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BackgroundThere is increasing interest in discontinuing biological therapies for patients with rheumatoid arthritis (RA) achieving good clinical responses, provided patients maintain clinical benefit.MethodsWe assessed patients with RA from the Corrona registry who discontinued treatment with their first tumour necrosis factor inhibitor (TNFi) while in low-disease activity (LDA) or lower levels of disease activity. Patients were followed until they lost clinical benefit, defined as increased disease activity or change in RA medications. Duration of maintenance of clinical benefit was estimated using the Kaplan–Meier method. Cox proportional hazard models were assessed to identify factors related to maintenance of benefit.ResultsWe identified 717 eligible patients with RA from 35 656 in the Corrona registry. At discontinuation, patients had a median RA duration of 8 years, mean clinical disease activity score of 4.3±0.11; 41.8% were using TNFi as monotherapy. 73.4% of patients maintained benefit for >12 months after discontinuing therapy and 42.2% did so through 24 months. Factors predictive of maintaining clinical benefit in multivariate analysis included lower disease activity, less pain and better functional status at the time of TNFi discontinuation. Among 301 patients initiating their first TNFi within the registry, faster responders (ie, those who achieved LDA in 4 months or less) did better than slower responders (HR 1.54 (95% CI 1.17 to 2.04)). RA disease duration did not affect maintenance of clinical benefit.ConclusionsDiscontinuation of a first course of TNFi may be associated with persistent clinical benefit. Half of patients maintained response through 20 months. Several patient characteristics may help predict persistent benefit.

BackgroundCardiovascular (CV) risk stratification for patients with rheumatoid arthritis (RA) should facilitate evidence-based management. Prior work has derived an internally validated a CV risk score, the Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis (ERS-RA), using US data. The aim of this study was to perform an external validation among unselected patients with RA from Europe.MethodsThree large, partially overlapping, cohorts of patients with RA from the Swedish Rheumatology Quality register were identified for external validation, two with information on smoking and two with close to 10 years of median follow-up. The 10 -year rate of first CV events was assessed using the Kaplan-Meier method. The performance of ERS-RA was assessed using C-index and comparisons of observed versus predicted risks.ResultsThe C-index for ERS-RA varied across the three RA cohorts, from 0.75 to 0.78. Predicted risks corresponded well to observed risks among individuals with ≤10 % observed 10- year CV risk, but underestimated risk in individuals with a higher observed risk. In the absence of data on smoking, ERS-RA underestimated the CV risk by 3.3%, whereas in the cohorts including data on smoking, the calibration was within 1% (0.06% and 0.7%). In the clinically relevant risk intervals (ConclusionsIn an unselected Swedish population with RA, ERS-RA performed well, although the 10-year CV risk was underestimated in high-risk groups and in the absence of data on smoking. ERS-RA could be considered as a risk stratification tool for targeted preventive interventions in clinical rheumatology practice.

