Search

Objective: Deep vein thrombosis (DVT) of the lower extremities is the most common form of vascular involvement in Behcet disease (BD), frequently leading to post-thrombotic syndrome (PTS) as a disabling complication. We have described the clinical characteristics and predictors of PTS presence among patients with BD and lower extremity DVT. We also used venous Doppler ultrasound (US) examinations in our assessment. Methods: Patients with BD (n = 205; 166 men, 39 women; age 39 6 9.5 years) and a history of DVT were investigated. The Villalta scale was used to assess the presence and severity of PTS. Doppler US examinations were performed within 1 week of the clinical evaluation. The total number of vessels with reflux, thrombi, recanalization, and collateral vessels were calculated. Results: Of the 205 patients with BD, 62% had had PTS and 18% had had severe PTS. Patients with PTS had had greater reflux (P = .054) and thrombosis (P = .02) scores compared with patients without PTS. Treatment with anticoagulation (AC), immunosuppressive (IS) therapy, or AC combined with IS drugs did not affect the occurrence of PTS. However, patients treated with IS therapy, with or without AC drugs, had a decreased incidence of severe PTS compared with the AC-only group (P = .017). Patients treated with AC plus IS agents also had increased collateral scores compared with patients treated with only IS drugs. Interferon-a use seemed to provide better recanalization scores compared with azathioprine only (1.0 [range, 0-14] vs 2.5 [range, 0-10]; P = .010). Conclusions: Patients with BD and DVT have a high risk of developing severe PTS. IS treatment decreases the development of severe PTS. AC therapy might influence the course of PTS by increasing the collateral scores, and the use of interferon-a also increased recanalization scores. Routine assessment with Doppler US examinations could be helpful in the prediction of severe PTS. (J Vasc Surg Venous Lymphat Disord 2021;9:1451-9.)

Background Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease that requires lifelong colchicine treatment. Colchicine is the mainstay of the treatment which decreases the frequency and the severity of recurrent FMF attacks, also, prevents the development of amyloidosis. This study aimed to investigate the rates of colchicine treatment adherence in patients with FMF and the factors related to treatment non-adherence. Materials and methods This observational study was conducted with 179 patients with FMF between November 2018 and April 2019 in a tertiary rheumatology outpatient clinic. The sociodemographic and clinical data were recorded. Compliance Questionnaire on Rheumatology (CQR) was used to assess the treatment adherence and the Beliefs About Medicines Questionnaire (BMQ-T) was used to assess a patient?s beliefs about colchicine. The factors associated with adherence to the treatment were evaluated. Results The study included 113 male (63.1%) and 66 (36.9%) female patients with a mean age of 30 (25-44) years. The rate of the patients who declared regular colchicine usage was 66.5%. The frequency of non-adherent patients was 83.8% according to CQR. Treatment adherence was better in patients with comorbid diseases than those without (41.4% vs. 22%, respectively, p = 0.028). The frequency of married patients in the adherent group (72.4%) was higher than the non-adherent group (47.3%) (p = 0.013). The colchicine dose used in the adherent group was 1.5 (1.3-1.8) mg/day, whereas it was 1.5 (1.0-1.5) mg/day in the non-adherent group (p = 0.033). The adherence rate was rising with increasing scores of BMQ-T Specific Necessity. As the scores of BMQ-T General Overuse and General Harm increased, non-adherence to colchicine increased. Conclusion Evaluating adherence to colchicine treatment with objective methods is crucial to ensure sufficient treatment and prevent amyloidosis. Determining beliefs about colchicine may increase patients? adherence to treatment.

Objective The etiopathogenesis of spondyloarthropathies (SpA) is still unclear. Recently, anti-CD74 antibody has been suspected to play a role in SpA etiopathogenesis. This study aimed to examine the levels of anti-CD74 antibody in patients with SpA and investigate their association with disease activity. Methods This study was conducted using data from patients who were treated at the departments of rheumatology and gastroenterology between June 2013 and November 2013. The demographic and clinical characteristics of the participants and their serum IgG-type antibodies against anti-CD74 were analyzed. Results We analyzed 111 patients with ankylosing spondylitis (AS), 108 patients with inflammatory bowel disease (IBD), and 101 healthy controls. The rate of human leukocyte antigen-B27 positivity was 86.5% in patients with AS and 21.3% in patients with IBD. The mean levels of anti-CD74 antibodies in the AS, IBD, and control groups were 6.99±3.24 ng/mL, 6.25±3.34 ng/mL, and 7.83±4.72 ng/mL, respectively. Anti-CD74 levels were higher in healthy controls than in patients with IBD (p=0.009). There was no significant difference in anti-CD74 levels between the AS and IBD groups and the AS and control groups. In addition, there was no correlation between anti-CD74 levels and disease activity. Conclusion This study could not find an association between anti-CD74 levels and SpA in Turkish patients.

Background/aim: to evaluate treatment adherence and predictors of drug discontinuation among patients with inflammatory arthritis receiving bDMARDs within the first 100 days after the announcement of the COVID-19 pandemic. Materials and methods: a total of 1871 patients recorded in TReasure registry for whom advanced therapy was prescribed for rheumatoid arthritis (RA) or spondyloarthritis (SpA) within the 3 months (6-9 months for rituximab) before the declaration of COVID-19 pandemic were evaluated, and 1394 (74.5%) responded to the phone survey. Patients' data regarding demographic, clinical characteristics and disease activity before the pandemic were recorded. The patients were inquired about the diagnosis of COVID-19, the rate of continuation on bDMARDs, the reasons for treatment discontinuation, if any, and the current general disease activity (visual analog scale, [VAS]). Results: a total of 1394 patients (493 RA [47.3% on anti-TNF] patients and 901 SpA [90.0% on anti-TNF] patients) were included in the study. Overall, 2.8% of the patients had symptoms suggesting COVID-19, and 2 (0.15%) patients had PCR-confirmed COVID-19. Overall, 18.1% of all patients (13.8% of the RA and 20.5% of the SpA; p = 0.003) discontinued their bDMARDs. In the SpA group, the patients who discontinued bDMARDs were younger (40 [21-73] vs. 44 years [20-79]; p = 0.005) and had higher general disease activity; however, no difference was relevant for RA patients. Conclusion: although the COVID-19 was quite uncommon in the first 100 days of the pandemic, nearly one-fifth of the patients discontinued bDMARDs within this period. The long-term effects of the pandemic should be monitored., Hacettepe Rheumatology Society

