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Background Antiphospholipid syndrome (APS) is an autoimmune disease defined as the presence of antiphospholipid antibodies (aPL), at least a clinical thrombotic event and is associated with an important risk of organ damage. The new index proposed, Damage Index in patients with Thrombotic Antiphospholipid Syndrome (DIAPS) may be an useful tool to estimate cumulative damage in patients with primary and secondary APS. It includes 38 clinical items expanded to show the complexity of clinical manifestations in APS patients. Objectives The aim of this study is to analyze the serological pattern as potential predictive factor for an increased DIAPS. Methods All consecutive patients known with APS according to the Sapporo and/or Sydney classification criteria were included in our monocentric cohort. Data on medical history, clinical manifestations, aPL profile and medication were collected. DIAPS score was used to measure damage in each patient. The relationship between aPL profile and DIAPS score was analysed. Results Seventy six patients with APS were included: 11 patients with primary APS, 65 patients with secondary APS. Their mean disease duration was 9.59±7.39years. The most frequent clinical manifestation from DIAPS was the peripheral vascular (deep vein thrombosis, intermittent claudication, tissue loss, vascular venous insufficiency) found in 61.8% of patients, followed by the neuropsychiatric manifestations (46.1%). The mean DIAPS score in our cohort was 4.25±3.51, not significantly different between patients with primary vs secondary APS (4.72 vs 4.16, p=0.629). Lupus anticoagulant (LA) was found in 25 patiens (32.9%), anti cardiolipin antibodies (aCL) in 49 patients (64.5%) and antibodies to β2-glycoprotein I (β2GPI) in 23 patients (30.3%). There were 36 patients known with a single positive aPL (47.4%), 27 patients (35.5%)with 2 positive aPL and only 2 patients with triple positivity. There were no significant differences regarding antibody profile between patients with primary and secondary APS. Higher values of DIAPS were seen in patients with β2GPI (p=0.042) and with positivity for 2 aPL (p=0.003). DIAPS value correlated to the presence of β 2GPI (p=0.042, R=0.233) and to positivity for two aPL (p=0.003, R=0.341). Conclusions Our study suggests that double positivity for aPL, especially the presence of β2GPI confers an increased value of DIAPS in patients with primary and secondary APS. References M-C Amigo et al. Development and initial validation of a damage index (DIAPS) in patients with thrombotic antiphospholipid syndrome (APS). Lupus (2015) 24, 927–934. LM Amezcua-Guerra. Improving definitions for an index of cumulative organ damage in patients with the antiphospholipid syndrome (DIAPS). Lupus (2016) 25, 671–672. Disclosure of Interest None declared

Background The Quality of life (QoL) in patients with SLE is deeply affected by multiple factors including psychological and physical factors, the functional status and the general perception over health. Objectives Evaluation of Quality of life and the perceptions over the disease in patients with SLE.functional status and the general perception over health. Methods This is a 10 month prospective, cross-sectional study performed on 52 patients hospitalized diagnosed with SLE according to SLICC 2012 criteria. There were evaluated demographic data, organs manifestations, disease activity scores (SLEDAI, SLICC) and treatment. To evaluate the QoL several questionnaires were performed: Health Assessment Questionnaire (HAQ), EuroQol five dimensions questionnaire (EQ5d), Illness Perception Questionnaire and SF-36. Results All patients were women with the mean age 49 years with a mean durations of illness 136 month (14). The mean SLEDAI – 5,52 (5,37) and SLICC – 2,25 (1,71). The mean HAQ value was 0,83 (0,81). The HAQ score doesn9t correlate with SLICC (p=0,461) and with SLEDAI (p=0,172), but it was correlated with the neuropsychiatric manifestations. So the psychiatric affectation influences performing the usually daily activities (p=0,005). When assessing Illness Perception Questionnaire, patients considered their life seriously affected by pain, mean value 6,3 (2,6), 72% consider