Background Psoriatic arthritis (PsA) is a chronic inflammatory condition affecting the skin and joints, and can lead to significant joint damage, disability and reduced quality of life. Disease severity varies among patients and is not well characterized in a real world setting. Objectives To characterize the PsA patients by skin severity (defined by body surface area, BSA) and joint (defined by modified disease activity score, mDAS) in the Corrona PsA/Spondyloarthritis (SpA) registry, a large cohort of PsA-SpA patients in the US. Methods PsA patients enrolled in the registry between 4/2013 and 7/2015 were included. Patients were categorized by the level of skin involvement measured by BSA (low:BSA≤3%; moderate: BSA>3% & BSA≤10%; high:>10%) and joint severity as measured by mDAS (low:mDAS≤2.7; moderate:mDAS>2.7 & mDAS≤4.1 & high:mDAS>4.1). Patient characteristics at registry enrollment and biologic use were evaluated and one-way analysis of variance/Chi-square tests were used for continuous and categorical variables to evaluate differences. Results 1613 PsA patients were included, of which 1281 were categorized by BSA severity (low=64%, moderate=22%, high=14%) and 1331 by mDAS severity (low=21%, moderate=53%, high=26%). Overall, there were 53% females, mean (SD) age of 54 (13) yrs, mean (SD) disease duration of 12 (10) yrs. Majority of patients were referred by a primary care provider (40%) followed by self-referral (23%) or a rheumatologist (19%); 5% were referred by a dermatologist. Presence of dactylitis (10%, 13% and 22% in low, moderate and high resp.), and enthesitis (18%, 23% and 40% in low moderate and high resp.) were highly correlated with mDAS categories (p Conclusions Majority of PsA patients present to the rheumatologist with moderate/severe joint symptoms and mild skin symptoms, and are primarily referred by PCPs, self-referred, or other rheumatologists. mDAS severity was correlated with presence of dactylitis/enthesitis and the number of enthesitis sites. The majority of PsA patients (60%) were treated with biologic agents regardless of joint or skin severity; however over 90% of patients with high joint or skin severity were treated with biologic therapy. Acknowledgement This study is sponsored by Corrona, LLC. Initial funding for the Corrona SpA registry was provided by AbbVie. In the last two years, AbbVie, Amgen, BMS, Crescendo, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB have supported Corrona LLC. through contracted subscriptions. Disclosure of Interest P. Mease Grant/research support from: Celgene, Novartis, Abbvie, Amgen, BMS, Janssen, Lilly, Pfizer, UCB, Consultant for: Celgene, Corrona, Merck, Novartis, Abbvie, Amgen, BMS, Crescendo, Genentech, Janssen, Lilly, Merck, Pfizer, UCB, Speakers bureau: Abbvie, Amgen, BMS, Crescendo, Genentech, Janssen, Lilly, Novartis, Pfizer, UCB, M. Skup Shareholder of: AbbVie, Inc., Employee of: AbbVie, Inc., C. Karki Employee of: Corrona, LLC, C. Etzel Consultant for: Merk, Employee of: Corrona, LLC, W. Malley Employee of: Corrona, LLC, Paid instructor for: Lamar University, J. Greenberg Shareholder of: Corrona, LLC, Consultant for: AstraZeneca, Celgene, Genentech, Janssen, Novartis and Pfizer, Employee of: Corrona, LLC, A. Joshi Shareholder of: AbbVie, Inc., Employee of: AbbVie, Inc.

Background The treatment goal for patients (pts) with psoriatic arthritis (PsA) is to suppress disease activity. Little is known about clinical outcomes in pts who stop TNFi therapy after achieving low disease activity (LDA) during routine care. Objectives We evaluated time to rebound (i.e., increase in joint symptoms after therapy discontinuation) in pts with PsA who achieved LDA prior to stopping TNFi therapy as well as changes in measures of disease activity at the first visit following TNFi discontinuation. Methods In the Corrona registry, we identified pts with PsA who initiated a TNFi (adalimumab, etanercept, infliximab, golimumab), achieved LDA based on Clinical Disease Activity Index (CDAI) ≤10 on TNFi therapy, discontinued TNFi altogether while still in LDA (persistence on conventional disease modifying medication was allowed) and had at least 1 follow-up visit while off TNFi. Demographic and clinical characteristics were assessed at discontinuation date (index date). To assess time to rebound, pts were followed until earliest of the following events: rebound of symptoms (CDAI >10), initiation of another biologic/small molecule or last follow-up visit. Kaplan-Meier curves were generated for time to rebound (CDAI >10). To assess impact of TNFi discontinuation, change in disease activity measures including CDAI, modified Health Assessment Questionnaire (mHAQ), pt and physician global assessments, and pt pain were assessed between discontinuation and first post-index visit. Results There were 94 pts (57% female, 51% biologic-experienced at TNFi initiation) who met study criteria. At TNFi discontinuation, mean (standard deviation [SD]) age and disease duration were 52.6 (12.7) and 9.8 (7.4) years, respectively. Over time, 67 (73%) pts had a rebound in symptoms, with median time to rebound of 