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BackgroundRheumatoid factor-positive subtype of juvenile idiopathic arthritis (RF+ JIA) is a relatively rare condition (5-7% of all cases of JIA), but is associated with a poor prognosis. For these patients (pts), it is extremely important to timely prescribe adequate therapy, including biologics (B), to prevent rapid progression and early disability.ObjectivesTo analyze in retrospective study the rate of usage, efficacy and safety of B in pts with RF+ JIA.MethodsPts with RF+ JIA were identified from clinical database. Diagnosis of RF+ JIA was reviewed based on New Classification Criteria for JIA, PRINTO, 2019 [1]. Demographic and clinical data, therapy, efficacy and adverse effects observed under B were analysed.ResultsThe diagnose RF+ JIA was verified in 81 pts (11,1% boys). The median age at onset of JIA was 12.0 y.o. (7.4; 14.0). The median age at time of diagnosis – 13.0 y.o. [9.3; 15]. In total, RF+ were detected in 93.8% of pts (median 71.4 IU/ml [IQR 28.8; 218.5]), anti-cyclic citrullinated peptide antibodies-positive (ACCP+) - in 70.4% of pts (median 164.9 EU/ml [97.4; 300]). 64.2% of pts had combination RF+ and ACCP+, 29.6% - only RF+, 6.2% - only ACCP+. The therapy included NSAIDs in 97.5% of pts, steroids – in 48.1%, DMARDs in all pts (methotrexate (MTX) alone – 80.2%, 2 DMARDs – 13.6%, 3 DMARDs consecutive – 6.2%), B - in 85.2 % of pts. 2 pts received JAK-inhibitors (1 - tofacitinib, 1 – baricitinib). The median of the number of active joints at start of B was 16 [10; 23]. The median of ESR was 26 [18;43] mm/h, CRP - 14.7 [5.3;31.8] mg/l. We observed extra-articular manifestations in 29.0% of pts: 24.6% - lymphadenopathy, 4.3% - rheumatoid lung disease, 2.9% - rheumatoid nodules, 4.3% - distal polyneuropathy. Secondary Sjögren’s syndrome (SS) was diagnosed in 27.5% of pts. The experience of using B included from 1 to 4 prescriptions sequentially: 83.3% of pts received only 1 B, 20.3% - 2 B, 8.7% - 3 B, 4.3% - 4 B. B was started during the 1st year of disease in 82.7% of pts due to the rapid progression of the erosive process. As the 1st B used: abatacept (ABA) – 47.8%, etanercept (ETA) – 20.3%, adalimumab (ADA) – 10.1%, rituximab (RTM) – 7.2%, infliximab (INF) – 5.8%, tocilizumab (TCZ) – 4.3%, golimumab (GLM) – 1.4%, sarilumab – 2.9%. As the 2nd B used: 26.1% - RTM, 21.7% - ADA, 17.4% each - ETA and ABA, 13.0% - TCZ, 4.3% - GLM. As the 3d B used: 33.3 % each – TCZ and ADA, 22.2% - PTM, 11.1% - ETA. 3 pts received successively 4 B (ABA-ETA-ADA-TCZ, ABA-ETA-ADA-RTM, TCZ-ABA-ADA-RTM). Adverse events (AE) were observed in 24.6% of pts as recurrent uncomplicated upper respiratory tract infections being the most common. The reasons for substitution therapy were serious AE, subsequent loss of effect. The frequency of ACCP+ was not statistically different in groups with the effective use of only 1 B and, if necessary, replacement. In the presence of systemic manifestations, preference was given to TCZ or RTM, with secondary SS - RTM or ABA.ConclusionMost pts with RF+ JIA needs to require B in the first year of the disease. Application B has good efficacy and an acceptable safety profile. The presence of systemic manifestations/secondary SS influence on choice of B. Our data didn’t reveal the effect of ACCP+ on preferred choice or frequency of replacement B.References[1]Martini A, Ravelli A, Avcin T, et al. Toward New Classification Criteria for Juvenile Idiopathic Arthritis: First Steps, Pediatric Rheumatology International Trials Organization International Consensus. J Rheumatol. 2019 Feb;46(2):190-197. doi: 10.3899/jrheum.180168Disclosure of InterestsMaria Kaleda Speakers bureau: Pfizer, Roche, Novartis, Irina Nikishina Speakers bureau: Pfizer, MSD, Roche, Novartis, Sobi, Evgeny Fedorov Speakers bureau: Novartis, Sobi, MEDAC, Svetlana Salugina Speakers bureau: Novartis, Sobi, Svetlana Arsenyeva: None declared, Zarina Kolkhidova: None declared, Anna Shapovalenko: None declared, Tamara Pachkoria: None declared, Valeriia Matkava: None declared

