Background:Patient-reported outcomes (PROs) have become an essential component of patients’ assessment in the management of Rheumatoid Arthritis(RA).They have been reported to be at least as informative if not more than physician assessed outcomes.MyRA Touch was pioneered by the Rheumatology Unit of Hospital Tuanku Jaa’far in Seremban Malaysia in March 2018,to engage and empower all RA patients on their own disease activity monitoring. It is an electronic platform, designed to enhanced the application of electronic patient reported outcomes (ePROs) among RA patients where they examine and record their own painful and/or swollen joints for DAS28 calculation and report their health assessment through Routine Assessment of Patient Index Data with 3 Measures (RAPID 3).MyRA Touch is an applications (App) that is user friendly and available in four major spoken languages (English, Chinese, Malay and Tamil) with an animated version for patients who are illiterate.Objectives:The objectives of this study are to determine the correlation between:I)Patient-reported and physician reported DAS28 ESR/CRPII)RAPID3 and Clinical Disease activity Index (CDAI)III)RAPID3 and DAS28 ESR/CRP assessed by physician and patientIV)RAPID3 and inflammatory markers ESR/CRP.Methods:This was a cross-sectional study carried out in the Rheumatology Unit of Hospital Tuanku Jaa’far. All data entered through MyRA Touch App from April 2018 till April 2020 was analysed.Results:There were a total of 562 patients who entered the data in the App, 87.9% were women. The ethnic compositions of the study subjects comprised of Indians (36.7%) followed by the Malays (34.7%),Chinese (26.3%) and other ethnics (2.3%). About half of patients (59.8%) were in the 51-70 age group whereas 22.9%,1.8% and 15.5% were in the 31-50,18-30 and above 70 age groups respectively. The majority of our patients (96%) were literate. A total of 54.3% of them received secondary education, 27% primary, 12.2% tertiary and 6.6% did not receive any formal education.There was a high level of correlation between DAS28 ESR/CRP performed by patient and DAS28 ESR/CRP assessed by physician, (r=0.808 for DAS28 ESR and r=0.804 for DAS28 CRP). RAPID3 also showed high level of correlation with CDAI and DAS28 CRP assessed by patient (r=0.700 and r=0.718 respectively). There was a moderate correlation between DAS28 ESR/CRP done by physician with RAPID3 (r=0.656 and r=0.696 respectively).RAPID3 demonstrated little correlation with inflammatory markers ESR and CRP (r=0.141 and r=0.171 respectively).Conclusion:PROs via DAS 28 (ESR/CRP) and RAPID3 showed moderate to high correlation with disease activity assessed by physician. We can empower patients to perform their own disease assessment by using the MyRA Touch App before seeing their physician and the information provided in the App, can help to reduced consultation time. During the COVID-19 pandemic, telemedicine is very much encouraged. By using the MyRA Touch, patients can assess their own tender and swollen joint count on a homunculus, evaluate their own physical function, health and pain using the RAPID3 parameters. The information obtained from the PROs in the MyRA touch App enables the physician to make a more comprehensive virtual assessment of the patient’s condition which helps in treatment decision making. In conclusion, MyRA Touch is an useful tool for disease activity measurement by patient.References:[1]Jenny AA, Diana BC, Omar JC, et al. Usefulness of Patients-Reported Outcomes in Rheumatoid Arthritis Focus Group. Hindawi Publishing Corporation Arthritis, vol 2012,Article ID935187.[2]Ana MO, Clifton OB. Patient Reported Outcomes in Rheumatoid Arthritis Clinical Trials. Curr Rheumato Rep.2015 April;17(4):501.Disclosure of Interests:None declared

BackgroundTargeted synthetic therapies brought revolutionary progress in rheumatoid arthritis (RA) management and culminated a paradigm shift over a decade. However, only a subset of patients responded clinically and achieved sustained remission. The interindividual factors may vary resulting in failure of therapeutic target and clinical response.ObjectivesWe investigated the clinical and sociodemographic predictors of Tofacitinib response in RA patients at three, six and twelve months.MethodsThis retrospective study included 164 RA patients from the nationwide MARBLE registry who received Tofacitinib. Patients’ clinical data were extracted from medical records. The response to Tofacitinib in terms of clinical remission, low disease activity (LDA) and DAS28 improvement (EULAR response) were measured at baseline, 3 months, 6 months and 12 months of therapy based on disease activity score (DAS)28 for RA. Factors predicting treatment response were analysed using binary logistic regression analysis.ResultsOur data revealed that at 3-month, 6-month and 12-month of Tofacitinib treatment, 17.7%(n=29), 67.7%(n=111) and 60.4%(n=99) RA patients achieved low disease activity/clinical remission. Further analysis demonstrated that anti-cyclic citrullinated peptide antibody (anti-CCP)-positivity and joint erosion were independently associated with unsatisfactory EULAR response (ie., anti-CCP at 3-month, OR=2.270, p<0.05; 6-month, OR=7.773, p<0.0001; and 12-month, OR=4.645, p<0.0001). Lower frequencies of clinical remission were associated with the presence of erosive joint throughout the three follow-up periods of treatment (OR=2.040 to 3.868; p<0.05), while only anti-CCP positive was found to be significantly associated with lower frequencies of LDA at 6-month and 12-month of treatment (anti-CCP positive, 6-month OR=3.659, p<0.0001 and 12-month OR=2.130; p<0.0001)ConclusionOur data suggest that joint erosion and anti-CCP positivity are strong predictive biomarkers for lower achievement of clinical remission, LDA and satisfactory EULAR response in patients with RA receiving tofacitinib treatment.References[1]M. Sugawara YF, A. Noguchi, S. Tanimura, Y. Shimizu, I. Nakagawa MY, N. Abe, M. Kono, M. Kato, K. Oku, O. Amengual IY, H. Takahashi, T. Atsumi. Prediction of the intolerance or non-responder to Janus kinase inhibitors in patients with rheumatoid arthritis: a preliminary retrospective study with integrative cluster analysis. Clinical and experimental rheumatology. 2022;40:1674-80.[2]Bird P, Hall S, Nash P, Connell CA, Kwok K, Witcombe D, et al. Treatment outcomes in patients with seropositive versus seronegative rheumatoid arthritis in Phase III randomised clinical trials of tofacitinib. RMD open. 2019;5(1):e000742.[3]van Vollenhoven RF, Lee EB, Fallon L, Zwillich SH, Wilkinson B, Chapman D, et al. Tofacitinib in Rheumatoid Arthritis: Lack of Early Change in Disease Activity and the Probability of Achieving Low Disease Activity at Month 6. Arthritis care & research. 2019;71(1):71-9AcknowledgementsSpecial thanks to Director General of Health Malaysia for his permission to present this article and International Medical University Research Grant [PHMS I-2021 (04)] for financial support.Disclosure of InterestsNone Declared.