8 months (95% CI 6–12). At first post-index visit, there was a significant mean increase in all measures of disease activity except mHAQ (Table). Conclusions Rebound of symptoms in PsA patients occurred frequently with the majority of patients having worsening of disease activity by the next visit after TNFi discontinuation. These results suggest careful consideration before stopping these agents after achievement of low disease activity. Acknowledgement This study is sponsored by Corrona, LLC. The Corrona RA registry has been supported through contracted subscriptions in the last two years by AbbVie, Amgen, BMS, Crescendo, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB. Disclosure of Interest L. Harrold Grant/research support from: Pfizer and Astra Zeneca, Consultant for: Genentech and Pfizer, Employee of: Corrona, LLC, B. Stolshek Shareholder of: Amgen, Inc., Employee of: Amgen, Inc., S. Rebello Employee of: Corrona, LLC, D. Collier Shareholder of: Amgen, Inc., Employee of: Amgen, Inc., A. Mutebi Employee of: Amgen, Inc., S. Wade Consultant for: Amgen, Inc., W. Malley Employee of: Corrona, LLC, Paid instructor for: Lamar University, J. Greenberg Shareholder of: Corrona, LLC, Consultant for: AstraZeneca, Celgene, Genentech, Janssen, Novartis and Pfizer, Employee of: Corrona, LLC, C. Etzel Consultant for: Merck, Employee of: Corrona, LLC

Background While some treatment options for psoriatic arthritis (PsA) are similar to those initially developed for rheumatoid arthritis (RA), their introduction to the clinic has generally increased in the recent years. Also, there has been a perception among some that RA is perhaps associated with greater disease burden compared to PsA. Objectives The objective of this study was to determine and compare the disease activity related to peripheral arthritis and biologic use in patients with RA and PsA over the past 10 years in Corrona registry. Methods All patients between 01/2002 – 03/2013 were included and patients were grouped in 2 year intervals 2002–2003, 2004–2005, 2006–2007, 2008–2009, 2010–2011, 2012–2013. Within each time period, standardized differences were used to identify patient characteristics that were different between PsA and RA patients. Logistic regression models evaluated the likelihood of being in moderate/high clinical disease activity index (CDAI) and use of biologics in PsA patients compared to patients with RA, adjusting for covariates within each time period. Random effects logistic regression models were also considered to account for site random effects. Results A total of 20982 and 2552 RA and PsA patients respectively were studied over the six time intervals. The mean age was 59 yrs and 53 yrs for RA and PsA patients respectively. Mean CDAI and percentage of patients in moderate/severe disease activity were significantly higher in RA and PsA over the years; disease activity generally decreased over time for both (Figure). History of biologic use was similar between the two groups in 2002–03 (44% in RA vs 42.5% in PsA), however there was an upward trend in biologic use in both groups with higher use among PsA patients over the past years (figure). Similarly current biologic use also increased from 36.3% vs 36.1% in RA vs PsA in 2002–03 to 52.1% vs 62% in 2012–2013 respectively. Adjusted models showed that PsA patients were significantly less likely to be in moderate/severe disease activity defined by CDAI (OR (95% CI): 0.79 (0.72, 0.88)) over the past years and more likely to be on a biologic compared to RA patients in 2012–13 (Odds ratio (95% CI): 1.37 (1.25, 1.49)). Conclusions Although disease activity has generally decreased while biologic therapy use has increased over recent years, there continues to be a significant proportion of PsA and RA patients with moderate/severe disease. Joint burden among PsA patients is slightly lower in comparison to RA, although biologic use was higher in the PsA population. Future research should evaluate the correlation in disease activity and biologic use over time. Acknowledgement This study is sponsored by Corrona, LLC. The Corrona, LLC. RA registry has been supported through contracted subscriptions in the last two years by AbbVie, Amgen, Astra Zeneca, BMS, Crescendo, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB. The design, study conduct, and financial support for the study was provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the abstract. Disclosure of Interest A. Kavanaugh Grant/research support from: Amgen Abbvie Jannsen Pfizer Novartis, J. Griffith Shareholder of: AbbVie, Inc., Employee of: AbbVie, Inc., C. Karki Employee of: Corrona, LLC, C. Etzel Consultant for: Merk, Employee of: Corrona, LLC, J. Kremer Shareholder of: Corrona, LLC, Consultant for: AbbVie, Amgen, BMS, Genentech, GSK, Lilly, Medimmune, Pfizer, Sanofi, Employee of: Corrona, LLC, Speakers bureau: Genentech (for non-branded talk only), J. Greenberg Shareholder of: Corrona, LLC, Consultant for: AstraZeneca, Celgene, Genentech, Janssen, Novartis and Pfizer, Employee of: Corrona, LLC, A. Ganguli Shareholder of: AbbVie, Inc., Employee of: AbbVie, Inc.

