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Purpose: The severe course of COVID-19 in individuals with chronic diseases has led to concerns in the management of rheumatic diseases during the pandemic therefore we aimed to define the factors associated with the frequency and severity of COVID-19 in patients with axial spondyloarthritis (axSpa) in this study. Materials-Methods: Patients with axSpa who were followed up in three tertiary hospitals and used their treatment regularly for at least six months were included. We assessed the relationship between axSpa associated variables such as disease duration time, radiological severity, treatment and COVID-19 outcomes. Results: A total of 833 patients with a mean disease duration of 109 months were analyzed; 64.5% had ankylosing spondylitis, 35.5% had non-radiographic axSpa diagnosis, and 59.4% of patients were treated with biologic agent . The frequency of COVID-19 was 23% (n: 192); only five pateints (0.5%) had a history of intensive care unit. Advanced age, hypertension (HT), and diabetes mellitus (DM) were found to be significantly more common in those with involvement in high resolution computed tomography (HRCT) (p:0.02, p:0.01, and p

AMAÇ: Bu çalışmanın amacı, romatoid artritli bireylere bakım verenlerin yükü ve algıladıkları sosyal destek düzeyinin belirlenmesidir.GEREÇ VE YÖNTEM: Tanımlayıcı ve kesitsel tipteki bu çalışma, Haziran 2020 – Aralık 2020 tarih aralığında bir uygulama ve araştırma hastanesinin romatoloji polikliniğine muayene olmak için gelen 130 Romatoid artritli birey ve yakını ile tamamlandı. Veriler, “Hasta ve Bakım Verici Bilgi Formu”, “DAS-28 Skoru”, “VAS Skoru”, “Sağlığı Değerlendirme Anketi (HAQ)”, “Zarit Bakım Yükü Ölçeği” ve “Çok Boyutlu Algılanan Sosyal Destek Ölçeği” ile elde edildi. Veri analizi, tanımlayıcı istatistikler, Mann-Whitney U testi, Kruskal-Wallis testi ve Spearman Korelasyon testi ile yapıldı.BULGULAR: Araştırmaya katılan bakım verenlerin yaş ortalaması 46.31±13.46, %58,5’i erkek, %59,2’si eşi ve %45.4’ü 1-5 yıl arasında bakım vermekteydi. Romatoid artritli hastaların VAS, DAS-28 ve HAQ skoru ile bakım yükü arasında anlamlı bir ilişki olduğu, ayrıca deformasyon gelişen Romatoid artrit hastalarının bakım yükünün daha yüksek olduğu belirlendi (p, AIM: The aim of this study is to determine the caregivers burden and perceived social support level of individuals with rheumatoid arthritis. MATERIAL AND METHOD: This descriptive and cross-sectional study was completed with 130 individuals with rheumatoid arthritis and their relatives who came to the rheumatology outpatient clinic of a practice and research hospital between June 2020 and December 2020. Data were obtained with the “Patient and Caregiver Descriptive Information Form”, “DAS-28 Score”, “VAS Score”, “Health Assessment Questionnaire (HAQ)”, “Zarit Care Burden Scale” and “Multidimensional Perceived Social Support Scale”. Data analysis was performed with descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test and Spearman Correlation test.RESULTS: The mean age of the caregivers participating in the study was 46.31±13.46 years, 58.5% were male, 59.2% were spouses and 45.4% were providing care between 1-5 years. It was determined that there was a significant relationship between the VAS, DAS-28 and HAQ scores of patients with rheumatoid arthritis and the burden of care, and the care burden of rheumatoid arthritis patients with deformation was higher (p

To evaluate the association of systemic immune-inflammation index (SII) levels, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) with severity of noninfectious uveitis. This retrospective study included 46 patients with noninfectious uveitis (uveitis group) and 46 age- and sex-matched healthy subjects (control group). The demographic and ocular findings, localization, and activity of uveitis were recorded at the time of onset evaluation. SII, NLR, and PLR levels of patients were compared between the groups. SII, NLR, and PLR levels were significantly higher in uveitis group when compared to control group (p

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

Amac: Bu calismada ankilozan spondiliti olan hastalarda noropatik agrinin hastalik aktivite indekslerine etki edip etmedigi ve ayni zamanda tedavide kullanilan anti-TNFα gibi ajanlarin bununla iliskili olup olmadigini arastirmayi amacladik. Gerec ve Yontem: Calismaya modifiye New York kriterlerine gore ankilozan spondilit tanis konan 98 hasta ve yas ve cinsiyet uyumlu 99 saglikli kontrol alindi. Her iki grupta noropatik agri painDETECT skorlamasina gore yapildi. Ankilozan spondilit hastalarinin hastalik aktiviteleri BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), BASFI (Bath ankylosing spondylitis functional index), VAS agri (Visual Analog Scale) ve Leeds entezit indeksi ile degerlendirildi. Ayrica her iki gruba HAQ (Health Assesment Questionnaire) ve Beck depresyon olcegi uygulandi. Ayrica ankilozan spondilit hastalari anti-TNFα ilac kullanan ve kullanmayan seklinde iki grup olarak karsilastirildi. Bulgular: PainDETECT hasta grubunda kontrol grubuna gore istatistiksel olarak anlamli derecede yuksekti. Ankilozan spondilit grubunda ortalama painDETECT 22,1 kontrol grubunda ise 9,95 idi (p

Musculoskeletal findings are common in sickle cell patients and may be confused with inflammatory arthritis. In addition, complications such as frequent infections may create difficulties while choosing drugs such as steroids, methotrexate, or antiTNFs. Our aim is to reveal whether the treatment is different in sickle cell patients with rheumatic diseases such as rheumatoid arthritis.Patients followed by Rheumatology and Hematology divisions of Hatay Mustafa Kemal University Hospital were retrospectively screened. Excluding patients with musculoskeletal findings associated with sickle cell disease (SCD), patients with chronic or acute inflammatory arthritis were enrolled into study. Demographic data, disease activities, the drugs used, frequency of infection, and sickle cell-related crisis before and after rheumatic disease diagnosis-treatment of the patients were examined.Inflammatory rheumatic disease was detected in 14 of 28 sickle cell patients evaluated in the rheumatology department for musculoskeletal complaints. Twelve of the patients were female and 2 were male. The median duration of rheumatic disease was 27 months (16.5). Eight of these patients had rheumatoid arthritis, 1 had ankylosing spondylitis, reactive arthritis, gout, connective tissue disease, undifferentiated monoarthritis, and 1 patient had undifferentiated oligoarthritis. For rheumatic disease, 11 (78.6%) of the patients were using steroids, 8 (57.1%) hydroxychloroquine, 4 (28.6%) methotrexate and sulfasalazine, 2 (14.3%) leflunomide, 1 (7.1%) anti-TNF (etanercept), and 1 allopurinol and colchicine. The frequency of SCD-related crisis and annual serious infections before and after rheumatic disease treatment were similar (p = 0.31).The clinical manifestations of inflammatory arthritis such as rheumatoid arthritis and sickle cell disease may overlap. The use of drugs such as steroids, methotrexate, or anti-TNF in sickle cell patients with rheumatic disease is the same as in patients without sickle cell disease. However, treatment should be individualized in patients with complications such as infection.

Amaç: Bu araştırmanın amacı, romatoid artrit tanısı almış bireylerde serum D vitamini seviyelerinin hastalık aktivitesi ile ilişkisini saptamaktır. Materyal ve Metod: Kesitsel ve retrospektif olarak planlanan bu çalışma, Ekim 2019- Mart 2020 tarihleri arasında 337 romatoid artritli bireyin medikal dosyaları incelenerek tamamlandı. Araştırmaya, Romatoloji polikliniğinde takip edilen, hekim tarafından romatoid artrit tanısı konmuş ve en az 1 yıldır romatoid artrit rahatsızlığı olan bireyler dahil edildi. Veriler, araştırmacılar tarafından oluşturulan “Sosyodemografik ve Laboratuvar Tahlil Formu” ve “Hastalık Aktive Skoru-28” kullanılarak elde edildi. Verilerin analizi tanımlayıcı istatistikler, Kruskal Wallis, Mann-Whitney U testi ve Sperman korelasyon analizi ile yapıldı. Bulgular: Araştırmaya katılan 337 romatoid artritli bireyin %83,4’ü kadın, yaş ortalaması 54,38±13,0, hastalık yılı ortalaması 4,08±3,67 ve hastalık akivitesi skor ortalaması 3,14±0,82 idi. Bireylerin %73,3’ünün D vitamini seviyesi ≤20 ng/mL’nin altındaydı. Romatoid artritli bireylerin D vitamini seviyesi ile yaş değişkeni arasında pozitif yönde zayıf bir ilişki, hastalık aktive skoru arasında ise negatif yönde zayıf bir ilişki olduğu belirlendi (p, Amaç: Bu araştırmanın amacı, romatoid artrit tanısı almış bireylerde serum D vitamini seviyelerinin hastalık aktivitesi üzerindeki etkisini saptamaktır. Materyal ve Metod: Tanımlayıcı, kesitsel ve retrospektif olarak planlanan bu çalışma, Ekim 2019- Mart 2020 tarihleri arasında 337 romatoid artritli bireyin medikal dosyaları incelenerek tamamlandı. Araştırmaya, Romatoloji polikliniğinde takip edilen, hekim tarafından romatoid artrit tanısı konmuş ve en az 1 yıldır romatoid artrit rahatsızlığı olan bireyler dahil edildi. Veriler, araştırmacılar tarafından oluşturulan “Sosyodemografik ve Laboratuvar Tahlil Formu” ve “Hastalık Aktive Skoru-28” kullanılarak elde edildi. Verilerin analizi tanımlayıcı istatistikler, Kruskal Wallis ve Mann-Whitney U testi ile Sperman korelasyon analizi ile yapıldı. Bulgular: Araştırmaya katılan 337 romatoid artritli bireyin %83,4’ü kadın, yaş ortalaması 54,38±13,0, hastalık yılı ortalaması 4,08±3,67 ve hastalık akivitesi skor ortalaması 3,14±0,82 idi. Bireylerin %73,3’ünün D vitamini seviyesi ≤20 ng/mL’nin altındaydı. Romatoid artritli bireylerin D vitamini seviyesi ile yaş değişkeni arasında pozitif yönde zayıf bir ilişki, hastalık aktive skoru ile negatif yönde zayıf bir ilişki olduğu belirlendi (p

