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Background:Axial spondyloarthritis (axSpA) is a common chronic inflammatory disease of the axial skeleton. Some cytokines have important roles in initiation and progression of disease and are elevated in active disease. Additionally, Wnt signaling pathway inhibitors and noggin also appear to be involved in pathogenesis of ankylosing spondylitis. Anti-tumor necrosis factor-alpha (TNF) agents have dramatically improved the clinical outcome of axSpa; however, acceptable clinical improvement is not achieved in all patients and capacity of anti-TNF to slow or prevent structural damage still remains controversial.Objectives:To evaluate the effect of anti-TNF on inflammatory and noninflammatory milieu in patients with axSpA.Methods:In this prospective study we included 30 biologic treatment naive adult patients with axSpA and 30 healthy controls. All patients with high disease activity were treated with anti-TNF therapy for 6 months. Laboratory and clinical evaluation of all patients were performed at baseline and after 6 months of anti-TNF treatment. Following cytokines and wnt/BMP antagonists were measured; TNF-Alpha, COX-2, IL-6, IL-17, IL-22, IL-23, IL-33, dickkopf-1, sclerostin, noggin.Results:The mean age of patients with axSpA and healthy controls were 38.1±13.3 and 37.7±7.7 years, respectively (p>0.005). At baseline, the median (IQR) TNF-alpha was higher in axSpA patients when compared to healthy controls, 34.4 pg/ml (31.4-37.03) vs 18.1 pg/ml (12.1-28.4), (pConclusion:Elevation of some cytokines which are important in pathogenesis of axSpA and nonincrease in noggin with anti-TNF drugs may affect effectiveness of anti-TNF treatment.Table 1.Changes of cytokines, dickkopf-1, sclerostin and noggin with anti-TNF treatment.Pre-Anti-TNFPost-Anti-TNFP valueIL-645(39.1-68.8)47.6(27.3-61.1)0.750IL-1793.3 (85.1-104.8)102.1(86.6-114.6)0.026IL-22159,2 (151,9-178.4)183.5(156.3-304.6)0.033IL-2336.5 (26.1-52.9)41.3(28.4-55.5)0.658IL-33127.8 (106.6-186.1)147.06(128.5-213.4)0.016COX20.176 (0-0.374)0.202(0.051-1.151)0.469TNFalpha34.4(31.4-37.03)30.7(12.8-35.6)0.004Dickkopf-1446.7(356.9-529.3)881.3(663.1-972.2)Sclerostin312.4 (140.8-412.7)405.1(276.3-452.5)0.018Noggin48.3(17.04-153.9)31.2(11.3-103.7)0.264Disclosure of Interests:None declared

Background:Follow-up in all rheumatologic patients is critical, particularly Familial Mediterranean Fever (FMF). Current recommendations for all experts by the EULAR state that patients with FMF should be evaluated 6-monthly intervals to monitore the character and frequency of the attacks and the acute phase response. Disease-related complications such as amyloidosis can beasymptomaticand need only a careful follow-up.Objectives:to quantify this phenomenon and to find predictive factors of visit compliance in patients with FMF.Methods:The study included 474 adult patients with a diagnosis of FMF who followed at the outpatient rheumatology clinic of tertiary university hospital, from January 2018 to December 2018. . Demographic, socioeconomic data, familiy history, comorbid disease, medication history, characteristics, the International Severity Score for FMF (ISSF),autoinflammatory disease damage index (ADDI) were recorded. Visit compliance was defined as the presence of two visits in the outpatient rheumatology clinic for FMF last one year for the purposes set out in EULAR suggestion.Those who had fewer than two visits in the last one year were considered noncompliant.Results:230 (48.5%) were compliant while 244 (51.5 %) patients were noncompliant with their rheumatology visit. Both compliant and noncompliant patients had similar median age and disease duration. Female sex and being married was increased the visit compliance.The results of the logistic regression model exploring factors associated with compliance indicated that presence of family history in parents, absence of family history in sibling, treatment with biologic agents, other drug using,presence of more than 2 attacks except fever and adequate medical care were important predictors of visit compliance.Conclusion:In conclusion, if FMF