Aim: Coexistence of DM and TB influences TB treatment outcomes. TB increases hyperglycaemia due to inflammatory response. Effect of prediabetes (PDM) on TB treatment outcomes is unknown. The aim was to assess the effect of PDM on treatment outcomes after TB treatment. Methods: This is a prospective observational cohort study (EDOTS - part of RePORT India Consortium) of 569 eligible New smear positive cases screened for DM between 2014 to 2018 in TB units in North Chennai, South India. Out of 569 subjects, 179 with a known history of DM were excluded.The remaining 390 screened TB subjects, 120 were excluded based on culture results and unwillingness to participate in the study. HbA1c was assessed at baseline and categorised into two groups (Gp): normoglycaemia (Gp1) (<5.7%) and PDM (Gp 2) (5.7 to 6.4%) and followed them at 3rd and 6th month and treatment outcomes were assessed at the end of the TB treatment. Results: Prevalence of Prediabetes was 41.1%. There was no significant difference in the treatment outcomes between the groups(p=0.54). Total cure rate was 72.7% with no significant difference between the groups. There was a higher proportion of treatment failures (7.9%) amongGp1 as compared to Gp 2 (4.5%) (p = 0.33). There were 15.8 vs. 17.1% treatment defaulters. Higher proportion of deaths occurred during the course of DOTS in Gp 2 (7.2%) compared to Gp 1 (1.3%) (p = 0.06). At the end of intensive phase of DOTS treatment, about 23.8 % were observed to have positive sputum smear in Gp 2 compared to 8.6% in Gp 1 (p=0.019). The estimated relative risk to remain as sputum smear positive among prediabetes at the end of intensive phase was 3.0 (95% CI: 1.2-7.6). Conclusion: Higher prevalence of prediabetes was evident among TB patients. Among those who had prediabetes, death rate was higher during the course of the treatment and higher proportion remained sputum smear positive at the end of the intensive phase of TB treatment. Disclosure V. Viswanathan: None. A. Devarajan: None. S. Kumpatla: None. M. Dhanasekaran: None. S. Babu: None. H. Kornfeld: None. Funding Government of India (BT/MB/INDO-US/REPORT/03/2013-140)

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Background: Rheumatoid arthritis (RA) is a common disease that causes substantial morbidity in most patients and premature mortality in many. All the drugs used in the treatment of rheumatoid arthritis show significant toxicity and hence it is important to monitor the drugs for adverse drug reaction. This study will estimate the prescribing pattern and bring out the possible adverse drug reactions in patients with rheumatoid arthritis.Methods: This study included 200 patients with rheumatoid arthritis who fulfilled the study criteria were observed for three months. Their prescriptions were collected and analysed. The symptoms of adverse drug reaction were documented through questionnaire. The causality assessment was done by WHO-UMC assessment scale and severity by using modified Hartwig-Seigel severity assessment scale.Results: This study showed most of the patients were female (86%). Majority of them were in age group of 51-60 years. Average number of drugs per prescription was 10.57. Out of 200 patients, 2% were on single DMARD and 50.5% were on two DMARDs. 40% and 7.5% were taking three and four DMARDs respectively. A total of 450 adverse drug reactions were reported, out of which 68.4% due to steroid,12.5% due to DMARDs and 19.1 due to use of NSAIDs, DMARDs and glucocortisteroids. Chloroquine maculopathy occurred in 3 patients and elevated liver enzymes due to methotrexate in 3 patients, which necessitated DMARD withdrawal. Most patients had 1-3 ADRs. 6% of ADRs were severe and 54% belongs to probable category of causality assessment.Conclusions: Treatment of rheumatoid arthritis is mainly based on DMARDs, glucocorticosteroids and NSAIDs. So, occurrence of ADR is much common. Proper monitoring of therapy and timely modification of drugs and lifestyle can reduce the ADR occurrence.

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