BackgroundThe study of the features of the course and mutual influence of the new coronavirus disease COVID-19 and various rheumatic diseases (RD) in children can still give us new lessons, warnings and fears.ObjectivesTo update the analysis in a retrospective study the course of covid-19 in children with RD based on the results of two years of the pandemic. To analyze the impact of COVID-19 on the course of RD in children.MethodsRetrospective analysis based on data from single center. The study included patients with RD and confirmed COVID-19 for 2 years (2020-2021).ResultsWere registered 320 cases of COVID-19 in children with RD. 158 (49%) patients were asymptomatically infected, 162 (51%) had clinical symptoms. A detailed description of the groups is presented in Table 1. Clinical symptoms were fever (67%), anosmia (47%), rhinitis (34%), cough (19%), arthralgia/myalgia (16%), dyspepsia (5%), rash (2.5%), pneumonia (3%). In the majority of cases (98%), COVID-19 proceeded in mild to moderate severity. Hospitalization due to COVID-19 was required just in 5 cases. 2 children were admitted to the intensive care unit. First, an 11-year-old girl with sJIA with the history of recurrent episodes of MAS resolved by regular administration of canakinumab. 2nd, a 12-year-old girl with Sjogren’s syndrome, who received Rituximab and 1 month later she developed the COVID-19 with MIS-like clinical picture, pneumonia with 25%CT lessions. Both cases have a favorable outcome.Table 1.Clinical characteristics of children with COVID-19 and RDCovid-19 with symptoms (n= 162)Covid-19 asymptomatic (n=158)Worsening of RD after Covid-19 (n=51/320)Sex (F/M)96/66109/4933/18Age, years (Me[25;75]) *15 [9;17]11 [8;14]13 [10;16]IgG Covid-19 positive9112630IgM Covid-19 positive864PCR Covid-19 positive1064822Diagnosis of RDJIA non-systemic11010430sJIA11109SLE652JDM963Scleroderma8153Sjögren’s syndrome862Overlap syndrome040AIDs (CAPS, FMF, Behçet’s disease)972FOP (Fibrodysplasia ossificans progressive)110Treatment of RDNSAID monotherapy23274DMARDs10712529Systemic glucocorticoids362913bDMARDs737221Etanercept22338Adalimumab15113Golimumab1232Infliximab010Abatacept973Tocilizumab663Sarilumab221Canakinumab331Rituximab330Tofacitinib110Baricitinib020Immunoglobulin human normal (in last 6 month)732Duration of disease, years (Me[25;75])5 [2;8]4 [2;8]5 [2;7]Duration of treatment DMARDs, years (Me[25;75])4 [2;7]4 [2;7]4 [2;5]Duration of treatment bDMARDs, years (Me[25;75])4 [1;5,5]3 [2;6]2 [0,6;5]The activity stage of RD by the start of COVID-19Remission919033Low disease activity604916High disease activity11192Temporary withdrawal of DMARD and bDMARDs during COVID-1958818Worsening/flare of RD42951*- pThe clinical characteristics of the patients are presented in Table 1. COVID-19 didn`t affect the course of RD in the 86% of pts. However, 15% developed a flare of the RD with average of 3 months after COVID-19. In this group for 13 pts (girls mostly F/M-9/4, mean age 15 years [9;16]), COVID-19 triggered the new onset of RD (non-systemic JIA – 4, Uveitis – 1, non-bacterial osteomyelitis – 3, systemic JIA – 2, Scleroderma – 2, Sjögren’s syndrome – 1. 12 from 13 these children had clinical symptoms on COVID-19. Whether this is Long-COVID syndrome or an independent RD is not known.ConclusionOur study suggests that the new coronavirus infection in most cases in children with RD, had mild or asymptomatic course, regardless of therapy with immunosuppressive drugs and bDMARD, except of 1 observation with the previous therapy of Rituximab. Worsening of RD after coronavirus infection developed in 15% of cases, regardless of its clinical manifestations. In 13 patients, the RD were started just after COVID-19. The explosive increasing of the incidence of a new strain of COVID-19 for a past month may change the current results and conclusions.Disclosure of InterestsNone declared