patients visit compliance increase, their functionality, medication adherence and quality of life will increase and flares and complication of disease can decrease. Thus, we highlight some recommendations for FMF specialist, patients and health care providers to improve outcomes.Table 2.Multivariate logistic regression analysis for predictive factors of visit compliance of the patients with FMF, n=430Adj. OR%95 CI**pFamily history in parents(positive history vs negative)1,81,0-3,10.03Family history in sibling(negative history vs positive)1,91,2-3,10.004Comorbid disease status1,30,7-2,50.32Treatment(anakinra&canakinumab vs colchicine)3,71,7-8,20.001Drug using(other drugs vs FMF drugs)2,21,1-4,40.01More than 2 attacks except fever2,31,2-4,00.004Chronic peripheral arthritis2,30,8-6,60.10Proteinuria2,20,7-6,70.14Adequate medical care1,91,2-3,10.003Number of index flare within last 12-month0,90,9-1,00.38ISSF severity score0,80,7-1,10,30Disclosure of Interests:None declared

Background:Interstitial lung disease (ILD) is a common morbidity and mortalitiy reason for connective tissue disorders (CTD). Data related to treatment options in the literature is limitedObjectives:To describe the role of azathiopurine (AZA) in the first line treatment of connective tissue disease related interstitial lung disease CTD-ILD, comparing with cyclophosphamide (CYC)Methods:Between 2009 and 2019 all interstitial lung disease patients admitting rheumatology or pulmonology department were retrospectively evaluated. Among those patients,as an first line regimen treated with either azathiopurine or cyclophospamide were included. Primary end point was FVC percentage change at 6th month.Results:Among 328 CTD-ILD, 57 patients had AZA treat and 79 patients had CYC for the first line treatment. Patients treated with AZA tend to have limited disease and older age. CYC treatment had a mean of 2,41% increase in FVC but in AZA -1,44% decrease in FVC predicted (p:0,041) 5 major CTD groups were defined (systemic sclerosis (SSc), rheumatoid arthritis (RA), primer sjögren syndrome (pSS), dermatomyositis/ polimyositis (PM/DM), autoimmune features of intestitial lung disease (IPAF)). AZA had similar efficacy in, PM/DM and IPAF groups but worse outcome in SSc, RA and pSS compared to CYC.Conclusion:AZA treatment might be an option patients with limited disease extent and the diagnosis of PM/DM or IPAF. CYC was a better treatment in SSc, RA and pSS patientsReferences:[1]Kocheril, S.V., et al.,Comparison of disease progression and mortality of connective tissue disease-related interstitial lung disease and idiopathic interstitial pneumonia.Arthritis Care & Research: Official Journal of the American College of Rheumatology, 2005.53(4): p. 549-557.Table 1.CYC: treatment responses of cyclophosphamide and azathiopurine regimens AZA: azathiopurine CYC: cyclophosphamide, AZA: azathiopurine CTD: connective tissue disease, SSc:Systemic Sclerosis, RA: Rheumatoid Arthritis, pSS: primary sjogren syndrome, DM/PM/ASS: Dermatomyositis / Polimyositis/Antisynthetase Syndrome, IPAF: Idiopahtic interstital fibrosis with autoimmune feautres, FVC: forced vital capacityAZA(n:43)CYC (n:72)pProgression(overall)39,3%15,3%0,013SSc (n:47)60%11,9%0,029RA(n:16)62,5%25%>0,05pSS(n:16)71,4%11,1%0,035DM/PM/ASS(n:14)11,1%->0,05IPAF(n:20)28,6%23,1%>0,05FVC change (overall) (lt)-,129±0,7410,024±0,2490,189SSc (n:47)-0,086±1810,025±0,3510,286RA(n:16)-0,553±1,521-022±0,2620,341pSS(n:16)-0,328±0,2420,014±0,3130,167DM/PM/ASS(n:14)-0,0089±0,3700,120±0,0370,316IPAF(n:20)0,123±0,3200,120±0,1010,981FVC change (overall) (%)-1,44±10,652,41±7,550,041SSc (n:47)-3,00±3,672,23±8,270,031RA(n:16)-3,50±9,65-1,75±4,650,654pSS(n:16)-6,71±15,973,33±8,350,027DM/PM/ASS(n:14)0,00±11,854,40±2,700,313IPAF(n:20)2,06±9,045,28±6,700,380Disclosure of Interests:None declared