OBJECTIVES Sarcopenia is a progressive and generalized loss of muscle mass and function. The aim of this study was to evaluate the frequency of sarcopenia among patients with primary Sjogren's syndrome (SS) and the factors related with sarcopenia. METHODS Forty-four female patients with primary SS and 44 female control subjects were included in this cross-sectional study between February and August 2019. Sarcopenia was evaluated by the handgrip test, Skeletal Muscle Mass Index, and gait speed test. RESULTS Eleven patients (25.0%) had presarcopenia in the SS group and 2 (4.5%) in the control group (p = 0.007). Compared with control subjects, SS patients had lower results of hand grip and gait speed tests (p = 0.005 and p < 0.001, respectively). According to the Mini Nutritional Assessment Short Form, patients with presarcopenia had higher risk of malnutrition compared with patients without sarcopenia (p = 0.043). Patients with presarcopenia had higher scores in the European League Against Rheumatism Sjogren's Syndrome Patient-Reported Index pain domain and patient visual analog scale for global disease activity compared with patients without sarcopenia (p = 0.044 and p = 0.036, respectively). In multivariate regression analysis, European League Against Rheumatism Sjogren's Syndrome Patient-Reported Index pain was associated with hand grip strength (p = 0.016, R2 = 0.13) and Mini Nutritional Assessment Short Form was associated with Skeletal Muscle Mass Index (p = 0.005). CONCLUSIONS Risk of sarcopenia is increased in patients with SS. Pain and malnutrition may contribute to presarcopenia. Evaluating pain and patient's global disease activity may help physicians to determine patients with increased risk of sarcopenia. Controlling disease activity and pain and preventing malnutrition may reduce the risk of development of sarcopenia.

OBJECTIVE To evaluate the presence of sarcopenia in patients with rheumatoid arthritis (RA). METHOD This cross-sectional study included 100 patients with RA and 100 gender-matched healthy individuals. Sarcopenia was assessed by performing tests evaluating muscle strength, muscle mass, and physical performance, using the criteria determined by The European Working Group on Sarcopenia. Sarcopenia is defined as a decrease in muscle strength and muscle mass. On the other hand, presarcopenia is defined as a decrease in muscle strength with a normal muscle mass. RESULTS The participants comprised of 70 females and 30 males. The frequency of presarcopenia was 35% in the RA group and 9% in the control group (P

Introduction: Familial Mediterranean fever (FMF) patients had 5–10% colchicine resistance. Although FMF attacks are characterized by acute phase elevation, there are no biomarkers that can show colchicine resistance yet. The serum endocan levels may elevate in inflammatory and auto-inflammatory diseases.Objectives: This study aimed to evaluate serum endocan levels in FMF patients according to whether attack and colchicine resistance or not and also compare them with classical acute phase reactants.Methods: In this single-center and cross-sectional study, a total of 111 FMF patients and 60 healthy individuals were enrolled. All patients' basic demographic and clinical data were recorded and blood samples were collected.Results: A total of 46 (41.4%) FMF patients had colchicine resistance. In comparison to the FMF patients according to colchicine response, colchicine resistance patients had a significantly higher median (IQR) endocan levels than colchicine responsive patients [36.98 ng/ml (97.41) vs. 13.57 ng/ml (27.87), p = 0.007], but there were no differences between in terms of median ESR and CRP levels. Inversely, serum endocan levels were similar during an attack and attack-free period in FMF patients, although ESR and CRP levels were significantly different. Interestingly, the highest serum endocan levels were in the control group.Conclusion: In conclusion, serum endocan levels were higher in colchicine resistance than colchicine responsive patients, but attack state had no effect on serum endocan levels in our study. Unlike ESR and CRP, serum endocan may be a novel biomarker for detection of colchicine resistance and distinguish the FMF attacks.

Objective Because of concerns about malignancy risks, using biological disease-modifying antirheumatic drugs (bDMARDs) in patients with a history of malignancy remains a challenging issue in rheumatology practice. This study aimed to investigate bDMARD preferences of physicians when treating of rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients with a history of malignancy. Methods The data for this cross-sectional study were gathered from the TReasure database using a date range of December 2017 and January 2020. Biological disease-modifying antirheumatic drug preferences were analyzed for 40 RA patients and 25 SpA patients with a history of malignancy. Results The most frequently prescribed bDMARD was rituximab, which was given to 28 RA patients (70%). For 25 patients (62.5%), the time between the diagnosis of malignancy and starting on a bDMARD regimen was less than 60 months, with a median interval of 43.5 months. Among SpA patients, the preferred bDMARDs were secukinumab and etanercept, which were each administered to 7 patients (28%). For 13 SpA patients (52%), the time between the diagnosis of malignancy and starting on bDMARDs was less than 60 months, with a median interval of 97 months. Conclusions The observed bDMARD preferences may be related to the therapeutic effects of rituximab on lymphoproliferative malignancies, the protective effects of secukinumab on tumor progression, and the short half-life of etanercept. Biological disease-modifying antirheumatic drugs should be used in RA and SpA patients with malignancy in case of high inflammatory activity.

OBJECTIVES Behcet's disease (BD) is a type of systemic vasculitis and inflammatory disease of unknown etiology, which is associated with fatigue and lower quality of life (QoL). The aim of this study was to assess the relationship between Behcet's Disease Current Activity Form (BDCAF) and Behcet's Disease Quality of Life (BDQoL), depression, anxiety and fatigue in Behcet's disease. METHODS We conducted a cross-sectional study of 155 BD patients and 107 healthy subjects in a single center over a 1 year period. All participants completed the Multidimensional Assessment of Fatigue (MAF) questionnaire, and the Hospital Anxiety and Depression (HADS) scale. Disease activity in the BD patients was assessed using the BDCAF, and the physician's global assessment (PGA). BD patients also completed the BDQoL questionnaire. RESULTS There was no significant difference in age and gender between the groups. BD patients had significantly higher HADS-anxiety (HADS-A), HADS-depression (HADS-D) and MAF scores than the healthy control group (P