Background Rheumatoid arthritis is a chronic illness associated with pain and disability making it difficult to function. Objectives This study proposes to characterize baseline quality of life in biologic naive rheumatoid arthritis (RA) patients just prior initiation of their first biologic. Methods Biologics naive RA patients who initiated their first biologic (abatacept, TNFi and non-TNF biologic) or small molecule between 12/2005 and 08/2014 within the Corrona, LLC registry were identified. Initiation of first biologic or small molecule (first line use) was defined as first indication of biologic use for a patient that was previously naive to any biologic or small molecule prior to initiation of study drug. Baseline characteristics at the time of biologic initiation were captured including demographics, clinical disease activity index (CDAI), patient global assessment, patient pain, functional status (using the modified Health Assessment Questionnaire [mHAQ]), as well as ambulation, self-care, performance of usual activities, and feeling anxious/depressed based on the EQ5-D. The impact of RA was assessed overall and by medication type. Specifically descriptive statistics were performed including t-tests and Chi-square tests comparing abatacept initiators to TNFi initiators and initiators of other non-TNF biologics and small molecules (non-TNFi/sm). Results Among 4,232 first time biologic users, 364 (9%) initiated abatacept, 3689 (87%) TNFi, and 179 (4%) other non-TNFi/sm. Abatacept initiators as compared to TNFi initiators were more likely to be older (62.8 years vs. 56 years; P Conclusions Most RA patients at the time of their first biologic initiation were substantially impacted by their arthritis in terms of pain, fatigue, functional status and ability to perform usual activities and walking. This was despite the majority of patients receiving nonbiologic disease modifying anti-rheumatic drugs. There were no substantial differences based on the type of biologic/small molecule medication initiated. Acknowledgements This study is sponsored by Corrona, LLC. The Corrona RA registry has been supported through contracted subscriptions in the last two years by AbbVie, Amgen, Astra Zeneca, BMS, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB. Disclosure of Interest L. Harrold Grant/research support from: Corrona, LLC., K. Gandhi Employee of: Bristol-Myers Squibb, C. Etzel Employee of: Corrona, LLC., A. Nadkarni Employee of: Bristol-Myers Squibb, K. Saunders Employee of: Corrona, LLC., S. Kelly Employee of: Bristol-Myers Squibb, J. Greenberg Shareholder of: Corrona, LLC., Consultant for: AstraZeneca, Celgene, Novartis and Pfizer, Employee of: Corrona, LLC.

