,21% 92 72 78,26% 93 77 82,80% HADS 95 27 28,42% 92 87 94,57% 93 91 97,85% FACIT 95 93 97,89% 92 91 98,91% 93 92 98,92% RA HAQ 112 111 99,11% 124 124 100,00% 115 114 99,13% SF-36 112 96 85,71% 124 101 81,45% 115 98 85,22% HADS 112 9 8,04% 124 111 89,52% 115 114 99,13% FACIT 112 108 96,43% 124 122 98,39% 115 114 99,13% EQ5D 112 105 93,75% 124 119 95,97% 115 113 98,26% Only HADS had a significative (p<0.000) improvement for every disease, with the use of the touchscreen computers from interval 1 to 2. On our intermediate evaluation comparing paper to tablet we saw a lower percentage of questionnaires fully completed (although not statistical significative) and a formal awareness formation addressing the causes was made with all the physicians and nurses of the day hospital. The PRO from Reuma.pt was not developed for tablets and some issues regarding missing data associated with that was found Conclusions The use of technology can contribute for better data in Reuma.pt and other national registries by saving time (medical and nurse) for clinical evaluation, by integrating patients in their evaluations and by cost reduction, and carbon footprint. Issues regarding the adaptability of software to tablet technology have to be addressed to insure an overall improvement. Disclosure of Interest None declared

AB0413 Hepatitis B Serologic Profile and Reactivation in Rheumatic Patients Treated with Biological Therapies – Single Centre Experience

Background Biologic therapy for rheumatic diseases has been associated with increased risk of latent infections reactivation such as tuberculosis or hepatitis B (HB), due to severe immunosuppression. However, the actual risk of HB reactivation is still unclear regarding the several biologics available, especially in low-incidence countries such as Portugal. Objectives To evaluate the serologic HB profile of biologic-treated rheumatic patients in a single centre and assess the incidence of HB reactivation. Methods We retrospectively collected electronically available HB serology of rheumatic patients that ever started biological therapy at our department and we reviewed the clinical course to identify reactivation cases, defined as raising viral load and transaminases. Results We included 288 patients with available electronic data on HB serologies. Mean age was 43.9±15.7 years (3.1 to 82.3 years), disease duration was 10.9±9.5 years, 63.9% of patients were female and the most common rheumatic disease was rheumatoid arthritis (112, 38.9%), followed by ankylosing spondylitis (76, 26.4%) and psoriatic arthritis (54, 18.8%). As first biologic, 254 patients (88.2%) started anti-TNF agents, 14 (4.9%) rituximab, 11 (3.8%) tocilizumab and 9 patients (3.1%) another biologic. 30 patients (10.4%) eventually stopped biologic treatment. 185 patients (64.2%) were treated with concomitant methotrexate (mean dosage 15.7±5.4mg), 81 (28.1%) with other DMARDs and 169 (58.7%) were treated with corticosteroids (58.7%). All of the 288 patients were HBsAg negative and 23 were anti-HBc positive (9%). The 23 anti-HBc positive patients did not differ significantly from the overall population in terms of age, gender distribution, disease duration, follow-up time, biologic discontinuation or biologic started. No patient received prophylactic antiviral therapy and there were no cases of reactivation or isolated rise in viral load during a cumulative biologic exposure of 1005.6 patient-years (Fig. 1). Figure 1. Hepatits B serologic pattern of rheumatic patients starting biological therapy Conclusions In our cohort, there were no cases of HB reactivation on the 288 patients treated with biologic therapy. Anti-HBc positivity was infrequent, viral load was undetectable in all cases and no chronic HB cases were detected. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4716

PReS-FINAL-2095: Older age predicts poor response to 6-months methotrexate therapy in a juvenile idiopathic arthritis cohort of patients

The identification of predictive factors of poor response to methotrexate (MTX) in juvenile idiopathic arthritis (JIA) patients could contribute to optimize the treatment strategy, namely by the earlier introduction of biological treatments.