Search

Background/objectivesTo maintain and optimise the quality of care provided by health professionals in rheumatology (HPRs), adequate educational offerings are needed. This task force (TF) aimed to develop evidence-based recommendations for the generic core competences of HPRs, with specific reference to nurses, physical therapists (PTs) and occupational therapists (OTs) to serve as a basis for their postgraduate education.MethodsThe EULAR standardised operating procedures for the development of recommendations were followed. A TF including rheumatologists, nurses, PTs, OTs, patient-representatives, an educationalist, methodologists and researchers from 12 countries met twice. In the first TF meeting, 13 research questions were defined to support a systematic literature review (SLR). In the second meeting, the SLR evidence was discussed and recommendations formulated. Subsequently, level of evidence and strength of recommendation were assigned and level of agreement (LoA) determined (0–10 rating scale).ResultsThree overarching principles were identified and 10 recommendations were developed for the generic core competences of HPRs. The SLR included 79 full-text papers, 20 of which addressed the competences, knowledge, skills, attitudes and/or educational needs of HPRs from multiple professions. The average LoA for each recommendation ranged from 9.42 to 9.79. Consensus was reached both on a research and educational agenda.ConclusionEvidence and expert opinion informed a set of recommendations providing guidance on the generic core competences of HPRs. Implementation of these recommendations in the postgraduate education of HPRs at the international and national level is advised, considering variation in healthcare systems and professional roles.

Background The structural and functional changes of the skeletal muscles in idiopathic inflammatory myopathies (IIM) caused by inflammation and immune changes can be severely disabling. The objective of this study was to assess the effect of a 24-week program combining a supervised training of activities of daily living (ADL), resistance, and stability with home exercise for improving muscle function, compared to a daily home-based exercise representing the regular outpatient care. Methods Fifty-seven patients with IIM were consecutively and non-selectively enrolled in an intervention (IG, n = 30) or control (CG, n = 27) group. Both groups were provided a standard-of-care pharmacological treatment and follow-up. Only the IG underwent the supervised intervention twice a week for 1 h per session. At baseline, 12, 24, and 48 weeks, all patients were assessed by an assessor blinded to the intervention for primary outcomes: muscle strength (Manual Muscle Testing of eight muscle groups [MMT-8]) and endurance (Functional Index-2 [FI-2]), and secondary outcomes: stability and body composition. Secondary outcomes also included questionnaires evaluating disability (Health Assessment Questionnaire [HAQ]), quality of life (Short Form 36 [SF-36]), depression (Beck’s Depression Inventory-II [BDI-II]), and fatigue (Fatigue Impact Scale [FIS]), and analysis of the systemic and local inflammatory response and perceived exertion to assess the safety of the intervention. Results Twenty-seven patients in the IG and 23 in the CG completed the entire program and follow-up. At week 24, compared to deterioration in the CG, we found a significant improvement in the IG in muscle strength (mean % improvement compared to baseline by 26%), endurance (135%), disability (39%), depression (26%), stability (11%), and basal metabolism (2%) and a stabilization of fitness for physical exercise. The improvement was clinically meaningful (a 24-week change by >20%) in most outcomes in a substantial proportion of patients. Although the improvement was still present at 48 weeks, the effect was not sustained during follow-up. No significant increase in the systemic or local expression of inflammatory markers was found throughout the intervention. Conclusions This 24-week supervised intervention focused on ADL training proved to be safe and effective. It not only prevented the progressive deterioration, but also resulted in a significant improvement in muscle strength, endurance, stability, and disability, which was clinically meaningful in a substantial proportion of patients. Trial registration ISRCTN35925199 (retrospectively registered on 22 May 2020).

BackgroundHealth professionals in rheumatology (HPRs) should participate in post-graduate or continuous education to update and advance their knowledge and skills. This can improve patient outcomes and increase quality of care.1 EULAR aims to become a leading provider of postgraduate education for HPRs.ObjectivesThe aims of this study were to evaluate the current motivations for participating in postgraduate education of HPRs, identify barriers and facilitators for participation in postgraduate education, and evaluate participation in the current educational offerings of EULAR for HPRs across Europe.MethodsAn online survey was developed and distributed in collaboration with the EULAR Standing Committee of Education and Training (ESCET) and the Paediatric Rheumatology European Society (PReS). The questionnaire was translated by national HPR representatives in 24 languages to cover the 25 national member organisations. Barriers were assessed using 5-point Likert scales, higher scores representing higher barriers. Quantitative data were analysed using descriptive statistics. In addition, we ran the Latent Dirichlet Allocation (LDA) on the answers to the open questions. LDA is an unsupervised probabilistic topic modelling technique that extracts the meanings of a pre-defined number of topics. Design of the survey and reporting of results were done according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).ResultsThe online questionnaire was accessed 3,589 times but only 667 complete responses were recorded. HPRs from 34 European countries responded to the survey; 80% of whom were women. The highest-ranked educational need was prevention, including lifestyle interventions and professional development. Although EULAR was well known among HPRs, only 32.1% of HPRs in adult care and 18.6% of HPRs in paediatric care have ever heard of the EULAR School of Rheumatology (Table 1 A).Table 1.A: Feedback on EULAR. Data are presented separately for HPRs in adult and paediatric care; except for the filter questions, no mandatory questions were included in the survey. To clarify the number of responses per question, the number of valid answers for each question was reported.VariablesHPRs in adult careHPRs in paediatric careHave you ever heard of the EULAR School of Rheumatology?61443 I am not sure, n(%)62 (10.1%)7 (16.3%) No, n(%)355 (57.8%)28 (65.1%) Yes, n(%)197 (32.1%)8 (18.6%)Are you aware of courses offered by the EULAR School of Rheumatology? (sub question)1978 I am not sure, n(%)30 (15.2%)2 (25.0%) No, n(%)63 (32.0%)5 (62.5%) Yes, n(%)104 (52.8%)1 (12.5%)Have you ever attended one of the EULAR School of Rheumatology courses? (sub question)1031 I am not sure, n(%)1 (1.0%)0 No, n(%)47 (45.6%)0 Yes, n(%)55 (53.4%)1 (100%)Have you ever participated in a EULAR annual congress meeting?61843 I am not sure, n(%)11 (1.8%)0 No, n(%)457 (73.9%)39 (90.7%) Yes, n(%)150 (24.3%)4 (9.3%)The main barriers to participation in EULAR’s educational offerings were identified by HPRs in adult care and in paediatric care (respectively) as: the unfamiliarity with the course content (3.48 [±1.50]; 3.92 [±1.46]), the associated costs (3.44 [±1.35]; 3.69 [±1.28]) and English language (2.59 [±1.50]; 2.80 [±1.34]).ConclusionEULAR is well-known by HPRs in Europe, however, awareness of educational offerings is low and barriers to participation are numerous. To become the leading provider of postgraduate training by 2023, EULAR could use a “franchise” model that can be tailored to local conditions. This could be achieved by strengthening national organizations by actively involving them in the development of training programs and disseminating these programs and offerings through their networks.References[1]World Health Organization. Health workforce: Education and training: World Health Organization; 2019 [Available from: https://www.who.int/hrh/education/en/ accessed November, 2019 2019.Disclosure of InterestsLisa Sperl: None declared, Tanja Stamm Speakers bureau: AbbVie, Novartis, Roche, Sanofi, and Takeda, Consultant of: AbbVie and Sanofi Genzyme, Grant/research support from: AbbVie and Roche, Margaret Renn Andrews: None declared, Mathilda Bjork: None declared, Carina Boström: None declared, Jeannette Cappon: None declared, Jenny de la Torre-Aboki: None declared, Annette de Thurah: None declared, Andrea Domjan: None declared, Razvan Dragoi Speakers bureau: Received speaker fees last year from: Pfizer, Elly Lilly, Sandoz, Abbvie, Secom, EwoPharma, Fernando Estevez-Lopez: None declared, Ricardo J. O. Ferreira: None declared, George E. Fragoulis: None declared, Jolanta Grygielska: None declared, Katti Korve: None declared, Marja Leena Kukkurainen: None declared, Christel Madelaine-Bonjour: None declared, Andrea Marques: None declared, Jorit Meesters: None declared, Rikke Helene Moe: None declared, Ellen Moholt: None declared, Erika Mosor: None declared, Claudia Naimer-Stach: None declared, Mwidimi Ndosi: None declared, Polina Pchelnikova: None declared, Jette Primdahl: None declared, Polina Putrik: None declared, Anne-Kathrin Rausch Osthoff: None declared, Hana Smucrova: None declared, Sinisa Stefanac: None declared, Marco Testa: None declared, Leti van Bodegom-Vos: None declared, Wilfred Peter: None declared, Heidi A. Zangi: None declared, Olena Zimba: None declared, T.P.M. Vliet Vlieland: None declared, Valentin Ritschl: None declared

