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Background:In Italy Osteoarthritis (OA) is a widespread and disabling disease that affects an increasingly large number of patients in the population, representing one of the main causes of morbidity and disability with high socio-economic costs. The etiology of OA is multifactorial, even if the significant association with some modifiable risk factors like mechanical overload and obesity is now well demonstrated. Early diagnosis and treatment strategies in OA could reduce both patient morbidity and associated costs.Objectives:Promoted by the Italian Society of Rheumatology (SIR), The Early Symptomatic OsteoaRThritis (ESORT) registry has the aim to study the natural history of OA from the earliest stages (pre- radiographic) considering risk factors in the progression of the disease, and the influence of therapeutic factors on long-term disease outcomes. The ESORT register aims to describe the socio-demographic and clinical characteristics of patients affected by OA in Italy; evaluates the extent of symptoms, functional damage, comorbidities, the frequency of use of drugs currently indicated in our country, and differences related to clinical subsets according with comorbidities and geographical localization of the patient.Methods:Actually 8 Italian Rheumatology centers are involved in the online data entry data of the SIR registry (developed and validated by SIR Study Center), considering patients affected by OA. In particular, the electronic database collects information about main demographic variables, significant anamnestic elements (risk factors and comorbidities), localization of OA, laboratory data, clinimetric indices with WOMAC / FIHOA / VAS scales, radiographic instrumental data and therapy in act. These data are reported in specific forms in the register with annual reassessment.Results:Currently, 318 patients with OA are included in the “ESORT” registry with an extension of observation up to 48 months, 214 women and 104 men with an average age of 71 years and an average weight of 72 kg. About 14% of patients affected by knee OA show Kellgren and Lawrence radiological stage 0 in presence of painful symptoms at the knees. The most frequent localization of OA is the knee (63%), followed by the hip (41%), hand (36%), spine (34%), and other sites (16%). The Table 1 shows details of some parameters (average age, average weight, intake of NSAIDs, intake of opioids and intake of chondroprotectors) according to the localization of the disease. From the registry data, patients with OA results treated mainly with NSAIDs and chondroprotectors, and patients with knee OA are the most frequently treated with opioid analgesics (44%), less used in other OA locations.Conclusion:The “ESORT” register is a useful tool for epidemiological and clinical information relating to patients with OA and for monitoring the evolution of the disease and the response to therapy.Average age (years)Average weight (kg)Intake of NSAIDs (% of patients)Intake of opioids (% of patients)Intake of chondroprotectors (% of patients)OA hand706774%10%25-31%OA knee747585%44%53-59%OA hip697075%25%24-28%OA spine757576%14%19-28%OA other localization747369%13%15-35%Disclosure of Interests:Gianfranco Gigliucci: None declared., Orazio De Lucia: None declared., Antonella Fioravanti: None declared., Felice Galluccio: None declared., Serena Guiducci: None declared., Antimo Moretti: None declared., Marco Matucci-Cerinic Speakers bureau: Consulting fees or honorarium from Actelion, Janssen, Inventiva, Bayer, Biogen, Boehringer, CSL Behring, Corbus, Galapagos, Mitsubishi, Samsung, Regeneron, Acceleron, MSD, Chemomab, Lilly, Pfizer, Roche, Grant/research support from: Consulting fees or honorarium from Actelion, Janssen, Inventiva, Bayer, Biogen, Boehringer, CSL Behring, Corbus, Galapagos, Mitsubishi, Samsung, Regeneron, Acceleron, MSD, Chemomab, Lilly, Pfizer, Roche, Antonella Murgo: None declared., Simone Parisi Speakers bureau: Personal fees (as speaker and/or consultant) from NOVARTIS, BMS, LILLY, UCB, MSD, PFIZER, ABBVIE, BIOGEN, AMGEN, JANSENN CILAG, CHIESI and GRUNENTHAL outside the submitted work;, Consultant of: Personal fees (as speaker and/or consultant) from NOVARTIS, BMS, LILLY, UCB, MSD, PFIZER, ABBVIE, BIOGEN, AMGEN, JANSENN CILAG, CHIESI and GRUNENTHAL outside the submitted work;, Roberta Ramonda: None declared., Sara Tenti: None declared., Enrico Tirri: None declared., Alberto Migliore Speakers bureau: Grants from Abiogen,Lilly,Fidia,Jansen (outside the submitted work), Consultant of: Grants from Abiogen,Lilly,Fidia,Jansen (outside the submitted work), Grant/research support from: Grants from Abiogen,Lilly,Fidia,Jansen (outside the submitted work).

