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To determine limited joint mobility (LJM) of the hand in patients with systemic sclerosis (SSc).LJM was evaluated with "prayer sign" and "tabletop sign" tests. LJM staging was done by Rosenbloom classification method. LJM (+) and LJM (-) patients were compared in terms of demographic findings (gender, age and duration of disease), laboratory results (ESR, CRP, anti-nuclear antibody (ANA), anti-topoisomerase I and anti-centromere), and modified Rodnan skin score (mRss) results.In our study, a total of 217 patients, including 113 patients with a diagnosis of SSc, and 104 as a healthy control group with similar age and gender distribution to these patients, were included. A total of 113 (F=98, M=15) patients (limited cutaneous SSc (lcSSc=71), diffuse cutaneous SSc (dcSSc=42)) were included in this study and LJM positivity was found in 66.4% (lcSSc=38, dcSSc=37). A statistically significant difference was observed in between lcSSc and dcSSc patients according to the presence of LJM (p0.001). There was a moderate positivity relationship between LJM and mRss (lcSSc r=0.449, p0.001; dcSSc r=0.565, p0.001).In our study, it was found that LJM staging correlated with mRss and dcSSc patients had more severe LJM findings than lcSSc. We conclude that "prayer sign" and "tabletop sign" tests used in hand evaluation in SSc patients have similar clinical results with mRss and can be simple bedside tests in daily practice. Key Points • This is the first study examining limited joint mobility (LJM) with "prayer sign" and "tabletop sign" tests in systemic sclerosis (SSc) patients. • "Prayer sign" and "tabletop sign" tests can be easily performed in daily practice. • We found Rosenbloom LJM staging correlated with modified Rodnan skin score. LJM of the hand can be a good prognostic indicator for early stage SSc patients.

Background:The frequency of comorbidities has increased in spondyloarthritis patients compared to the general population. The effect of comorbidities on tumour necrosis factor alpha inhibitor (TNFi) drug retention and treatment response has not been well evaluated.Objectives:The purpose of this study to assess the impact of comorbidities on the first TNFi drug survival and treatment response in patients with axial spondyloarthritis (axSpA) registered in theTURKBIOdatabase.Methods:In this study, the frequency of comorbidities, disease activity scores at baseline and month 6 and drug retention were recorded in AxSpA patients iniating first TNFi treatment between 2011 and 2019. Kaplan Meier plot and log rank tests were used for drug survival analysis. Cox regression analysis with HR was performed to evaluate the correlation between comorbidities and drug survival.Results:There were 2428 patients with AxSpA (39.3% female) who used their first TNFi during the study period. Among them, a total of 770 (31%) had at least one comorbid disease. Hypertension was the most common comorbidity (9.7%), followed by the affective disorders (8%) and chronic lung disease (5.8%). The baseline characteristics of patients are shown in Table 1.The presence of any comorbidity did not impact the first TNFi retention (Figure 1). When comorbidities were analysed seperately, we found that only history of cerebrovascular event was negatively associated with drug retention rate (HR: 6.9, p:0.008). There was no statistically significant difference in Bath AS Disease Activity Index 50% (BASDAI50) response between patients with and without comorbidity at 6 months. Less axSpA patients with comorbidity achieved a ASDAS score ≤ 2.1 compared to patients without comorbidity at 6 months.Table 1.Baseline Characteristics of PatientsRadiographic Spondyloarthritis, n (%)2318 (95.5)Female, n(%)954 (39.3)Age, year42.2±11.8Age at diagnosis, years32.5± 11.3Age at initial TNFi, years39.4 ± 11.1Symptom duration, years9.7± 7.5Time to initial TNFi, years7±6.8HLA-B27- positivity, n (%)1144 (47.1)Smokers, n (%)1068 (44)Baseline BASDAI35.5±22.2Baseline ASDAS-CRP2.8±1.1Baseline CRP (mg/L)15.7±24.4VAS global patient46.6±28.7-Quantitative variables are presented as mean ± SD, and qualitative variables are presented as frequency and percentage-ASDAS-CRP, Ankylosing Spondylitis Disease Activity Score using C-reactive protein VAS, visual analogue scaleConclusion:The results of this study demonstrated that the presence of previous cerebrovascular event decreased the first TNFi survival in patients with axSpA. It also suggested that comorbidities might decrease TNFi treatment response.Disclosure of Interests:None declared

Background:Currently, biologic treatments are used effectively in patients with psoriatic arthritis (PsA).Objectives:The aim of this study was to evaluate and compare long-term drug survival of the first biologic treatments including adalimumab, certolizumab, etanercept, golimumab, infliximab, secukinumab and ustekinumab in patients with PsA.Methods:PsA patients, electronically registered at each visit in the TURKBIO database between 2011 and 2019 were included in the study. PASW 18.0 for Windows was used for statistical analysis. Drug survival rates were calculated by Kaplan Meier method.Results:355 patients (227 women; axial PsA = 48, peripheral PsA = 307) were included in the study (Table 1). Adalimumab was the most commonly used first biologic treatment (n=125; 37.6%). The rate of drug survival was found to be 0.75 at month 60 in patients receiving the first biologic treatment (Figure 1). There was no significant difference in drug survival rate between tumor necrosis factor alpha inhibitor (TNFi) and non-TNFi biologic drugs (p=0.56). No difference was also found in drug survival rates between each biologic treatment.Table 1.Initial demographic and clinical datas of patients with PsAPsA Patients (n=355)Females, n (%)227 (63,9)Age of diagnosis, years*34,6 (27-42)CRP baseline*6 mg/ L (3-15)ESR baseline*24 mm/h (10-38)Smoking, n (%)Current99 (28,5)Never192 (55,3)Previous56 (16,2)HLA B27 positivity,n (%)41 (26,4)First biologic agent, n (%)-TNFi332 (95,4)AdalimumabEtanercept125 (37,6)80 (24,1)Golimumab52 (15,6)Certolizumab44 (13,3)Infliximab31 (9,4)- Other biologic agents16 (4,6)Secukinumab13 (81,3)Ustekinumab3 (18,7)*median (min-max)Conclusion:The results of this study establish that more than half of patients with PsA can remain in their initial biologic treatment over a long term. It has been observed that the choice of biologic treatment did not effect the drug survival in PsA.Disclosure of Interests:None declared

Background The first symptoms of ankylosing spondylitis (AS) patients usually begin prior to 45 years, but can occur later in life. Objectives The purpose of this study is to evaluate the efficacy and safety of anti-TNFα treatment in late-onset AS (LoAS) patients in comparison to those with adult onset AS (AoAS). Methods We studied AS patients in TURKBIO registry between the dates of January 2011 and November 2018. All the patients fulfilled the modified New York criteria for AS 1 and were classified into 2 groups based on their age at symptom onset: AoAS (age>16 but ≤45 years); and LoAS (age>45 years). In both groups, the following data were compared: (1) epidemiological variables (2) clinical manifestations, including signs and symptoms at diagnosis; (3) laboratory results (4) disease activity markers and follow-up parameters (BASDAI, ASDAS-CRP and HAQ); (5) previous and current treatments (6) adverse events. Results A total of 2551 AS patients (91,1% with AoAS and 8.9% with LoAS) were included in the study. LoAS group had more female patients, older age, shorter disease duration and diagnostic delay, higher initial ESR and less HLA-B27 positivity