To update the European League Against Rheumatism (EULAR) recommendations for the role of the nurse in the management of chronic inflammatory arthritis (CIA) using the most up to date evidence. The EULAR standardised operating procedures were followed. A task force of rheumatologists, health professionals and patients, representing 17 European countries updated the recommendations, based on a systematic literature review and expert consensus. Higher level of evidence and new insights into nursing care for patients with CIA were added to the recommendation. Level of agreement was obtained by email voting. The search identified 2609 records, of which 51 (41 papers, 10 abstracts), mostly on rheumatoid arthritis, were included. Based on consensus, the task force formulated three overarching principles and eight recommendations. One recommendation remained unchanged, six were reworded, two were merged and one was reformulated as an overarching principle. Two additional overarching principles were formulated. The overarching principles emphasise the nurse’s role as part of a healthcare team, describe the importance of providing evidence-based care and endorse shared decision-making in the nursing consultation with the patient. The recommendations cover the contribution of rheumatology nursing in needs-based patient education, satisfaction with care, timely access to care, disease management, efficiency of care, psychosocial support and the promotion of self-management. The level of agreement among task force members was high (mean 9.7, range 9.6-10.0). The updated recommendations encompass three overarching principles and eight evidence-based and expert opinion-based recommendations for the role of the nurse in the management of CIA.

Background: Skeletal muscle, pulmonary, and articular involvement in idiopathic inflammatory myopathies (IIM) limit the mobility/self-sufficiency of patients, and can have a negative impact on body composition. Objectives: To assess body composition and physical activity of IIM patients and healthy controls (HC) and the association with selected inflammatory cytokines in IIM. Methods: 54 patients with IIM (45 females; mean age 57.7; disease duration 5.8 years; PM, (22)/DM, (25)/IMNM, (7)) and 54 age-/sex-matched HC (45 females, mean age 57.7) without rheumatic/tumor diseases were included. PM/DM patients fulfilled Bohan/Peter criteria for PM/DM. We assessed body composition (densitometry: iDXA Lunar, bioelectric impedance: BIA2000-M), physical activity (Human activity Profile, HAP questionnaire), disease activity (MITAX and MYOACT activity score), muscle involvement (manual muscle test, MMT-8 and functional index, FI2) and plasma levels of 27 cytokines (commercial multiplex ELISA kit, Bio-Rad Laboratories). Data are presented as mean±SD. Results: Compared to HC, patients with IIM had a trend towards significantly increased body fat% (BF%) as assessed by iDXA (39.9±7.1 vs. 42.4±7.1 %, p=0.077), but significantly decreased lean body mass (LBM) as assessed both by iDXA (45.6±8.1 vs. 40.6±7.2 kg, p=0.001) and BIA (52.6±8.8 vs. 48.7±9.0 kg, p=0.023), and increased extracellular mass/body cell mass (ECM/BCM) ratio (1.06±0.15 vs. 1.44±0.42, p Conclusion: Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our IIM patients, which are associated with their disease activity and duration, inflammatory status, skeletal muscle involvement, and physical activity. Plasma levels of several inflammatory cytokines were associated with alterations of body composition in IIM patients and highlight the potential role of inflammatory status on impaired body composition during the course of IIM. Acknowledgement: Supported byAZV NV18-01-00161A, MHCR 023728 and GAUK 312218 Disclosure of interests: Sabina Oreska: None declared, Maja Spiritovic: None declared, Petr Cesak: None declared, ondrej Marecek: None declared, Hana Storkanova: None declared, Hana Smucrova: None declared, Barbora Heřmankova: None declared, Kateřina Kubinova: None declared, Martin Klein: None declared, Lucia Vernerova: None declared, Olga Růžickova: None declared, Karel Pavelka: None declared, Ladislav Senolt Grant/research support from: abbVie, Consultant for: abbVie, Bristol-Myers Squibb, Celgene Corporation, Merck Sharp and Dohme, Novartis, Pfizer, Roche, UCB, amgen, Takeda, Speakers bureau: abbVie, amgen, Bristol-Myers Squibb, Celgene Corporation, Eli Lilly, Merck Sharp and Dohme, Novartis, Pfizer, Roche, UCB, Heřman Mann Consultant for: Pfizer, Eli Lilly, Sanofi, Speakers bureau: abbVie, Roche, Pfizer, MSD, Eli Lilly, Sanofi, Jiři Vencovský Consultant for: Samsung, Speakers bureau: abbVie, Novartis, Pfizer, Sanofi, Eli Lilly, Biogen, UCB, MSD, Werfen, Roche, Michal Tomcik: None declared

