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AB0270 Outcomes after discontinuation of TNF blockers in rheumatoid arthritis

Background Although there have been reports of sustained remission, especially in early diseases, after discontinuation of anti-TNF agent after achieving remission, outcomes after discontinuation of anti-TNF agents are not well known. But in real practice there are always unexpected circumstances where anti-TNF agents are discontinued. Objectives We investigated the patients who had received anti-TNF agent for treatment of RA and then discontinued for reasons other than ineffectiveness to assess the outcome after discontinuation of anti-TNF agents. Methods Retrospective medical record review was conducted of 291 patients with RA treated with biologics from December 2000 to November 2009 at Hanyang University Hospital for Rheumatic Diseases to assess for flare after anti-TNF discontinuation. Flare was defined, in accordance with the OMERACT working definition of RA flare, as any worsening of disease activity leading to modification in therapy. Results Twenty-one patients were included in the analysis after excluding 110 patients who were being maintained on anti-TNF agents, 23 patients treated with biologics other than anti-TNF agents, 9 who had received anti-TNF agents for less than 3 months, and 128 patients who had discontinued for other reasons (88 after completion of clinical trials, 22 due to ineffectiveness, 18 due to lost to follow-up). Of the 21 patients, 17 patients (81%) had flared and 4 patients (19%) showed no flare. Conclusions Majority (81%) showed flare after discontinuation of anti-TNF agents within a median of 6 months in a cohort of RA patients. Disclosure of Interest None Declared