Background: the course of novel coronavirus disease 2019 (COVID-19) has been of special concern in patients with inflammatory rheumatic diseases (IRDs) due to the immune dysregulation that may be associated with these diseases and the medications used for IRDs, that may affect innate immune responses. Objective: in this cohort study, we aimed to report the disease characteristics and variables associated with COVID-19 outcome among Turkish patients with IRDs. Methods: between April and June, 2020, 167 adult IRD patients with COVID-19 were registered from 31 centers in 14 cities in Turkey. Disease outcome was classified in 4 categories; (i) outpatient management, (ii) hospitalization without oxygen requirement, (iii) hospitalization with oxygen requirement, and (iv) intensive care unit (ICU) admission or death. Multivariable ordinal logistic regression analysis was conducted to determine variables associated with a worse outcome. Results: 165 patients (mean age: 50 ± 15.6 years, 58.2% female) were included. Twenty-four patients (14.5%) recovered under outpatient management, 141 (85.5%) were hospitalized, 49 (30%) required inpatient oxygen support, 22 (13%) were treated in the ICU (17 received invasive mechanic ventilation) and 16 (10%) died. Glucocorticoid use (OR: 4.53, 95%CI 1.65-12.76), chronic kidney disease (OR: 12.8, 95%CI 2.25-103.5), pulmonary disease (OR: 2.66, 95%CI 1.08-6.61) and obesity (OR: 3.7, 95%CI 1.01-13.87) were associated with a worse outcome. Biologic disease-modifying antirheumatic drugs (DMARDs) do not seem to affect COVID-19 outcome while conventional synthetic DMARDs may have a protective effect (OR: 0.36, 95%CI 0.17-0.75). Estimates for the associations between IRD diagnoses and outcome were inconclusive. Conclusions: among IRD patients with COVID-19, comorbidities and glucocorticoid use were associated with a worse outcome, while biologic DMARDs do not seem to be associated with a worse outcome., NA

Interleukin-6 receptor antagonist, tocilizumab (TCZ), is known to be effective in the treatment of amyloidosis in patients with familial Mediterranean fever (FMF). But there are limited data about the effect of TCZ on frequency of attacks. In the current study, we aimed to find out whether TCZ therapy could decrease the frequency of recurrent attacks of FMF or not.The recorded files of 15 patients who had received intravenous TCZ for the improvement of amyloidosis associated with FMF, were evaluated retrospectively. Data of demographic and clinical characteristics of patients were archived from those files.Three female and 12 male patients received TCZ due to amyloidosis were included to the study. The mean age was 42.07 ± 14.37 years. All of the patients were in full compliance with colchicine treatment. According to international severity scoring system for FMF, all of the patients had severe disease. The frequency of attacks recorded was evaluated during TCZ treatment, and it was reported that one patient had no response, six patients had decreased attack frequency and eight patients had no attacks.Tocilizumab is found to be efficient on improvement of amyloidosis and decreasing the frequency of recurrent attacks in patients with FMF. Besides, TCZ is well tolerated among the patients. Further and prospective studies with larger sample are needed to support these results.

Fatigue is a symptom that affects the 40-80% of patients with rheumatoid arthritis (RA) and impairs the quality of life. The aim of this study was to assess multidimensional fatigue scales, the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ) and the Bristol Rheumatoid Arthritis Fatigue Numerical Rating Scale (BRAF-NRS) and to evaluate their relationship with disease activity in Turkish RA patients. The study included 180 patients with RA. The Disease Activity Score (DAS28), Clinical Disease Activity Index (CDAI), and Simplified Disease Activity Index (SDAI) were used to evaluate disease activity. The participants comprised of 142 females and 38 males. The mean ± standard deviations of DAS28, CDAI, and SDAI were 3 ± 1.24, 9.51 ± 7.96, and 10.5 ± 8.38 respectively. All scales except the emotional subscale were correlated with disease activity. The emotional subscale correlated with CDAI and SDAI but not with DAS28. The results of the study indicated that fatigue and disease activity were correlated. Fatigue is a symptom that impairs the quality of life but it can be easily coped with by controlling disease activity. Thus, it should be assessed in a multidimensional perspective.

Introduction : Behçet’s disease (BD) is a complex multisystemic inflammatory disorder which is characterized by recurrent attacks of acute inflammation. As there is no universally recognized pathognomonic laboratory marker of BD, its diagnosis is still based on clinical findings. Aim : To evaluate the role of calprotectin and ischemia modified albumin (IMA) as biomarkers in the assessment of disease activity of BD. Material and methods : A total of 93 patients with BD and 62 age- and gender-matched healthy controls were included in the study. Disease activity was assessed with the BD Current Activity Form (BDCAF) score. Serum levels of calprotectin, high-sensitivity C-reactive protein (hsCRP) and IMA were measured in the patient and control groups. Results : Serum levels of calprotectin, IMA and hsCRP in patients with BD were higher than those of the healthy control group (p < 0.001 for all). No correlations between calprotectin and IMA, hsCRP, erythrocyte sedimentation rate, CRP, or BDCAF score were found. Conclusions : As the calprotectin level are increased in BD patients, it could be a candidate biomarker which plays a role in BD pathogenesis.

Background:Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease mainly affecting sacroiliac joints and spine. Peripheral arthritis, dactylitis and enthesitis may also occur. Extra musculoskeletal manifestations (EMMs; uveitis [AAU], inflammatory bowel disease [IBD] and psoriasis [Pso] are among the most common ones) are important features and might have an impact on the disease burden in patients with axSpA. The presence of EMM, in particular IBD and AAU could influence the choice of TNFi however little is known regarding the role of peripheral manifestations together with the EMM on the prescribing patterns in axSpA patients.Objectives:To examine the frequency of peripheral and EMMs in a real-world axSpA cohort and their effect on the choice of first advanced treatment.Methods:In total 1687 axSpA patients (58% male and the mean age (±SD) was 38.5 ± 10.9) who initiated his/her first biologic were included in the present analysis. The data for the current study was obtained from the TReasure web-based registry; in which RA and SpA patients treated with bDMARDs from different regions of Turkey. Baseline demographic, disease related characteristics, peripheral and EMMs were extracted. Characteristics of patients with and without peripheral/extra-musculoskelatal involvement were compared as well as factors/covariates associated with the choice of first TNFi and secukinumab was analysed.Results:Enthesis (28.2%) was found the most common peripheral manifestations and peripheral arthritis (26.4%) and hip arthritis (24.4%) followed it. Symptom duration to the first advanced treatment initiation was significantly shorter in axSpA patients with peripheral arthritis, enthesitis, dactylitis and psoriasis and longer in hip arthritis and AAU. HLA-B27 positivity was significantly lower in patients with arthritis, psoriasis and IBD and higher with hip arthritis and AAU. In multivariate analysis the presence of IBD is significantly associated with the preference of monoclonal TNFi (mab) over etanercept (ETA) (OR 5,770; 95%CI 1.788-18.616). However ETA was preferred in patients with hip arthritis (p=0.003), longer symptom duration (p=0.049), and using sulfasalazine (p=0.043). In comparison with mabs, secukinumab (SEC) prescription was found to be significantly associated with higher age (p=0.001), sulfasalazin (p=0.001) and methotrexate usage (p=0.053) among axSpA patients need their first advanced treatment.Conclusion:The results of the current study confirm the pathophsyologic associations of peripheral involvement and EMM in axSpA patients. Apart from hip arthritis the presence of IBD has an impact on the prescription of advanced treatment in real-life.Table 1.Clinical characteristics of patients in cohortAll patients(n=1678)Peripheral arthritis(n=445)Dactilitis(n=81)Enthesis(n=476)Uveitis(n=193)Psoriazis(n=152)IBD(n=78)Hip involvemet(n=412)Age, mean±SD38,5±10,938,3±11,637,4±11,137,9±10,741,3±11,439,9±11,341,6±12,239,2±11,2Male sex,n (%)974 (57,7)184 (41,3)34 (42)238 (50)96 (49,7)54 (35,5)43 (55,1)272 (66)Symptom duration, mean month±SD108,5±98,996,9±92,979,1±76,5100,4±92,7144,7±110,287,7±9494,5±98133,3±108,2HLA B27 positivity, n (%)621 (53,7)142 (46,3)27 (51,9)174 (49,4)104 (77)34 (36,2)16 (27,1)186 (59,8)Concomitant cDMARD usage (yes), n (%)420 (24,9)170 (38,2)39 (48,1)133 (27,9)53 (27,5)58 (38,2)24 (30,8)99 (24)BASDAİ,mean±SD5,1±2,55,1±35,3±3,15,3±2,94,7±2,55,6±2,44,8±2,35,3±2,1ASDAS-CRP, mean±SD3,1±1,52,6±1,92,5±1,82,8±1,72,9±1,73,4±1,33,1±1,53,7±1,4Disclosure of Interests:None declared