compared to the AoAS (Table 1). Peripheral arthritis (not statistically significant) and dactylitis was seen more common in the LoAS. The frequency of other involvements was similar between the groups (Table1). The frequency of using drugs was similar between each groups although the use of glucocorticoids and sulphasalazine was more common in the LoAS. Switching from the first anti-TNFα treatment to the second one was more common in the AoAS. However, there was found no significant difference between the two groups in 2 or more switch ratios (Table 1). At the latest visit after the anti-TNFα therapy, the mean improvement in BASDAI was significantly higher in the AoAS (Table 2). A total of 10 (4.4%) serious adverse events were reported in LoAS and 39 (1.7%) in AoAS patients in the follow-up (HR: 2.62; 95% CI: 1.32–5.18). Severe infections were the most commonly seen serious adverse events (1.3% in LoAS and 0.8% in AoAS), followed by allergic reactions (0.9% in LoAS and 0.3% in AoAS). Tuberculosis was observed in 2 patients (0.9%) in LoAS and 9 (0.4%) in AoAS, malignancy in 3 patients (1.3%) in LoAS and 6 (0.3%) in AoAS. Conclusion Our data showed that almost 8.9% of the patients with AS had late-onset of symptoms. The results suggested that LoAS patients might have different demographic, clinical features, disease activity parameters at baseline. The frequency of anti-TNFα use and response rate to the treatment was also similar in LoAS to those in AoAS patients. The LoAS patients seem to have more common severe adverse events compared to the AOAS patients possibly related to their older age. References [1] Van der Linden S, Valkenburg HA. Evaluation of diagnostic criteria for AS. Arthritis Rheum1984; 27: 361–368. Disclosure of Interests Sadettin Uslu: None declared, Gercek Can: None declared, Ayse Cefle: None declared, Sema Yilmaz: None declared, Sinem Burcu Kocaer: None declared, Tuba Yuce Inel: None declared, Semih Gulle: None declared, Suleyman Serdar Koca: None declared, Servet Yolbas: None declared, Mehmet Akif Ozturk: None declared, Soner Senel: None declared, Nevsun Inanc: None declared, Ediz Dalkilic Grant/research support from: MSD and Abbvie, Consultant for: MSD, Abbvie,Roche, UCB, Pfizer and Novartis, Speakers bureau: MSD, Abbvie,Roche, UCB, Pfizer and Novartis, Ozgul Soysal: None declared, abdurrahman tufan: None declared, Servet Akar Grant/research support from: MSD, Abbvie, Roche, UCB, Novartis, Pfizer, Amgen, Consultant for: MSD, Abbvie, Roche, UCB, Novartis, Pfizer, Amgen, Speakers bureau: Pfizer, Merih Birlik: None declared, Ismail Sari: None declared, Nurullah Akkoc: None declared, Fatos Onen: None declared

Background:A significant increased risk of COVID-19 related adverse outcomes of the biological or target-directed synthetic DMARDs (b/tsDMARDs) has not yet been reported. For this reason, it is recommended to continue b/tsDMARD treatments with maximum compliance with pandemic measures.Objectives:The aim of this study was to evaluate the effects of patients using b/tsDMARDs on drug survival and rheumatic disease control during pandemic.Methods:In this study, patients diagnosed with rheumatic disease using b/tsDMARDs and who were followed up during the 12-month period (January 2020-2021) including the onset of the Covid-19 pandemic at Dokuz Eylul University Faculty of Medicine Rheumatology Clinic were evaluated. In the first 3 months of the pandemic (March-June 2020), the patients skipped at least 2 cycles of treatment with the fear of Covid-19 infection except for infection / surgical reasons was considered as a disruption of the drug. The drug retention rates of the patients on b/tsDMARDs treatments during the pandemic process and the factors affecting this situation were evaluated.Results:The rate of disrupting their b/tsDMARDs was higher in patients> 65 years of age, with