Different phrasing of the PG-VAS gives different DAS28 results. As the DAS28 is a key outcome measure, such differences have the potential to influence clinical decisions relating to eligibility for biologic agents and evaluation of new therapies. We urgently need to decide on the concept to be measured and the phrasing required to capture this. The PG-VAS phrasing should then be standardized and validated.

Utilization of processing protocol to determine percent increase in activity from baseline within ROI of active LGIB on scintigraphy has predictive value in determining which patients will not benefit from conventional angiography.

This presentation will focus on the speaker’s experience of switching patients who are on an originator biologic therapy to a biosimilar, using a shared decision making approach. It will initially explore what constitutes shared decision making, why it is important when switching to biosimilars and the benefits of this approach.The speaker will discuss how this change in therapy was achieved in practice when switching patients to both intravenous and subcutaneous biosimilars. There will be a focus on the patient consultation itself, recognising patient anxiety and an exploration of why some patients declined to switch.The speaker will share how loss of efficacy to the biosimilar was managed, and how this influenced the shared decision making approach.Clinician’s concerns will also be considered, specifically the inability to maintain pharmacovigilance (in not having sufficient nursing resources to add patients who had switched to a biosimilar to a national register). This is relevant to shared decision making as providing evidence and reassurance to patients regarding safety of biosimilars relies on this data collection.The guidance referred to in this presentation is from NHS England, National Institute for Health and Care Excellence and the British Society for Rheumatology, so it has a UK focus. However, the main themes of the talk should be relevant to all audience members as it considers the opposing pressures on Rheumatology nurses to be change agents and make cost savings in implementing this switch to biosimilars. Whilst nurses also need to act as the patient advocate in ensuring shared decision making is a reality: that a face-to-face consultation takes place and that the patient can decline to switch and not feel penalised. The speaker will reflect on how the trust in her relationship with her patients was tested by this experience.The main recommendation from this presentation is that rheumatology teams need to be proactive in managing this change and securing extra funding for nursing or pharmacy support. This ‘invest to save’ approach will enable appropriate consultation with patients to allow them to give informed consent to switch their therapy and feel supported whilst this switch takes place. It also enables maximum cost savings by ensuring the switch occurs quickly.Disclosure of InterestNone declared

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