Background Canakinumab is a human IgGκ monoclonal antibody targeting Interleukin (IL)-1β; its action involves the neutralization of the signaling of IL-1β, the most important cytokine in the pathogenesis of Osteoartrhitis (OA). In response to IL-1β, chondrocytes secrete other proinflammatory cytokines, neutral metalloproteinases (MMPs), nitric oxide (NO); furthermore IL-1β inhibits chondrocytes proliferation and induces apoptosis. Objectives The aim of our study was to evaluate the possible in vitro effects of canakinumab on human OA chondrocytes cultures cultivated in the presence or absence of tumor necrosis factor (TNF)-α. Methods Chondrocytes, from femoral cartilage of five OA patients who underwent surgery for hip prostheses, were isolated using sequential enzymatic digestion. Primary cultures so obtained were incubated with canakinumab (1μg/ml and 10μg/ml) alone or with TNF-α (10ng/ml). We evaluated after 48h cell viability, release of proteoglycans (PG) and NO in culture medium, inducible nitric oxide synthase (iNOS) and MMP-1,3,13 expression, the percentage of apoptosis and necrosis. After 24h we performed IL-1β dosage (ELISA). Finally, we used a transmission electron microscope (TEM) for morphological assessment. Results Canakinumab alone at the two concentrations studied hadn9t cytotoxic effect and didn9t modify significantly IL-1β levels in the culture medium. TNF-α caused a significant decrease of the percentage of viable cell (P Conclusions It is generally accepted that IL-1β and TNF-α are the pivotal cytokines involved in OA physiopathology. Hence, the neutralization of these cytokines appears to be a logical development for OA therapy. In the present study we showed, for the first time, that canakinumab counteracts the negative effect of TNF-α on OA chondrocyte cultures, probably inhibiting IL-1β signaling. References Dhimolea E. Mabs 2010;2:3-13. Fioravanti et al. J Pharmacol Sci 2012;20:6-14. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5066

Background White adipose tissue produces more than 50 adipokines and other molecules that participate through endocrine, paracrine, autocrine or juxtacrine mechanisms of action in a wide variety of physiopathological processes, including food intake, insulin sensitivity, vascular sclerotic processes, immunity and inflammation (1,2). Tumor necrosis factor (TNF) receptor-associated periodic syndrome (TRAPS) is the most common autosomal dominant autoinflammatory disorder and is caused by mutations in the TNFRSF1A gene encoding the 55-kD receptor for TNF-α (TNFRSF1A) (3). Objectives the aims of our study were to evaluate serum leptin, resistin, visfatin and adiponectin levels in patients with tumor necrosis factor receptor-associated periodic syndrome (TRAPS), in comparison to healthy controls, and to correlate their levels to parameters of disease activity and/or severity. Methods serum leptin, resistin, visfatin and adiponectin levels were obtained from 14 TRAPS patients carrying mutations involving cysteine residues, from 16 TRAPS patients carrying other mutations, and from 16 healthy controls. Demographic, clinical and laboratory parameters, including amyloidosis were entered for each patient. Comparisons between groups as well as reciprocal comparisons have been evaluated. Results Serum leptin, resistin, visfatin and adiponectin did not significantly differ among the 3 groups. Serum leptin significantly correlated with the number of attacks/year (multiple R=0.32, multiple adjusted R 2 =0.19, p 2 =0.57, p s =0.42, r 2 =0.18, p s =0.57, r 2 =0.32, p Conclusions Although a prospective design study and larger cohort are mandatory, adipokines serum levels and their correlations with parameters of disease activity and/or severity, seem to show a baseline pattern in TRAPS patients. References Lago F, Dieguez C, Gόmez-Reino J, Gualillo O. Adipokines as emerging mediators of immune response and inflammation. Nat Clin Pract Rheumatol 2007;3:716-24. Cantarini L, Simonini G, Fioravanti A, et al.Circulating levels of the adipokines vaspin and omentin in patients with juvenile idiopathic arthritis, and relation to disease activity. Clin Exp Rheumatol 2011 [Epub ahead of print]. McDermott MF, Aksentijevich I, Galon J, et al. Germline mutations in the extracellular domains of the 55 kDa TNF receptor, TNFR1, define a family of dominantly inherited autoinflammatory syndromes. Cell 1999; 97:133-44. Disclosure of Interest None Declared