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an infectious agent affecting respiratory system the most and spreads rapidly due to large number of ACE2 receptors in the lung. Arthralgia and myalgia are the most common rheumatologic findings, but arthritis is rare. Hyperinflammatory condition called cytokine storm causes acute respiratory distress syndrome (ARDS) leading to death. Although coronavirus disease 2019 (COVID-19) is mild or asymptomatic in most cases, it may progress to pneumonia and ARDS, especially in elderly patients who have comorbidities. Drugs such as tocilizumab which suppress inflammatory response and reduce cytokine storm may be effective on treating COVID-19 pneumonia. Cytokine storm, the cause of which is not fully understood and in which many structures of immune system interact with each other, is quite complex and has different mechanisms contributing to it. Although antimalarial drugs such as hydroxychloroquine are used in the treatment, there is no definite evidence that they are effective. It has been shown that the prevalence and course of COVID-19 in rheumatic diseases is similar to the general population, and that increasing age and additional comorbid conditions increase the risk of mortality. It is recommended that anti-rheumatic drugs used in the treatment of rheumatic diseases should not be stopped unless the patient is infected with COVID-19.

This study aimed to compare Tuberculin Skin Test (TST) and QuantiFERON (R)-TB Gold In-Tube (QFT-GIT) test in rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients scheduled for biological and targeted synthetic disease modifying anti-rheumatic drugs (DMARDs) in a Bacillus Calmette-Guerin-vaccinated population. Adult RA (n = 206) and SpA (n = 392) patients from the TReasure database who had both TST and QFT-GIT prior to initiation of biological and targeted synthetic DMARDs were included in the study. Demographic and disease characteristics along with pre-biologic DMARD and steroid use were recorded. The distribution of TST and performance with respect to QFT-GIT were compared between RA and SpA groups. Pre-biologic conventional DMARD and steroid use was higher in the RA group. TST positivity rates were 44.2% in RA and 69.1% in SpA for a 5 mm cutoff (p < 0.001). Only 8.9% and 15% of the patients with RA and SpA, respectively, tested positive by QFT-GIT. The two tests poorly agreed in both groups at a TST cutoff of 5 mm and increasing the TST cutoff only slightly increased the agreement. Among age, sex, education and smoking status, pre-biologic steroid and conventional DMARD use, disease group, and QFT-GIT positivity, which were associated with a 5 mm or higher TST, only disease group (SpA) and QFT-GIT positivity remained significant in multiple logistic regression. TST positivity was more pronounced in SpA compared to that in RA and this was not explainable by pre-biologic DMARD and steroid use. The agreement of TST with QFT-GIT was poor in both groups. Using a 5 mm TST cutoff for both diseases could result in overestimating LTBI in SpA.

Objective. the effect of smoking in psoriatic arthritis (PsA) is under debate. Our aim was to test whether smoking is increased in axial PsA (axPsA). Methods. Included in the analysis were 1535 patients from PsArt-ID (PsA-International Database). the effect of smoking on axPsA (compared to other PsA phenotypes) and radiographic sacroiliitis were investigated. Results. Current smoking was more common in axPsA (28.6% vs 18.9%, p < 0.001). It also was found as an independent predictor of axPsA (OR 1.4) and radiographic sacroiliitis (OR 6.6). Conclusion. Current smoking is significantly associated with both axPsA and radiographic sacroiliitis in patients with PsA., Union ChimiqueBelge (UCB); Turkish Society for Rheumatology (TRD), D. Solmaz had funding from Union ChimiqueBelge (UCB) for an axial spondyloarthritis fellowship. S. Bakirci had funding from the Turkish Society for Rheumatology (TRD). S.Z. Aydin received honoraria from Abbvie, Celgene, UCB, Novartis, Jannsen, and Sanofi.

OBJECTIVES: To analyse the clinical and laboratory factors associated with bamboo spine. METHODS: Data of patients fulfilling the 2009 ASAS classification criteria for axial spondyloarthritis, registered in the national, multicentre, longitudinal, and observational database of TReasure was analysed. Radiographs were assessed using the Bath Ankylosing Spondylitis Radiologic Index (BASRI). Data of patients with a bamboo spine (Group 1) was compared to data derived from patients with a longstanding disease of at least 15 years but no syndesmophytes (Group 2). RESULTS: Out of the 5060 patients, 1246 had eligible radiographs. There were 111 patients (8.9%) with a bamboo spine. Male sex was more common among patients with bamboo spine. The median BMI of 27.7 (25.8-31.1) in Group1 was higher than the BMI of 25.9 (22.9-29.2) in Group 2 (p

Background/Aim: Rheumatoid arthritis associated interstitial lung disease (RA-ILD) is a major concern in RA patients and events of ILD have been reported in patients treated with tofacitinib in RA clinical trials and in the post-marketing setting. The aim of this study was to assess the real-life efficacy and safety of tofacitinib in patients with RA-ILD. Methods RA patients with ILD diagnosis based on the HRCT images of the lungs from eight different centers recruited to study. As a control group, RA patients without ILD under tofacitinib was included. Demographic data, patients’ characteristics, available pulmonary function tests regarding RA and RA-ILD at the visit in which tofacitinib was initiated and for the last follow-up visit under tofacitinib were recorded. Reasons of tofacitinib discontinuation were also recorded. Drug retention rates were compared by log-rank test. p value

Objective: The aim of this research is to convey in-depth life experiences from the perspective of patients with rheumatoid arthritis.Methods: This descriptive and phenomenological study was completed with a total of 24 individuals who came to the rheumatology outpatient clinic for examination between 15 July and 15 August 2020 and had rheumatoid arthritis for at least 1 year. The data were collected through face-to-face interviews with the “Patient Information Form” and “Semi-structured Interview Form” created by the researchers. During the interviews, the statements of the patients with rheumatoid arthritis were recorded with a voice recorder. Content analysis method was used in the evaluation of the data.Results: As a result of the coding, 3 themes were determined. 1) Initial response to diagnosis, 2) Impact of rheumatoid arthritis symptoms on patients, 3) Coping strategies. While some of the patients with rheumatoid arthritis experienced denial and anger when the diagnosis was first made, some of them accepted because their family members had the same disease. With the disease, their lives have been affected physically, emotionally, socially and economically. It was determined that they used methods such as adapting to treatment, receiving family support, strengthening their self-management and turning to religion when coping with the disease.Conclusion:This study reveals how rheumatoid arthritis affects patients’ lives from the moment they are diagnosed and how they cope with the disease. It is recommended that health professionals consider the patient’s point of view in disease management and create their treatment with a holistic approach., Amaç: Araştırmanın amacı, romatoid artritli hastaların perspektifinden yaşam deneyimlerinin derinlemesine aktarılmasıdır.Gereç ve Yöntem: Tanımlayıcı ve fenomenolojik olarak tasarlanan bu araştırma, 15 Temmuz- 15 Ağustos 2020 tarihleri arasında romatoloji polikliniğine muayene olmak için gelen ve en az 1 yıldır romatoid artrit tanısı olan toplam 24 birey ile tamamlanmıştır. Veriler, araştırmacılar tarafından oluşturulan “Hasta Tanıtım Formu” ve “Yarı Yapılandırılmış Görüşme Formu” ile yüz yüze görüşülerek toplanmıştır. Görüşmeler sırasında romatoid artritli hastaların ifadeleri ses kayıt cihazı ile kaydedilmiştir. Verilerin değerlendirilmesinde içerik analizi yöntemi kullanılmıştır.Bulgular: Yapılan kodlamalar sonucunda 3 tema belirlenmiştir. 1) Tanıya verilen ilk tepki, 2) Romatoid artrit semptomlarının hastalar üzerindeki etkisi, 3) Baş etme stratejileri. Romatoid artritli hastaların bir kısmı ilk tanı konulduğunda inkâr ve öfke yaşarken bir kısmı da aile üyelerinde aynı hastalık bulunduğu için kabullenmiştir. Hastalıkla birlikte yaşamları fiziksel, duygusal, emosyonel, sosyal ve ekonomik açıdan etkilenmiştir. Hastalıkla başa çıkarken tedaviye uyum sağlama, aile desteği alma, öz-yönetimlerini güçlendirme ve dine yönelme gibi yöntemleri kullandıkları belirlenmiştir.Sonuç: Bu çalışma, romatoid artritin hastaların yaşamlarını tanı konduğu andan itibaren nasıl etkilediğini ve hastalıkla nasıl baş ettiklerini ortaya koymaktadır. Sağlık profesyonellerinin hastalık yönetiminde hastanın bakış açısını dikkate alma ve holistik bir yaklaşımla tedavilerini oluşturmaları önerilmektedir.

