LAUSR

Background The frequency and characteristics of patients with Palindromic Rheumatism (PR) (transient acute attacks of articular inflammation) prior to early rheumatoid arthritis (ERA) are unknown. Objectives To compare ERA patients who did versus did not report a history of transient episodes of joint inflammation preceding RA diagnosis. Methods Study participants were patients with ERA or suspected RA (symptoms <1 year; 83% met 2010 ACR/EULAR criteria) enrolled in the Canadian Early ArThritis CoHort (CATCH) between April 2017 to March 2018 who completed a questionnaire on prior inflammatory joint symptoms that “come and go”. Chi-square and t-tests were used to compare characteristics in patients with versus without a reported history of prior palindromic symptoms. Simple, and multivariable logistic regression with backward selection (p<0.2) were used to determine crude and adjusted predictors of palindromic symptoms. Results 154 ERA patients were included; 66% were female and mean (sd) age was 54 (15) years. 54% had previous joint pain and swelling prior to their current episode; 42% endorsed prior episodic joint pain and swelling, approximately half of whom (20% of total, N=31) reported transient joint symptoms for over six months. Patients reporting previous palindromic symptoms were more often female, seropositive, had more comorbidities, and lower swollen joints and baseline CDAI (p<0.05). In multivariable regression, female sex, higher income, seropositivity, back or spine issues, and lower CDAI were associated with history of palindromic symptoms (Table 1). Conclusion Half of ERA patients self-reported transient episodes of inflammatory arthritis prior to being diagnosed with RA. They are more likely female, seropositive, with higher income and lower disease activity. Acknowledgement The CATCH study was designed and implemented by the investigators and financially supported through unrestricted research grants from: Amgen and Pfizer Canada - Founding sponsors since January 2007; AbbVie Corporation since 2011; Medexus Inc. since 2013; Eli Lilly Canada since 2016 and Merck Canada since 2017. Previously funded by Hoffmann-LaRoche and Janssen Biotech from 2011-2016,UCB Canada and Bristol-Myers Squibb Canada from 2011-2018, and Sanofi Genzyme from 2016-2017. Disclosure of Interests Leah Ellingwood: None declared, Orit Schieir: None declared, Marie-France Valois: None declared, Susan J. Bartlett Consultant for: Pfizer, UCB, Lilly, Novartis, Merck, Jansen, Abbvie, Louis Bessette Grant/research support from: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Consultant for: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Speakers bureau: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Carol Hitchon: None declared, Gilles Boire Grant/research support from: Investigator-initiated studies: Amgen, Abbvie, BMS, Eli Lilly, Merck, Novartis, Pfizer, Consultant for: Advisory boards: Amgen, BMS, Celgene, Eli Lilly, Pfizer, Speakers bureau: Merck, BMS, Pfizer, Glen Hazlewood: None declared, Edward Keystone Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, F. Hoffmann-La Roche Inc, Gilead, Janssen Inc, Lilly Pharmaceuticals, Pfizer Pharmaceuticals, Sanofi-Aventis, Consultant for: AbbVie, Amgen, AstraZeneca Pharma, Biotest, Bristol-Myers Squibb Company, Celltrion, Crescendo Bioscience, F. Hoffmann-La Roche Inc, Genentech Inc, Gilead, Janssen Inc, Lilly Pharmaceuticals, Merck, Pfizer Pharmaceuticals, Sandoz, UCB., Speakers bureau: Amgen, AbbVie, Bristol-Myers Squibb Canada, F. Hoffmann-La Roche Inc., Janssen Inc., Merck, Pfizer Pharmaceuticals, Sanofi Genzyme, UCB, Diane Tin: None declared, Carter Thorne Grant/research support from: Investigator-initiated studies: Amgen, Pfizer. RCTs: Abbvie, Celgene, CaREBiodam, Novartis, Pfizer, Consultant for: Advisory board: Abbvie, Amgen, Celgene, Lilly, Medexus/Medac, Merck, Novartis, Pfizer, Sanofi. Consultant: Abbvie, Centocor, Janssen, Lilly, Medexus/Medac, Pfizer, Speakers bureau: Medexus/Medac, Vivian Bykerk Grant/research support from: Mallinckrodt, BMS, Crescendo Biosciences, Sanofi/Regeneron., Consultant for: Amgen, Pfizer, UCB, Scipher, Sanofi/Genzyme/Regeneron, Janet Pope Consultant for: Eli Lilly and Company