Background:Colchicine is the mainstay of treatment in FMF. However, in daily practice it is not easy to maintain effective colchicine doses in substantial number of patients, due to its side effects.Objectives:It was aimed to investigate prevalence and risk factors for colchicine side effects that limit optimal drug dosing and permanent discontinuation.Methods:All patients were recruited from “FMF in Central Anatolia” (FiCA) cohort, 915 adult subjects with minimum follow up time of 6 months and had compliance of treatment were included. Demographic and anthropometric data, FMF disease characteristics, disease severity, complications and treatment features were recorded on a web based registry. Prevalence of colchicine intolerance and characteristics of intolerant patients were analyzed.Results:Effective colchicine doses cannot be maintained in 172 (18.7%) subjects. Main side effects that limit optimal dosing were as follows; diarrhea in 99 (10.8%), elevation in transaminases in 54 (5.9%), leukopenia in 10 (%1.1), renal impairment in 14 (1.3%), myopathy in 5 (0.5%) and allergic skin reaction in two. Colchicine had to be permanently ceased in 18 (2%) patients because of serious toxicity. Male gender and obesity were found to be associated with liver toxicity and having normal body weight was associated with diarrhea. Chronic inflammation and proteinuria were more common in colchicine intolerant patients and they had reported more frequent attacks compared to those tolerating optimal doses.Conclusion:Colchicine intolerance is an important problem in daily clinical practice, mainly due to diarrhea and liver toxicity. Suboptimal colchicine dosing associated with complications.References:[1] Sönmez, H.E., E.D. Batu, and S. Özen,Familial Mediterranean fever: current perspectives.Journal of inflammation research, 2016.9: p. 13.[2] Sari, İ., M. Birlik, and T. Kasifoğlu,Familial Mediterranean fever: an updated review.European journal of rheumatology, 2014.1(1): p. 21.[3] Ozen, S., et al.,EULAR recommendations for the management of familial Mediterranean fever.Annals of the rheumatic diseases, 2016.75(4): p. 644-651.Table 1.Prevalence of all side effects of colchicine and reasons for drug discontinuationSide effectAll side effectsN=172*Permanent cessationN=18*Diarrhea9911Liver toxicity544Leukopenia101Muscle toxicity52Skin reaction2-Nausea4-Infertility2-* some patients had more than one clinically significant side effectTable 2.Disease course in colchicine tolerant and intolerant patientsColchicine TolerantN=743Colchicine IntolerantN=172p valueChronic inflammation115 (15.4%)45 (26.1%)Number of attacks in the last year4.05±6.087.60±9.6Proteinuria44 (5.9 %)20 (11.6%)0.025Amyloidosis33 (% 4.4)23 (13.3%)ADDI (median)1 (1)1 (1)ADDI: auto-inflammatory disease damage index, FMF: familial Mediterranean feverDisclosure of Interests:Hasan Satiş: None declared, Berkan Armagan: None declared, Erdal Bodakci: None declared, Nuh Atas: None declared, Alper Sari: None declared, Dilek Yapar: None declared, Nazife Sule Yasar Bilge: None declared, reyhan bilici salman: None declared, Gözde Kübra Yardimci: None declared, Hakan Babaoglu: None declared, Levent Kiliç: None declared, mehmet akif ozturk: None declared, Berna Goker: None declared, seminur haznedaroglu: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB, Timuçin Kaşifoğlu: None declared, abdurrahman tufan: None declared

Background:Lung nodules in rheumatoid arthritis (RA), patients impose diagnostic and therapeutic challenges due to unpredictable outcome of these nodules. biologic (b) disease-modifying anti-rheumatic drugs (bDMARDs) are important therapeutic agents used in treatment of RA. There is hesitation about use of conventional synthetic DMARDs (csDMARD) and bDMARDs due to increased risk of nodules although their association remains unclear. There are scarce data on lung nodules observed in RA patients and systematic studies are needed.Objectives:The aim of this study is to evaluate effects of biologic treatments and conventional synthetic DMARDS on pulmonary nodules observed in rheumatoid arthritis patients.Methods:Electronic health records of RA patients who had had thorax computed tomography (CT) confirmed lung nodules in the last 5 years were retrospectively evaluated. Pre-treatment and post-treatment follow up CT images were meticulously examined for the number, size, attenuation, calcification, and cavitary formation. Demographic