Background: Systemic sclerosis (SSc) is a chronic autoimmune disease that may affect all aspects of life including sexual function. Objectives: To assess sexual function, pelvic floor function and sexual quality of life women with SSc compared to age-/sex-matched healthy controls (HC). To subanalyze sexual function in sexually active individuals. Methods: In total 47 women with SSc (mean age: 50.5, disease duration: 5.6 years, lcSSc/dcSSc: 27/20, mRSS: 12.7, ESSG activity index: 2.5), who fulfilled the ACR/EULAR 2013 criteria, and 47 healthy women (mean age: 50.5) filled in 11 well-established and validated questionnaires assessing sexual function, pelvic floor function, quality of life, fatigue, physical activity and depression. Data are presented as mean±SEM. Results: Compared to HC, patients with SSc had significantly higher prevalence and greater severity of sexual impairment (FSFI, BISF-W), pelvic floor dysfunction (PISQ-12, PFIQ7), and worse sexual quality of life (SQol-F) (table 1). There were no significant differences in sexual function between limited and diffuse SSc. Even sexually active SSc patients reported significantly greater sexual health impairment compared to sexually active HC. Sexual health impairment in SSc was associated with disease activity/duration, health status, physical activity, fatigue and depression (table 2). Conclusion: Women with SSc reported significantly impaired sexual function, sexual quality of life and pelvic floor function than age-matched HC. Worse scores in SSc were associated with disease activity/duration/health status, physical activity, fatigue, and depression. Acknowledgements: Supported by AZV-16-33574A, MHCR 023728. Disclosure of Interests: Barbora Heřmankova: None declared, Maja Spiritovic: None declared, Hana Smucrova: None declared, Sabina Oreska: None declared, Hana Storkanova: None declared, Kristyna Bubova: None declared, Karel Pavelka: None declared, Jiři Vencovský Consultant for: Samsung, Speakers bureau: AbbVie, Novartis, Pfizer, Sanofi, Eli Lilly, Biogen, UCB, MSD, Werfen, Roche, Ladislav Senolt Grant/research support from: AbbVie, Consultant for: AbbVie, Bristol-Myers Squibb, Celgene Corporation, Merck Sharp and Dohme, Novartis, Pfizer, Roche, UCB, Amgen, Takeda, Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Celgene Corporation, Eli Lilly, Merck Sharp and Dohme, Novartis, Pfizer, Roche, UCB, Radim Becvař Consultant for: consultancy Actelion, Michal Tomcik: None declared

Background Systemic sclerosis (SSc) is characterized by stiffness and contraction of tissues, which leads to a limitation in the execution of day-to-day activities. The aim of our study was to investigate the impact of specialized physical-occupational therapy (POT) focused on the hands/face and QoL of SSc patients. Objectives Fifty five patients fulfilled the EULAR/ACR criteria for SSc and had skin involvement leading to hand/face function impairment. 25 patients were recruited into the intervention group (IG) and 30 patients into the control group (CG). Both groups received an educational material for home exercise, but only the IG underwent a 6-month intervention with a subsequent 6-month follow-up period. Methods Patients were assessed by a physician and a physiotherapist blinded to intervention at months 0, 3, 6, and 12. Patients also filled out patient reported outcomes questionnaires and provided blood for routine laboratory analysis and bio-banking. Data analysis was done between groups and within the group. Results Compared to the observed statistically significant deterioration in the CG, we found a statistically significant improvement in the IG in objectively assessed function and strength of hand, distance between incisors and functional ability (SHAQ) (Table). Only numerical improvements in the IG during the intervention compared to numerical deterioration in CG that did not reach statistical significance were observed in subjectively assessed hand function and mouth handicap, functional ability (HAQ) and in some domains of QoL (SF-36) and fatigue (FIS – cognitive function). During the follow-up period, there was a significant deterioration or stagnation of the achieved positive results in the IG. Conclusion Our program led to a significant improvement in the observed parameters that was clinically significant in a substantial proportion of patients, and prevention of the expected worsening of hand/face handicap and QoL. Acknowledgement Supported by AZV-16-33574A, SVV for FTVS UK 2019-260466, MHCR 023728. Disclosure of Interests Maja Spiritovic: None declared, Hana Smucrova: None declared, Sabina Oreska: None declared, Hana Storkanova: None declared, Barbora Heřmankova: None declared, Petr Cesak: None declared, Adela Rathouska: None declared, Olga Růžickova: None declared, Karel Pavelka: None declared, Ladislav Senolt Grant/research support from: AbbVie, Consultant for: AbbVie, Bristol-Myers Squibb, Celgene Corporation, Merck Sharp and Dohme, Novartis, Pfizer, Roche, UCB, Amgen, Takeda, Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Celgene Corporation, Eli Lilly, Merck Sharp and Dohme, Novartis, Pfizer, Roche, UCB, Jiři Vencovský Consultant for: Samsung, Speakers bureau: AbbVie, Novartis, Pfizer, Sanofi, Eli Lilly, Biogen, UCB, MSD, Werfen, Roche, Radim Becvař Consultant for: consultancy Actelion, Michal Tomcik: None declared

Background: Idiopathic inflammatory myopathies (IIM) are a group of disorders characterized by skeletal muscle inflammation that can cause functional impairment including sexual dysfunction. Objectives: To assess sexual function, pelvic floor function and sexual quality of life of women with IIM compared to age-/sex-matched healthy controls (HC). To subanalyze sexual function in sexually active individuals. Methods: In total 27 women with IIM [mean age: 54.2, disease duration: 7.3 years, dermatomyositis (DM, 10)/polymyositis (PM, 13)/necrotizing myopathy (IMNM, 3)/inclusion body myositis (IBM, 1)], who fulfilled the Bohan/Peter 1975 criteria for DM/PM, and 27 healthy women (mean age: 54.2) filled in 11 well-established and validated questionnaires assessing sexual function, pelvic floor function, quality of life, fatigue, physical activity and depression. Data are presented as mean±SEM. Results: Compared to HC, patients with IIM had significantly higher prevalence and greater severity of sexual impairment (FSFI, BISF-W), dysfunction of pelvic floor (PISQ-12), and worse sexual quality of life (SQoL-F) (table 1). There were no significant differences in sexual function between PM and DM. Even sexually active IIM patients reported significantly greater sexual health impairment compared to sexually active HC. Sexual health impairment in IIM was associated with laboratory markers of disease activity, health status, physical activity, fatigue and depression (table 2). Conclusion: Women with IIM reported significantly impaired sexual function, sexual quality of life and pelvic floor function than age-matched HC. Worse scores in IIM were associated with disease activity/health status, physical activity, fatigue and depression. Acknowledgement: Supported by aZV-16-33574A, MHCR 023728. Disclosure of interests: Barbora Heřmankova: None declared, Maja Spiritovic: None declared, Hana Smucrova: None declared, Sabina Oreska: None declared, Hana Storkanova: None declared, Kristyna Bubova: None declared, Karel Pavelka: None declared, Jiři Vencovský Consultant for: Samsung, Speakers bureau: abbVie, Novartis, Pfizer, Sanofi, Eli Lilly, Biogen, UCB, MSD, Werfen, Roche, Ladislav Senolt Grant/research support from: abbVie, Consultant for: abbVie, Bristol-Myers Squibb, Celgene Corporation, Merck Sharp and Dohme, Novartis, Pfizer, Roche, UCB, amgen, Takeda, Speakers bureau: abbVie, amgen, Bristol-Myers Squibb, Celgene Corporation, Eli Lilly, Merck Sharp and Dohme, Novartis, Pfizer, Roche, UCB, Heřman Mann Consultant for: Pfizer, Eli Lilly, Sanofi, Speakers bureau: abbVie, Roche, Pfizer, MSD, Eli Lilly, Sanofi, Michal Tomcik: None declared