a diagnosis of RA and who needed to come to the hospital for bDMARD treatment (p=0.007, p=0.015 and p=0.004, respectively).The overall 1-year b/tsDMARD retention rates was found 91%. It was determined that a history of interruption in b/tsDMARD treatments in the first 3 months of the pandemic [OR: 1.28 (CI: 1.042-8.71), p=0.014] and the need to come to the hospital to receive bDMARD [OR: 0.59 (CI: 0.64-13.11), p=0.041] caused unresponsiveness to return to the same bDMARD treatment and a significant increase in the risk of discontinuation of the biologic treatment.Conclusion:We conclude that it is important for patients to continue taking b/tsDMARD treatments without interruption in the days past abnormal periods such as pandemic conditions and to make sufficient effort for minimum dose of CS and low disease activity by determining patient-based risk.Table 1.Demographic and clinical characteristics of b/tsDMARDs patientsTotal (n=521)b/tsDMARD Continue (n=424) (82.4%)b/tsDMARD Interruption (+) (n=97) (17.6%)PMedian (Min./Max.)Median (Min./Max.)Median (Min./Max.)Age, years48 (18/86)47 (18/82)52 (21/81)0.008tDisease Duration, years11,2 (2/43.3)130 (22/490)142 (22/519)0.41tb/ts DMARD Duration, months40 (12/192)40 (12/192)40 (12/156)0.176tn (%)n (%)n (%)Female278 (53.4)225 (53.1)53 (54.6)0.826Most common rheumatic diseases AxSpa or other SpA283 (54.3)232 (54.7)51 (52.6)0.737 RA134 (25.7)100 (23.6)34 (35.1)0.015l PsA44 (8.4)40 (9.4)4 (4.1)0.109 Vasculitis32 (6.1)27 (6.4)5 (5.2)0.817 Others28 (5.4)25 (5.9)3 (3.1)0.338b/tsDMARD at Hospital/Health center140 (26.9)102 (24.1)38 (39.2)0.004l(OR: 0.59)b/tsDMARD administration route (IV)137 (26.3)100 (23.6)37 (38.1)0.005lActive/Progressive Disease92 (17.7)14 (3.3)78 (80.4)l(OR: 4.8)Start/continue with the same b/tsDMARD55 (10.6)3 (0.7)52 (53.6)pUnresponsiveness, b/tsDMARD switch16 (3.1)9 (2.1)7 (7.2)0.017pb/tsDMARD stopped permanently/deceased29 (5.6)9 (2.1)20 (20.6)ffb/tsDMARD retention (Total)474 (91)406 (95.8)68 (70.1)tIndependent Samples t Test (Bootstrap), pPearson Chi-Square Test (Monte Carlo), ffFisher freeman Halton Test (Monte Carlo), lLinear-by-Linear Association Test(Monte Carlo, Exact), SD.: Standard deviation; * OR, Odds Ratio,Disclosure of Interests:None declared

Background:Studies indicate that patients with rheumatoid arthritis (RA) are at increased risk of developing several comorbid disorders. Comorbidities affect treatment decisions, the effectiveness of the treatment, quality of life, RA prognosis, and survival rate [1].Objectives:The aim of thisstudyto investigate the impact of comorbidity on the first TNF inhibitor treatment persistence in RA.Methods:In the TURKBIO database, patients with an ICD 10-diagnosis of RA (M05 or M06) who started TNF inhibitor therapy between January 2011 and June 2019 were enrolled. Demographic and clinical characteristics, acute phase reactants, disease activity scores (DAS 28 CRP, HAQ, CDAI, VAS global), initial comorbidities and numbers, drug persistence, were evaluated. Kaplan-Meier plots and Cox proportional hazard regression analyses were performed.Results:A total of 1172 patients >18 years of age treated with TNF-α inhibitors were included in the study. The most prevalent comorbidities were: hypertension in 262 patients (32.6%), obesity in 254 (32.6%), osteoporosis in 178 (22.3%), chronic lung disease in 143 (17.9%) and depression in 126 (15.8%). The baseline characteristics are summarised in Table 1. The presence of comorbidity did not affect the survival rate of the first TNF inhibitor therapy in the RA patients (p: 0.65). Comorbidities had no effect on DAS28 CRP (> 1.2 reduction) responses at 6 and 12 months of treatment (p: 0.18, p: 0.83, respectively). As the mean disease duration increases, the persistence of the first TNF inhibitor decreases by 5%.Conclusion:This study demonstrated the increasing burden of comorbidities in RA. However, it suggested that the presence and number of comorbidities did not influence the rate of persistence in the first TNF inhibitor drug and the response to treatment.References:[1] Gabriel, S.E. and K. Michaud,Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases.Arthritis research & therapy, 2009.11(3): p. 229.Disclosure of Interests:None declared