features, smoking status, disease characteristics and used medications were retrieved from file records. Clinical and laboratory findings, demographic features, treatment and follow-up duration, number of solid and cavitary nodules were compared between groups.Results:There were 21 patients in both biologic (11 females, mean age; 59.7±8.4) and csDMARD (12 females, mean age; 71.4±8.3) treated groups. There was no difference in frequency of nodule types and sizes between csDMARD and bDMARDs groups(table) despite csDMARD users were remarkably older. Administered biologic treatments were anti-TNF-alpha in 8, tofacitinib in 7, rituximab in 4, and abatacept in 2 patients. The most common types of nodules were solid and cavitary nodules, observed in 17 and 8 patients, respectively in biologic users. Calcific nodules were present in three patients, and ground glass nodules were observed in a single patient. Nodules were multiple in 12 patients and solitary in 9 patients. Calcific and ground glass nodules were all solitary in our study. Cavitary and solid nodules were concurrent in five patients. Median follow duration was 14(5-55) months. Progression was observed in small number of patients; three patients in receiving aTNFα, and one in rituximab(figure) and one in abatacept users. Interestingly none of patients receiving tofacitinib did not show progression. There was no difference regarding number of patients who progressed with either csDMARD or bDMARDs. None of the nodules showed malignant transformation within the observation period.Conclusion:In conclusion, risk of progression in lung nodules with biologic treatments is seem to be low, at least not more than csDMARD in short term and any malignant transformation was not observed in our study.References:[1]Esposito AJ, Chu SG, Madan R, Doyle TJ, Dellaripa PF. Thoracic Manifestations of Rheumatoid Arthritis. Clin Chest Med. 2019 Sep;40(3):545-560. doi:10.1016/j.ccm.2019.05.003. Epub 2019 Jul 6. Review. PubMed PMID: 31376890.Table.Changes in nodule characteristics with respect to treatment groups.csDMARDbDMARDsSOLID NODULESPre-treatmentTotal number of nodules, n7254Post-treatmentCompletely diminished, n514Regressed, n512Stable, n3320Enlarged, n234Cavitary transformation64De novo solid nodules267CAVITARY NODULESPre-treatmentTotal number of nodules1016Post-treatmentCompletely diminished, n01Regressed05Stable48Enlarged, n62Newly formed cavitary nodules69***number less than calculated due to cavitation,**de novo 5 nodules, 4 transformation from solid nodulesFigure.Nodule progression in a patient receiving rituximab (white arrow)Disclosure of Interests:None declared

Background:Systemic sclerosis (SSc) is a complex disease, characterized by multi-system organ involvement including interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH). The decrease in physical activity in SSc patients with lung involvement has been demonstrated by self-reported physical capacity and 6 min-walking test (6MWT) (1, 2). Commercial smart bands can provide data on daily physical activity, sleep characteristics, blood oxygen concentration and heart rate measurement, therefore may aid in monitoring disease activity.Objectives:The aim of this study is to evaluate physical activity in SSc patients by using a commercial smart band and investigate its association with clinical characteristics and patient-reported outcome measures of disease activityMethods:This prospective observational study included SSc patients with having a smartphone. Patients characteristics including age, sex, and organ involvements were recorded. Each participant was subjected to pulmonary function tests and 6MWT. All of patients answered Scleroderma Health Assessment Questionnaire (SHAQ, consisting of HAQ-Disability Index (DI) and visual analog scales (VAS) domains). All patients received Fitbit inspire HR smart band® which records the number of steps, heart rate, distance and was instructed to wear it continuously for one week. Tracked data was collected from smartphones via Fitbit application.Results:Fifteen SSc patients (14 females and 1 male) participated in the study, 8 (53.3%) had