Background The spondyloarthritides (SpA), such as ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are a group of rheumatologic diseases with shared genetic, pathophysiologic and clinical elements now known to be more prevalent than rheumatoid arthritis (RA). Disease characteristics and outcomes are less well studied than RA. Corrona has investigated over 4000 pts with PsA since 2003. The Corrona SpA registry was launched on 3/21/2013 to include all SpA including AS and other forms of axial and peripheral SpA and more deeply investigate PsA. Enrollment and 6 monthly follow-up data is ongoing. Objectives The purpose of this analysis is to provide a profile of the demographic and clinical characteristics of the initial patients in this US registry population. The registry will be a rich resource for outcomes research as follow-up time is accrued. Methods Thus far, 35 of the Corrona investigative sites have been trained to enroll, representing a diverse geographic and private/academic mix. Data at time of enrollment into the registry for a subset of 1411 patients enrolled between 3/21/2013 and 10/17/2014 are presented in this abstract. Data are gathered on demographics, clinical characteristics, referral source, disease activity, function, quality of life, work productivity, comorbid conditions, previous and current treatments, laboratory tests, and imaging. Results Sixty-nine percent (969/1411) of the patients enrolled in the PsA/SpA registry since 3/13 have a diagnosis of PsA. Median age among all subjects is 53 years. Forty-nine percent of all subjects are female (52% in PsA and 45% in SpA patients) and 51% are obese (BMI >30, as calculated by physician reported height and weight). One-tenth of the subjects have a history of iritis/uveitis, 6% have a history of IBD, but Conclusions The registry has enrolled a growing number of patients with all forms of SpA. Biologic monotherapy use is common among patients with a diagnosis of PsA or SpA. Detailed data on disease characteristics, natural history, treatment and safety outcomes will be presented. Acknowledgements This study is sponsored by Corrona, LLC. Initial funding for the Corrona SpA registry was provided by AbbVie. In the last two years, AbbVie, Amgen, Astra Zeneca, BMS, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB have supported Corrona LLC. through contracted subscriptions. Disclosure of Interest P. Mease Grant/research support from: Celgene, Merck, Novartis, Abbvie, Amgen, BiogenIdec, BMS, Genentech, Janssen, Lilly, Pfizer, UCB, Consultant for: Celgene, Merck, Novartis, Abbvie, Amgen, BiogenIdec, BMS, Crescendo, Genentech, Janssen, Lilly, Merck, Pfizer, UCB, Vertex, Speakers bureau: Abbvie, Amgen, BiogenIdec, BMS, Crescendo, Genentech, Janssen, Lilly, Pfizer, UCB, C. Etzel Employee of: Corrona, LLC., J. Kremer Shareholder of: Corrona, LLC., Consultant for: AbbVie, Amgen, BMS, Genentech, Lilly, Pfizer, Employee of: Corrona, LLC., S. Deveikis Employee of: Corrona, LLC., Y. Li: None declared, J. O9Connor Employee of: Corrona, LLC., A. Kavanaugh Grant/research support from: AbbVie, Amgen, Janssen, L.P., UCB, E. Ruderman Consultant for: Corrona, LLC., J. Curtis Grant/research support from: Roche/Genentech, UCB, Janssen, Corrona, Amgen, Pfizer, BMS, Crescendo, Abb Vie, Consultant for: Roche/Genentech, UCB, Janssen, Corrona, Amgen, Pfizer, BMS, Crescendo, Abb Vie, C. Ritchlin Grant/research support from: Amgen, Janssen, and UCB, Consultant for: Abbvie, Amgen, Janssen, Regeneron, and UCB, D. van der Heijde Consultant for: AbbVie, Amgen, AstraZeneca, Augurex, BMS, Celgene, Centocor, Chugai, Covagen, Daiichi, Eli-Lilly, Galapagos, GSK, Janssen, Merk, Novartis, Novo-Norodisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Shering-Plough, UCB, Vertex, D. Solomon Consultant for: Amgen, Lilly and Corrona, J. Greenberg Shareholder of: Corrona, LLC., Consultant for: AstraZeneca, Celgene, Novartis and Pfizer, Employee of: Corrona, LLC.