BackgroundChildren and adolescents who suffered from the rare polygenic autoinflammatory disease such as multifocal non-bacterial osteomyelitis (NBO) can stay without specialized care for the long time. Currently we don’t have standardized treatment for these patients. Administration of Biologics (B) established on opportunity to diagnose juvenile idiopathic arthritis (JIA) or juvenile ankylosing spondylitis (JAS) in relation to combination of bone lesions with arthritis and/or axial skeleton damage.ObjectivesTo describe clinical/laboratory findings and therapy approaches in patients with NBO who was treated by BA.MethodsWe analyzed a single center retrospective nine-year study, which includes cohort of 56 patients (pts) with multifocal NBO. 22 pts of them were treated by different B (TNF-inhibitors mostly) in our pediatric department. Standard rheumatological assessment were included for all pts. X-ray, whole-body MRI and/or scintigraphy were done for revealing all localizations of bone lesion. Infection, oncology and other reasons of bone damage were excluded at the time of B administration.ResultsIn total we identified 22 pts (10-boys; 12-girls) treated by B (TNF-inhibitors as first-line) among the whole group (n=56). The median age at the disease onset was 10 years (Me 10, range 1.3;16,5). Classifying diagnosis according to rheumatological nosology as JIA or JAS we were able for legal administration of targeted agents. 12 pts had JIA (7 girls), 10 pts had JAS (5 girls). JIA was presented by poly- (7 pts) and oligoarticular (5 pts) types. MRI evidence of axial involvement that was established on active erosive sacroiliitis with deep bone marrow edema had 15 pts (68%), on active spondylitis in thoracic spine – 3 pts, on erosive arthritis with partial ankyloses of facet joints of neck – 3 pts; multiple syndesmophytes had 1 girl. According to our findings, axial damage associated with NBO had developed much earlier (at 2 y.o. as minimum) than in case of «idiopathic» JAS. HLA-B27 positive was 11 pts, high levels of ANA had 5 pts (all of them HLA-B27 negative). Extraskeletal manifestations were observed in 8 pts (acne conglobate, uveitis, inflammatory bowel disease – one in each condition, psoriasis pustulosus – 5). High laboratory markers were revealed before biologics in 14 pts. Non-biological therapy was based on worldwide practice and included NSAIDs (all pts), methotrexate (10 pts), sulfasalazine (10 pts, in 9 pts it was withdrawal), bisphosphonates (2 pts), glucocorticoids (7 pts). Persistent arthritis, severe course of NBO, appearance of new bone lesions, refractory to treatment were determinant factors for administrate the TNF-inhibitors. Among first line of B etanercept (ETN) was used in 14 pts (63%), adalimumab (ADA) – in 5 pts (23%), golimumab – in 2 pts (9%), infliximab (IFX) – in 1 pts (4,5%). At the start of B the average age was 13.7 years (range 7.2-17.9); mean disease duration was 3,4 years (range 0.3-8.1). There were 4 cases of withdrawals: 1 for IFX (to ETN) due to development of skin involvement (chalazion,streptoderma), 3 for ETN. In 2 pts due to inefficacy ETN was switched to ADA. Decreasing of disease activity was detected in the most of patients. Among them 2 pts developed the whole