Career situation of first and presenting author Student for a master or a PhD. Introduction Systemic sclerosis (SSc) is accompanied by stiffness and contraction of tissue, predominantly of the skin, caused by fibrosis and resulting in reduced quality of life. The aim of our study was to determine the effect of specialized physical-occupational intervention (POI) on hand/face function and strength, and quality of life of SSc patients. Objectives The study included a total of 55 patients who fulfilled the EULAR/ACR criteria for SSc (2013) and had skin involvement leading to hand-function impairment and mouth handicap. 25 patients were recruited into the intervention group (IG) and 30 patients into the control group (CG). Both groups received educational material for home exercise, but only the IG underwent a 6 month intervention with a subsequent 6 month follow-up period. Methods Patients were assessed by a physician and a physiotherapist blinded to intervention at months 0, 3, 6, and 12, and parameters evaluating hand/face and quality of life were recorded. Patients also filled out PRO (patient reported outcomes) questionnaires and provided blood for routine laboratory analysis and bio-banking. Data analysis was done between groups and within the group. Results Compared to the observed statistically significant deterioration in the CG, we found a statistically significant improvement in the IG in objectively assessed function and strength of hand, distance between incisors and lips and functional ability (SHAQ). Only numerical improvements in the IG during the intervention compared to numerical deterioration in CG that did not reach statistical significance were observed in subjectively assessed hand function and mouth handicap, functional ability (HAQ) and in some domains of QoL (SF-36) and fatigue (FIS–in cognitive function). During the follow-up period, there was a significant deterioration or stagnation of the achieved positive results in the IG. Conclusions Our specialized POI intervention led to a significant improvement in the observed parameters that was clinically significant in a substantial proportion of patients, and prevention of the expected worsening of hand/face function and strength and quality of life. Acknowledgements Supported by AZV-16-33574A, SVV for FTVS UK 2019-260466, MHCR 023728. Disclosure of Interest None declared

Career situation of first and presenting author Student for a master or a PhD. Introduction Skeletal muscle, pulmonary and articular involvement in idiopathic inflammatory myopathies (IIM) limit the mobility/self-sufficiency of patients, and can have a negative impact on body composition. Objectives To assess body composition and physical activity of IIM patients and healthy controls (HC). Methods 54 patients with IIM (45 females; mean age 57.7; disease duration 5.8 years; PM, 22/DM, 25/IMNM, 7) and 54 age-/sex-matched HC (45 females, mean age 57.7) without rheumatic/tumor diseases were included. PM/DM patients fulfilled Bohan/Peter criteria for PM/DM. We assessed anthropometric parameters and body composition (by densitometry: iDXA Lunar, and by bioelectric impedance: BIA2000-M), and physical activity (by Human Activity Profile questionnaire, HAP). Routine biochemistry analysis was performed after 8 hours of fasting. Disease activity was evaluated by MITAX and MYOACT activity score, muscle involvement by manual muscle test (MMT-8) and functional index 2 (FI2). Results Compared to HC, patients with IIM had significantly increased body fat% (BF%) but significantly decreased lean body mass (LBM), bone mineral density (BMD) and increased extracellular mass/body cell mass (ECM/BCM) ratio, which reflects worse muscle predispositions for physical activity and deteriorated nutritional status. Disease duration negatively correlated with BMD and LBM (assessed by BIA). Disease activity assessed by MITAX and MYOACT positively correlated with LBM (assessed by both BIA and DXA), as well as with basal metabolic rate (BMR), and fat free mass (FFM). CRP was positively associated with BF% (iDXA and BIA). Higher BF% (iDXA) was associated with worse physical endurance (FI2) and worse ability to perform physical activity (HAP). MMT-8 score negatively correlated with ECM/BCM ratio. Conclusions We found significant negative changes in body composition of our IIM patients compared to healthy age-/sex-matched individuals, associated with their disease activity and duration, inflammatory status, skeletal muscle involvement, and physical activity. These data could reflect their impaired nutritional status and predispositions for physical exercise, aerobic fitness and performance. References None. Acknowledgements Supported by AZV NV18–01-00161A, MHCR 023728 and GAUK 312218 Disclosure of Interest None declared.

Career situation of first and presenting author Student for a master or a PhD. Introduction Idiopathic inflammatory myopathies (IIM) are characterized by inflammation and atrophy of skeletal muscles, pulmonary and articular involvement, which leads to functional impairment, reduced quality of life including sexual life. Objectives The aim of this study was to assess sexual functions/quality of life and pelvic floor function in female IIM patients compared to age-/sex-matched healthy controls (HC). Methods In total, 22 women with IIM [mean age: 55.1, disease duration: 7.9 years, dermatomyositis (DM, 8)/polymyositis (PM, 10)/necrotizing myopathy (IMNM, 3)/inclusion body myositis (IBM, 1)], who fulfilled the Bohan/Peter 1975 criteria for DM/PM, and 22 healthy controls (mean age: 55.1 years) filled in 12 well-established and validated questionnaires assessing sexual function and pelvic floor function, fatigue, physical activity and depression. We used the following questionnaires: Female Sexual Function Index (FSFI), Brief Index of Sexual Function for Women (BISF-W), Sexual Quality of Life Questionnaire (SQoL-F), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), Pelvic Floor Distress Inventory Questionnaire (PFIQ7), Fatigue Impact Scale (FIS), Beck’s Depression Inventory II (BDI II), Health Assessment Questionnaire (HAQ) and Human Activity Profile (HAP). Results Compared to HC, patients with IIM had significantly higher prevalence and greater severity of sexual dysfunction (FSFI, BISF-W: in all subscales as well as total scores), dysfunction of pelvic floor (PISQ-12), and worse sexual quality of life (SQoL-F). Worse scores in IIM patients were associated with elevated muscle enzyme levels [lactate dehydrogenase: FSFI (r=−0.524, p=0.0123), BISFW (r=−0.528, p=0.0115)], greater fatigue [FIS: FSFI (r=−0.434, p=0.0438), BISF-W (r=−0.488, p=0.0211), SQoL-F (r=−0.488, p=0.0070), PISQ-12 (r=0.643, p=0.0013)], more severe depression [BDI-II: PISQ-12 (r=0.474, p=0,0258)], deteriorated quality of life [HAQ: PISQ-12 (r=0.476, p=0.0252)], and worse ability to perform physical activities [HAP: FSFI (r=0.437, p=0.0417), BISF-W (r=0.451, p=0.0351), PISQ-12 (r=−0.494,p=0.0195)]. Conclusions Women with IIM reported significantly disturbed sexual function, sexual quality of life and pelvic floor function than age-matched healthy controls. Worse scores in IIM were associated with disease activity, physical activity, fatigue, depression and quality of life. Acknowledgements Supported by AZV-16-33574A, MHCR 023728, and SVV – 2 60 373. Disclosure of Interest None declared.

