Ab0765 Decoding Successful Corticosteroid Withdrawal in Rheumatoid Arthritis: Insights Into Prognostic Determinants

Background: The withdrawal of corticosteroid therapy in rheumatoid arthritis (RA) patients proves to be a complex process, requiring an individualized and meticulous approach. This study aims to unveil predictive factors that determine the success or failure of corticosteroid withdrawal in RA patients. Objectives: The primary objective of this study is to identify and analyze prognostic factors influencing successful corticosteroid withdrawal in rheumatoid arthritis patients undergoing methotrexate therapy, aiming to enhance personalized treatment strategies and improve long-term outcomes in rheumatologic care. Methods: This cross-sectional study included 100 patients with RA according to the 2010 ACR/EULAR criteria, all treated with corticosteroid and methotrexate (15-25 mg/week). Patients were classified into two groups: those who successfully withdrew from corticosteroid therapy (G1) and those who failed (G2). Results: Data were collected from 100 patients. The median age was 52 [31; 78] years, with 83% being women. Mean CRP at inclusion was 19.5 ± 17.7 mg/L, DAS28-CRP at inclusion was 4.3 ± 1.4, and 28% of patients received at least one Solumedrol IV bolus. Out of the 100 patients in the study, 76% successfully withdrew from corticosteroid therapy, while 24% failed. Patients in group G1 were younger, with an average age of 46 ± 6.6 years, compared to 57 ± 9.6 years for group G2 (p = 0.24), had a shorter duration of corticosteroid treatment (3.9 ± 3.6 months vs. 35.7 ± 37.2 months, p < 0.001), and a lower corticosteroid dose at inclusion (4 ± 1.5 mg, p = 0.002). Multivariate regression analysis results indicated that disease duration (odds ratio [OR] = 0.801, 95% CI 0.729-0.928, p < 0.001) and disease remission (OR = 3.108, 95% CI 1.074-11.475, p = 0.048) were significantly associated factors with the success of corticosteroid withdrawal in RA patients under methotrexate. Conclusion: These promising results shed light on the clinical practice of rheumatologists by providing key indicators for identifying patients most likely to succeed in corticosteroid withdrawal. By optimizing treatment, we contribute to improving the quality of life for RA patients and more efficiently managing this condition. This scientific advancement also paves the way for targeted and personalized therapeutic approaches, thereby reducing long-term dependence on corticosteroid therapy in RA patients. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.