remission with resolving of active arthritis and bone marrow edema spots. Skin lesions (acne, psoriasis) were significantly improved. There weren’t fixed adverse events during TNF-therapy except of the development of staphylococcus sepsis under ETN in a patient with rare genetic comorbidity (congenital indifference to pain). ETN was withdrawn immediately. The patient was treated for a long time by the surgery methods and antibiotics. A year later because of flares of arthritis JAK-inhibitors tofacitinib was administrated and marked improvement achieved.ConclusionEstablished on our experience, we can suggest that treatment with TNF-inhibitors is a good therapy approach for patients with high activity of NBO. It’s expected that option of prescribing BA can prevent progression and bone destruction.Disclosure of InterestsNone declared

BackgroundWhole-body MRI (WB-MRI) has the potential to detect early or hidden signs of inflammation and seems to be more informative test than X-ray and ultrasound methods for bone and joints diseases. WB-MRI is important for identification of asymptomatic inflammation areas that are not available for clinical examination methods (sacroiliitis, TMJ). WB-MRI can become a tool for monitoring the progression of the disease and the efficacy of therapy. There is not enough data of knowledge about the role of WB-MRI in children with JIA.ObjectivesTo evaluate the results of WB-MRI in children with rheumatic diseases (RD) in a single-center retrospective study.Methods57 WB-MRI studies performed in children with RD in our center as a part of real-life diagnostic procedures.ResultsAmong 57 children there are 22 boys and 35 girls, the average age is 13 years [11; 16]. 33 patients were examined once, 20 children twice after the initial course of therapy, two children underwent WB-MRI three times to evaluate the dynamics. It was most important to detect inflammatory lesions in multifocal non-bacterial osteomyelitis (mf-NBO). The structure of diagnosis and therapy before and after WB-MRI is present in Table 1.Table 1.The effect of MRI on changes in the structure of diagnoses and approaches to therapyBefore WB-MRIAfter WB-MRIDiagnosis:Juvenile idiopathic arthritis (JIA)2212JIA+ mf-NBO2230JIA+ mf-NBO +Psoriasis58JIA+ mf-NBO +FMF11JIA+ Psoriasis20JIA+IBD11 (JIA+IBD+ mf-NBO)Fibrodisplasia ossificans progressive (FOP) +JIA11Systemic JIA11Juvenile dermatomyositis (JDM)11Systemic lupus erythematosus (SLE)11SLE+ mf-NBO01Therapy:NSAIDs mono1712DMARDs2629Biologics: / bDMARDs: anti-TNFα Tofacitinib Abatacept121011272151Bisphosphonates45No current therapy3011 patients have multimorbidity (in addition to RD, one girl has Down syndrome). 5 pts had severe hypermobility syndrome patients making it difficult to identify inflammation due to the discrepancy between objective signs and the absence of limitation of joint mobility. 2 patients had multiple ankylosis. 7 patients underwent surgical interventions: 5 because of vertebral fracture, 2 because of osteomyelitis.The WB-MRI revealed: 48 polyarthritis signs, 33 osteitis, 3 osteonecrosis, 11 sacroiliitis, 1 sequestration, 1 epiphyseolysis, 1 initial signs of myositis. Surgical intervention was recommended to two patients after the diagnosis of WB-MRI (sequestration of the osteomyelitis focus and vertebral fracture).Figure 1.WB-MRI 10-yrs old girl with JIA+ mf-NBO +Psoriasis. Than WB-MRI picture 4 months after the Etanercept administration. Positive dynamics in the sacroiliac joints, but the persistence of osteitis in the right radius, calcaneus, femur with the forming lytic destruction.The principal significance and purpose of the performance of WB-MRI were disease control (continuation of therapy) - 22 (39%), the onset of DMARDs/bDMARDs – 17 (30%), the change of bDMARDs - 2 (3%), differential diagnosis – 16 (28%).ConclusionWB-MRI is useful for detecting asymptomatic and radiologically hidden lesions in JIA. Early diagnosis leading to appropriate treatment can prevent long-term structural damage to the joint. WB-MRI is a important tool for the diagnosis and diseases control in children with RD.Disclosure of InterestsNone declared

