G.-T. Kim

Compliance and persistence with hydroxychloroquine in South Korean patients with systemic lupus erythematosus

We aimed to analyze compliance and persistence with hydroxychloroquine (HCQ) in real practice and identify risk factors for poor adherence in South Korean patients with systemic lupus erythematosus (SLE). This retrospective longitudinal study evaluated 235 SLE patients in whom oral HCQ was newly started from 2002 to 2016 at a tertiary hospital in South Korea. Compliance was assessed using one-year medication possession ratio (MPR) and non-compliance was defined as a one-year MPRu2009<u20090.8. Persistence was determined as the time from HCQ treatment initiation to discontinuation without interruption for ≥56 days. The mean one-year MPR of HCQ was 0.88 and the frequency of non-compliance was 19.9%. During the study period, 115 (48.9%) patients discontinued HCQ and forgetfulness and/or carelessness (73%) were the most common reason for HCQ non-persistence, followed by adverse events (10.4%), unknown factors (10.4%), and pregnancy (6.1%). Median duration until HCQ discontinuation was 55.1 months and the one-year persistence rate to HCQ was 0.8. SLE Disease Activity Index 2000 (SLEDAI-2K) u2009<u20096 was a significant risk factor for non-compliance (ORu2009=u20092.98, pu2009=u20090.001) and non-persistence (HRu2009=u20091.55, pu2009=u20090.046) with HCQ after adjusting confounding factors. However, HCQ adherence was not associated with the dose of HCQ or concomitant immunosuppressive medications. Our data showed that overall adherence to HCQ in SLE patients was suboptimal in real practice and SLEDAI-2K score u2009<u20096 was a risk factor for poor adherence, suggesting the need to improve adherence with HCQ treatment in SLE patients, especially in those with low disease activity.

THU0144 Cognitive function of patients with rheumatoid arthritis is associated with disease activity but not carotid atherosclerotic changes

Background Rheumatoid arthritis (RA) is a complex inflammatory disease that has features of atherosclerosis and cognitive decline. Although the relationship between atherosclerosis and cognitive impairment has been studied and replicated, whether cognitive deficits in RA can be attributed to their atherosclerotic changes is not well understood. Objectives This study investigated the cognitive function in patients with RA using the Korean version of the Consortium to Establish a Registry for Alzheimers disease (CERAD-K) neuropsychological battery and evaluated whether cognitive function was affected by the carotid arterial atherosclerosis. Methods We examined seventy RA patients and forty healthy controls. RA activity was assessed by disease activity score with 28 joints-erythrocyte sedimentation rate (DAS28-ESR) and objective memory impairment was defined as a performance score of 1.5 standard deviations below the respective age-specific, education-specific, and sex-specific normative means for at least one of the four episodic memory tests in CERAD-K; the Word List Memory, Word List Recall, Word List Recognition, and Constructional Recall tests [1]. Carotid arteries were scanned for the presence of plaque and intima-media thickness (IMT). We assessed potential risk factors of cognitive impairment in RA patients using regression analyses. Results Of the CERAD-K subtests, there were a significant difference between the RA patients and healthy controls in verbal fluency (12.97±3.73 vs 15.48±4.57, respectively; p=0.004) and Boston Naming Test (11.50±2.08 vs 12.30±1.77, respectively; p=0.035). Carotid ultrasound revealed significantly more plaques in the RA patients than in the healthy controls (39% vs 15%, respectively; p=0.017). RA patients with memory impairment have significantly higher score of DAS28-ESR (4.14±0.99 vs 2.60±0.88, respectively; p<0.001), age (65.71±7.71 vs 58.50±11.33, respectively; p=0.009), and mean cIMT (0.56±0.10 vs 0.50±0.08, respectively; p=0.027) compared to RA patients without memory impairment. In multivariable regression analysis, CERAD-K total score showed a significant negative correlation with age (β=-0.415, p<0.001) or DAS28-ESR (β=-4.685, p<0.001), but no correlation was found between CERAD-K total score and presence of plaque or cIMT (Table 1). Conclusions Our results indicate that disease activity of RA and aging contribute to cognitive impairment, but there was no association between cognitive function and clinical or subclinical carotid atherosclerotic changes in RA patients. References Lee JH, Lee KU, Lee DY, Kim KW, Jhoo JH, Kim JH, et al. Development of the Korean version of the consortium to Establish a Registry for Alzheimers disease Assessment Packet (CERAD-K): clinical and neuropsychological assessment batteries. J Gerontol B Psychol Sci Soc Sci 2002;57:47–53. Disclosure of Interest None declared