Background There are limited data describing patterns of discontinuations of biologic therapy for rheumatoid arthritis (RA) in real-world settings. Such information could help clinicians understand real-life treatment patterns and serve as a marker of effectiveness to help inform decisions. Objectives To describe the patterns and reasons for discontinuation of biologics within 1 year after initiation of treatment in the Corrona C omparative E ffectiveness R egistry to study T herapies for A rthritis and I nflammatory Co n ditions (CERTAIN) study. Methods CERTAIN is a prospective, nonrandomized, comparative effectiveness cohort study nested within the US Corrona registry and included adult patients with RA who have at least moderate disease activity (Clinical Disease Activity Index >10) and are starting or switching biologics.1 This descriptive study included all patients who initiated a biologic in CERTAIN and discontinued the biologic or switched to a different biologic before their 12-month follow-up visit. Reasons for discontinuation were evaluated based on physician's report and categorized as efficacy reasons, safety reasons, both and other reasons unrelated to safety or efficacy. Results A total of 2361 patients enrolled in CERTAIN contributed 2809 all-biologic initiations to this analysis, which included 1670 anti–tumor necrosis factor agents (aTNFs) and 1139 non-aTNFs. At the time of the analysis, data were available for 1174 biologic initiations from patients who completed CERTAIN, with 344 initiations still in follow up. Baseline characteristics at the time of biologic initiation were as follows: median age, 57 years; female, 79%; median RA duration, 5 years; and rheumatoid factor (RF) and/or anti-cyclic citrullinated peptide (ACCP) antibody seropositivity, 68%. After excluding those initiations still in follow up, 909 of 2465 initiations (37%) resulted in a discontinuation within 12 months, with reasons for discontinuation available for 635 patients (70%; [Table][1]). A higher proportion of biologics were discontinued by the 3-month follow-up visit due to safety reasons, while a higher proportion of initiations were discontinued after the 3-month follow-up visit due to efficacy reasons ( P

Background There is limited evidence comparing the types of patients initiated on different classes of biologic medications, and this information is critical when conducting comparative observational research among patients with RA. Objectives This study compared baseline characteristics of biologic naive rheumatoid arthritis (RA) patients initiating abatacept as compared to tumor necrosis factor inhibitors (TNFi), and other non-TNFi biologics and small molecules (non-TNFi/sm). Methods Biologics naive RA patients who initiated abatacept, TNFi and other non-TNFi/sm from 12/2005 to 8/2014 within the Corrona registry were identified. Initiation of first biologic or small molecule (first line use) was defined as first indication of biologic use for a patient that was previously naive to any biologic or small molecule prior to initiation of study drug. Baseline characteristics at time of biologic initiation were captured including demographics, comorbid conditions, and RA disease characteristics including age at disease onset, disease duration, prior and concomitant medication use, and disease activity. Descriptive statistics were performed including t-tests and Chi-square tests comparing abatacept initiators to TNFi and other non-TNFi/sm initiators. Results Among the 4,232 first time biologic users, 364 (9%) initiated abatacept, 3689 (87%) TNFi, and 179 (4%) other non-TNFi/sm. Abatacept initiators as compared to TNFi initiators were more likely to be older (62.8 years (yrs) vs 56 yrs; P Conclusions In a real world national cohort of biologic naive RA patients, those initiated on abatacept had a different profile than those initiating TNFi and non-TNFi/sm. Specifically abatacept users were older at the time of biologic/small molecule initiation, had onset of RA at an older age, and were more frequently using concomitant non-MTX nbDMARDS. Additionally abatacept initiators had a longer disease duration as compared to TNFi initiators. These findings are consistent with data from real-world registries in the US and Europe. Acknowledgements This study is sponsored by Corrona, LLC. The Corrona RA registry has been supported through contracted subscriptions in the last two years by AbbVie, Amgen, Astra Zeneca, BMS, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB. Disclosure of Interest L. Harrold Grant/research support from: Corrona, LLC., K. Gandhi Employee of: Bristol-Myers Squibb, C. Etzel Employee of: Corrona, LLC., A. Nadkarni Employee of: Bristol-Myers Squibb, K. Saunders Employee of: Corrona, LLC., S. Kelly Employee of: Bristol-Myers Squibb, J. Kremer Shareholder of: Corrona, LLC., Consultant for: AbbVie, Amgen, BMS, Genentech, Lilly, Pfizer, Employee of: Corrona, LLC.