limited SSc and 7 (46.7) had diffuse SSc. The mean age was 48.5±15.5 and the median disease duration was 4 (min-max:1-9) years. Eleven (73.3%) patients had ILD and one patient had PAH. Musculoskeletal complaints were evident in two patients. Forced vital capacity (FVC, % predicted), diffusion capacity of lung for carbon monoxide (DLCO, %) in patients with ILD were significantly lower than patients without ILD median (IQR) 102 (30) vs 80 (27) p= 0.026, 57 (20) vs 95 (13), p= 0.002, respectively. The median distance of 6MWTs were 450 (225) vs 568 (102) in ILD and non-ILD groups. The median total weekly step counts of ILD patients were remarkably lower in ILD patients compared to non-ILD 36.137 (17.879) vs 58.114 (80.681) steps/week, (p= 0.01). Patients with ILD had a bit higher median heart rate compared to non-ILD, 73 (9) vs 67.5 (12). The total weekly step counts were correlated with pulmonary function tests, including forced expiratory volume in one second (FEV1%) (r= 0.57, p= 0.025), FVC (%) (r= 0.65, p= 0.009), and DLCO (%) (r= 0.70, p= 0.005), patient-reported disease severity (r=-0.66, p= 0.007), and breathing problem (r= -0.55, p= 0.03) domains of SHAQ. There was no correlation between weekly step counts and 6MWTConclusion:The assessment of physical activity with smart activity bands may help to identify SSc patients with ILD. Tracked physical activity using smart bands correlates with pulmonary function tests and performs better than 6MWT, suggesting it as a useful tool for the assessment of disease activity.References:[1]Battaglia S, Bellia M, Serafino-Agrusa L, Giardina A, Messina M, Cannizzaro F, et al. Physical capacity in performing daily activities is reduced in scleroderma patients with early lung involvement.Clin Respir J(2017) 11(1):36-42.[2]Mainguy V, Provencher S, Maltais F, Malenfant S, Saey D. Assessment of daily life physical activities in pulmonary arterial hypertension.PLoS One(2011) 6(11):e27993.Disclosure of Interests:None declared

Background Patients with rheumatoid arthritis (RA) have increased risk of cardiovascular disease. Retinal vascular caliber (RVC) is one of the new tools to determine the cardiovascular risk. RVC includes central retinal artery and vein equivalents (CRAE and CRVE). It is well known that CRVE is closely related with chronic inflammation (1). Objectives The objective of this study was to assess RVC score in RA patients and compared the data with those of SLE patients and age-sex-comorbidity equivalent population. Methods Forty-seven RA patient were enrolled in this study between July 2014 and January 2015. Demographic data of patients were recorded. Before the measurement of RVC, disease activity was measured by Disease Activity Score-28 (DAS-28). Functional capacity assessed by Health Assessment Questionnaire (HAQ). Disease activity was categorized according to DAS-28 (DAS-28 5.1 high disease activity). Thirty-two SLE patients and 45 healthy controls constituted the control groups. RVC was measured from the dilated fundus photographs, and summarized as the central retinal artery and vein equivalents (CRAE- CRVE) using a semi-automated computer-assisted method (IVAN, Wisconsin University-Figure 1). Measurement of the retinal vascular caliber performed in between the 0,5–1 disc distance from the optical disc margin (Zone B, figure 1). Arterioles and venules were marked semi-automatically by the software (Red=arterioles, Blue=Venules). The largest 6 vessels width used in the previously accepted formula for calculating the CRAE and CRVE. Retinal photography was performed in all patients at baseline and 24 of RA patients were re-evaluated 5.2±2.1 months later. Results The mean age of RA, SLE patients and healthy controls were 52.1±11.9, 41.4±14.5, and 47.2±17.3 (p=0,008), respectively. Female sex (83%, 84%, and 80%, p>0.05), hypertension (40%, 31%, and 27%, p>0.05) and diabetes mellitus (8%, 3%, and 11%, p>0.05) frequencies were similar in all groups. CRAE score was similar in RA, SLE, and healthy controls (147.8±11.7 μm, 148.3±12.8μm, and 147.4±17.6μm), respectively. CRVE score was also similar (213.3±17.8 μm, 209.2±14,1μm, and 