FRI0262 Clinical, laboratory and immunological characteristics of 413 patients with systemic lupus erythematosus in south korea: a multicenter retrospective cohort study

Background Epidemiologic studies have described clinical characteristics of patients with systemic lupus erythematosus (SLE) in Middle Eastern Asia and Western countries and marked ethnic and geographic differences in the prevalence, severity and outcome of SLE have been reported. However, data from Northeast Asia countries including South Korea are lacking. Objectives To investigate demographic, clinical, laboratory and immunological characteristics and prognosis of patients with SLE in South Korea. Methods We retrospectively evaluated 413 SLE patients (380 female, 33 male, mean age 40.6 years) diagnosed at 3 tertiary rheumatology centers in South Korea from 1992 to 2016 by reviewing medical chart. All patients fulfilled 1997 revised American College of Rheumatology classification criteria for SLE and were ethnically Korean. Results The mean (±SD) age at disease diagnosis was 30.9 (±12.8) years and the median (IQR) disease duration was 108 (60–168) months. The commonest clinical manifestations in our patients were arthritis (59.1%), fever (49.9%), malar rash (48.4%), alopecia (43.8%) and oral ulcer (35.1%). The frequency of major organ involvement was as follows: biopsy-proven lupus nephritis (40.7%), neuropsychiatric involvement (19.4%), secondary anti-phospholipid antibody syndrome (6.1%) and lupus pneumonitis (1.7%). Class IV (41.1%) was the most common type of lupus nephritis followed by class V (15.5%). Regarding hematologic abnormalities, the cumulative incidence of leucopenia was 74.3%, thrombocytopenia 46.5%, lymphopenia 45.1% and hemolytic anemia 8.7%. Antinuclear antibodies were detected in 97.8%, anti-Sm in 38.4%, anti-dsDNA IgG in 56.5%, anti-cardiolipine IgG in 27.4%, anti-cardiolipine IgM 11.8%, lupus anticoagulant in 23.2%, anti-Ro in 62.3%, anti-La 30.2% and anti-RNP in 47.9%. Twenty (4.8%) patients died during median follow-up of 84 months and the 5-year and 10-year survival rates were 96.9% and 95.5%, respectively (Figure 1). The major causes of death were infection (35%) and diffuse alveolar hemorrhage (20%). In multivariable Cor regression models, male (HR=8.68, p<0.001), age at diagnosis ≤16 years (HR=3.33, p=0.033), serositis (HR=3.04, p=0.018) and thrombocytopenia (HR=3.23, p=0.041) were associated with poor survival, while SLE patients with hydroxychloroquine use showed better survival (HR=0.11, p=0.001). Conclusions Compared with data from other countries, the higher prevalence of hematologic manifestatons and positive anti-Ro antibody were prominent feature of South Korean SLE patients. Overall survival rate in our patients was better than that in other populations. References Khanfir MS et al. TULUP (TUnisian LUPus): a multicentric study of systemic lupus erythematosus in Tunisia. Int J Rheum Dis 2013;16:539–46. Al Arfaj AS et al. Clinical and immunological manifestations in 624 SLE patients in Saudi Arabia. Lupus 2009;18:465–73. Disclosure of Interest None declared

FRI0129 Association between Hearing Loss and Carotid Subclinical Atherosclerosis in Female Rheumatoid Arthritis Patients