Background:Postthrombotic syndrome(PTS) defines chronic manifestations of venous insufficiency following deep vein thrombosis(DVT).It is the most frequent and disabling complication of DVT.Objectives:Aim of the study is to describe clinical characteristics and predictors of PTS,severe PTS among Behçet’s disease(BD)patients with known low extremity DVT.Also,to depict venous Doppler ultrasonography(US)findings and its association with the clinical characteristic and treatments.Methods:This retrospective multicenter study included 205(166men,39women;mean age 39±9.5 years)BD patients with DVT history.The Villalta scale was used to assess the presence and severity of PTS.Doppler US of bilateral legs are performed within 1 week of clinical evaluation.Total number of vessels with reflux,thrombi,recanalization and collaterals were calculated and presented as scores.Results:Of 205 BD patients with known DVT history; 127(62%) had PTS and 18% had severe PTS diagnosed by Villalta scale.(Table 1)Table 1.Demographic and Clinical Characteristics of PatientsEntire Study Population (n:205)PTS present (n:127)PTS absent (n:78)P valueSex(male,%)166,81%101,79.5%65,83.3%.584History of smoking,%105,52%64,51.2%41,53.2%.895BMI(n:198)26.2±4.626.7±525.6±3.8.123Disease duration,years9(5-15)10(5-16)8(5-13).205DVT following time years6(3-11)7(3-11.5)5(3-9).179Current age39±9.540.5±9.636.8±8.8.012Number of vascular events1(1-2)1(1-2)1(1-2).723VeinesQoL total82±16.375.8±1492.2±14.6VeinesQoL symptom37.5±934.4±8.342.6±7.7Doppler Findingsİliofemoral thrombi41,26.5%32,35%9,17%.014Bilateral involvement62,43.4%45,49%17,33%.080All median values presented with interquartileranges(IQR)Table 2 summarize multivariate logistic regression analyses for the risk of having PTS-moderate/severePTS.Table 2.Multivariate Regression Analysis of presence of PTSOdds Ratio(with 95%CI)PCurrent age1.05(1.01-1.10).048BSAS1.06(1.04-1.10).000Bilateral Doppler USG involvement2.81(1.18-6.67).019İliofemoral thrombi2.74(1.02-7.38).045Moderate/severe PTSOdds RatiopBody mass index1.09(1.001-1.19).048IS0.10 (0.02-0.05).005Severe PTS patients had increased reflux(p=.027) compared to mild group and decreased recanalization scores(p=.013)compared to moderate group(Figure1)Patients treated with AC+IS had increased recanalization(p:.078),collateral scores compared patients treated with only ISs(p=.004)(Figure2)Conclusion:After an acuteDVT,BD patients faced with high risk of having PTS,severe PTS.ISs decreases the risk of having PTS.Our results also suggest that AC treatment may decrease severity of PTS by increasing recanalization of thrombi.Figure 1.US scores for PTS absent and present group Reflux score(p=.054) and thrombosis scores(p=.02)Figure 2.US scores for treatment groupsReferences:Disclosure of Interests:None declared

Background Immunoglobulin a vasculitis (IgAV) [formerly called Henoch– Schonlein purpura (HSP)] is an IgA mediated systemic vasculitis which primarily affects skin, gastrointestinal system and small vessels of kidneys. Exact pathogenesis of IgAV remains unknown. A fewclinicalstudiesevaluatedthe role of oxidativeinjury in thepathogenesis of vasculitis. Ischemia modified albumine (IMA) and Neopterin increased status of oxidative stress. Objectives The aims of the study are to investigate serum neopterin and IMA levels in patients with IgAV and evaluate the association of these markers with disease activity and relapse. Methods Thirty-four consecutive adult patients (24 males and 10 females) admitted to the rheumatology clinic of ankara Numune Training and Research Hospital meeting the IgAVAmerican College of Rheumatology (ACR) criteria were enrolled in this cross-sectional study. Demographic and clinical features of IgAV and control group were recorded into a predefined protocol. Disease activity was categorized as “remission” or “active” according to BVAS. BVAS ≥1 was accepted “active”.Serum neopterin levels, hsCRP and IMA were evaluated according to BVAS and compared to healthy control group. Results Serum median (IQR) neopterin, IMA levelsandhsCRPwerehigher in thestudygroupthan in controlgroup [2.01 (12.5) ng/mL vs. 1.77 (1.37) ng/mL, 0.67 (0.2) ng/mL vs. 0.43 (0.17) ng/mL, 5.6 (17.1) mg/L vs. 1.55 (1.6) mg/L, p=0.095, p Conclusion Oxidative stress is important in HSP pathogenesis. Roles of hsCRP,Neopterin and IMA as potential markers of diagnosis and disease activity seem to be worth studying in the future studies with larger study groups. Disclosure of interests None declared