217.5±26.2μm). There was no correlation between DAS-28, HAQ score with RVC scores. At baseline, ten (21%) of patients had active disease, and 22 (47%) patients had low disease activity. CRVE score was higher in active RA patients than low disease activity patients (222.8±10.1 vs. 207.3±17.8, p=0.004). There was no correlation between the changes of DAS-28 and HAQ with the RVC changes during follow-up period. Conclusions CRVE is associated with systemic inflammation and possibly increased CV risk (1,2). Although, CRVE and CRAE were similar in RA, SLE and healthy control groups, however especially active RA patients had worse CRVE level. Measurement of retinal vein caliber is a sensitive methods for assessment of microvascular circulation. Further studies should be focused to importance of abnormal CRVE and cardiovascular status in rheumatic diseases. References Archives of Ophthalmology 2006;124:87–94. Annals of Internal Medicine 2009;151:404–13. Disclosure of Interest None declared

Background Ocular involvement is one of the major reason of disability for Behcet disease (BD). BD may be a cause of acquiered blindness particularly among young adult population. Objectives The objective of this study was to assess prevalence of severe visual loss with BD among blind population. Methods Demographic data of blind people was recorded and followed by Ankara metropolitan municipality education and technology center. There were 675 blind people at these center. Telephone numbers were not found at 131 peoples and we also did not reach 250 peoples by phone. At the end, medical history was took from 294 peoples. Participants were searched by standard questionnaire for BD. We also searched to cause of blindness either acquired or congenital. If patients had BD or suspicious BD, they were recalled for future investigation for BD by a rheumatology and ophtalmology physician. Patients with BD were assessed for disease characteristics, time of visual impairment. Results Overall, 213 of 294 (72.4%) peoples were male. One hundred nine of 294 (37.1%) peoples had acquired blindness. Six of those 109 (5.5%) patients had BD. Five of 6 patients already had BD, however, 1 of 6 patients did not known their diagnosis. All of BD were male sex, median age was 38.6 years old (range 24-64 years).The median age for diagnosis was 20 years old (range 14-35 years) and the median duration from diagnosis to visual loss was 2.5 years (range 1- 11 years). All patients with BD had recurrent oral aphtous ulcer and ocular involvement. Other diseease characteristics were genital ulcers (83%), skin involvement (67%), arthritis (50%), arthralgia (66%), neurological involvement (17%). None of the patients had deep venous thrombosis. Uveitis location were known at 3 patients, one had both anterior and posterior uveitis, 2 patients had only posterior uveitis. Conclusions BD is still one of the cause of acquired visual impairment in Turkey. In a Japan study at 1965, on the other hand before immunosuppressive treatment period, BD was the 12% of cause of acquired blindness (1). Today, immunosuppressive treatments use in routine practice, and frequency of BD among visual loss population looks tendency of decrease. However BD still seems to be important cause of acquired visual loss, particularly prevalant country such as Turkey. References Shimizu T, Tanaka I, Ogino K. Current status of Behcet9s disease in Japan. Igaku no Ayumt 75:332-341, 1970 Disclosure of Interest None declared

Background Anti-TNF alpha (TNFi) drug survival is one of the relevant outcome measure in rheumatological diseases. Objectives Objective of this study was to compare TNFi drug survival in ankylosing spondylitis (AS) and axial spondyloarthritis (AxSpA). Methods HUR-BIO (Hacettepe University Rheumatology Biologic Registry) is a single center biological registry since 2005. HUR-BIO biological dataset included demographic data, education level, co-morbidities, smoking, BMI, HLA-B27, switch ratio, baseline and follow-up disease activity parameters (such as BASDAI, BASFI, CRP, ESR, global VAS). Patients with lost of follow-up searched regarding