Background The incidence of hearing loss (HL) has been on the rise in patients with rheumatoid arthritis (RA). However, limited information exists regarding the pathogenic mechanisms of HL in RA patients1,2. Objectives This study sought to evaluate the prevalence and characteristics of HL in RA patients compared with a control group and to identify factors associated with the degree of HL in RA patients. Methods We enrolled 64 RA patients and 70 healthy controls in a prospective manner. Each subject was tested with pure tone audiometry including high frequencies ranging from 0.5 to 16 kHz. For each set of tests, mean values for air conduction at each frequency and tympanometric values were calculated to exclude middle ear disease. In the RA group, auto-antibodies, erythrocyte sedimentation rate, high-sensitivity C-reactive protein, and RA disease activity were measured, and carotid ultrasonography was performed for the detection of indicators of subclinical atherosclerosis, including arterial stiffness index beta (β-index) and carotid intima-media thickness (cIMT). Results The prevalence of HL was higher in the RA group than the control group (37.1% vs. 65.6%, p=0.001). The hearing threshold value difference between groups was significant at frequencies of 0.5, 1, 2, 4, and 8 kHz (p<0.05). Age showed the strongest correlation to HL at all frequencies in RA patients (p<0.01). cIMT was also strongly related to HL at all frequencies, whereas β-index was related to HL only at high frequencies (8, 12, and 16 kHz), acting as an early marker of HL (both p<0.05). Conclusions HL was more prevalent in the RA group than the control group. cIMT and β-index were strongly correlated with HL in the RA group, which implies that subclinical atherosclerosis may play an important role in HL in RA patients. References Özkırış M, Kapusuz Z, Günaydın İ, Kubilay U, Pırtı İ, Saydam L. Does rheumatoid arthritis have an effect on audiovestibular tests? Eur Arch Otorhinolaryngol. 2014;271:1383–7 Pascual-Ramos V, Contreras-Yáñez I, Rivera-Hoyos P, Enríquez L, Ramírez-Anguiano J. Cumulative disease activity predicts incidental hearing impairment in patients with rheumatoid arthritis (RA). Clin Rheumatol. 2014;33:315–21. Disclosure of Interest None declared

AB0400 Open Labeled, Multicenter 24-Week Study To Assess The Efficacy and Safety of Tacrobell® in Active Rheumatoid Arthritis Patients

Background Rheumatoid arthritis (RA) is chronic inflammatory disease characterized by persistent synovitis and structural joint damage with T cell-driven inflammation. Tacrolimus suppress activation of T cells through the inhibition of calcineurin. Objectives We evaluated the efficacy and safety of Tacrobell® (Tacrolimus from Chong Kun Dang Pharma Inc.) in Korean active RA patient who had inadequate response to disease-modifying anti-rheumatic drugs (DMARDs) including Methotrexate (MTX). Methods During the study period from Aug. 2012 to Jun. 2015, in this open labeled, multicenter study, 111 patients were enrolled. Patients were in active disease state with Disease Activity Score28 (DAS28) ≥3.2 despite previously taken at least one conventional DMARD including MTX. Patients had wash out period with DMARDs, except MTX. Patients received Tacrobell® during 24 weeks. The initial dose was 1 mg once daily and was increased to 3mg once daily by 1mg, every 4 weeks. The disease activity was measured by the DAS28-ESR at 4, 8, 16, 24-week after the add on Tacrobell®. Simplified Disease Activity Index (SDAI), Korean Health Assessment Questionnaire (KHAQ)-20, Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP) and the safety was assessed. Results Data from 97 patients were evaluated in full set analysis. At week-24, EULAR response rate were 83.5% (81 of 97) with improvements from week-16 in 74.2% (72 of 97). Mean DAS28-ESR was continuously decreased of 5.64 at baseline, 4.14 (±1.22, p<0.001) at week-16 and 3.66 (±1.39, p<0.001) at week-24. Efficacy rates according to SDAI were 89.7% (87 of 97) and KHAQ-20 score decreased -2.42 (±4.37, p<0.001) from baseline 7.27 (±4.59) at week-24. Mean ESR was decreased -10.97 (±24.16, p<0.001) at week-16, -14.77 (±24.57, p<0.001) at week-24 from baseline 46.05 (±23.22). Mean CRP was decreased from 2.86 (±7.85, p=0.0578) at baseline to 1.34 (±3.02, p=0.0367) at week-24. The most common adverse events were in gastrointestinal (18 of 108; 16.679%) and respiratory disorder (12 of 108; 16.67%). In serious adverse events (6 of 108, 5.56%), two cases (pneumonia, high glucose level) were related with Tacrobell® and recovered with treatment. At laboratory exam, no abnormal findings with increased BUN or Cr as known common Tacrolimus side effect. Systolic blood pressure increased 2.12 mmHg at week-8. Conclusions This study demonstrated the efficacy of add on Tacrobell® therapy to MTX in patients with active RA. References Tsutomu T., et al (2013) Post-marketing surveillance of the safety and effectiveness of tacrolimus in 3,267 Japanese patients with rheumatoid arthritis Mod Rheumatol.; 24(1):8–16 Takeyuki K., et al (2013) Long-term therapeutic effects and safety of tacrolimus added to methotrexate in patients with rheumatoid arthritis Rheumatol Int.; 33:871–877 Mariko K., et al (2013) Efficacy of adjunct tacrolimus treatment in patients with rheumatoid arthritis with inadequate responses to methotrexate Mod Rheumatol.; 23:788–793 Kawai S., et al. (2011) Efficacy and safety of additional use of tacrolimus in patients with early rheumatoid arthritis with inadequate response to DMARDs-a multicenter, double-blind, parallel-group trial Mod Rheumatol.; 21(5):458–68 Disclosure of Interest None declared