Background Familial Mediterranean Fever (FMF) is the most common hereditary, chronic autoinflammatory disease. Colchicine is the mainstay of the treatment, which reduces frequency of attacks and amyloidosis risk. Complementary and alternative medicine (CAM) therapies can be a non-mainstream treatment choice in chronic diseases. Frequency of use of CAM therapies among patients with FMF is not established yet. Objectives In the current study we aimed to identify the prevalence of the patients using CAM therapies and the factors associated with CAM usage among the patients with FMF. Methods One hundred and sixty-five patients were included in the study. Data regarding demographic, social and clinical characteristics were obtained from the patients. The patients were asked whether they were using any type of CAM and if they had suffered harm and/or benefit. The treatment adherence of the patients was assessed using by Morisky Green Levine Scale (MGLS). The Beliefs About Medicines Questionnaire (BMQ-T) was used to assess patient’s beliefs about medicines. Results Fifty-six (33.9%) patients declared to use at least one CAM. The mean age of the patients was 34.1 ±12.7 years and the mean disease duration was 16.8±10.8 years. The mean dose of colchicine was 1.4±0.4 mg/day. Patients with concomitant disease and positive history of FMF in relatives had higher rates of using of CAM (p=0.011 and p=0.014 respectively). There was no statistically significance between age, sex, marital, socioeconomic and working status, difficulty of access to the treatment center, dose of colchicine, adverse events related to colchicine, attack frequency and disease severity of the patients and frequency of CAM using (p>0.05). The most frequently chosen types of CAM modalities were massage therapy (12.1%), imagining (9.7%), relaxation techniques (9.1%), cupping (9.1%) and natural products (9.1%). It is found that 42 (75.0%) of patients reported that they have suffered benefit from CAM. The mean duration of the using of CAM was 7.9 ±6.4 years. According to the BMQ-T, there was higher rate of concern about colchicine among patients that were using CAM (p=0.035) (Table 1). There was no statistically significance between compliance with colchicine treatment and using of CAM (p=0.313). Conclusion Colchicine is the gold standard of treatment because of the known effect of colchicine treatment on the severity and frequency of FMF attacks and the risk of development of amyloidosis. Approximately one third of patients with FMF were using at least one of the CAM modalities in the current study. Concerns about colchicine treatment may have increased the tendency to use CAM therapies. On the other hand, patients should be informed that CAM therapies should not be an alternative to colchicine. Disclosure of Interests None declared

Background Familial Mediterranean Fever (FMF) is an autoinflammatory disease requiring long-term treatment. Increasing the compatibility with colchicine treatment in patients with FMF is the first step for preventing amyloidosis. Patients’ beliefs about medicines and treatment may affect treatment adherence and treatment success. Objectives The aim of this study was to determine adherence to colchicine treatment and related factors in FMF patients. In addition, patients’ beliefs about colchicine, which are one of the important factors affecting the treatment adherence of patients, were evaluated. Methods Total of 179 patients with FMF was included in this study. The demographic and clinical features and MEFV gene mutations were recorded. The treatment adherence of the patients was assessed using by Compliance Questionnaire on Rheumatology (CQR). The Beliefs About Medicines Questionnaire (BMQ-T) was used to assess patient’s beliefs about colchicine. The relationship between compliance of treatment and clinical characteristics of patients were assessed. Results One hundred thirteen (63.1%) of the patients were male. The mean age of patients was 34.5 ± 12.7 years and mean delay in diagnosis was 6.7 ± 8.4 years. The mean dose of colchicine was 1.37 ± 0.43 mg/day and, the percentage of patients using colchicine regularly was 66.5%. Adherence to treatment was higher in patients with concomitant diseases than those without comorbidities (p = 0.028). In addition, treatment compliance was higher in married patients compared to single patients (p = 0.013). The colchicine dose used in compatible patients was higher than in non-compatible patients (p = 0.033) (Table 1). We also found that as the BMQ-T Specific Necessity scores increased, compliance with treatment increased. On the other hand, as the BMQ-T General Overuse and General Harm scores increased, non-compliance with treatment increased (Table 2). Conclusion In patients with FMF, it is important to evaluate the compliance with the treatment due to the importance of colchicine to prevent amyloidosis that may occur in patients without treatment. As this study shows it is also important to determine patients’ beliefs about medicine in terms of their influence on patients’ compliance with treatment. Disclosure of Interests None declared

Background Familial Mediterranean Fever (FMF) is the most frequent hereditary autoinflammatory disease in the worldwide. Colchicine is the mainstay of the treatment that is used for both preventing the attacks and developing amyloidosis. In case of colchicine resistance, which constitutes almost 5% of all patients, there are some alternatives such as anti-TNF agents, IL-6 and IL-1 antagonists. These agents have also been used in patients with established amyloidosis secondary to FMF. Tocilizumab (TCZ), an IL-6 receptor antagonist, although is effective in the treatment of amyloidosis, little known about its effectiveness in the preventing of febrile attacks. Objectives In this study, we aimed to find out whether TCZ therapy decrease the frequency of recurrent attacks of FMF or not. Methods This retrospective cross-sectional study designed in a tertiary rheumatology clinic between the years 2009 and 2019. A total of 15 patients were given intravenous TCZ at a dose of 8mg/kg/month, to improve amyloidosis associated with FMF. Data of demographic and clinical characteristics of patients were obtained retrospectively from patient files. Results Three female and 12 male patients received TCZ for amyloidosis treatment. The mean age of patients was 42.07±14.37 years and disease duration was 25.73±10.86 years. All of the patients had biopsy results providing amyloidosis. According to international severity scoring system for FMF, all of the patients had severe disease. Demographic and clinical data were shown in Table 1. The frequency of attacks was evaluated during TCZ treatment, and it was reported that 1 patient had no response, 6 patients had decreased attack frequency and 8 patients had no attacks. Serious adverse events were seen in none of the patients. MEFV:Mediterranean Fever, TCZ:Tocilizumab Conclusion Tocilizumab is found to be effective on improvement of amyloidosis. In the current analysis, we found that TCZ also decreases the frequency of recurrent attacks in patients with FMF. Besides, TCZ is well tolerated among the patients. Further and prospective studies with larger sample are needed to support these results. References [1] Yilmaz S, Cinar M, Simsek I, Erdem H, Pay S. Tocilizumab in the treatment of patients with AA amyloidosis secondary to familial Mediterranean fever. Rheumatology2015;54:564-565 Disclosure of Interests None declared