We wanted to see how close we could get to our goal of treating rheumatoid arthritis (RA) without the use of glucocorticoids (GCs) in the disease-modifying antirheumatic drugs (DMARDs) era using real-life data. Established in 2017, the TReasure database is a web-based, prospective, observational cohort for Turkey. As of May 2019, there were 2,690 RA patients recorded as receiving biologic and targeted synthetic DMARDs (bDMARDs and tsDMARDs) therapy. At the start of the bDMARDs or tsDMARDs, patients with follow-up visits of at least 3 months were registered. At the time of registration and the last visit, doses of GCs were recorded and it was determined if the target dose of ≤ 7.5 mg was achieved. During registration and follow-up, 23.4% of the patients did not receive GCs and 76.5% of the patients received GCs at any time. GCs could be stopped after 59 (25–116) months in 28.4% of these patients, but 71.6% of patients were still using GC. The target GC dose could not be achieved in 18.2% of these patients (n = 352). The rate of continuing to use GC was significantly higher in women, in the elderly, those with rheumatoid factor (RF) positive, with higher Visual Analog Scale (VAS) pain and Disease Activity Score (DAS)-28. The initial GC dose of ≥ 7.5 mg/day was found to be crucial in not reaching the GC target dose (p

In this study, we aimed to determine the frequency ofA total of 66 participants (30 BD patients, 36 healthy subjects) were included in this study. TheThe distribution of

The relationship between the cornea and systemic autoimmune diseases has been demonstrated in prior studies. Corneal Visualisation Scheimpflug Technology (Corvis ST) provides a specific and detailed assessment of corneal biomechanical features, such as stiffness and elasticity.This study aims to evaluate corneal biomechanical changes in patients with systemic autoimmune diseases using Corvis ST.This prospective study included 36 patients with ankylosing spondylitis (AS), 38 patients with rheumatoid arthritis (RA), and 36 age- and sex-matched healthy subjects. After ophthalmologic examinations Pentacam HR and Corvis ST was performed on all eyes. The mean keratometric and pachymetric data, corneal biomechanical parameters, biomechanical intraocular pressure (bIOP) were analysed.There was no statistically significant differences among the groups regarding age, gender, refraction, visual acuity, IOP, pachymetry and keratometry. Compared to healthy controls, the mean velocity values of applanation 1 (A1V) and 2 (A2V), deformation amplitude (DA), and corvis biomechanical index (CBI) were statistically significantly higher and stiffness parameter at first applanation (SPA1) was statistically significantly lower in AS and RA patients (all p 0.05). In both AS and RA groups, disease duration was found to be negatively correlated with SPA1 (p = 0.043, 0.027, respectively) and positively correlated with CBI (p = 0.022, 0.020, respectively).AS and RA patients have a decreased corneal stiffness compared to healthy subjects. Disease duration seems to be correlated with these changes.

Background: Several societies published recommendations for latent tuberculosis infection (LTBI) screening before biological and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) in rheumatoid arthritis (RA) but not for other inflammatory arthritides such as spondyloarthritis (SpA). Using RA guidelines could result in overestimating Tuberculin Skin Test (TST) positivity in SpA. This study aimed to compare the distribution of TST results in SpA and RA patients along with comparison in terms of QuantiFERON®-TB Gold In-Tube (QFT-GIT) test in a Bacillus Calmette-Guérin-vaccinated population.Methods: Adult RA (n=206) and SpA (n=392) patients from the TReasure database who had both TST and QFT-GIT prior to initiation of biological and targeted synthetic DMARDs were included in the study. Demographic and disease characteristics along with pre-biologic DMARD and steroid use were recorded. The distribution of TST and performance with respect to QFT-GIT were compared between RA and SpA groups.Results: Pre-biologic conventional DMARD and steroid use was higher in the RA group. TST positivity rates were 44.2% in RA and 69.1% in SpA for a 5 mm cut-off (pConclusions: TST positivity was more pronounced in SpA compared to that in RA and this was not explainable by pre-biologic DMARD and steroid use. The agreement of TST with QFT-GIT was poor in both groups. Using a 5 mm TST cut-off for both diseases could result in overestimating LTBI in SpA.

Introduction: Immunosuppressive drug use is common in the treatment of systemic lupus erythematosus (SLE). In cases receiving immunosuppressive therapy, screening for hepatitis B reactivation risk is also recommended. In this study, we aimed to investigate the frequency of hepatitis B screening in cases diagnosed as having SLE, who were followed up in the Rheumatology Clinic of Hatay Mustafa Kemal University. Materials and Methods: We included 93 patients who were followed-up in the Rheumatology Clinic of Hatay Mustafa Kemal University with the diagnosis of SLE between July 2017-December 2019 in our study. The screening rates of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core protein antibody (anti-HBc IgG) of the cases and the immunosuppressive drugs used by them were analyzed retrospectively. Results: The mean age of the cases was 38 years (minimum-maximum: 18-79), and 91.4% were women. Of the cases, 43 (46.2%) were determined to be never screened for hepatitis B, 34 (36.6%) screened inadequately, and only 16 (17.2%) screened fully. In 22 cases receiving high-risk immunosuppressive therapy, the rate of full screening of hepatitis B was 27.3%. Conclusion: In patients with SLE, even those who used high-risk immunosuppressive therapy, screening rates were found low. We think that awareness should be increased in this regard by performing joint training with clinics that start immunosuppressive therapy, a periodic repetition of these trainings should be done, and also multi-center studies should be conducted.

Spondyloarthritis (SpA) is a group of diseases with overlapping skeletal and extra-articular features. Acute anterior uveitis (AAU) is the most common extra-articular manifestation of SpA. The relation between AAU and SpA is well defined in the current literature. Our study aims to analyze the frequency and factors associated with AAU in different forms of SpA in a large nationwide cohort of Turkish SpA patients.Retrospective cohort study.The data were obtained from the TReasure database, which compiles data from records of the web-based Rheumatoid Arthritis (RA) and SpA patients treated with biological disease-modifying anti-rheumatismal drugs from different regions of Turkey. The clinical characteristics of SpA and uveitis are recorded.Data of the 4,297 SpA patients were included in the study. Overall, 475 of 4,297 patients (11.0%) had experienced 1 or more episodes of uveitis. SpA patients with older age (P.001), a smoking history (P = .004), delayed diagnosis (P = .001), longer disease duration (P.001), arthritis (P.001), positive HLA-B27 (P.001), a family history of SpA (P.001), and radiographic damage (presence of sacroiliitis, syndesmophytes, bamboo spine, hip involvement) (P.001 for all) more commonly had uveitis. On the other hand, uveitis was less prevalent in patients with psoriasis and psoriatic arthritis (P.001 for both).Uveitis may be the key feature leading to SpA diagnosis. Patients with radiographic damage and long disease duration have an increased risk for uveitis in both male and female SpA patients. Patients with uveitis should be referred to a rheumatologist for a thorough evaluation of SpA.

The temporal relationship between the onset of skin psoriasis (Pso) and psoriatic arthritis (PsA) is a long and well-known feature of psoriatic disease. Psoriatic skin lesions emerge years before the development of musculoskeletal manifestations in nearly 75% of PsA patients. While skin and joint manifestations develop within one year in 15-20% of the patients, joint manifestations precede the skin involvement by a year or more in about 10% of the patients (1).

Objective Joints with different sizes and anatomical locations can be affected in psoriatic arthritis (PsA). Our aim was to explore the effect of different joint patterns on patient-reported outcomes (PROs) in patients with mono-oligoarthritis. Methods Within PsArt-ID (Psoriatic Arthritis- International Database), 387/1670 patients who had mono-oligoarthritis (1-4 tender and swollen joints) were enrolled in cross-sectional assessment. the joints were categorized according to their size (small/large) and location (upper/lower extremity) and PROs, physician global assessment and C-reactive protein (CRP) were compared. Analysis was made by categorizing according to joint counts (1-2 joints/ 3-4 joints). Results the mean age (SD) was 46.9 (14.24) with a mean (SD) PsA duration of 3.93 (6.03) years. Within patients with 1-2 involved joints (n = 302), size of the joints only had an impact on CRP values with large joints having higher CRP (P = .005), similar to lower extremity involvement (P = .004). PROs were similar regardless of size or location if 1-2 joints were inflamed. Within patients with 3-4 involved joints (n = 85), patient global assessment (PGA), pain, fatigue and physician global assessment were higher in the group with large joints. Similarly, PGA, pain, and physician global assessment were higher in patients with lower extremity involvement as well as higher CRP values. Conclusion For PsA patients with 3-4 joints involved, lower extremity and large joints are associated with poorer outcomes with worse PROs, physician global assessment, and higher CRP. the size and anatomical location of the joints are less important for patients with 1-2 joints in terms of the PROs., Union Chimique Belge (UCB); Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK), This work was supported by the Union Chimique Belge (UCB) (to Dilek Solmaz for axial spondyloarthritis fellowship) and the Scientific and Technological Research Council of Turkey (TUBITAK) (to Sibel Bakirci).