Background:Therapy with interleukin 17 (iIL17) inhibitors in Russia is indicated for patients with ankylosing spondylitis (AS) or psoriatic arthritis (PSA). If standard therapy is ineffective in these diseases, both tumor necrosis factor inhibitors (iTNF) and iIL17 can be prescribed as the first biologics.Objectives:To study the clinical features of patients with spondyloarthritis (SPA) who were first prescribed iIL17 in a rheumatology center for 12 months.Methods:During the period from January to December 2019, iIL17 was initiated to 43 SPA patients. To compare the clinical picture, the study additionally included 40 SPA patients who were prescribed iTNF during the same period. The diagnosis of AS was based on the mNY criteria, and psoriatic arthritis was based on the CASPAR criteria. In the combined group of 83 patients, AS was in 52 (62.7%), and PSA – in 31; the age of patients was 39.3±10.8 years, and the duration of the disease was 15.1±8.2 years; men were 47 (56.6%).Results:In the iIL17 group, AS had 23 (53.5%) patients, and PSA – 20 (46.5%), while in the iTNF group, respectively, 29 (72.5%) and 11 (27.5%; χ2=3.2, p=0.76). Among the patients who were prescribed iIL17, men were 29 (67%), and in the iTNF group – 18 (45%; χ2=4.2, p=0.04). In terms of activity indicators (ESR, CRP, BASDAI ASDAS-CRP), patients who were prescribed iIL17 or iTNF did not differ significantly from each other. Peripheral arthritis, dactylitis, and entesitis were observed with almost the same frequency in both groups. In the iIL17 group, there were almost 2 times more patients with psoriasis (53.5% and 25.0%; pConclusion:Thus, in clinical practice iIL17 often prescribed for SPA male patients with psoriasis and previous treatment experience by iTNF. The activity of the disease and the presence of non-axial manifestations practically do not affect the choice of biological therapy.Disclosure of Interests:None declared.

Background:About one year ago at the beginning of the new SARS-CoV-2 infection pandemic, it was expected, that rheumatic disease (RD) and immunosuppressive therapy could predispose to a more severe course of the Covid-19 infection. At that time, it was unspeakable how this infection would occur in children with RВ in compare to adults. Now it’s time to draw preliminary conclusions.Objectives:to analyze all features of COVID19 infection in children with RDMethods:The retrospective single center study of all patients with pediatric RD who had the COVID19 infection up to the end of January 2021. It was analyzed all variety of clinical manifestations, changing in therapy at the time of COVID-19 and after it, the dynamics of the RD and consequences of the new viral disease.Results:The study included 66 patients under the age of 18 with various RS, including autoinflammatory disease (AIDs). The diagnostic distribution, sex ratio, age and previous therapy present in the Table 1. There were patients treated with DMARDS (methotrexate -47, hydroxychloroquine -3, mycophenolate mofetil -2, colchicine -1), NSAID monotherapy -6, systemic steroids -10; 29 patients recived Biologics, including combination with methotrexate. None of our patients had a severe course of the COVID-19, none of 66 patients was hospitalized for emergency indications in the intensive care unit or in other specialized departments. The