Background Increasing clinical and scientific interest has recently been raised on hand osteoarthritis (HOA); a peculiar subgroup of patients experiment more severe symptoms and characteristic structural damage in the joints (central erosion type lesions - CE). No agreed criteria have been established about the number of erosive joints necessary for the definition of erosive disease. So far reports have been published utilizing both the one erosive joint and the two erosive joints criteria (1-2) Objectives To evaluate clinical and radiographic features of HOA patients divided into three groups: a)-without CE joint (CEJ), b)-with one CEJ, c)-with at least two CEJ. Methods 419 patients with HOA were enrolled; on the basis of the presence of central erosion in IP joints they were divided into the three groups. Demographic (gender, age, age of disease onset), clinical (BMI) and radiographic features [Kellgren & Lawrence (K&L) and Kallman’s scores obtained from radiographs of both hands] from all patients were recorded. In addition we evaluated the presence of marginal erosions (ME). Results While significant differences were found between group b and group c in all evaluated items [Age, mean ± sd (95%CI) =67.3±6.7 (66.9-67,7) vs 68.9±8.0 (68.7-69.1); Age at disease onset, mean ± sd (95%CI) =56.0±9.9 (55.4-56.6) vs 53.7±9.4 (53.4-54.0); Disease duration, mean ± sd (95%CI) =7.9±6.5 (7.5-8.4) vs 11.3±8.7 (11.0-11.5); Total Kallman, mean ± sd (95%CI) =83.2±17.3 (76.5-89.8) vs 98.7±2.4 (95.8-101.6); KL ME, %(n) =19.5 (198/1016) vs 33.9 (1667/4912), p Conclusions Since patients without CEJ and patients with only one CEJ had similar values of two relevant features (age at disease onset, K&L score) we suggest that the definition of erosive disease should be confined to patients with at least two CEJ. References Kwok WY, Kloppenburg M, Rosendaal FR, van Meurs JB, Hofman A, Bierma-Zeinstra SM. Erosive hand osteoarthritis: its prevalence and clinical impact in the general population and symptomatic hand osteoarthritis. Ann Rheum Dis 2011;70:1238-42. Epub 2011 Apr 6 Punzi L, Ramonda R, Sfriso P. Erosive osteoarthritis. Best Pract Res Clin Rheumatol 2004;18:739-58. Disclosure of Interest None Declared

Background Idiopathic acute recurrent pericarditis (IRAP) represents the most troublesome complication of acute pericarditis and is an autoimmune process (1). White adipose tissue produces more than 50 adipokines that participate in inflammation and autoimmunity (2,3). Objectives Our aims were to evaluate serum leptin, resistin, visfatin and adiponectin in IRAP patients versus healthy controls and to correlate their levels to parameters of disease activity. Methods Serum leptin, resistin, visfatin and adiponectinlevels were assayed by enzyme-linked immunosorbent assay in 14 IRAP patients during recurrences(group 1), in 23 IRAP patients during symptom-free intervals (group 2) and in 18 healthy controls (group 3). Assessment parameters included demographic characteristics of patients and controls, clinical characteristics of patients and markers of inflammation. Comparisons between groups as well as reciprocal comparisons were evaluated. Results group 1 showed serum leptin (p s =0.43, r 2 =0.27, p Conclusions leptin, adiponectin and visfatin are increased in IRAP patients versus healthy controls. Our data suggest that these adipokines might be involved in IRAP pathogenesis and that a possible increased cardiovascular risk in these patients, through an early onset atherosclerosis, should be kept in mind. SAA might be a link between IRAP and increased cardiovascular diseases. References Caforio AL, Brucato A, Doria A, Brambilla G, Angelini A, Ghirardello A, et al. Anti-heart and anti-intercalated disk autoantibodies: evidence for autoimmunity in idiopathic recurrent acute pericarditis.Heart 2010; 96:779-784. Lago F, Dieguez C, Gόmez-Reino J, Gualillo O. Adipokines as emerging mediators of immune response and inflammation. Nat Clin Pract Rheumatol 2007; 3:716-24. Lago F, Gόmez R, Conde J, Scotece M, Gόmez-Reino JJ, Gualillo O. Cardiometabolic comorbidities and rheumatic diseases: focus on the role of fat mass and adipokines. Arthritis Care Res (Hoboken) 2011; 63:1083-90. Disclosure of Interest None Declared

Pulsed signal therapy (PST) is an extension of pulsed electromagnetic fields (PEMF) therapy. PEMF have been used widely to treat non-healing fractures and related problems in bone healing since approval by the Food and Drug Administration in 1979.1,2 Recently, PEMF therapy has been used to treat patients with osteoarthritis (OA) of the knee and cervical spine, with encouraging results.3,4 In vitro studies have also shown a stimulating activity of PEMF on cartilaginous metabolism.5 PST, in contrast with PEMF, uses specific physiological changing rectangular pulses as stimuli, which are transmitted in a programmed alternating fashion that mimics the body’s natural streaming potentials for one hour of treatment. We studied the effects of PST on human OA chondrocytes cultivated in the presence and absence of a negative stimulus represented by interleukin 1β (IL1β) and we evaluated the concentration of proteoglycans (PGs) in the culture medium and the morphology of the chondrocytes after exposure to PST. Human OA chondrocytes were cultivated in alginate gel on Petri dishes for 72 hours with and without IL1β …