Yildiz, Fatih/0000-0003-3628-8870; Cinar, Muhammet/0000-0002-6150-3539 WOS: 000537230800003 PubMed ID: 31922480 Objective: Our aim is to test the validity of the Psoriasis Symptom Inventory (PSI), a patient-reported outcome, to assess the psoriasis severity within the scope of rheumatology. Methods: Within the PsA international database (PSART-ID), 571 patients had PSI, while 322 of these also showed body surface area (BSA). Correlations between PSI, BSA, and other patient- and physician-reported outcomes were investigated. Results: There was a good correlation between PSI and BSA (r=0.546, p

WOS: 000505281300007, PubMed: 30680951, Objective Psoriatic arthritis (PsA) has a genetic background. Approximately 40% of patients with psoriasis or PsA have a family history of psoriasis or PsA, which may affect disease features. The aim of this study was to assess the effects of family history of psoriasis and PsA on disease phenotypes. Methods Data from 1,393 patients recruited in the longitudinal, multicenter Psoriatic Arthritis International Database were analyzed. The effects of family history of psoriasis and/or PsA on characteristics of psoriasis and PsA were investigated using logistic regression. Results A total of 444 patients (31.9%) had a family history of psoriasis and/or PsA. These patients were more frequently women, had earlier onset of psoriasis, more frequent nail disease, enthesitis, and deformities, and less frequently achieved minimal disease activity. Among 444 patients, 335 only had psoriasis in their family, 74 had PsA, and 35 patients were not certain about having PsA and psoriasis in their family, so they were excluded from further analysis. In the multivariate analysis, family history of psoriasis was associated with younger age at onset of psoriasis (odds ratio [OR] 0.976) and presence of enthesitis (OR 1.931), whereas family history of PsA was associated with lower risk of plaque psoriasis (OR 0.417) and higher risk of deformities (OR 2.557). Family history of PsA versus psoriasis showed increased risk of deformities (OR 2.143) and lower risk of plaque psoriasis (OR 0.324). Conclusion Family history of psoriasis and PsA impacts skin phenotypes, musculoskeletal features, and disease severity. The link between family history of psoriasis/PsA and pustular/plaque phenotypes may point to a different genetic background and pathogenic mechanisms in these subsets., Turkish Society for Rheumatology; Scientific and Technological Research Council of TurkeyTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK), Supported by the Turkish Society for Rheumatology. Dr. Bakirci's work was supported by the Scientific and Technological Research Council of Turkey and the Turkish Society for Rheumatology.

Background:Beyond the joints, rheumatoid arthritis (RA) may affect lungs. Especially the involvement of the paranchyme, RA-associated interstitial lung disease (RA-ILD), is a major cause of mortality and morbidity. Tofacitinib, an oral JAK 1/3 inhibitor, has been used increasingly in the management of rheumatoid arthritis (RA) in recent years. Recently, a couple of animal and human studies reported promising results (1).Objectives:To assess the real-life efficacy and safety of tofacitinib in patients with RA-ILD in TReasure registry.Methods:This is a multicenter, observational study included RA patients with ILD diagnosis based on the HRCT images of the lungs, and were followed in 8 different centers participated in the TReasure database. Demographic data and patients’ characteristics regarding RA and RA-ILD at the visit in which tofacitinib was initiated and for the last follow-up visit under tofacitinib were recorded. Using the present study cohort, the RA patients with ILD receiving tofacitinib were compared with those without ILD receiving tofacitinib (controls) in terms of the general and disease-related characteristics and data of concomitant DMARD use. To evaluate retention rates of tofacitinib and reasons for discontinuation, data of the patients with RA-ILD in this study cohort were compared with the data of RA patients without ILD who were followed in Hacettepe University (major contributor of the TReasure registry). This research was funded by Pfizer.Results:A total of 47 RA patients with RA-ILD and a control group of 387 patients without ILD were included. The RA patients with ILD receiving tofacitinib were mostly male, older, and had higher baseline disease activity as compared with those without ILD (Table). The ILD pattern was known in 44 (93.6%) of 47 RA-ILD: 16 (36.3%) had UIP, 24 (54.5%) had NSIP, and 4 (9.1%) had airway disease. While 15 (31.9%) of the patients was asymptomatic, most common initial symptom was shortness of breath (in 14 (29.7%) patients). 18 patients had pre- and post-treatment FVC% and FEV1% values (with a median of 12 (9-19) months). Mean FEV1%; 82.1 vs. 82.8 (pre and post-treatment, respectively, p=0.079), mean FVC%; 79.8 vs. 82.8 (pre and post-treatment, respectively, p=0.014). To evaluate retention rates and reasons for discontinuation, 47 RA-ILD and 239 RA patients without ILD were analyzed. Retention rates were similar (p=0.21, log-rank) (Figure). Most common cause of tofacitinib discontinuation in RA-ILD group was infections (5 (25%) patients). Follow-up durations under tofacitinib were 15 (7-32) and 11 (4-24) months in ILD + and – groups, respectively. The rate of drug discontinuation due to infection in the RA patients with and without ILD was 6.3 per 100 patient-years and 2.4 per 100 patient-years, respectively.Table 1.Characteristics of the RA patients with and without ILD under tofacitinibVariablesRA-ILD(+) n=47RA-ILD(-) n=387pMale sex20 (42.6)69 (17.8)Age, years64 (57-69)56 (46-64)Disease duration for RA, months128 (78-212)110 (64-183)0.171Smoking statusNever smoker26 (55.3)211 (56.4)0.259 Current&Ex-smoker19 (44.7)163 (43.6)RF (+)36 (78.3)249 (68.8)0.187Anti-CCP (+)30 (65.2)196 (61.6)0.640RF positive or CCP (+)41 (87.2)242 (76.3)0.094Presence of comorbidity33 (70.2)203 (52.5)0.021DAS-28 before tofacitinib5.4 (4.6-6.22)4.36 (3.22-5.58)ESR before tofacitinib, mm/h38 (19-73)29 (17-45)0.029CRP before tofacitinib6.75 (1.63-24)9.95 (4.18-25.1)0.065Follow-up duration under tofacitinib15 (7-32)7 (3-12)Figure 1.Tofacitinib retention rates in the RA patients with and without ILDConclusion:In majority of patients, pulmonary functions remained stable during follow-up. Tofacitinib seems as a promising option for RA-ILD. High rate of discontinuation due infections was observed in RA-ILD patients under tofacitinib; however, it should be kept in mind that RA-ILD patients were older than RA patients without ILD.References:[1]Bejarano M, et al AB0418 ILD in Patients with RA Treated with tofacitinib. ARD;78:1672.Disclosure of Interests:Umut Kalyoncu Speakers bureau: Pfizer, Abbvie, UCB, Amgen, Emre Bilgin: None declared, Abdulsamet Erden: None declared, Hasan Satiş: None declared, abdurrahman tufan: None declared, Emre Tekgoz: None declared, Aşkin Ateş: None declared, Belkis Nihan Coşkun: None declared, Burcu Yağiz: None declared, Orhan Küçükşahin: None declared, Veli yazisiz: None declared, Gezmiş Kimyon: None declared, Cemal Bes: None declared, Ali İhsan Ertenli: None declared, Sedat Kiraz: None declared