diagnosis of Covid-19 infection was based on different evidences: positive PCR in 15 (23%) cases, high levels of immunoglobulins G and M - in 64 (97%) and 7 (11%) respectively, viral pneumonia was confirmed by CT in 2 (10%) cases. A manifest clinical picture presented just in 21 (32 %) of patients, the others were carried the disease asymptomatically. Among the clinical manifestations of SARS-CoV-2 that were observed in our patients were the following: fever, as the most frequent symptom - 19 (90%), rhinitis - 12 (57%), anosmia - 10 (48%), sore throat - 3 (14%), arthralgia/myalgia in 4 (19%), rash - 1 (5%) case, cough - 4 (19%) cases. it is important to note that until July 2020, only 4 patients were registered, and in the next 6 months – 62. The treatment against Covid-19 in our patients with clinical symptoms included: NSAID monotherapy -4 (19%), Systemic steroids -2 (10%), Hydroxychloroquine -2(10%), Antibiotics-5 (24%).Table 1.Clinical characteristics of children with RD according to presence of symptoms of Covid-19ParameterCovid-19 symptomatic course (n=21)Covid-19 asymptomatic course (n=45)p-valuesSex ratio (F/M)9/1230/15nsDuration of RD (Me. Years)4 (2;6)4 (2;7)nsAge(years)Me>10 yrs15 (13; 17)12011 (8;13.5)1926Covid-19 evidencesIgG Covid-19 +1945nsIgM Covid-19 +34nsPCR Covid-19 +110nsDiagnosis of RDJIA non-systemic1431nssJIA13nsSLE41nsJDM11nsScleroderma6nsAIDs (CAPS, FMF, FOP)13nsPrevious therapyNSAID monotherapy36nsDMARDs1633nsSystemic steroids47nsTNF-inhibitors512nsAbatacept13nsIL6-inhibitors (Tocilizumab, Sarilumab)02nsJAK-kinase inhibitors12nsWorsening/flare of RD after Covid-19 infection50pConclusion:Our study suggests that the presence of RD and immunosuppression therapy does not lead to an increased frequency or severe course of Covid-19 infection in children. The final conclusion will be drawn as the data accumulates.Disclosure of Interests:None declared

Background:Juvenile dermatomyositis (JDM) is the most common idiopathic inflammatory myopathy (IIM) of childhood, but the involvement of muscle also can be complication of systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD) and different overlap syndromes. The presence of myopathy can significantly affect the prognosis of the disease and the quality of life. Despite of the absence of official indication for biological therapy fo IIM, it`s may be needed in severe course of disease.Objectives:To analyze in retrospective study the efficacy and safety of Biologics (B) in patients (pts) with IIM in our pediatric rheumatology center.Methods:The study included all pts with rheumatic diseases (RD), who had IIM and received B during past 10 years.Results:A total of 17 pts (10 females) were identified: 23.5% with JDM, 11.8% - SLE, 35.3% - MCTD, 29.4% - overlap syndromes. The median age at the onset of RD was 9.75 years [interquartile range (IQR) 6.9; 13.5]. The median disease duration at the onset of myopathy was 7.0 months [3.0; 10.0], in all pts with JDM – at onset. All pts had myopathic syndrome. The rash tipical for JDM was in 8 pts (47%). The lung involvement observed in 6 pts (35.3%). Levels of serum muscle enzymes (CK, ALT, AST and lactate dehydrogenase [LDH]) were elevated in 88.2% of pts: CK in 52.9% (mean ± std 624.35±1007.2 U/L), ALT – 82.4% (mean ± std 142.18±148.16U/L), AST – 82.4% (mean ± std 159.6±201.1 U/L), LDH – 88.2% (mean ± std 492.5±229.2 U/L). Abnormal EMG findings were in 10 pts (59.4%). Nailfold capillaroscopic changes tipical for IIM had 10 pts (59.4%). Before B 94.1% of pts received corticosteroids (CS), 58.8% - methotrexate, 29.4% - hydroxychloroquine, 17.6% - cyclophosphamide, 11.8% - cyclosporine, 5.9% - mycophenolate mofetil, 5.9% - azathioprine, 47% - IVIG. B therapy was started due to insufficient efficacy of previous therapy. The median age at start of B was 12.3 years [IQR 9.5; 15.0]. The median disease duration prior to treatment with B was 2.25 years [IQR 0,8; 3.6]. 