Background:Axial spondyloarthritis (axSpA) is a chronic, inflammatory disease that primarily affects the axial skeleton. Secukinumab is a human monoclonal antibody that binds to the protein interleukin (IL)-17A. Although some studies showed that obesity had a negative effect on the efficacy of tumor necrosis factor alpha inhibitor (TNFα -i) treatment in AS patients (1), no data is available for secukinumab.Objectives:To evaluate the effect of obesity on the treatment response and drug survival of secukinumab in patients with axSpA.Methods:We performed an observational cohort study based on the TURKBIO between 2018-2020. A total of 185 patients were included in the study. The patients were divided into three groups as obese (BMI≥30 kg/m2), overweight (BMI:25-30 kg/m2), and normal (BMI2). Disease activity was evaluated at baseline and 3, 6 and 12 months of secukinumab therapy. Clinical response was evaluated as achievement of BASDAI50, ASAS20/40, and ASDAS-Clinical and improvement (CII and MI) rates.Results:185 axSpA patients were identified in the registry; 135 (72%) had available BMI data. Thirty nine (28.8%) patients were obese. The mean age of obese patients was higher (p=0.002). The frequency of HLA-B27 and male gender was lower in obese group (p=0.012 and p=0.013, respectively). There was no significant difference between groups in terms of clinical response parameters at 3, 6 and 12 months (Table 1). Drug retention rates were higher in biologic naive patients(p=0.007) (Figure 1).Table 1(BMI )(BMI 25-30)(n=63)(BMI ≥ 30)(n=39)PAll patients (n=185)Age (years)40.2±11.345.7±11.750.0±10.60.002 *45.2±11Male Gender n (%)25 (75.8)34 (54.0)16 (41.1)0.012 **104 (56.2)HLA-B27 (+) n (%)14 (73.6)37 (84.0)11 (44.0)0.013 **76 (64.3)Prior Naive/1/≥2 bDMARD n (%)12 (36.3)/9 (27.3)/12 (36.3)17 (26.9)/13 (20.6)/33 (52.4)10 (25.6)/14 (35.8)/27 (69.2)0.30256 (30.3)/ 49 (26,5)/ 80 (43,2)ASAS20 response¶13 (61.9)/11 (57.9)/4 (57.1)19 (48.7)/16 (59.3)/8 (42.1)11 (40.7)/7 (29.1)/3 (50.0)0.345/0.073/0.88659 (518)/47 (49.5)/20 (42.6)ASAS40 response¶9 (42.9)/7 (36.8)/3 (42.9)15 (39.5)/10 (37)/1 (5.3)6 (24)/5 (20,8)/3 (50.0)0.334/0.386/0.01240 (35.0)/29 (30.5)/11 (23.4)BASDAI50 response ¶10 (47.6)/9 (47.4)/4 (57.1)15 (39.5)/11 (40.5)/3 (15.8)9 (34.6)/5 (21.7)/3 (50.0)0.634/0.192/0.07748 (42.1)/37 (38.9)/16 (34.0)ASDAS-CII ¶3 (14.3)/5 (26.3)/1 (14.3)6 (17.6)/8 (30.8)/5 (27.8)6 (23.1)/5 (21.7)/2 (33.3)0.237/0.162/0.53123 (21.4)/22 (23.6)/11 (23.9)ASDAS-MI ¶5 (23.8)/3 (15.8)/0 (0)8 (23.5)/6 (23.1)/2 (11.11 (3.8)/1 (4.3)/1 (16.7)0.237/0.162/0.53118 (16.8)/18 (19.3)/8 (17.4)§; Mean±SD. ¶; at 3/6/12 Months, n (%),*One-way ANOVA test, ** Pearson Chi-Sqaure TestFigure 1Conclusion:This study demonstrated that obesity had no impact on the efficacy and retention of secukinumab treatment in patients diagnosed with axSpA. The drug survival was found to be higher among biologic-naive axSpA patients compared to biologic-experienced.References:[1]Ottaviani S.et al. ‘’Body mass index influences the response to infliximab in ankylosing spondylitis’’,Arthritis Res Ther 2012; 14: R11Disclosure of Interests:None declared