the illness will be present for the rest of their lives, 90% appreciate that treatment is improving the QoL mean 9,3 (1,3), 68% consider to have many severe symptoms, more than 80% patients consider themselves preoccupied for their illness, more than 70% are emotionally affected by their illness and 48% consider stress being the main determinant factor of their illness. Questionnaire EQ-5d: 10% must stay in bed due to the disease, 8,33% can not wash or dress themselves, 12,5% are unable to perform usual daily activities, 62% experience pain or a moderate uncomfortable state and 65% are worried and or depressed. Cardio-vascular manifestations are correlated with diminished mobility (p=0,002) leading to deficiency in self care (p=0,002)also correlated with renal (p=0,034) and psychiatric (p=0,022) manifestations. Psychiatric manifestations also affect usual daily activities (p=0,05). Age is correlated with pain and uncomfortable state (p=0,004) but the responses to this item of EQ5D are not correlated with organ affectation, biological modification or disease activity scores. The presence of cutaneous manifestations is correlated with anxiety and depression (p=0,02). Based on SF36 when calculating the mean value on each category was observed all the 8 categories affected - smallest values at physical role (37,32) and general health (34,21), less influenced part being the social function (51,32).None of this items of SF 36 is correlated with SLICC or SLEDAI. Conclusions SLEDAI as well as SLICC or specific organ involvement give no indications over the patients QoL, which must be assessed by performing HAQ and SF 36. References Lupus. 2016 Mar 16. pii: 0961203316638934. [Epub ahead of print]Gender differences in systemic lupus erythematosus concerning anxiety, depression and quality of life.Macedo EA1, Appenzeller S2, Costallat LT2. Disclosure of Interest None declared

Background Ankylosing spondylitis (AS) represents a considerable socioeconomic burden due to early disease onset, development of functional disability and life-time costs. The impact of originator adalimumab on the extent of outpatient attendance, hospitalizations and sick leave in relation to clinical outcomes is not known in Central and Eastern Europe (CEE). Objectives To evaluate disease activity, physical function, selected health care resource utilization and sick leaves in patients treated with adalimumab in clinical practice in CEE countries. Methods This was a 52-week multi-center post-marketing observational study conducted in 5 countries in CEE. Eligible AS patients were prescribed originator adalimumab according to the local practice; 5 study visits (V) were performed approx. 3 months apart. Disease activity was measured by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Index (ASDASCRP), treatment response as BASDAI50 and ΔASDAS≥-2 (at study end), physical function by Bath Ankylosing Spondylitis Functional Index (BASFI). Data on AS related healthcare resource utilization and sick leave during the study was recorded prospectively through a systematic interview with the patient at each study visit. For pre-and post-treatment comparison, the same sort of data were recorded retrospectively at baseline visit for the 3-month period preceding adalimumab therapy, verified against chart review, then multiplied by 4 to match the prospective follow-up duration. Descriptive statistics were used; last observation carried forward data are presented herein. Results 452 patients were enrolled, 360 completed the study. Mean age was 42.9 (±12.1) yrs; 68.7% were male and 62.7% were employed at baseline. Average disease duration was 7.7 (±8.7) yrs. Mean BASDAI and ASDAS decreased from 6.3 (±2.1) and 4.0 (±1.1) at baseline to 2.3 (±2.0) and 1.9 (±1.1) at study end, respectively; mean BASFI from 6.2 (±2.3) to 2.6 (±2.3). BASDAI and ASDAS based treatment response was seen at study end in 72.3% and 58.9% of patients, respectively. The mean number of hospital admissions and inpatient days decreased from 2.8 (±3.9) to 0.9 (±2.8) and from 23.0 (±40.8) to 3.9 (±17.7), respectively (pre- and post-treatment). The mean number of sick leaves and sick leave days decreased from 3.2 (±8.8) to 1.1 (±5.6) and from 32.2 (±69.2) to 5.1 (±24.5), respectively (employed patients only, n=282). The reduction of hospital admissions/days, sick leaves and sick leave days were higher in treatment responders compared to non-responders. No new safety signal was detected. Conclusions Treatment with adalimumab in routine clinical practice in 5 CEE countries resulted in clinically meaningful improvements in disease activity and physical function as well as reduced healthcare resource utilization and sick leaves. Acknowledgements The design, study conduct, and financial support for the clinical trial were provided by AbbVie. AbbVie participated in the interpretation of data, drafting, review, and approval of the abstract. Disclosure of Interest D. Opris-Belinski Consultant for: Abbvie, BMS, Pfizer, Roche, Teva and consulting fees from Abbvie, BMS, Pfizer, Roche, Teva., S. Erdes Consultant for: Abbvie, MSD, Pfizer, USB, BIOCARD, Gedeon Richter, Dr. Reddy9s, Novartis., S. Grazio Consultant for: Abbvie/Abbott Lab, Roche, MSD, Eli Lilly, Pfizer, Boehringer Ingelheim, Grunenthal, Stada, Sanofi-Aventis, PharmaSwiss, Berlin-Chemie, Pliva/Teva, Belupo, Krka, consulting fees from: Abbvie/Abbott Lab, Roche, MSD, Eli Lilly, Pfizer, Grunenthal, L. Senolt Consultant for: AbbVie, Bristol-Myers Squibb, Celgene Corporation, Eli Lilly, Merck Sharp and Dohme, Novartis, Pfizer, Samsung, Takeda, UCB., M. Hojnik Employee of: AbbVie, O. Nagy Employee of: AbbVie, L. Iosub Employee of: AbbVie, S. Szantό Consultant for: Abbvie, Bristol Myers-Squibb, Novartis, Pfizer, Roche, Teva

Background Behcet9s Disease is a rare type of vasculitis that involves both arterial and venous blood vessels of all sizes. The type of organ involvement and overall disease activity evaluated in the clinical practice determine the course of treatment and the decision to initiate immunosuppression. Activity scores such as Birmingham Vasculitis Activity score (BVASv3), Behcet9s Disease Current Activity Form2006 (BDCAF), or damage indices like Vasculitis Damage Index (VDI) have been developed in this respect. Objectives To evaluate the ability of classical immunosuppressant therapy to prevent damage progression. To find the correlation between disease activity scores: BVASv3, BDCAF, long term treatment, immunosuppressant use and damage after remission, as calculated by VDI. Methods A study on a cohort of patients diagnosed with Behcet9s Disease from an Internal Medicine and Rheumatology Clinic was performed. Activity and damage scores,BVASv3,BDCAF and VDI after obtained remission, were calculated. The documented cases were diagnosed according to the International Criteria for Behcet9s Disease (ICBD).Windows Excel/SPSS20.0 (Spearman9s correlation)were used to analyse the data. Results The study included 16 patients treated with long term cortisone and immunosuppressive therapy. The mean age at the time of the diagnosis was 32.3years with a male predominance 62% (10 patients). Severe systemic involvement was present in 10 cases (Ophthalmological involvement-6cases, recurrent venous thrombosis-6cases, pulmonary vasculitis-1 case, severe cardiac involvement-1case, central nervous system involvement-3cases) and all patients received classical immunosuppression (cyclophosphamide, azathioprine).The mean scores for BVASv3 and BDCAF at the time of the diagnosis were 9 and 4.12.A strong correlation was identified between BVASv3 and BDCAF (r=0.830, p Conclusions Damage progression is influenced by disease activity, as calculated by activity scores (BVASv3 and BDCAF). Classical immunosuppression is used for severe organ involvement and for limiting new organ lesions once started. There was a stronger correlation between long-term cortisone use and VDI than between immunosuppression duration and damage. The damage index increased by irreversible organ damage due to disease activity and long term cortisone use, but not due to the immunosuppressive therapy. References DavatchiF,et al How to deal with Behcet9s disease in daily practice. Int J Rheum Dis. 2010 May. Raashid Ahmed Luqmani Disease assessment in systemic vasculitis. Nephrol Dial Transplant 2015. Acknowledgements The first two authors,Sinziana Daia-Iliescu and Casandra Buzatu contributed equally to this study. Disclosure of Interest None declared