Background Familial Mediterranean Fever (FMF) is a chronic hereditary disease which is characterized by recurrent attacks of fever accompanied by serositis. Severity of disease is related with morbidities such as amyloidosis and chronic renal failure. Objectives The aim of this study was to evaluate disease severity with two disease severity scores in FMF patients, and compare them. Methods The study included 160 patients with FMF. Demographic and clinical data were recorded in the patients’ form. The patients’ disease severity were evaluated with International Severity Scoring System for FMF (ISSF) and The Second Set of FMF severity score (F-SS-2). Results A total of 160 patients, comprising of 106 males (66.3%) and 54 (33.8%) females with a mean age of 33.5 ± 12.2 years were evaluated. Mean disease duration was 16.6 ± 10.3 years. Other demographic and clinical characteristics of the patients were shown in Table 1. According to ISSF, 67 (41.9%) patients were classified as having mild disease, 80 (50.0%) patients as intermediate disease and 13 (8.1%) patients as severe disease. On the other hand, 59 (36.9%) patients were classified as having mild disease, 41 (25.6%) patients as intermediate disease and 60 (37.5%) patients as severe disease according to F-SS-2 score. Higher rates of patients were found having severe disease according to F-SS-2 compared with ISSF (p F-SS-2: The second set of Familial Mediterranean Fever severity score, ISSF: International Severity Scoring System for Familial Mediterranean Fever, aPearson Chi-Square test Conclusion Disease severity scores should be used for treatment choice, evaluation of disease prognosis and classify patients according to disease severity in clinical trials. In the current study, we found a difference between the classifications of disease severity, which could be a result of each scoring system uses different parameters of the disease. Disclosure of Interests None declared

AIM The aims of the study are to investigate serum neopterin and ischemia modified albumin (IMA) levels in patients with immunoglobulin A vasculitis (IgAV) and evaluate the association of these markers with disease activity and relapse. METHOD Thirty-four consecutive adult patients (24 male and 10 female) admitted to the rheumatology clinic and met the IgAV American College of Rheumatology (ACR) criteria were enrolled in this cross-sectional study. Demographic and clinical features of IgAV and a control group were recorded into a predefined protocol. Disease activity was categorized as "remission" or "active" according to Birmingham Vasculitis Activity Score (BVAS). BVAS ≥ 1 was accepted as "active". Serum neopterin levels, high-sensitivity C-reactive protein (hsCRP) and IMA were evaluated according to BVAS and compared to the healthy control group. RESULTS Serum median (interquartile range) neopterin, IMA levels and hsCRP were higher in the study group than in control group (2.01 [12.5] ng/mL vs 1.77 [1.37] ng/mL, 0.67 [0.2] ng/mL vs. 0.43 [0.17] ng/mL, 5.6 [17.1] mg/L vs. 1.55 [1.6] mg/L, P = .095, P

Background:Sarcopenia is the progressive and generalized loss of muscle mass, strength and function especially among elderly population. Inflammation may lead to sarcopenia regardless of age.Objectives:To evaluate the frequency of sarcopenia and related factors in patients with primary Sjogren’s syndrome (SS).Methods:A total of 44 female patients with SS and 44 age matched female healthy controls were included in this cross-sectional study. Sarcopenia was evaluated by hand grip test, skeletal muscle index (SMI) and 6 meters gait speed (GS) test. According to recommendations of European Working Group on Sarcopenia in Older People (EWGSOP2) 2018, sarcopenia is defined as decrease in results of both hand grip test and SMI, whereas, probable sarcopenia is defined as only decrease in results of hand grip test. Mini Nutritional Assessment Short Form (MNA-SF) was used for evaluating nutritional statement. EULAR SS patient reported index (ESSPRI) and EULAR SS disease activity index (ESSDAI) used for evaluating disease activity. Patient global assessment (PGA) was assessed with visual analogue scale (VAS 0-10 cm). Patients with arthritis in dominant hand and/or ankle joints were excluded from the study.Results:The mean age of participants was 55.3±10.4 years. Eleven patients (25.0%) had probable sarcopenia in SS group and 2 (4.5%) in control group (p=0.007). Compared with healthy controls, SS patients had lower results of hand grip and 6 meters GS tests (p=0.005 and p2=0.13) and MNA was associated with SMI (p=0.005) (Table 2).Table 1.Factors associated with probable sarcopenia in Sjogren’s syndromeSjogren’s syndrome groupNo sarcopenia(n=33)Probable Sarcopenia(n=11)p-valueESSPRI pain*5 (0-10)7 (3-10)0.044bVAS patient*4 (0-10)6 (0-10)0.036bMNA SF, n (%)0.043CNormal nutritional status (12-14)32 (97)8 (72.7)Risk of malnutrition (8-11)1 (3)3 (27.3)ESSPRI: EULAR Sjogren’s Syndrome Patient Reported Index, VAS: Visual Analogue Scale, MNA SF: Mini Nutritional Assessment Short Form. *Variables given as median (minimum-maximum)aIndependent Samples Student t test,bMann-whitney U,CFisher’s Exact test.Table 2.Multivariate analysis for hand grip strength and SMI in patients with Sjogren’s syndromeUnstandardized Coefficients95% Confidence Interval for BStandardized Coefficientsp-valueBStd.ErrorLowerUpperBetaHand grip strengthConstant24,4921,69521,07127,914–ESSPRI pain-0,7070,282-1,276-0,139-0,3610,016SMIConstant5,4191,7051,9788,860–0.003MNA0,3800,127-1,276-0,1390,4190,005ESSPRI: EULAR Sjogren’s Syndrome Patient Reported Index, SMI: Skeletal Muscle Index, MNA: Mini Nutritional AssessmentConclusion:Risk of sarcopenia is increased in patients with SS. In the current study, it is shown that pain is related with sarcopenia. ESPPRI pain is a sign of continuing chronic inflammation in patients with SS. Malnutrition, which can indirectly related with SS, may also contribute to this process. Excessive pain may lead to decrease daily activities and nutritional status of patients with SS. Evaluating pain and patient’s global disease activity may help physicians to find out patients with increased risk for sarcopenia. Controlling disease activity and pain and preventing malnutrition may reduce the risk for development of sarcopenia.Acknowledgments :None to declareDisclosure of Interests: :None declared