to last TNFi prescription date with either local computer system or national social security institution database. Inition and last date of TNFi were noted from those systems. First TNFi drug switch date (either advers event or inefficacy) was accepted as main variable for drug survival. Kaplan-Meier plots and log rank tests were used to assess drug survival. HUR-BIO is not sponsored by any pharmaceutical company. Missing data ratio of baseline disease activity measures were 38.5% at BASDAI, 22.1% at ESR, 23.9% at CRP and 60.6% at BASFI. Results There were 874 patients (747 AS and 127 AxSpA). Mean age was 40.7±11.4 years old. Overall, 533 (61%) of patients were male, mean disease duration was 8.3±7.1 years and mean symptom duration was 12.8±8.9 years. Initial biological drugs were etanercept 346 (39.6%), infliximab 270 (30.9%) and adalimumab 258 (29.5%). Overall, initial biological drugs were continued at 497 (56.9%) patients. Of 245 (29.7%) patients had at least one biological switch. First biological drug survival was more frequent at male sex (61.4% vs 49.8%, p=0.001) and patients with highest ESR level (31.6 (23.7) vs 27.8 (22.3) mm/hour, p=0.041). In logistic regression analysis, male sex had tendency of better TNFi drugs survival [OR 1.65 (95%CI 0.96-2.83), p=0.070]. Patients with use usage of etanercept had tendency of more frequent drugs survival than monoclonal antibodies (log-rank p=0.057) (Table and Figure 1). Retention rate was similar at both AS and AxSpA patients. Conclusions In this single center observational registry, etanercept had tendency of better drug retention rate than monoclonal antibodies. Overall, anti-TNF drugs retention rate was well both AS and AxSpA than rheumatoid arthritis. On the other hand, certain confounder factors such as baseline disease activity, functional status were not known in whole patients, thus our results should evaluate in this limitation Disclosure of Interest None declared

Background There are still controversial data regarding the development of malignancy after TNF inhibitor (TNFi) therapy. Objectives The objective of this study was to assess whether TNFi increases the risk of cancer development in Turkish Rheumatoid Arthritis (RA) patients in a single center real life experience Methods HUR-BIO (Hacettepe University Rheumatology Biologic Registry) is a single center biological registry since 2005 that include 815 RA patients under biological treatments. Overall, 679 of 815 patients were treated with TNFi drugs. Collected data includes demographic data, co-morbidities, smoking, switch ratio, baseline and follow-up disease activity parameters. Malignancy history before TNFi drugs were recorded from local database. After TNFi exposure, malignancy data were obtained from local database, social security administration data and Republic of Turkey Ministry of Health data. Development of cancer was assessed by calculating 100 patient–year exposure. These results are compared with Turkey 2005 Cancer Data and standardized incidence ratio (SIR) were identified (1). SIR was calculated by multiplying the ratio between expected number of cancers and observed number of cancer by 100. Results The mean age of 679 RA (77.8% women) patients was 50.4 (13.1) years and total duration of TNFi was 1623 patient-years. Initial TNFi were adalimumab 223 (32.8%), etanercept 321 (47.3%), infliximab 115 (16.9%) and golimumab 20 (3.0%). Before TNFi drugs, 2 patients had malignancy history (one breast cancer and one prostate cancer). During follow-up period, 5 additional cancer were obtained (Table 1). SIR was calculated as 1.26 in patients with advanced malignancy after anti-TNF drugs (confidence interval could not be obtained because of the small sample size). Conclusions In this single center real life experience, the incidence of malignancy after TNFi drugs at RA patients probably remains within the confidence interval according to the healthy population. We did not have RA control groups with DMARDs, and this is the limitation of our study. References Haydaroglu A et al. Turk Onkoloji Dergisi 2007;22:22-28. Disclosure of Interest None declared