Background:Limited joint mobility (LJM) is a musculoskeletal disorder caused by flexion contractures of hand is a common complication in systemic sclerosis (SSc) patients. The distal parts of the upper limb (hands and fingers) is the most involved site in SSc.Objectives:In this study, we aimed to evaluate LJM in SSc patients and to determine the relationship between the clinical features of the disease.Methods:A total of 113 patients (>18 years old) diagnosed with diffuse cutaneous systemic sclerosis (DcSSc) and limited cutaneous systemic sclerosis (LcSSc) and 104 healthy controls were included in this study. LJM was evaluated with “prayer sign” and “table top sign” tests. LJM staging was done by Rosenbloom classification method(1, 2). LJM (+) and LJM (-) patients were compared in terms of demographic findings (gender, age and duration of disease), laboratory results (ESR, CRP, ANA, anti-topoisomerase I and anti-centromere) and modified Rodnan Skin Score (mRSS) results.Results:In our study, a total of 113 patients diagnosed with SSc and 104 healthy controls with similar age and gender distribution were included. While LJM (+) was detected in 75 (66.4%) (LcSSc = 38, DcSSc = 37) of the patients diagnosed with SSc, LJM (mild) (+) was detected in 3 (2.8%) of the control group. One of these people had right 2nd DIF joint contracture due to osteoarthritis, and 1 patient was found to have simple contractures due to minor hand injury previously (Table 1). A statistically significant difference was observed in between LcSSc and DcSSc patients according to the presence of LJM (pTable 1.Comparison of demographic findings between SSc and Control groupSSc Group (n=113)Control Group (n=104)p valueAge, year57.02 ± 11.5858.47 ± 11.260.061Gender (F / M)98 (86.7) / 15 (13.3)65 (62.5) / 39 (37.5)0.064CRP (mg/L)5.45 ± 5.392.14 ± 1.12ESR (mm/hr)25.19 ± 18.914.46 ± 10.090.024Smoking, n (%)Smoker89 (78.8)70 (67.3)0.464Non-Smoker24 (21.2)34 (32.7)LJM (Absent / Present)Present75 (66.4)3 (2.8)Absent38 (33.6)101 (97.2)Rosenbloom classificationLcSSc (n=71) (%)DcSSc (n=42) (%)Total (n=113) (%)Normal46.511.933.6Mild22.514.319.5Moderate23.933.327.4Severe7.140.519.5Table 2.Comparison of demographic and clinical findings LJM(-) and LJM(+) in SScLJM (-) (n=38)LJM (+) (n=75)p valueAge, year54.16 ± 11.8258.47 ± 11.260.061SSc Typen (%)n (%)LcSSc, n (%)DcSSc, n (%)33 (56.8)38 (50.7)5 (13.2)37 (49.3)Gender,F/M (%)37 (97.3) / 1 (2.7)61 (81.3) / 14 (18.7)0.018Raynaud’s (symptom duration), month148 (44-456)150 (35-588)0.990Non-raynaud (symptom duration), month108 (28-458)138 (38-447)0.132mRSS, median2 (0-14)8 (0-36)CRP (mg/L)4.21 ± 4.486.08 ± 5.710.069ESR (mm/hr)19.74 ± 1027.95 ± 21.60.270Renal crisis, n (%)1 (2.6)4 (5.3)0.662PAH, n (%)8 (21.1)14 (18.7)0.762ANA positivity, n (%)36 (94.7)70 (93.3)1Anti-centromere positivity, n (%)18 (47.4)19 (25.3)0.01Anti-topoisomerase-1, n (%)8 (21)34(45.3)0.01Smoking, n (%)n (%)n (%)Non-smoker30(78.9)59 (78.7)0.970Smoker8 (21.1)16 (21.3)Figure 1.Conclusion:In our study, it was found that LJM staging positively correlated with mRSS and DcSSc patients had more severe LJM findings than LcSSc. We conclude that “prayer sign” and “table top sign” tests used in hand evaluation in SSc patients have similar clinical results with mRSS and can be easily performed in daily practice in about 3 minutes.References:[1]Rosenbloom AL. Limitation of finger joint mobility in diabetes mellitus. The Journal of diabetic complications 1989; 3: 77-87.[2]Nashel J, Steen V. Scleroderma mimics. Current rheumatology reports 2012; 14: 39-46.Disclosure of Interests:None declared