Career situation of first and presenting author Student for a master or a PhD. Introduction Systemic sclerosis (SSc) is a chronic autoimmune disease leading to various physical and psychological impairments including sexual dysfunction. Objectives The aim of this study was to assess sexual functions/quality of life and pelvic floor function in female SSc patients compared to age-/sex-matched healthy controls (HC), and to analyze the potential impact of disease activity, fatigue, physical activity and depression. Methods In total, 41 women with SSc (mean age: 50.9, disease duration: 5.8 years, lcSSc/dcSSc: 18/23, mRSS: 13.6, ESSG activity index: 2.5), who fulfilled the ACR/EULAR 2013 criteria, and 41 healthy controls (mean age: 50.9) without rheumatic diseases filled in 12 well-established and validated questionnaires assessing sexual function/quality of life, pelvic floor function, fatigue, physical activity and depression. We used the following questionnaires: Female Sexual Function Index (FSFI), Brief Index of Sexual Function for Women (BISF-W), Sexual Quality of Life Questionnaire (SQoL-F), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), Pelvic Floor Distress Inventory Questionnaire (PFIQ7), Fatigue Impact Scale (FIS), Beck’s Depression Inventory II (BDI II), Health Assessment Questionnaire (HAQ), Scleroderma Health Assessment Questionnaire (SHAQ) and Human Activity Profile (HAP). Results Compared to HC, patients with SSc had significantly higher prevalence and greater severity of sexual dysfunction (FSFI, BISF-W: in all subscales as well as total scores), dysfunction of pelvic floor (PISQ-12, PFIQ7), and worse sexual quality of life (SQol-F) (table). Worse scores in SSc patients were associated with higher disease activity [ESSG activity index: SQol-F (r=−0.364, p=0.0443)], greater fatigue [FIS correlated negatively with both FSFI, and BISF-W], more severe depression [BDI-II: FSFI (r=−0.553, p=0.0002), BISF-W (r=−0.514, p=0.0007)], deteriorated quality of life [SHAQ: FSFI (r=−0.536, p=0.0003), BISF-W (r=−0.563, p=0.0001), SQol-F (r=−0.338, p=0.0382), PISQ-12 (r=0.563, p=0.0051)], and worse ability to perform physical activities [HAP: FSFI (r=0.407, p=0.0082), BISF-W (r=0.409, p=0.0078)]. Conclusions Women with SSc reported significantly impaired sexual function, sexual quality of life and pelvic floor function than age-matched healthy controls. Worse scores in SSc were associated with disease activity, physical activity, fatigue, depression and quality of life. Acknowledgements Supported by AZV-16-33574A, MHCR 023728, and SVV – 2 60 373. Disclosure of Interest None declared.

Career situation of first and presenting author Student for a master or a PhD. Introduction Fibrosis of the skin and visceral organs, especially digestive tract, and musculoskeletal involvement in systemic sclerosis (SSc) can have a negative impact on body composition and physical activity. Objectives The aim was to assess body composition and physical activity of SSc patients and healthy controls (HC) and the association with selected inflammatory cytokines in SSc. Methods 59 patients with SSc (50 females; mean age 52.5; disease duration 6.7 years; lcSSc:34/dcSSc:25) and 59 age-/sex-matched HC (50 females, mean age 52.5) without rheumatic or tumour diseases were included. SSc patients fulfilled ACR/EULAR 2013 criteria. We assessed body composition (densitometry: iDXA Lunar, bioelectric impedance: BIA-2000-M), physical activity (Human Activity Profile, HAP questionnaire), disease activity (ESSG activity index) and serum levels of 27 cytokines (commercial multiplex ELISA kit, Bio-Rad Laboratories). Data are presented as mean ±SD. Results Compared to HC, patients with SSc had significantly lower body mass index (BMI), body fat% (BF%) and visceral fat weight (VF), and also significantly decreased lean body mass (LBM), and bone mineral density (BMD). Compared to HC, patients with SSc had increased extracellular mass/body cell mass (ECM/BCM) ratio, reflecting deteriorated nutritional status and worse muscle predispositions for physical activity. Increased ECM/BCM in SSc positively correlated with disease activity (ESSG), skin score (mRSS) and inflammation (CRP, ESR), and was associated with worse quality of life (HAQ, SHAQ), fatigue (FSS), and decreased physical activity (HAP). ESSG negatively correlated with BF%. HAP positively correlated with BMD. Increased serum levels of several inflammatory cytokines were associated with alterations of body composition. Conclusions Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our SSc patients, which are associated with the disease activity and physical activity, and could reflect their nutritional status, and gastrointestinal and musculoskeletal involvement. Serum levels of certain inflammatory cytokines were associated with alterations of body composition in SSc patients. References none Acknowledgements Supported byAZV NV18–01-00161A, MHCR 023728 and GAUK 312218. Disclosure of Interest None declared.