Background:Psoriatic disease (PsD) is a chronic immune-mediated inflammatory disorder and predominantly involves the skin and joints. There is a better known relationship between the severity of PsD with some comorbidities such as metabolic syndrome, cardiovascular disease and obesity. Visceral Adiposity Index (VAI) has been shown to be an important marker, gender- dependent for insulin resistance, adipose tissue function and distribution.Objectives:The aim of this study was to evaluate the relationship between the VAI and cardiovascular risk scores of patients with psoriatic arthritis.Methods:This study was conducted with 101 PsD patients who fulfilled the classification criteria for Psoriatic Arthritis (CASPAR) criteria and 98 healthy subjects. Demographic and clinical data were recorded. Disease activity was evaluated with the Health Assessment Questionnaire (HAQ), Disease Activity Index for Psoriatic Arthritis (DAPSA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Disease Activity Index (BASFI) and Psoriasis Area Severity Index (PASI). The SCORE, Framingham index, metabolic syndrome (MetS), Body mass index (BMI) and VAI values of the patients and the VAI values of the healthy subjects were calculated.Results:Mean BMI (kg/m2) was calculated as 29.63 5.66. According to the SCORE measurements, 53 (52.5%) patients were at low risk, 45 (44.6 %) at moderate risk, and 3 (3 %) at high risk. No patients were at very high risk. According to the Framingham score, 72 patients (71.3%) were at low risk, 22 patients (21.8%) at intermediate risk and 7 patients (6.9%) at high risk. The risk was found to be statistically significantly higher in the PsD group compared to the healthy control group in respect of metabolic syndrome, obesity (BMI >30) and VAI levels (p 30 (obesity), diabetes mellitus and hypertension compared to without these comorbidities (pConclusion:Patients with psoriasis are more susceptible to obesity and other diseases such as metabolic syndrome, dyslipidemia, cardiovascular diseases, insulin resistance and diabetes. Therefore, control of bodyweight in PsD patients is important for management of the disease. Since VAI can be calculated simply from routinely taken measurements, the VAI level can be used to determine cardiovascular risk and VAI may also provide clues about comorbidities in patients with newly diagnosed PsD.Table.Correlations (r) between disease activity and metabolic and cardiovascular risks of patientsParametersBASDAIPASIDAPSABASFIHAQVAISCOREFramingham risk scoreFramingham risk score0.020.0950.285**0.202**0.0670.299**0.5231SCORE-0.079-0.0260.0950.065-0.010.05810.523**VAI0.1280.1920.1010.1050.01910.0580.299**HAQ0.1290.1350.421**0.284**10.019-0.010.067BASFI0.764**0.140.484**10.284**0.1050.0650.202*DAPSA0.462**0.341**10.484**0.421**0.1010.0950.285**PASI0.09210.341**0.1400.1350.192-0.0260.095BASDAI10.0920.462**0.764**0.1290.128-0.0790.024Abbreviation; VAI: Visceral Adiposity Index, SCORE: Systematic Coronary Risk Evaluation Index, Health Assessment Questionnaire (HAQ), Disease Activity Index for Psoriatic Arthritis (DAPSA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Disease Activity Index (BASFI) and Psoriasis Area Severity Index (PASI).*pDisclosure of Interests:None declared

Background:Sarcopenia is defined as the decrease in strength, mass and function of muscles and may be related with aging, chronic inflammation or malnutrition. Proinflammatory cytokines may be associated with development of sarcopenia.Objectives:The aim of this study was to evaluate sarcopenia in patients with Rheumatoid Arthritis (RA).Methods:One hundred patients with RA (30 Male/70 Female) and 100 healthy controls (30 Male/70 Female) were included in this cross sectional study. According to The European Working Group on Sarcopenia in Older People (EWGSOP2) 2018, three parameters; muscle strength, muscle mass and physical performance, which are evaluated by hand grip strength, Body Impedance Analyzer (BIA) and 6 meters gait speed test, respectively, are used to diagnose sarcopenia. Patients with arthritis in dominant hand joints and ankle joints were excluded. Sarcopenia is defined as the decrease of strength and mass of muscles. On the other hand patients with low muscle strength but normal muscle mass are defined as probable sarcopenia.Results:The mean age was 58.52±10.95 for patients and 56.62±10.08 for controls (p=0.203). Frequency of probable sarcopenia was 35 (35.0%) in RA and 9 (9.0%) in control group (p2=0.62) (Table 2).Table 1.Factors associated with sarcopenia in rheumatoid arthritisRheumatoid arthritis groupNo sarcopenia(n=65)Probable Sarcopenia(n=35)p-valueSex, n (%) Male24 (36.9)6 (17.1)0.04a Female41 (63.1)29 (82.9)Age*55.00 (25.00−82.00)63.00 (24.00−82.00)0.004bDisease duration (year)*4.00 (1.00−37.00)8.00 (1.00−41.00)0.037bDAS28 CRP*2.13 (1.08−4.69)2.55 (1.54−5.56)0.010bDAS28 ESR (mean±SD)2.63±0.943.36±1.00cCDAI*5 (0−25)9 (0−29)0.012bSDAI*5.09 (0.04−26.04)9.8 (0.39−31.7)0.006bHAQ*0.15 (0−1.05)0.4 (0−19.5)baPearson Chi-Square,bMann-Whitney U Test,cIndependent Samples t-Test. *Variables given as median (minimum-maximum) DAS: Disease activity score ESR:Erythrocyte sedimentation rate, CRP:C-reactive protein, CDAI: Clinical Disease Activity Index, SDAI: Simplified Disease Activity Index, HAQ: Health Assessmnet QuestionnaireTable 2.Multivariate analysis for hand grip test in patients with rheumatoid arthritisUnstandardized Coefficients95% CIStandardized Coefficientsp-valueBStd.ErrorLowerUpperBetaConstant53.653.8945.9361.37−Gender−13.061.41−15.86−10.26−0.60DAS28 CRP−3.210.70−4.61−1.82−0.29Age−0.220.06−0.33−0.10−0.23DAS: Disease activity score CRP:C-reactive proteinConclusion:Loss of muscle strength in patients with RA may be seen frequently. Longer disease duration and higher disease activity should lead to development of sarcopenia due to chronic inflammation. Sarcopenia potentially effects patients’ social lives and daily functions and conceive decrease quality of life. Physicians should be aware of development of sarcopenia during the course of the disease, and take into account the preservative and preventive methods against to sarcopenia including exercise and control of disease activity.Acknowledgments:None to declareDisclosure of Interests:None declared

Nivolumab is a monoclonal antibody against programmed cell death protein-1 which is assessed in the group of immune checkpoint inhibitors. It may lead to immune-related adverse events. In this article, we report a 38-year-old male patient diagnosed with seronegative arthritis after nivolumab therapy. This case supports that clinicians should be attentive for immune-related adverse events after use of immune checkpoint inhibitors.