Background:Suboptimal control of RA may lead to severe and progressive articular damage, loss of function, and deterioration of the quality of life (QoL).Objectives:To assess treatment satisfaction, sociodemographic, clinical, health care resource utilization, and QoL characteristics of patients with sub-optimally controlled RA and treated with conventional synthetic and/or biologic DMARDs.Methods:This study was an international, multicenter, cross-sectional, non-interventional study. Adult RA patients with moderate to severe disease activity (DAS28>3.2) were enrolled. Patient satisfaction was evaluated with Treatment Satisfaction Questionnaire for Medication (TSQM, version 1.4) with a scale ranging from 0 (indicating poor satisfaction) to 100 (indicating perfect satisfaction). Patients were questioned regarding treatment adherence, patient preferences, and expectations. Workability was evaluated using Work Productivity and Activity Impairment Questionnaire-Rheumatoid Arthritis (WPAI-RA, version 2.0). Short Form 36 (V2) survey were performed to all patients.Results:One hundred sixty-four patients were included in the study and most (78.0%) were female. The median age was 57.0 years, ranging between 22.0 and 84.0 years. Half of the patients (50.6%) were primary school graduates and 6.1% were unemployed due to RA and seeking work. Median time since RA diagnosis was 8.0 years and mean (±SD) DAS28-CRP score was 4.8 (±1.0). Mean total activity impairment was 54.9% (±27.4). In the past 3 months from enrollment, the mean number of healthcare professional and emergency room visits were 1.8 (±1.1) and 1.8 (±1.3), respectively. Mean number and length of hospitalizations in the previous 3 months were 1.1 (±0.3) times and 8.3 (±7.2) days, respectively. Mean TSQM scores were 53.5 (±21.4) for effectiveness, 86.0 (±26.7) for side effects, 67.8 (±16.5) for convenience, and 57.7 (±22.0) for global satisfaction. The leading expectation was ‘lasting relief of RA symptoms’ (mean score: 5.8). Preferred time until the effect of onset was ‘up to 1 week’ for 76.2% of the patients. Most of the patients (57.9%) preferred oral administrations and the most preferred frequency of administration was ‘once per day’ (46.3%). Mean physical and mental component summary scores for Short Form 36 (V2) survey were 37.9 (±8.3) and 40.1 (±10.7).Conclusion:Two-thirds of the patients with RA who have suboptimal responses are not satisfied with their treatments. Moreover, oral and once-daily treatment approaches stand out in patient preferences. Finally, suboptimal control leads to deterioration in clinical characteristics, workability, and QoL of patients with RA.Acknowledgements:The design, study conduct, and financial support for the study were provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the publication. All authors have received research funding for this study. The authors wish to thank B. Murat Ozdemir of Monitor CRO for medical editing and reviewing services of this manuscript. AbbVie provided funding to Monitor CRO for this work.Disclosure of Interests:Umut Kalyoncu Speakers bureau: AbbVie, Pfizer, UCB, Novartis, and Janssen, Consultant of: AbbVie, Pfizer, UCB, Novartis, and Lilly, Grant/research support from: AbbVie, Pfizer, and Janssen, Adem Kucuk Speakers bureau: AbbVie, Gokhan Sargin: None declared, Fatih Ozdener Speakers bureau: UCB, Nutricia Advanced Medical Nutrition, Grant/research support from: Nutricia Advanced Medical Nutrition, Servet Yolbaş Speakers bureau: AbbVie, UCB, Pfizer, and MSD, Berna Yurttas: None declared, Sezin Turan: None declared, Gezmiş Kimyon Speakers bureau: AbbVie, Amgen, Pfizer, Novartis, UCB, MSD, Johnson and Johnson, and Celltrion, Consultant of: Amgen, and Pfizer, ALI SAHIN Speakers bureau: Roche, Pfizer, and AbbVie, Consultant of: Roche and Pfizer, Sedat Yilmaz Speakers bureau: UCB, Pfizer, AbbVie, MSD, Novartis, and Celltrion, Consultant of: Pfizer and Novartis, Ridvan Mercan Speakers bureau: AbbVie, Novartis, MSD, Pfizer, UCB, Roche, Amgen, and Celltrion, Consultant of: Novartis, MSD, Pfizer, and Celltrion, Hakan Emmungil Speakers bureau: AbbVie, Pfizer, Novartis, and MSD, Muhammet Çinar Speakers bureau: AbbVie, Pfizer, Celltrion, UCB, Amgen, Novartis, and MSD, Grant/research support from: AbbVie, Pfizer, Celltrion, UCB, Amgen, Novartis, and MSD, İlhan Sezer Speakers bureau: AbbVie, Pfizer, MSD, Novartis, Celltrion, UCB, Amgen, and Abdi Ibrahim, Consultant of: AbbVie, Pfizer, MSD, Novartis, Celltrion, UCB, Amgen, and Abdi Ibrahim, Grant/research support from: AbbVie, Pfizer, MSD, Novartis, Celltrion, UCB, Amgen, and Abdi Ibrahim, Timuçin Kaşifoğlu Speakers bureau: AbbVie, Amgen, Roche, MSD, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Roche, MSD, Novartis, Pfizer, and UCB, Fulya Cosan Speakers bureau: AbbVie, Pfizer, Novartis, UCB, and MSD, Taskin Senturk: None declared, Nevsun Inanc Speakers bureau: AbbVie, UCB, Novartis, Pfizer, Roche, Lilly and MSD, Consultant of: Roche and Pfizer, Grant/research support from: Roche and Pfizer

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

WOS: 000397050600018, PubMed ID: 27794533, Objective. The aim was to assess the characteristics of PsA, find out how well the disease is controlled in real life, demonstrate the treatments and identify the unmet needs. Methods. The PsA registry of Turkey is a multicentre Web-based registry established in 2014 and including 32 rheumatology centres. Detailed data regarding demographics for skin and joint disease, disease activity assessments and treatment choices were collected. Results. One thousand and eighty-one patients (64.7% women) with a mean (S.D.) PsA duration of 5.8 (6.7) years were enrolled. The most frequent type of PsA was polyarticular [437 (40.5%)], followed by oligoarticular [407 (37.7%)] and axial disease [372 (34.4%)]. The mean (S.D.) swollen and tender joint counts were 1.7 (3) and 3.6 (4.8), respectively. Of these patients, 38.6% were on conventional synthetic DMARD monotherapy, 7.1% were on anti-TNF monotherapy, and 22.5% were using anti-TNF plus conventional synthetic DMARD combinations. According to DAS28, 86 (12.4%) patients had high and 105 (15.2%) had moderate disease activity. Low disease activity was achieved in 317 (45.7%) patients, and 185 (26.7%) were in remission. Minimal disease activity data could be calculated in 247 patients, 105 of whom (42.5%) had minimal disease activity. The major differences among sexes were that women were older and had less frequent axial disease, more fatigue, higher HAQ scores and less remission. Conclusion. The PsA registry of Turkey had similarities with previously published registries, supporting its external validity. The finding that women had more fatigue and worse functioning as well as the high percentage of active disease state highlight the unmet need in treatment of PsA.

Background: Articular manifestations may differ in ulcerative colitis (UC) and Crohn’s disease (CD). Genetic and non-genetic factors like sex, smoking, and presence of HLA-B27 were previously shown to modify the expression of articular and other extraintestinal manifestations of IBD. Objectives: The aim of this study is to document disease features and factors affecting the expression of articular manifestations in Turkish patients with IBD-related (enteropathic) arthritis under treatment with disease modifying antirheumatic drugs (DMARDs). Methods: Data regarding enteropathic arthritis (EA) were collected from the TReasure database, a nation-wide multicenter observational registry of inflammatory arthritis patients. Results: Among 4066 patients with seronegative spondyloarthropaties (SpA), 156 (3.8%) had EA, not reflecting a true prevalence due to selection bias. Demographic and clinical features according to IBD groups were summarized in Table 1. Rates of presence of sacroiliitis were similar between patients with UC and CD (39.9% and 60.1%, p=0.086 respectively). Rates of HLA-B27 positivity were 31.6% and 7.1% in patients with and without radiographic sacroiliitis, respectively (p=0.101). Enthesitis, dactylitis, psoriasis, family history forSpA, ESR, CRP, BASDAI and aSDAS levels had similar distributions in patients with and without radiographic sacroiliitis. Rates of “never-smoked” (26.5% vs 64.7%) and “current smoking” (32.4% vs 17.6%) significantly differed in patients with and without sacroiliitis (overall p=0.012) Conclusion: Our data confirm an association between smoking status and disease manifestations, particularly radiographic sacroiliitis. References [1] Fries W. Clinical features and epidemiology of spondyloarthritides associated with inflammatory bowel disease. World J Gastroenterol2009; 15: 2449-2455. Disclosure of interests: Orhan Kucuksahin: None declared, abdulsamet Erden: None declared, Ufuk Ilgen: None declared, Sedat Kiraz: None declared, ali Ihsan Ertenli: None declared, Nazife Sule Yasar Bilge: None declared, Timucin Kasifoglu: 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, Cemal Bes: None declared, Nilufer alpay Kanitez: None declared, Hakan Emmungil Grant/research support from: MSD, Roche, Pfizer, abbvie, Consultant for: Novartis, Roche, Speakers bureau: MSD, Roche, Pfizer, abbvie,Celltrion, Novartis, Pamir atagunduz: None declared, Belkis Nihan Seniz: None declared, Burcu Yagiz: None declared, Suleyman Serdar Koca: None declared, Muhammet Cinar: None declared, askin ates: 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, Onay Gercik: None declared, Duygu Ersozlu: None declared, Veli yazisiz: None declared, Gezmis Kimyon: None declared, Muge aydin: None declared, Ridvan Mercan: None declared, Burak Oz: None declared, Zeynel abidin akar: None declared, Omer Karadag: None declared, Bahar Kelesoglu: None declared, Sedat Yilmaz: None declared, Yavuz Pehlivan: None declared, Ender Terzioglu: None declared, Levent Kilic: None declared, Sukran Erten: None declared, Koray Tascilar: None declared, Umut Kalyoncu Grant/research support from: MSD, Roche, UCB, Novartis and Pfizer, Consultant for: MSD, abbvie, Roche, UCB, Novartis, Pfizer and abdi Ibrahim, Speakers bureau: MSD, abbvie, Roche, UCB, Novartis, Pfizer and abdi Ibrahim