Background:Idiopathic inflammatory myopathies (IIM) are rare diseases characterized by chronic muscle inflammation and multiple organ involvement. These serious clinical manifestations can be associated with significant impairment of quality of life, including sexual life.Objectives:This study aimed to compare sexual function in patients with IIM to age-/sex-matched healthy controls (HC) and determine the potential impact of clinical features on sexual function.Methods:In total, 62 women with IIM [mean age: 53.1, disease duration: 5.2 years, dermatomyositis (DM, 29)/ polymyositis (PM, 27)/ necrotizing myopathy (IMNM, 5)/ inclusion body myositis (IBM, 1)], who fulfilled the Bohan/Peter 1975 criteria for DM/PM, or ENMC criteria for IMNM or IBM, and 62 healthy controls (HC) (mean age: 53.1) without rheumatic diseases filled in 11 well-established and validated questionnaires assessing sexual function (FSFI, SFQ28, BISF-W, SQoL-F), pelvic floor function (PFIQ-7, PISQ-12), fatigue (FIS, Fatigue Impact Scale), physical activity (HAP, Human Activity Profile), disability (HAQ, Health Assessment Questionnaire), depression (BDI-II, Beck’s Depression Inventory-II), and quality of life (SF-36, Medical outcomes study Short Form 36 – PCS, Physical Component Summary; MCS, Mental Component Summary). A routine laboratory testing was performed. Data are presented as median (IQR).Results:Patients with IIM reported significantly greater prevalence and severity of sexual dysfunction (FSFI, BISF-W, SFQ28, SQoL-F) and pelvic floor dysfunction (PISQ-12, PFIQ-7) compared to HC (Table 1). The prevalence of sexual dysfunction in patients with IIM according to the FSFI cut-off score was 59%. Worse scores in IIM patients were associated with greater muscle weakness of m. gluteus maximus [MMT: FSFI (r=0.289, p=0.035), PFIQ-7 (r=-0.407, p=0.003)], m. gluteus medius [MMT: PFIQ-7 (r=-0.381, p=0.005)], more pronounced fatigue [FIF: SQoL-F (r=-0.412, p=0.003)], severer depression [BDI-II: SQoL-F (r=-0.459, p=0.0007)], worse functional disability [HAQ: FSFI (r=-0.436, p=0.005)], reduced physical activity [HAP: FSFI (r=0.403, p=0.001), SQoL-F (r=0.368, p=0.007)], and decreased quality of life [SF-36 PCS: FSFI-total (r=0.381,p=0.002), SF-36 MCS: SQoL-F (r=0.407, p=0.002)]. We did not observe any associations with disease duration, the current prednisone dose, or serum levels of muscle enzymes.Conclusion:Women with IIM reported significantly impaired sexual function and pelvic floor function compared to age-/sex-matched healthy controls. Worse scores in IIM were associated with disease-related features.Table 1.Sexual function and pelvic floor function in women with IIM and healthy controlsQuestionnaire: score range (meaning)IIM (n=62)HC (n=62)p-valueFSFI: Female Sexual Function Index: 2 (worst) - 36 (best)18.2 (3.2-28.5)28.4 (14.4-32.1)p=0.006BISF-W: Brief Index of Sexual Function forWomen: -16 (worst) - 75 (best)18.6 (2.7-32.3)34.0 (8.0-44.7)p=0.004SQoL-F: Sexual Quality of Life Questionnaire – Female: 0 (worst) - 100 (best)60.0 (41.4-83.6)86.7 (70.8-95.6)pPISQ–12: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form: 0 (best) - 48 (worst)14.5 (9.0-18.0)8.0 (5.0-12.0)pPFIQ7: Pelvic Floor Impact Questionnaire – short form 7: 0 (best) - 300 (worst)4.8 (0.0-23.8)0.0 (0.0-4.8)p=0.052SFQ-28: Sexual Functioning Questionnaire-28 desire: 5 (worst) - 31 (best)18.0 (13.3-20.0)19.0 (17.0-22.0)p=0.042SFQ-28 arousal sensation: 4 (worst) - 20 (best)9.5 (7.0-11.0)12.0 (9.0-14.3)p=0.082SFQ-28 arousal lubrication: 2 (worst) - 10 (best)6.0 (4.0-8.0)7.0 (5.0-9.0)p=0.112SFQ-28 arousal cognitive: 2 (worst) - 10 (best)6.0 (4.3-7.0)6.0 (5.0-7.3)p=0.235SFQ-28 orgasm: 1 (worst) - 15 (best)11.0 (8.0-13.0)12.0 (9.8-13.0)p=0.279SFQ-28 pain: 2 (worst) - 15 (best)12.0 (10.0-15.0)15.0 (13.0-15.0)p=0.004SFQ-28 enjoyment: 6 (worst) - 30 (best)19.0 (14.3-24.3)23.0 (19.0-25.0)p=0.027SFQ-28 partner: 2 (worst) - 10 (best)9.0 (8.0-10.0)10.0 (9.0-10.0)p=0.012Acknowledgements:Supported by MHCR 023728, GA UK 1578119, and SVV 260373Disclosure of Interests:None declared

Background:Systemic sclerosis (SSc) is a chronic multisystem disease that may affect all aspects of life including sexual function.Objectives:To assess sexual function, pelvic floor function in 80 women and 14 men with SSc compared to age-/sex-matched healthy controls (HC) and to analyze the potential impact of clinical features on sexual health.Methods:In total 80 women (mean age: 49, disease duration: 6.1 years, lcSSc/dcSSc: 53/27, mRSS: 9.3, ESSG activity index: 2.1) and 14 men with SSc (mean age: 51.6, disease duration: 3.1 years, lcSSc/dcSSc: 6/8, mRSS: 12.9, ESSG activity index: 2.2) who fulfilled the ACR/EULAR 2013 criteria, filled in 12 well-established and validated questionnaires assessing sexual function, pelvic floor function, quality of life, fatigue, physical activity and depression. Full names of questionnaires are listed in Table 1. These questionnaires were also completed by 80 healthy women and 14 healthy men with identical age. Data are presented as mean±SEM.Table 1.Clinical parameterCorrelated parametersrp-valueESSG diseases activity indexFSFI Arousal domain-0.300pIIEF EF-0.597p=0.0240CRPIIEF Orgasmic Function-0.668p=0.0081mRSSMSHQ Sexual Desire0.555p=0.0613FISBISF-W-0.410p=0.0002MAFFSFI-0.399p=0.0002BDI-IIBISF-W-0.381p=0.0002IIEF EF-0.801p=0.0005HAPSQoL-F0.383p=0.0006BISF-W0.456pIIEF EF0.639p=0.0062SHAQFSFI- 0.409pBISF-W-0.451p=0.0002Name of Questionnaires/Acronyms:FSFI: Female Sexual Function Index; BISF-W: Brief Index of Sexual Function for Women; SQoL-F/M: Sexual Quality of Life Questionnaire-Female/Male; PISQ–12: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form; PFIQ7: Pelvic Floor Distress Inventory Questionnaire; IIEF: International Index of Erectile Function; MSHQ: Male Sexual Health Questionnaire; FIS: Fatigue Impact Scale; MAF: Multidimensional Assessment of Fatigue; BDI-II: Beck’s Depression Inventory II; HAP: Human Activity Profile; SHAQ: Scleroderma Health Assessment Questionnaire; ESSG: European Scleroderma Study Group; CRP: C-reactive protein; mRSS: modified Rodnan skin scoreResults:Compared to HC, women with SSc had significantly higher prevalence and greater severity of sexual dysfunction [FSFI total score (SSc: 16.4±1.3, HC: 25.6±1.2, pConclusion:Both women and men with SSc reported significantly impaired sexual function compared to HC with identical age. Worse scores in SSc were associated with disease activity, increased systemic inflammation, health status, physical activity, fatigue and depression.Acknowledgments :Supported by MHCR 023728, SVV 260373 and GAUK 1578119.Disclosure of Interests:Barbora Heřmánková: None declared, Maja Špiritović: None declared, Hana Smucrova: None declared, Sabina Oreska: None declared, Hana Štorkánová: None declared, Kristyna Bubova: None declared, Karel Pavelka Consultant of: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Speakers bureau: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Jiří Vencovský: None declared, Ladislav Šenolt: None declared, Radim Bečvář Consultant of: Actelion, Roche, Michal Tomčík: None declared