Background:Treatment options for axial spondyloarthritis (axSpA) is currently limited, and up to 40% of the patients require biologic therapies to control symptoms. Early commencement of biologics suggested to have higher response rates but data regarding this subject is limited.Objectives:The primary aim was to investigate tumor necrosis factor inhibitor (TNFi) response and retention rates in axSpA patients who were treated in the early disease period (symptom duration (≤5 years). Our secondary aim was to identify factors predicting response to TNFi.Methods:Adult axial SpA patients who started TNFi treatments within the five years of their symptoms were identified and defined as “Group 1”. Patients whose TNFi treatments started five years after their initial symptoms served as a control group (Group 2: 5-10 years and Group3: ≥10 years). Response and survival rates at 6, 12, and 24 months were calculated. Predictors of response on TNFi survival at 24 months were also analyzed.Results:There was a total of 364 axiSpA (Group 1: 95, Group 2: 82 and Group 3: 187) patients in the study (69.8% male, 46.8±12.6 years). Group 1 patients tended to be younger, with a lower baseline CRP titers and lower HLA–B27 rate compared to the other groups. Drug survival rates were similar between the groups. This finding also remained similar when AS and nraxSpA patients analyzed separately. However, regardless of symptom duration, the drug retention rates were significantly higher in the AS group than in nraxSpA (Table 2). ASAS40 responses were higher in Group 1 than in Group 3 both at 12 and 24 months. Predictors of response based on ASAS40 at 24 months were treatment within the five years of the symptoms (OR:2.2) and age at baseline (OR:0.97) in univariate analysis. However, baseline ASDAS (OR:1.4) was the only factor in multiple regression.Conclusion:In this study we showed the following: 1) TNFi started in the early disease course resulted in a better ASAS40 response at both 12 and 24 months, 2) TNFi timing (started in the early or late disease period) seems not affecting drug retention rates, and 3) baseline disease activity is the most important predictor in achieving ASAS40 response at 24 months.Disclosure of Interests:None declared

Objective To analyze the dermatologic lesions and possible effects of immunosuppression treatment and p53 gene mutations on dermatologic findings in renal transplant recipients. Materials and Methods The study included 163 renal transplant recipients. After dermatologic examination, cultures, and histopathologic and genetic analyses were performed. A single-strand conformation polymorphism technique was used to analyze p53 gene mutations. Patients were categorized into 3 groups according to time since the transplantation procedure. Results were analyzed using the χ 2 test, using a software program (SPSS version 13.0; SPSS, Inc, Chicago, Illinois). Results Mean (SD) age of the 163 transplant recipients (65 women and 98 men) was 40 (11) years, and posttransplantation follow-up was 65 (55) months. The most frequently observed drug-related lesion was hypertrichosis, in 46 of 150 patients. Of 115 lesions, the most commonly observed were verruca vulgaris (n = 34) from viruses, and pityriasis versicolor (n = 21) from superficial fungal infections. Of the total group, 20 patients (12.2%) were mutation carriers. Compared with the entire cohort, the group with premalignant lesions demonstrated more p53 mutations (11% vs 50%; P = .004). Patients given cyclosporine therapy exhibited more premalignant or malignant cutaneous lesions compared with patients who received other agents ( P = .03). Conclusion Patients carrying p53 mutations developed a malignant lesion in the late posttransplantation period, which suggests the importance of prediction of risk.

Objective. The aim of this study was to investigate the quality of life of renal donors during long-term follow-up. Patients and Methods. The short form health survey (SF-36) questionnaire was compared between renal donors and the general population. We evaluated the relationship to postoperative complications and preoperative information with the quality of life. Results. Fifty renal donors of mean age 55.8 ± 12 years (range, 29-70 years) had a mean follow-up of 55.1 ± 47.2 months (range, 12-168 months). Complications after donor nephrectomy were related with physical function loss (r = - .397; P