Introduction Behcet's disease (BD) is a relapsing systemic inflammatory disorder. The diagnosis of BD is primarily based on clinical findings. Current biomarkers are not yet sufficient to diagnose and cannot anticipate the course of the disease and response to treatment. The aim of this study was to evaluate the relationship between the thiol-disulfide balance and disease activity and organ involvement in BD. Material and methods A hundred fifty patients with BD and 100 age- and gender-matched healthy controls were included in the study. Disease activity was assessed with the BD Current Activity form score. Serum levels of native thiol (NT), total thiol (TT), and disulfide were measured and the disulfide/native thiol, disulfide/total thiol and native thiol/total thiol levels were calculated for the patient and control groups. Results Native thiol, total thiol, native thiol/total thiol values of the BD patients were significantly lower than those of the control group. The disulfide/native thiol, disulfide/total thiol values of BD patients were higher compared to the control group and the disulfide value of the BD group was slightly higher compared to the control group. No correlation was determined between thiol levels and disease activity and organ involvement in BD. Conclusions In patients with Behcet's disease, the thiol-disulfide homeostasis balance shifted towards disulfide formation due to thiol oxidation. It may be used as a novel marker in BD because it is easy, practical, fully automated and relatively inexpensive.

Behçet's disease (BD) is a rare, chronic, inflammatory disorder characterized by multisystemic vasculitis including mucocutaneous, neurologic, and ophthalmic involvement. Our aim is to compare vascular endothelial growth factor (VEGF) and soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) levels in BD, among the patients having or not having organ involvement, disease activation and especially vascular involvement. Fifty-five patients with BD, 25 of which were accompanied by vascular involvement, and 31 control subjects were included in the study. Disease activity was assessed with the Turkish version of Behçet Disease Current Activity Form (BDCAF) and active vasculitis lesions at the time of study were recorded. Age at diagnosis was 32.2 ± 4.6, while the mean duration of BD was 96.3 (72.3) months. The median for BDCAF score was 2.0 (range 0, 3.0), and 29 (52%) of patients had active BD. The serum VEGF and sVEGFR-1 levels in patients with BD were significantly higher than that in controls [(298 (338.5) pg/mL; 93 (93.5) pg/mL in patients and 136.2 (73) pg/mL; 56.5 (48.5) pg/mL in controls, respectively, p .001 for both values] while difference in VEGF/sVEGFR-1 ratio was obtained close to borderline of significance (p = .03). Our study is the first report indicating elevated serum VEGF, sVEGFR-1, and more importantly VEGF/sVEGFR-1 ratio could play an important role in the development of trombosis in BD. VEGF and/or sVEGFR-1 should not be evaluated independently in the same patient group and the ratio of these two parameters is a more important indicator, especially in the evaluation of BD especially with vascular involvement together with the duration of disease.

Background Behcet’s disease (BD) is a relapsing systemic inflammatory disorder of unknown etiology. 1 Objectives In this study, we aimed to evaluate the relationship between the thiol-disulfide balance and disease activity and organ involvement in BD. Methods One hundred fifty (150) patients with BD and 100 age-gender matched healty controls were included in the study. Disease activity was assessed with the BD Current Activity Form (BDCAF) score. Serum levels of native thiol (NT), total thiol (TT), and disulfide were measured and the disulfide/native thiol, disulfide/total thiol and native thiol/total thiol levels were calculated for the patient and control groups. Results NT, TT, NT/TT values of the BD patients were significantly lower than those of the control group. The disulfide/NT, disulfide/TT values of BD patients were higher compared to the control group and the disulfide value of the BD group was slightly higher compared to the control group (table 1). No correlation was determined between thiol levels and disease activity and organ involvement in BD. Conclusions In patients with Behcet’s disease, the dynamic thiol-disulfide homeostasis balance shifted towards disulfide formation due to thiol oxidation. It may be used as a novel marker in BD because it is easy, practical, fully automated and relatively inexpensive. Acknowledgements The authors thank staff of Ankara Numune Training and Research Hospital, Department of Rheumatology for their generous friendly assistance in every step of this study. Disclosure of Interest None declared

Background Behcet’s disease (BD) is a type of systemic vasculitis and inflammatory disease with unknown etiology which is associated with fatigue and lower quality of life (QoL). 1 Objectives In this study we aimed to assess the relationship between BDCAF and BDQoL, depression, anxiety and fatigue in Behcet’s disease. Methods This is a cross-sectional study of 155 Behcet’s syndrome (BS) patients and 107 healthy controls in Turkey. All subjects completed the Multidimensional Assessment of Fatigue (MAF) questionnaire, Hospital Anxiety and Depression (HADS) scale. Disease activity among BS patients was assessed using the Behcet’s Disease Current Activity Form (BDCAF), and the physician’s global assessment (PGA). And BD patients completed the Behcet’s Disease Quality of Life (BDQoL) questionnaire. Results There was no significant difference with age and gender between the groups. BS patients had significantly higher HADS-anxiety (HADS-A), HADS-depression (HADS-D) and MAF scores than the healthy controls (p Conclusions Fatigue and anxiety is common in clinically active BS patients compared with healthy controls and inactive BD patients. Reference [1] Tascilar NF, Tekin NS, Ankarali H, et al. Sleep disorders in Behcet’s disease, and their relationship with fatigue and quality of life. J Sleep Res2012;21(3):281–288. Disclosure of Interest None declared

Objective: The basic aim of the study is to determine the outcome of anxiety (somatization, obsessive-compulsive, anxiety, and phobic anxiety), mood (interpersonal sensitivity, depression, and hostility) and psychotic symptoms (paranoid ideation and psychoticism) during undergraduate education. In this context, the effect of undergraduate education on psychological symptoms has been tested. Another aim of the study is to determine which psychological symptom or symptoms occur mostly in this period. Methods: The temporal change in the psychological symptoms of same people was aimed to be determined. In order to reach this aim the study was planned as a `longitudinal study' which is one type of scanning research. Data had been collected by Symptom Check List-90- R. Study had been conducted on 120 volunteer students. Results: Anxiety, mood and psychotic symptoms gradually increase at undergraduate 1st, 2nd and 3rd grade and decrease at 4th grade. Anxiety, mood and psychotic symptoms increase at 3rd grade mostly. Psychological symptoms which occur mostly at 3rd grade respectively are: obsessive-compulsive, interpersonal sensitivity, depression, paranoid ideation, anxiety, psychoticism, somatization and hostility. Phobic anxiety had not been found at any grade level. Conclusion: Psychological symptoms draw the shape of a convex graph during undergraduate education. Third grade is the peak point of the graph.