Background Systemic sclerosis (SSc) is a chronic autoimmune disease leading to various physical and psychological impairments including sexual dysfunction. Objectives To assess sexual functions/quality of life and pelvic floor function in female SSc patients compared to age-/sex-matched healthy controls (HC), and to analyse the potential impact of disease activity, fatigue, physical activity and depression. Methods In total, 41 women with SSc (mean age: 50.9, disease duration: 5.8 years, lcSSc/dcSSc: 18/23, mRSS: 13.6, ESSG activity index: 2.5), who fulfilled the ACR/EULAR 2013 criteria, and 41 healthy controls (mean age: 50.9) without rheumatic diseases filled in 12 well-established and validated questionnaires assessing sexual function/quality of life, pelvic floor function, fatigue, physical activity and depression. Full names of questionnaires are listed in the table 1. Data are presented as mean ±SEM. Results Compared to HC, patients with SSc had significantly higher prevalence and greater severity of sexual dysfunction (FSFI, BISF-W: in all subscales as well as total scores), dysfunction of pelvic floor (PISQ-12, PFIQ7), and worse sexual quality of life (SQol-F) (table 1). Worse scores in SSc patients were associated with higher disease activity [ESSG activity index: SQol-F (r=−0.364,p=0.0443), PFIQ7-gynaecological subscale (r=0.492,p=0.0036)], greater fatigue [all three questionnaires FSS/FIS/MAF correlated negatively with FSFI, BISF-W], more severe depression [BDI-II: FSFI (r=−0.553,p=0.0002), BISF-W (r=−0.514,p=0.0007), PFIQ7 (r=0.495,p=0,0010)], deteriorated quality of life [SHAQ: FSFI (r=−0.536,p=0.0003), BISF-W (r=−0.563,p=0.0001), SQol-F (r=−0.338,p=0.0382), PISQ-12 (r=0.563,p=0.0051), PFIQ7 (r=0.380,p=0.0142)], and worse ability to perform physical activities [HAP: FSFI (r=0.407,p=0.0082), BISF-W (r=0.409,p=0.0078)]. Conclusions Women with SSc reported significantly impaired sexual function, sexual quality of life and pelvic floor function than age-matched healthy controls. Worse scores in SSc were associated with disease activity, physical activity, fatigue, depression and quality of life. Acknowledgements Supported by AZV-16- 33574A and MHCR 023728. Disclosure of Interest None declared

Background Idiopathic inflammatory myopathies (IIM) are characterised by inflammation and atrophy of skeletal muscles, pulmonary and articular involvement, which limit the mobility/self-sufficiency of patients, and can have a negative impact on body composition. Objectives To assess body composition and physical activity of IIM patients and healthy controls (HC). Methods 54 patients with IIM (45 females/9 males; mean age 57.7; disease duration 5.8 years; polymyositis (PM, 22)/dermatomyositis (DM, 25)/necrotizing myopathy (IMNM, 7)) and 54 age-/sex-matched HC (45 females/9 males, mean age 57.7) without rheumatic diseases were included. PM/DM patients fulfilled Bohan/Peter criteria for PM/DM. Anthropometric parameters and body composition were assessed (by densitometry: iDXA Lunar, and by bioelectric impedance: BIA2000-M), and physical activity was evaluated using Human Activity Profile (HAP) questionnaire. Routine biochemistry analysis was performed after 8 hours of fasting. Muscle involvement was evaluated by manual muscle test (MMT-8) and functional index 2 (FI2). Data are presented as mean ±SD. Results Compared to HC, patients with IIM had a trend towards significantly increased body fat% as assessed by iDXA (BF%: 39.9±7.1 vs. 42.4%±7.1%, p=0.077), but significantly decreased lean body mass as assessed both by iDXA (LBM: 45.6±8.1 vs. 40.6±7.2 kg, p=0.001) and BIA (LBM: 52.6±8.8 vs. 48.7±9.0 kg, p=0.023), and increased extracellular mass/body cell mass (ECM/BCM) ratio (1.06±0.15 vs. 1.44±0.42, p DEXA was associated with worse physical endurance (FI2: r=−0.311, p=0.026) and worse ability to perform physical activity (HAP: r=−0.292, p=0.032). MMT-8 score negatively correlated with ECM/BCM ratio (r=−0.385, p=0.006). Conclusions Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our IIM patients, which are associated with their disease duration, inflammatory status, skeletal muscle involvement, and physical activity, and could reflect their impaired nutritional status and predispositions for physical exercise, aerobic fitness and performance. Acknowledgements Supported by AZV-16–33574A and SVV-260373. Disclosure of Interest None declared

Background Systemic sclerosis (SSc) is characterised by fibrosis of the skin and visceral organs, especially digestive tract, and musculoskeletal and lung involvement, which limit mobility/self-sufficiency of patients and can have a negative impact on body composition and physical activity. Objectives To assess body composition and physical activity of SSc patients and healthy controls (HC). Methods 59 patients with SSc [50 females; mean age 52.5; disease duration 6.7 years; limited cutaneous (lcSSc, 34)/diffuse cutaneous (dcSSc, 25)] and 59 age-/sex-matched HC (50 females, mean age 52.5) without rheumatic diseases were included. SSc patients fulfilled ACR/EULAR 2013 criteria. Anthropometric parameters and body composition were assessed (by densitometry: iDXA Lunar, and by bioelectric impedance: BIA-2000-M), and physical activity was evaluated using Human Activity Profile (HAP) questionnaire. Routine biochemistry analysis was performed after 8 hours of fasting. Pulmonary function and diffusing capacity of lung were examined, disease activity was evaluated by ESSG activity index. Data are presented as mean ±SD. Results Compared to HC, patients with SSc had significantly lower body-mass index (BMI:27.9±8.3 vs. 22.4±4.3 kg/m2, p Conclusions Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our SSc patients, which are associated with their disease activity and physical activity, and could reflect their nutritional status, and gastrointestinal and musculoskeletal involvement. We found no significant association between lung involvement and changes of body composition. Acknowledgements Supported by AZV-16–33574A and SVV-260373 Disclosure of Interest None declared

Background Idiopathic inflammatory myopathies (IIM) are characterised by inflammation and atrophy of skeletal muscles, pulmonary and articular involvement, which leads to functional impairment, reduced quality of life including sexual life. Objectives To assess sexual functions/quality of life and pelvic floor function in female IIM patients compared to age-/sex-matched healthy controls (HC). Methods In total, 22 women with IIM [mean age: 55.1, disease duration: 7.9 years, dermatomyositis (DM, 8)/polymyositis (PM, 10)/necrotizing myopathy (IMNM, 3)/inclusion body myositis (IBM, 1)], who fulfilled the Bohan/Peter 1975 criteria for DM/PM, and 22 healthy controls (mean age: 55.1 years) without rheumatic diseases filled in 12 well-established and validated questionnaires assessing sexual function/quality of life, pelvic floor function, fatigue, physical activity and depression. Data are presented as mean ±SEM. Results Compared to HC, patients with IIM had significantly higher prevalence and greater severity of sexual dysfunction (FSFI, BISF-W: in all subscales as well as total scores), dysfunction of pelvic floor (PISQ-12), and worse sexual quality of life (SQoL-F) (table 1). Worse scores in IIM patients were associated with elevated muscle enzyme levels [lactate dehydrogenase: FSFI (r=-0.524,p=0.0123), BISFW (r=-0.528,p=0.0115)], greater fatigue [FIS: FSFI (r=-0.434,p=0.0438), BISF-W (r=-0.488, p=0.0211), SQoL-F (r=-0.488,p=0.0070), PISQ-12 (r=0.643,p=0.0013)], more severe depression [BDI-II: PISQ-12 (r=0.474,p=0,0258)], deteriorated quality of life [HAQ: PISQ-12 (r=0.476,p=0.0252)], and worse ability to perform physical activities [HAP: FSFI (r=0.437,p=0.0417), BISF-W (r=0.451,p=0.0351), PISQ-12 (r=-0.494,p=0.0195)]. Conclusions Women with IIM reported significantly impaired sexual function, sexual quality of life and pelvic floor function than age-matched healthy controls. Worse scores in IIM were associated with disease activity, physical activity, fatigue, depression and quality of life. Acknowledgements Supported by AZV-16–33574A and MHCR 023728. Disclosure of Interest None declared

