Anti-TNF therapy improves hand function in rheumatoid arthritis within 3 months D Hull1, C Ball1, and S Abraham2 1 Kennedy Institute of Rheumatology, University of Oxford 2 Department of Medicine, Imperial College London BACKGROUND Hands and wrists are affected in 80-90% of patients with RA resulting in pain and reduced hand function thus impacting on quality of life. Anti-TNF therapy has revolutionised RA treatment but its effect on hand function has not been recorded to date using specific measures. The Health Assessment Questionnaire (HAQ) is not specific and lacks of sensitivity to subtle changes in function. The Michigan Hand Outcomes Questionnaire (MHQ) has been shown to be a reliable and sensitive measure of hand function and is validated for use in RA patients. RESULTS 16 RA patients: 12 females and 4 males, mean age 55.8 years Mean DAS28 score pre-treatment 5.29, reducing to 3.62 at 3 months after treatment initiation There was a significant improvement in overall MHQ score (p=0.0038) at 3 months MHQ sub-scores of function, work, hand pain and satisfaction improved significantly Improvement in overall MHQ score correlated significantly (r=0.82, p<0.0001) with change in DAS28 score at 3 months post start of treatment METHODS 16 patients with RA were assessed using MHQ before and at 3 months after starting anti-TNF treatment. Treatment response was assessed by DAS28 (CRP) score. Data from MHQ domains were analysed by comparing baseline and 3 months post treatment using Student’s paired t test. Correlations between MHQ scores and DAS28 scores assessed using Spearman rank. r=0.82 P<0.0001 DISCUSSION Treatment with anti-TNF in our cohort of 16 patients with RA significantly improved hand function as measured by MHQ within 3 months of commencing treatment. Improvement of hand function in this group correlated with overall improvement in their inflammatory status as shown by the DAS28 score The MHQ is a useful additional tool for measuring aspects of treatment. It is easy to administer, can identify change within 3 months and could be used clinically alongside other widely used measures such as DAS28 to monitor treatment response in RA. A B A B C D C D The Michigan Hand Outcomes Questionnaire (MHQ) 37-item questionnaire with 6 domains giving scores for: function, activities of daily living (ADL), pain, work, aesthetics and satisfaction REFERENCES Chung KC, Pillsbury MS, Walters MR, Hayward RA, Reliability and Validity Testing of the Michigan Hand Outcomes Questionnaire J Hand Surg 1998, 23A, 575-587 Chung KC, Hamill JB, Walters MR, Hayward RA, The Michigan Hand Outcomes Questionnaire (MHQ): Assessment of Responsiveness to Clinical Change Annals of Plastic Surgery 1999, 42, 619-622. Shauver MJ, Chung KC, The Minimal Clinically Important Difference of the Michigan Hand Outcomes Questionnaire J Hand Surg 2009;34A:509–514. Wolfe F A reappraisal of HAQ disability in rheumatoid arthritis. Arthritis Rheum2000 Dec;43(12):2751-61. Waljee JF, Chung KC, Kim HM, Burns PB, Burke FD, Wilgis DF, Fox DA Validity and responsiveness of the Michigan Hand Questionnaire in patients with rheumatoid arthritis: a multicenter, international study Arthritis Care Res 2010 Nov;62(11):1569-77.