Background: In rheumatoid arthritis (RA), biologic DMARDs are important treatment options in resistant patients. Inefficacy or side effects may cause switching between these drugs. Objectives: This study aimed to determine features of patients switching from one biologic DMARD to another in RA treatment and to investigate associated reasons for switching. Methods: This multicenter, prospective observational cohort study used the TReasure database in which web-based registration of RA and spondyloarthritis patients are being performed in 15 centers across different regions of Turkey. In this study, data of RA patients switching from one biologic agent to another were analyzed. Demographic and clinical data, follow-up duration, time to switch, and reasons for switching were retrieved from the database. Results: Of the included 2115 RA patients, 829 (39.2%) switched between biologic agents (switched group) and 1286 (60.8%) continued to receive their current therapies (continued group). The median follow-up duration of all patients was 3.7 years and the median time to switch was 1.1 years. In the switched group, the proportion of females and the median HAQ-DI score were higher as well as disease duration was longer (Table 1). Among the biologic agents used at first, 60.9% of the patients were receiving an anti-TNF agent and 39.1% of the patients were receiving other biologic agents (Table 2, figure 1). In the switched group (n=829), the main reasons for switching were secondary inefficacy (n=269), primary inefficacy (n=238), and side effects (n=178) followed by primary or secondary unknown inefficacy (n=30), patient’s demand (n=21), physician’s request (n=16), willing to be pregnant (n=7), other (n=31), and unknown (n=54). Conclusion: The patients in the Treasure database were followed-up approximately 4 years and about one-third of the patients had to switch from one biologic DMARD to another. The main reasons for this switching were primary (29.2%) and secondary (33.0%) inefficacy and 20% of the patients had to switch due to side effects. According to the switching pattern, about half of the patients using an anti-TNF agent at first switched to another anti-TNF agent and the other half switched to other biologic agents. Disclosure of Interests: Umut Kalyoncu Grant/research support from: MSD, Roche, UCB, Novartis and Pfizer, Consultant for: MSD, Abbvie, Roche, UCB, Novartis, Pfizer and Abdi Ibrahim, Speakers bureau: MSD, Abbvie, Roche, UCB, Novartis, Pfizer and Abdi Ibrahim, Ali Ihsan Ertenli: None declared, Abdulsamet Erden: None declared, Orhan Kucuksahin: None declared, Timucin Kasifoglu: 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, Cemal Bes: None declared, Nilufer Alpay Kanitez: None declared, Hakan Emmungil Grant/research support from: MSD, Roche, Pfizer, Abbvie, Consultant for: Novartis, Roche, Speakers bureau: MSD, Roche, Pfizer, Abbvie,Celltrion, Novartis, Pamir Atagunduz: None declared, Belkis Nihan Coskun: None declared, Burcu Yagiz: None declared, Suleyman Serdar Koca: None declared, Muhammet Cinar: None declared, Askin Ates: 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, Onay Gercik: None declared, Duygu Ersozlu: None declared, Veli Yazisiz: None declared, Gezmis Kimyon: None declared, Muge Aydin: None declared, Ridvan Mercan: None declared, Burak Oz: None declared, Nazife Sule Yasar Bilge: None declared, Zeynel Abidin Akar: None declared, Omer Karadag: None declared, Ayse Bahar Kelesoglu Dincer: None declared, Sedat Yilmaz: None declared, Ufuk Ilgen: None declared, Yavuz Pehlivan: None declared, Ender Terzioglu: None declared, Levent Kilic: None declared, Sukran Erten: None declared, Sedat Kiraz: None declared

Background In spondyloarthritis (SpA), biologic DMARDs are important treatment options in resistant patients. Inefficacy or side effects may cause switching between these drugs. Objectives This study aimed to determine features of patients switching from one biologic agent to another in SpA treatment and to investigate associated reasons. Methods This multicenter, prospective observational cohort study used the TReasure database in which web-based registration of rheumatoid arthritis and SpA patients are being performed in 15 centers across different regions of Turkey. In this study, data of SpA patients switching from one biologic agent to another were analyzed. Demographic and clinical data, follow-up duration, time to switch, and reasons for switching were retrieved from the database. Kaplan-Meier analysis was performed to show drug retention rates and Cox regression analysis was performed to investigate the factors affecting switching. Results Of the included 3138 SpA patients, 1165 (37.1%) switched to another biologic agent (switched group) and 1973 (62.9%) continued to receive their current therapies (continued group). The median follow-up duration of all patients was 3.8 years and the median time to switch was 1.0 years (0-13.4 years). According to the distribution of comorbidities, the rates of patients having diabetes mellitus, hyperlipidemia, asthma, gastrointestinal bleeding, and cancer were significantly higher in the switched group than those of in the continued group (8.4% vs. 5.8%, p=0.006; 14.5% vs. 9.2%, p In the switched group (n=1165), the main reasons for switching were secondary inefficacy (n=351), primary inefficacy (n=328), and side effects (n=267) followed by primary or secondary unknown inefficacy (n=57), physician’s request (n=45), patient’s demand (n=36), willing to be pregnant (n=9), other (n=37), and unknown (n=70). Conclusion In SpA patients, switching was frequent between anti-TNF agents and the median time to first switch was 1 year. Female gender, short disease duration, and lower BASDAI score were found to be the significant factors affecting switching from the anti-TNF agent used at first. The main reasons for this switching were primary (29.0%) and secondary (31.0%) inefficacy followed by side effects (23.6%). Switching between subcutaneous anti-TNF agents is generally less than switching from infliximab to another biologic agent. Disclosure of Interests Umut Kalyoncu Grant/research support from: MSD, Roche, UCB, Novartis and Pfizer, Consultant for: MSD, Abbvie, Roche, UCB, Novartis, Pfizer and Abdi Ibrahim, Speakers bureau: MSD, Abbvie, Roche, UCB, Novartis, Pfizer and Abdi Ibrahim, Sedat Kiraz: None declared, Abdulsamet Erden: None declared, Orhan Kucuksahin: None declared, Timucin Kasifoglu: 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, Cemal Bes: None declared, Nilufer Alpay Kanitez: None declared, Hakan Emmungil Grant/research support from: MSD, Roche, Pfizer, Abbvie, Consultant for: Novartis, Roche, Speakers bureau: MSD, Roche, Pfizer, Abbvie,Celltrion, Novartis, Pamir Atagunduz: None declared, Belkis Nihan Coskun: None declared, Burcu Yagiz: None declared, Suleyman Serdar Koca: None declared, Muhammet Cinar: None declared, Askin Ates: 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, Onay Gercik: None declared, Duygu Ersozlu: None declared, Veli Yazisiz: None declared, Gezmis Kimyon: None declared, Muge Aydin: None declared, Ridvan Mercan: None declared, Burak Oz: None declared, Nazife Sule Yasar Bilge: None declared, Zeynel Abidin Akar: None declared, Omer Karadag: None declared, Ayse Bahar Kelesoglu Dincer: None declared, Sedat Yilmaz: None declared, Ufuk Ilgen: None declared, Yavuz Pehlivan: None declared, Ender Terzioglu: None declared, Levent Kilic: None declared, Sukran Erten: None declared, Ali Ihsan Ertenli: None declared

To investigate the choroidal thickness in patients with scleroderma and to compare them with healthy control subjects. Forty-six patients with scleroderma (3 male and 43 female) and 31 healthy controls (6 male and 25 female) were included in the study. Twenty-five patients had limited-type and 21 patients had diffuse-type scleroderma. Only left eyes of the patients and control subjects were used in the analysis. Demographic features of all the patients and control subjects were recorded. Each subject underwent ophthalmological examinations including refraction, visual acuity, intraocular pressure, axial length (AXL) measurement, slit-lamp biomicroscopy, and fundus examination. Body mass index (BMI) was estimated for all participants. There were no significant differences between the patients with scleroderma and the control subjects in terms of age, gender, BMI, mean AXL, and mean spherical equivalent refractive error (SE) (P=0.1, P=0.086, P=0.37, P=0.55, and P=0.072 respectively). The patients with scleroderma had significantly thinner nasal, temporal, and subfoveal choroid than the healthy control subjects (P1=0.012, P2=0.046, and P3 0.05). Choroidal thickness in patients with scleroderma was significantly less than healthy control subjects. Vasculopathy in scleroderma is characterized by obliteration of arterioles and reduced capillary density may cause atrophy of choroid in patients with scleroderma.