Objectives Using a national registry of gout patients cared for by rheumatologists, we sought to characterize the differences between women and men with gout, in terms of predisposing factors, comorbid conditions, and treatments, in order to tailor and improve gout care to both sexes. Methods Rheumatologists participating in the Consortium of Rheumatology Researchers of North America (CORRONA) registry agreed to enroll their gout patients regardless of gender, disease severity, disease activity or medication use. All patients enrolled between 11/1/12 and 12/11/13 were included in the current study. Data gathered from patients and their rheumatologists at study enrollment included demographics, predisposing factors (comorbid conditions, medications, diet), gout disease characteristics, current treatments, and physical exam findings. Results Fifty-four rheumatologists enrolled 239 women and 928 men with gout. Women were older (71 vs. 61 years, p Conclusions Women with gout more frequently were receiving predisposing medications, and had gout-associated comorbidities and/or contraindications to NSAIDs and colchicine, while men more commonly had dietary risk factors. Physicians should be aware of these differences, in order to tailor their treatment recommendations, to ensure all patients achieve optimal disease control. Acknowledgements This study is sponsored by CORRONA. Initial funding for the CORRONA Gout registry was provided by Savient Pharmaceuticals, Inc. In the last two years, AbbVie, Amgen, AstraZeneca, Genentech, Horizon Pharma, Lilly, Novartis, Pfizer, Savient, Vertex, and UCB have supported CORRONA through contracted subscriptions. Disclosure of Interest L. Harrold Grant/research support: Takeda and AstraZeneca, Consultant for: CORRONA, Inc., C. Etzel Employee of: CORRONA, Inc., A. Gibofsky Shareholder of: AbbVie, Amgen, BMS, GlaxoSmithKline, Johnson&Johnson, Pfizer, Roche (Genentech), Consultant for: AbbVie, Amgen, AstraZeneca, Celgene, Horizon, Iroko, Pfizer, Roche (Genentech), UCB, Takeda, Antares, Speakers bureau: Abbvie, Amgen, Pfizer, Roche (Genentech), UCB, J. Kremer Shareholder of: CORRONA, Inc., Employee of: CORRONA, Inc., M. Pillinger Grant/research support: Takeda, Savient, K. Saag Grant/research support: Takeda, Ardea, Consultant for: Takeda, Ardea, N. Schlesinger Grant/research support: Novartis, Consultant for: Novartis, Sobi, Speakers bureau: Novartis, Takeda, Savient, R. Terkeltaub Grant/research support: VA Research Service, Consultant for: Takeda, Savient, ARDEA, BioCryst, Novartis, Regeneron, Sobi, Pfizer, AbbVie, V. Cox Employee of: CORRONA, Inc., J. Greenberg Shareholder of: CORRONA, Inc., Consultant for: AstraZeneca and Pfizer, Employee of: CORRONA, Inc. DOI 10.1136/annrheumdis-2014-eular.2486

Background The incidence of lymphoma is increased in patients with rheumatoid arthritis. There is controversy; however, regarding whether disease activity influences the incidence of lymphoma in this disease. Likewise, the effect of TNFi on the incidence of lymphomas in RA is unclear. We examined the effect of disease activity and the use of TNFi on the incidence of lymphomas in the CORRONA Registry. Methods Patients: All RA CORRONA patients were included who: 1) were on a TNFi or non-biologic DMARD (nbDMARD) at time of enrollment, (2) had available clinical disease activity index (CDAI) at the time of enrollment and (3) had at least one follow-up visit. If a patient switched among treatment groups (nbDMARD to TNFi), then time within each drug group was accounted for in the analyses. Outcomes: The incidence of MD reported lymphomas was the primary outcome. Analysis: Average CDAI was calculated as the area under the curve (AUC) during the period of follow-up. Additional variables examined included: age, gender, education, smoking, BMI, disease duration, RF/CCP status, erosions, other nbDMARD use (among TNFi group), prednisone, comorbid conditions and family history of cancer/lymphoma. In addition to descriptive statistics, lymphoma incidence rate per 100 person years was calculated. The Kaplan-Meier method estimated time to first lymphoma and the proportion of lymphoma events after drug initiation. As sensitivity analysis we used modified DAS28 for the CDAI. Results As of 3/4/13, 19,608 RA patients met the study inclusion criteria: 7729 (37.8%) used TNFi