Pos1357 Deciphering the Clinical Quandary: A Cross-Sectional Study on the Prevalence and Attributes of Difficult-to-Treat Rheumatoid Arthritis

Background: Recently, EULAR (European League Against Rheumatism) has defined Difficult-to-Treat Rheumatoid Arthritis (D2TRA) as a complex condition in patients with Rheumatoid Arthritis (RA). These individuals exhibit a failure to respond to at least two targeted treatments with different mechanisms of action, while displaying signs of disease activity and/or progression. The management of D2TRA proves challenging, both from the perspective of the rheumatologist and the patient. Our study aims to explore the prevalence of this specific entity and characterize its clinical aspects. Objectives: By elucidating the multifaceted clinical features and associated factors of D2TRA, our aim is to advance the understanding of this challenging subset within the rheumatoid arthritis spectrum, fostering enhanced strategies for its effective management and therapeutic intervention. Methods: We recruited 200 patients with RA (according to the 2010 ACR/EULAR criteria). To analyze factors associated with D2TRA, we divided our population into two groups: a group designated as "D2TRA" and a "control" group. Results: In total, 72 (40%) patients met the EULAR definition of D2TRA, with a mean age of 58 ± 10.9 years, compared to 53 ± 9.5 years for the controls. Rituximab was used in 78% of D2TRA patients in our sample. 48.6% received an anti-TNF-alpha, 25% received two anti-TNF alphas, and 15.2% received Tocilizumab. Our results showed that age (OR = 2.24, 95% CI: 1.04–4.02, p = 0.023), disease duration (OR = 2.15, 95% CI: 1.15–3.98, p = 0.05), and BMI (OR = 1.78, 95% CI: 1.09–3.08, p = 0.048) were significantly associated with "D2TRA". Furthermore, patients with intolerance or contraindication to csDMARDs were 1.5 times more likely to develop difficult-to-treat RA (OR = 1.49, 95% CI: 1.02–2.17, p Conclusion: "D2TRA" remains a significant challenge for rheumatologists. The findings of this study emphasize the importance of early management of RA and an individualized therapeutic approach. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.