Purpose: To investigate the results of dexamethasone (DEX) implant in the treatment of eyes with refractory Behcet posterior uveitis.Methods: A total of 17 eyes of 12 patients with active Behcet posterior uveitis were enrolled in the study. A single intravitreal injection of DEX implant was applied to each eye. Best corrected visual acuity (BCVA), central macular thickness (CMT), vitreous haze score, and intraocular pressure (IOP) were determined, at baseline and control visits of months 1, 3, 6, and 12.Results: The mean BCVA was significantly increased from baseline at each control visit (all p

Background:Although psoriatic arthritis (PsA) may be seen at any decades, juvenil onset PsA is relatively rare. Moreover, there were no more data about clinical features, treatments, and course in juvenile PsA when they reached to adult age.Objectives:The objective of this study was to assess and compare demographic and clinical features for juvenile onset PsA and adult onset PsA.Methods:PsART-ID is a multicenter, international database, investigating the disease characteristic in real life (1). Briefly, demographic data, PsA subtypes, uveitis, enthesitis, dactylitis, Co-morbidities, disease activity scores (TJC, SJC, VAS-pain, VAS patients and physician global assessments, VAS-fatigue, BASDAI), and functional status (HAQ-DI, BASFI) were recorded. Psoriasis and PsA starting age were noted, as well. Patients were classified as juvenile PsA or juvenile PsO (under 18 years old). Results were compared regarding to juvenile versus adult onset age.Results:Overall, 1644 PsA patients were included to study, 301/1644 (18.3%) patients had juvenile onset psoriasis. Of 39/1644 (2.4%) patients had juvenile onset PsA, as well. As expected, juvenile onset PsA patients were younger, however PsA disease duration were longer than adult onset PsA patients. There were no any difference between demographic and clinical data, except BMI and enthesitis were less frequently at the juvenile onset PsA groups. Although, ever csDMARD using were similar between two groups, however, juvenile onset PsA patients were used more frequently bDMARDs.Table.Comparison of demographic and clinical characteristics of juvenile and adult-onset psoriatic arthritisJuvenile onsetAdult onsetpN (%)39 (2.4)1605 (97.6)Female Sex n (%)24 (61.5)1006 (62.7)0.884PsA beginning age mean (SD)13.3 ± 3.8542.3 ± 12.9Current age mean (SD)26.6 ±10.747.3 ±13.07Duration of psoriasis (years)17.10 ± 11.2614.75 ± 11.780.124Duration of psoriatic arthritis (years)13.5 ±115.06 ± 6.7Cigarette smoking (ever) n (%)15/38641/14940.72Education duration/year (mean,SD)10.09 ± 3.679.52 ± 4.810.464BMI (kg/m2) (mean, SD)24.5 ±5.128.3 ± 5.21Family history of PsO/PsA n (%)15 (38.5)559 (34.9)0.642Nail involvement n (%)18 (46.2)762 (47.5)0.864Dactilitis n (%)9 (23.7)367 (24)0.958Entesitis n (%)3 (7.9)384 (25.7)0.013Uveitis n (%)-13 (4.3)0.713Axial involvement (%)15 (38.5)464 (29)0.199Methotrexate36 (92.3)1348 (84)0.162Sulfasalazine17 (43.6)612 (38.1)0.488Leflunomide14 (35.9)379 (23.6)0.076Biologic DMARDs102 (33.9)358 (26.8)0.013Conclusion:Although psoriasis may be seen frequently in the juvenile age, juvenile onset PsA was not so frequent in our PsA cohort. Although, ever csDMARD using were similar between two groups, however, juvenile onset PsA patients were used bDMARDs more frequently.References:[1]Kalyoncu U et al. The Psoriatic Arthritis Registry of Turkey: results of a multicenter registry on 1081 patients. Rheumatology. 2017;56:279-286.Disclosure of Interests:Serpil ERGULU EŞMEN: None declared, Ozun Bayindir: None declared, esen kasapoğlu: None declared, Sibel Bakirci: None declared, Dilek Solmaz: None declared, Gezmiş Kimyon: None declared, Atalay Doğru: None declared, Ediz Dalkiliç: None declared, Cem Özişler: None declared, Meryem Can: None declared, Servet Akar: None declared, Emine Figen Tarhan: None declared, Sule Yavuz: None declared, Levent Kiliç: None declared, Orhan Küçükşahin: None declared, Ahmet Omma: None declared, Emel Gönüllü: None declared, Fatih Yildiz: None declared, Duygu Ersözlü: None declared, abdurrahman tufan: None declared, Muhammet Çinar: None declared, Abdulsamet Erden: None declared, Sema Yilmaz: None declared, Seval Pehlevan: None declared, Mehmet Tuncay Duruöz: None declared, Sibel Aydin: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB

Background:Biosimilar infliximab (bio-INF) was approved for all indications of the reference product in several countries. It has been marketed since 2014 in Turkey and used in the same indications with its bio-originator.Objectives:Herein, we aimed to analyse clinical features and the drug survival rates of spondyloarthritis patients who have recieved bio-INF.Methods:This multicenter, prospective observational cohort study used the TReasure database in which web-based registration of rheumatoid arthritis and SpA patients are being performed in 13 centers across different regions of Turkey. Age, gender, and acute phase responses (erythrocyte sedimentation rate and C-reactive protein), HAQ scores, VAS patient global, VAS fatigue, VAS pain, VAS physician global, BASDAI, BASFI, ASDAS ESH and ASDAS CRP values, clinical findings of SpA patients, number of patients who has received bio-INF as first line therapy or after switch, treatments which are used before bio-INF, the reasons for switching bio-INF to another biologic DMARD and drug survival rates were retrospectively evaluated.Results:A total number of 231 SpA (94 (40.7 %) female, 137 (59.3%) male, mean age 43±11 yrs) patients have received biosimilar infliximab in the database. Of the 231 patients 127 (55%) had received bio-INF as first line therapy, whereas 104 (46 (19.9%) 2ndchoice, 58 (25.1%) 3rdchoice) patients used switching after another biologic DMARD. Previously used biologic and synthetic DMARDs were adalimumab (28.6%), etanercept (22.5%), golimumab (9.1%), original infliximab (8.2%), secukinumab (13.4%), methotrexate (23.8%), leflunamid (10.4%), sulphasalazine (60.6%). The baseline and first visit (3. Months) diseases activity scores were shown in Table 1. Drug survival rates were 79.1 in 12. months, 65.5 in 24. months and 54.6 in 60. months. (Figure 1). The most common reasons for switching from biosimilar infliximab to another biologic DMARD is secondary (25(10.8%)), and primary ineffectiveness (22(9.5%)). Other reasons to discontinuation of treatment are psoriasis (5 (2.1%)), infusion reaction (3(1.2%)), allergic reaction (22(8.8 %)), chest pain (3(1.2%)), dyspnea (1 (0.4%)), vasculitis (1 (0.4%)) and patient or doctor wish (7 (3.4%)).Conclusion:The results of this real life data provides evidence that biosimilar infliximab is an effective and safe treatment option with long term use in SpA patients. Drug survival rates of bio-INF is similar to its bio-originator.Table 1.Disease activity scoresBaseline visit3.monthpmedian (Q1-Q3)median (Q1-Q3)HAQ score0,63 (0,4-1)0,25 (0-1)BASDAI6,2 (4,8-7)2,8 (1-5)BASFI5,05 (3,3-6)2,1 (0,45-4)VAS Patient Global70 (50-80)30 (10-50)VAS Doctor Global60 (40-70)30 (20-40)VAS Pain50 (3-80)30 (10-50)0,572VAS fatigue70 (50-80)40 (10-65)ESR24 (11-45)11 (6-23)CRP12,1 (4,4-30)3,91 (2,19-9)ASDAS ESR3,12 (2,51-4)2,05 (1,39-3)ASDAS CRP3,53 (2,86-4)2,21 (1,5-3)*Wilcoxon Signed Rank TestFigure 1.Drug survival ratesDisclosure of Interests:Nazife Sule Yasar Bilge: None declared, Timuçin Kaşifoğlu: None declared, Sedat Kiraz: None declared, Ali İhsan Ertenli: None declared, Ediz Dalkiliç: None declared, Cemal Bes: None declared, Hakan Emmungil: None declared, Belkis Nihan Seniz: None declared, Burcu Yağiz: None declared, Muhammet Çinar: None declared, Servet Akar: None declared, Önay Gerçik: None declared, Duygu Ersözlü: None declared, Gezmiş Kimyon: None declared, Ridvan Mercan: None declared, Omer Karadag: None declared, Yavuz Pehlivan: None declared, Levent Kiliç: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB

Background:Methotrexate (MTX) is the most common first-line disease-modified anti-rheumatic drugs in psoriatic arthritis (PsA), despite the controversies.Objectives:In this study, we aimed to determine the rate of withdrawal rate of MTX in PsA and reasons for discontinuing.Objectives:In this study, we aimed to determine the rate of withdrawal rate of MTX in PsA and reasons for discontinuing.Methods:A large prospective international multicenter PsA registry was used for this study. Data were collected either at enrolment, based on history, or prospectively if there was a follow up. We analyzed the frequency of MTX usage, discontinuation and the reason for discontinuation. The time on MTX was compared according to the reason of discontinuation (inefficacy vs side effects) using Kaplan-Meier and Cox regression analyses to identify risk factors for discontinuation.Results:At the time of analyses, 1670 patients had been recruited to the registry and 1359 PsA patients had used MTX during the course of the disease (81.3%). Within these, 942 (69.3%) were still on MTX at the time of analysis, and 417 (30.7%) patients have discontinued (Table). The most common reasons for withdrawal were side effects (219/417, 52.5%) and ineffectiveness (88/417, 21.1%). Other reasons included pregnancy, remission, self-decision (11.9% for all). For 60 patients (14.3%), the reason could not be identified. In patients who were still on MTX, the median duration of MTX therapy was 31 months (IQR=59) compared to 17 months (IQR=43) in the withdrawal group. The most common side effects were gastrointestinal symptoms (47%) and abnormal liver function tests (25%). There was a significant difference in survival plots (Log-rank p=0.026) with discontinuing due to side effects occurring earlier than inefficacy (Figure 1). In cox regression model, longer disease duration was found as an independent predictor of MTX discontinuation due to all reasons [Hazard Ratio (HR)=1.01, 95% Confidence interval (CI)=1.0-1.02; p=0.003].Conclusion:MTX is frequently used on PsA treatment, despite the controversies in the literature. One third of patients with PsA discontinue MTX, most commonly due to side effects or inefficacy. Patients discontinue MTX earlier in case of having side effects. Longer disease duration is linked to MTX discontinuation.Table.Demographics and disease characteristics of study groupsAll patientsn=1359Still on MTXn=942Withdrawal MTX any reasonn=417pAge, mean (SD)46.4 (13.4)46.1 (13.4)47.7 (14.0)0.038Male gender, n (%)523 (38.5)360 (38.2)163 (39.1)0.761Ever smoking, n (%)569/1258 (46.2)390/861 (45.3)179/397 (45.1)0.966Psoriasis duration (years), mean (SD)14.2 (11.7)14.0 (11.2)16.4 (12.7)0.003Polyarthritis, n (%)657/1343 (48.9)471/931 (50.6)186/412 (45.1)0.066Axial disease, n (%)388/1343 (28.9)267/931 (28.7)121/412 (29.4)0.797Nail involvement (ever), n (%)644 (47.8)435 (46.6)209 (50.5)0.191Swollen Joint Count, mean (SD)1.5 (2.6)1.4 (2.6)2.0 (3.2)Tender Joint Count, mean (SD)3.0 (4.4)3.5 (5.0)4.2 (5.4)HAQ, mean (SD)0.6 (0.6)0.7 (0.7)0.8 (0.7)0.035BASDAI,mean (SD)37 (22)39 (23)46 (25)0.001Disclosure of Interests:Dilek Solmaz: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB, Ilaria Tinazzi: None declared, Ozun Bayindir: None declared, Ediz Dalkiliç: None declared, Atalay Dogru: None declared, Cem Özişler: None declared, Gezmiş Kimyon: None declared, Gozde Yildirim Cetin Speakers bureau: AbbVie, Novartis, Pfizer, Roche, UCB, MSD, Ahmet Omma: None declared, Emine Figen Tarhan: None declared, Levent Kiliç: None declared, Servet Akar: None declared, Sema Yilmaz: None declared, Meryem Can: None declared, Sule Yavuz: None declared, Orhan Küçükşahin: None declared, Sibel Bakirci: None declared, Sibel Aydin: None declared

Background:Serum autoantibodies closely reflect patterns of organ involvement and disease progression in systemic sclerosis (SSc). The entire autoantibody profile is less well defined in many cohorts and the data regarding their clinical associations and frequencies is limited.Objectives:To determine the autoantibody profile of patients with SSc, as well as their clinical associations, in well-characterized inception- cohort with disease duration less than 3 years.Methods:Serum samples of 100 patients out of 105 enrolled in the study were analyzed for ANA patterns with indirect immunofluorescence (IIF) assay using HEp-20-10/primate liver mosaic IIFT kit. Sera of 96 patients were subjected to commercial line immunoassay to quantify autoantibodies against 13 different autoantigens.Results:92 (92%) out of 100 patients were positive for ANA by IIF (Table 1). The speckled staining was the most pattern followed by nucleolar in 10 patients, centromere in 4, reticular in 1, nuclear in 2 and homogenous in 1. All patients (n= 96) patients were positive for at least 1 autoantibody by immunoblotting (Table 2). Twenty-two (49%) of patients with antiTopo I, 12 (44%) of the patients with antiCENP and 4 (22%) of the patients with antiRNAPIII were single positive. There was no difference in terms of the clinical findings when the patients with single and coexpression of these antibodies were compared. The distributions of the most frequent autoantibodies are shown in Figure 1. Interstitial lung disease was more frequent in the patients positive for anti-Topo I (78.8%) and anti-RNAPIII (27.3%). One of the two patients with breast cancer was anti-RNAPIII positive and none of the patients have diagnosed scleroderma renal crisis. Anti-Topo I was more common in patients with dcSSc (75%) and anti-CENP in lcSSc (46.4%).Table 1.Demographic, clinical and laboratory characteristics of the SSc patients.Sex Female N, %91 (86.7%) Male N, %14 (13.3) Female-to-male ratioAge, mean±SD years48.6±12.7Disease duration, mean±SD years2±1.4Disease classification N, % Diffuse39 (36.5%) Limited65 (62.5%) Sine scleroderma1 (1%)Interstitial lung disease37 (34.3%)Pulmonary arterial hypertension3 (2.8%)Scleroderma renal crisis0Digital ulcer14 (13.3%)Raynaud phenomenon105(100%)Telengiectasia31 (28.8%)Calcinosis1 (1%)Malignancy3 (2.9%)Antinuclear antibody profile N*, % Positive92 (92%)Staining pattern Speckled65 (65%) Nucleolar13 (13%) Centromere29 (29%) Homogeneous3 (3%) Reticular3 (3%)Table 2.Numbers and combinations of autoantibodies identified in the 96 SSc patients.Topo-ICENPRNAP IIIFibrillarinNOR90Th/ToPm/SclKuPDGFRRo52Topo-I22170159507CENP12202222011RNAPIII40121307Fibrillarin0000000NOR90011002Th/To04202Pm/Scl4306Ku102PDGFR00Ro522Single positive221240004102Total452718058179024Figure 1.Diagram of disease-related antibodies against the four main autoantibodies [anti-centromere (antiCENP) anti-Topoisomerase I (antiTopo I), anti-RNA polymerase III (antiRNAP III) and anti-Ro52).Conclusion:We presented the clinical and serologic features of the Turkish SSc patients from a new inception cohort. Clinical features of the SSc patients with single or multiple antibody positivity were not different.References:NoneDisclosure of Interests:None declared

Background Psoriatic arthritis (PsA) has a genetic background, approximately 40% of patients having a family history of psoriasis or PsA in first-degree relatives, which may impact the disease features. Objectives The aim of this study was to evaluate the effects of family history of psoriasis or PsA on the disease phenotypes. Methods The demographic and clinical data were retrieved from the longitudinal, multicenter PsArt-ID (Psoriatic Arthritis-International Database). Family history of psoriasis and PsA were investigated for 1st and 2nd degree relatives separately. The effect of the family history of psoriasis and/or PsA on disease phenotypes and severity were analysed, calculating the relative risks (RR). Results 1393 patients had the data for family history, 444 (31.9%) of whom was positive for psoriasis and/or PsA. The majority of the family history was only psoriasis (333/444; 75%) and 58.5% (260/444) of the patients had first-degree relatives affected. There was no differences in maternal or parental transmission rates however women had more psoriasis and/or PsA in their family (67.3% vs 32.7% p: 0.028). Patients with a family history had an earlier onset of age for psoriasis (29±14.8 vs 31±14.9 p: 0.007), more frequent nail involvement (50.7% vs 29.6% p: 0.032), more frequent enthesitis (28.2% vs 17.7% p Conclusions The family history of psoriasis and PsA has impacts on skin phenotypes, musculoskeletal features and the disease severity. The differences between family history of psoriasis and PsA and pustular vs plaque phenotypes may point out to a different genetic background and pathogenic mechanisms in these subsets. Disclosure of Interest None declared

Background The environmental and genetic factors play a crucial role in the pathogenesis of psoriatic arthritis (PsA) which may cause a difference in disease characteristics for patients from different geographical regions. Objectives The aim of the study was to explore the disease characteristics, treatment choices and comorbidities in patients with PsA in different countries to see the impact of geographic factors. Methods PsArt-ID (Psoriatic Arthritis- International Database) is a prospective, multicentre registry in PsA, which was initially developed in Turkey in 2014, with participation of Canada since 2015 and Italy since 2017. Patients with PsA are consecutively registered to this registry with the aim of investigating the real-life data. Patient characteristics across Turkey (n=1283) and Canada (n=119) are compared for this analysis. Results Canadian patients were older at the time of recruitment (Table). They also were more frequently smokers, had higher duration of education and higher BMI than patients in Turkey. Patients in Canada had more frequent polyarthritis (66.7% vs 39.6%, p Conclusions Geographical differences have impacts on the disease features in PsA, which may be due to genetic, environmental and cultural differences. The treatments are comparable suggesting a similar approach by the physicians. Disclosure of Interest None declared