Background Involvement of skin and musculoskeletal system in systemic sclerosis (SSc) leads to loss of function, disability and reduced quality of life. Data on efficacy of non-pharmacologic care in SSc is very limited due to variety in studied interventions/outcomes. Objectives To address the limitations of existing studies, and evaluate the effect of a controlled, long-term (24-week intervention, 24-week follow-up), intensive (1h physiotherapy + 0.5h occupational therapy twice weekly, and home-exercise for 0.5h 5x weekly), tailored physiotherapy programme on function/impairment of hands/face, and quality of life/disability in cohorts with a substantial number of SSc patients. Methods All patients fulfilled ACR/EULAR 2013 criteria, had skin involvement of hands/mouth, and were consecutively recruited from 2014 to 2016 at the Institute of Rheumatology in Prague. Both groups received educational materials and instructions for home exercise at baseline, however, only intervention group underwent the intensive physiotherapy programme. At months 0,3,6,12 all patients were assessed by a physician (physical examination, mRSS-Modified Rodnan9s skin score, EUSTAR SSc activity score, Medsger SSc severity score), and a physiotherapist blinded to intervention [validated measurements (dFTP-delta finger to palm, inter-incisor/inter-lip distance, grip strength using Baseline dynamometer); tests (HAMIS-Hand Mobility In Scleroderma)], patients filled out patient reported outcomes/questionnaires (CHFS-Cochin Hand Function Scale, MHISS-Mouth Handicap In SSc Scale, HAQ, SHAQ, SF-36) and provided blood for routine laboratory analysis and biobanking. Normality of data was tested, inter-group analysis was performed with 2-way ANOVA, and intra-group analysis by Friedmann9s test with Dunn9s post hoc test. Results 25 SSc patients (22 female/3 male, 14 limited cutaneous (lc)SSc/11 diffuse cutaneous (dc)SSc, median of age 54.0 and disease duration 7.0 years, mRSS 12) were recruited into the intervention group (IG) and 29 patients into the control group (CG) (25 female/4 male, 16 lcSSc/13 dcSSc, median of age 49.0 and disease duration 5.0 years, mRSS 11). Compared to observed statistically significant deterioration in CG over the period of m0-m6, we found statistically significant improvement in dFTP, grip strength, HAMIS, inter-incisor and inter-lip distance (Table 1). Only numerical improvement in IG compared to numerical deterioration in CG, which have not reached statistical significance, were observed in patient reported outcomes (CHFS, MHISS, HAQ, SHAQ, SF-36). Conclusions Our physiotherapy program not only prevented the natural course of progressive deterioration of function of hands/mouth (observed in the control group), but led to a significant improvement in monitored parameters, which was clinically meaningful in a substantial proportion of patients. Acknowledgements Supported by AZV-16–33574A. Disclosure of Interest None declared

Background Involvement of skin and musculoskeletal system in systemic sclerosis (SSc) leads to loss of function, disability and reduced quality of life. Data on efficacy of non-pharmacologic care in SSc is very limited due to variety in studied interventions/outcomes. Objectives and methods To address the limitations of existing studies, and evaluate the effect of a controlled, long-term (24-week intervention, 24-week follow-up), intensive (1 hour physiotherapy +0.5 hour occupational therapy twice weekly, and home-exercise for 0.5 hour 5x weekly), tailored physiotherapy program on function/impairment of hands/face, and quality of life/disability in cohorts with a substantial number of SSc patients. All patients fulfilled ACR/EULAR 2013 criteria, had skin involvement of hands/mouth, and were consecutively recruited between 2014–2016. At months 0,3,6,12 all patients were assessed by a physician (physical history, mRSS, EUSTAR SSc activity score, Medsger severity score), and a physiotherapist blinded to intervention [validated measurements (dFTP-delta finger to palm, inter-incisor/inter-lip distance, grip strength using Baseline dynamometer ); tests (HAMIS-Hand Mobility In Scleroderma)], patients filled out PRO questionnaires (CHFS-Cochin Hand Function Scale, MHISS-Mouth Handicap In SSc Scale, HAQ, SHAQ, SF-36) and provided blood for routine laboratory analysis and biobanking. Normality of data was tested and inter-group analysis performed with 2-way ANOVA and intra-group analysis by Friedmann’s test with Dunn’s post hoc test. Results 25 SSc patients (22 female/3 male, 14 lcSSc/11dcSSc, median of age 54.0 and disease duration 7.0 years, mRSS 12) were recruited into the intervention group (IG) and 29 patients into CG (25 female/4 male, 16 lcSSc/13 dcSSc, median of age 49.0 and disease duration 5.0 years, mRSS 11). Compared to observed statistically significant deterioration in CG over the period of m0-m6, we found statistically significant improvement in dFTP, grip strength, HAMIS, inter-incisor and inter-lip distance. Only numerical improvement in IG compared to numerical deterioration in CG, which have not reached statistical significance, were observed in patient reported outcomes (CHFS, MHISS, HAQ, SHAQ, SF-36). Conclusions Our physiotherapy program not only prevented the natural course of progressive deterioration of function of hands/mouth (observed in CG), but led to a significant improvement in monitored parameters, which was clinically meaningful in a substantial proportion of patients. Acknowledgement Supported by AZV-16–33574A.

Background Czech League Against Rheumatism plays an important role in promoting rheumatic patients in the Czech Republic. Its activity is aimed at raising awareness about rheumatic diseases, the struggle for full and equal life for people with rheumatic diseases and the establishment of regional clubs of Czech League Against Rheumatism. Objectives Create a campaign aimed to raise awareness about rheumatoid arthritis - a serious disease that destroys lives insidious way over 100,000 inhabitants of the Czech Republic. When most people understand the nature of rheumatoid arthritis, they can better help the patients manage their daily struggle with the disease. Methods Creating a campaign… “Give a helping glove and support a patient with rheumatoid arthritis” with the participation of experts from rheumatology and also the participation of personalities from the cultural and scientific life. Rheumatoid arthritis is most often manifested impairment of the joints of the hands. The symbol of the campaign thus became a special glove, developed by scientists from the Institute of Technology in the US, Georgia. These gloves can restrict the movement of the fingers and hand grip strength using metal plates - and faithfully simulate the symptoms of the disease. It can show a healthy people feeling in the shoes of people with rheumatoid arthritis. Creating a video with personalities who use gloves to perform daily activities and leisure activities. Results The main outcome of the campaign was the debate with an expert on the generation of positioning whitepaper document for timely treatment for patients with rheumatic disease. In response to the campaign has increased the number of members in Czech League Against Rheumatism, an increased number of visitors and fans of the Facebook page Czech League Against Rheumatism. It managed to raise awareness of rheumatic diseases among the general public. Conclusions This campaign seems to be very useful in influencing the professional and lay public. It is one of the ways how they can be involved in the functioning of the organization. References Czech PARE organization - Czech League Against Rheumatism Disclosure of Interest None declared