58.8% of pts received rituximab (RTX), 41.2% - abatacept (ABA). The median time between each course of RTX was 182 days [IQR 156–315]. 80% of pts underwent more than one course of RTM therapy, with a maximum of 5 courses. The median duration of ABA therapy was 2.8 years [IQR 1.6; 5.0]. Discontinuation of B due to serious AE was observed in 1 patient with overlap syndrome (5.9%) – macrophage activation syndrome (MAS) 8 day after RTX infusion (5th course, 1st infusion). One patient (female, 12.3 yo) died from MAS (at onset of SLE, developed before B), the others achieved remission. B therapy allowed to reduce the dose of CS to maintenance in all pts, decrease of calcinosis in 2 pts and improve the quality of life.Conclusion:Our study demonstrated that B is highly effective in children with IIM and have the acceptable safety. Early diagnosis and initiation of intensive therapy are important in reducing symptoms of myopathy in RD. It seems that the development of IIM in other RDs, not JDM, indicates the need for B and its good efficacy. The further extended studies are needed.Disclosure of Interests:None declared

Background:The problem of sarcopenia (SP) in rheumatoid arthritis (RA) is particularly significant in terms of assessing the risk of fractures, since SP leads to falls, which are an independent risk factor for fractures along with RA and osteoporosis.Objectives:To evaluate the bone mineral density (BMD) and fracture risk in women with RA and SP.Methods:79 women with RA based on the 2010 ACR/EULAR classification criteria were included: 20 (25%) women with confirmed SP (age median 59 [53; 64]) according to EWGSOP2 criteria and 59 (75%) women without SP (age median 60 [55; 67]) (p>0.05). We assessed clinical data: age, body mass index (BMI), disease duration, anthropometric measurements, C-reactive protein level, disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR), previous medication use including glucocorticoids and methotrexate, muscle strength and function. Dual-energy X-ray absorptiometry (DXA) to measure BMD of lumbar spine (LS), femoral neck (FN) and total hip (TH) was performed. The 10-year probability of major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture) and the 10-year probability hip fracture was calculated using the Russian version of the FRAX® tool. Statistical analysis was performed using non-parametric methods. All patients signed an informed consent to participate.Results:Median BMD in LS was 0.892 [0.772; 1.024] g/cm2in patients with SP and 0.910 [0.785; 1.028] g/cm2- without SP (p>0.05). There was significant difference between groups in the proximal femur BMD: 0.760 [0.731; 0.826] g/cm2in TH and 0.681 [0.607; 0.703] g/cm2in FN in patients with SP and 0.838 [0.735; 0.921] g/cm2in TH and 0.719 [0.622; 0.804] g/cm2in FN in patients without SP (p=0.009 and p=0.048, respectively). The frequency of osteoporosis was 35% and 22% in patients with and without SP (p>0,05). The 10-year probability of major osteoporotic fracture with / without femoral neck BMD data was 22,0% [17,0; 32,0] / 19,5% [18,5; 22,5 and 13,3% [9,8; 18,5] / 12,8% [9,3; 17,0] in patients with SP and without SP (рConclusion:There were no differences in the frequency of osteoporosis between patients with SP and without SP, however women with SP had proximal femur BMD less than women without SP. The probability of major osteoporotic fracture and hip fracture was significantly higher in patients with RA and SP compared with patients without SP.Disclosure of Interests:None declared