and 11879 (58.1%) used nbDMARD start of follow-up period. TNFi users had more severe disease at baseline (erosions: 52.3% versus 41%; p MD reported lymphomas were rare (67 lymphomas/60145 patient years=0.11/100 person years), resulting in very wide confidence intervals by disease activity (Table 1). Compared to nbDMARD the rate of incident lymphomas in TNFi users was 1.08 (0.93-1.25) using CDAI or mDAS (p=NS for both). Conclusions In the CORRONA database of 19608 RA patients neither disease activity nor use of TNFi affected the incidence of lymphomas over 3.1 years. Acknowledgements The CORRONA RA registry has been supported through contracted subscriptions in the last two years by Abbvie, Amgen, AstraZeneca, Genentech, Horizon Pharma, Eli Lilly, Novartis, Pfizer, Vertex and UCB. Disclosure of Interest D. Furst Grant/research support: AbbVie,Actelion, Amgen, BMS, Gilead, GSK, NIH, Novartis, Pfizer, Roche/Genentech, UCB, Consultant for: AbbVie, Actelion, Amgen, BMS, Janssen, Gilead, GSK, NIH, Novartis, Pfizer, Roche/Genentech, UCB, Speakers bureau: Abbvie, Actelion, UCB (CME ONLY), V. Cox Employee of: CORRONA, Inc., C. Etzel Employee of: CORRONA, Inc., J. Greenberg Shareholder of: CORRONA, Inc., Consultant for: AstraZeneca, Pfizer, Employee of: CORRONA, Inc., D. Collier Shareholder of: Amgen, Employee of: Amgen DOI 10.1136/annrheumdis-2014-eular.2064

Background Anti-citrullinated peptide antibodies (ACPA) have been considered a relatively specific marker for rheumatoid arthritis (RA), and may play a role in its pathophysiology. ACPA has been found at a greater prevalence among PsA patients (approximately 8% or more) 1 than in the general population. Also, ACPA have been isolated from the synovial fluid of PsA patients 2 . Several reports have suggested that PsA patients with positive ACPA may have greater swollen/tender joint counts with more deformities than ACPA negative PsA patients 3,4,5 ;other studies have suggested no difference 1,6 . Objectives To determine what clinical features differ between ACPA (+) and ACPA (-) PsA patients. Methods A cross sectional study of patients with physician diagnosed PsA in the CORRONA database, a large national registry of patients with RA and PsA. ACPA (+) and ACPA (-) PsA patients were evaluated for differences in disease activity, disease severity and immunomodulatory medication use. Evaluations included: tender joint count, swollen joint count, HAQ, patient global assessment, physician global assessment, DAS 28, CDAI, presence of enthesitis, presence of dactylitis, skin psoriasis activity, presence of Sjogrens symptoms, and radiographic changes (defined by presence or absence of erosions, joint space narrowing and joint deformity). ACPA (+) and ACPA (-) groups were also assessed for the presence of rheumatoid factor (RF) and repeat analysis was done to determine if RF presence contributed to any differences. Statistical methods included Pearson’s-chi-square test, Fisher’s exact test and one way ANOVA. Results Through 2012, a total of 5363 PsA patients were identified in the CORRONA database. 17.7% of the PsA patients had test results for ACPA: 842 were ACPA (-) and 116 ACPA (+). There was no significant differences in any measures of disease activity or disease severity (including radiographic changes) or the use of immunomodulatory medications between ACPA (+) and ACPA (-) patients. Further stratification into subgroups based upon the presence of RF did not reveal any clinically important differences. Image/graph Conclusions In a large cohort of PsA patients in clinical practice, there were no differences in disease activity, disease severity (including radiographic changes) or the use of immunomodulatory medications between ACPA (+) and ACPA (-) PsA patients. The data suggest that different than for RA, the presence of ACPA(+) may represent only an epiphenomenon in PsA. References Ann Rheum Dis . 2005; 64:1145. Clin Exp Rheum. 2007; 25(4): 599 J Rheum . 2005; 32: 511. BMC Res Not. 2009; 2: 44. Rheum (ox) 2005; 44:1056. Ann Rheum Dis . 2006; 65: 398. Disclosure of Interest D. Huynh: None Declared, C. Etzel Employee of: Corrona, V. Cox Employee of: Corrona, J. Kremer Shareholder of: Corrona, Employee of: Corrona, J. Greenberg Shareholder of: Corrona, Consultant for: Astra Zeneca, Novartis, Pfizer and Corrona, A. Kavanaugh: None Declared