THU0556 Assessment of Peripheral Small Fiber Nerve in Fibromyalgia

Background Fibromyalgia (FM) is related to the features of small fiber neuropathy (SFN). Sudoscan is a non-invasive device measures sweat gland dysfunction employing electrochemical skin conductance (ESC) and is useful for assessing peripheral small fiber nerve function. Little is known about the dysfunction of peripheral small fiber nerve in patients with FM. Objectives The aim of this study was to evaluate the prevalence and characteristics of SFN in patients with FM compared with a control group and to identify factors associated with SFN in FM. Methods 66 patients with FM (age: 53 ± 9 years old) to meet 2010 ACR preliminary diagnostic criteria and 66 healthy controls were enrolled. Each FM patient was required to fast 8 to 10 hours before blood samples. Serum fasting glucose, fasting insulin, Serum 25-(OH) D and the 75-gram two-hour oral Glucose tolerance test (GTT) were measured. Height and weight were measured and used to calculate Body mass index (BMI). Overt diabetes patients were excluded using their past and medication history. The small fiber neuropathy Symptoms Inventory Questionnaire (SFN-SIQ) was used to record neuropathic symptoms. Clinical assessments included fibromyalgia impact questionnaire (FIQ), Beck Depression Inventory (BDI), and The State-Trait Anxiety Inventory (STAI). All subjects underwent the examination of Sudoscan. Results The mean feet and hands ESC were significantly lower in the FM group than the control group.(table 1).Table 1. Comparison of Mean feet and hands ESC between FM and control group FM (n=66) Control (n=66) p-value Mean feet ESC (μS) 62.2±17.9 72.2±13.0 <0.001 Mean hands ESC (μS) 54.3±19.6 65.63±15.4 <0.001 Values are expressed as mean ± SD for 66 subjects in each group. Mean Hands ESC was irrelevant to age, BMI, SFN-SIQ, FIQ, fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and vitamin D and 2 hour GTT glucose level. However, Mean feet ESC showed significant correlation with fasting insulin (r= -0.34, p<0.01) and HOMA-IR (r= -0.37, p<0.01). Conclusions Sudomotor function was significantly lower in patients with FM than the control group. Mean feet ESC was correlated with hyperinsulinemia and HOMR-IR in patients with FM, which implies that SFN associated with insulin resistance may play an important role in FM pain. References Neurophysiol Clin. 2015 Dec;45(6):445–55. Epub 2015 Nov 17. Diagnosis of small fiber neuropathy: A comparative study of five neurophysiological tests. Curr Pain Headache Rep. 2015 Dec;19(12):55. The Role and Importance of Small Fiber Neuropathy in Fibromyalgia Pain. Caro XJ, Winter EF Disclosure of Interest None declared

THU0511 Factors Associated with Preclinical Atherosclerotic Changes in Carotid Artery in Men with Gout

Background Although a number of studies have reported that hyperuricemia and gout are independent risk factors for the development of cardiovascular disease (CVD), little is known about the relationship between hyperuricemia or gout and arterial stiffness. Objectives This study sought to compare carotid arterial stiffness in gout patients and healthy controls, and evaluate the predictive factors for arterial stiffness in male patients with gout using carotid ultrasonography. Methods In this cross-sectional study, 69 male gout patients and 64 male healthy controls without any known CVD were prospectively analyzed. Carotid artery stiffness index β (β-index) and the intima-media thickness (IMT) were measured as surrogate markers of preclinical atherosclerosis. We also measured serum uric acid, high sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), lipid profiles, and renal function. Adjusted comparison of the β-index and cIMT in both groups and their associations with clinical parameters were investigated. Results The gout group showed higher ESR, Cr, prevalence of HT and DM than the control group (p<0.05). However, HDL was higher in the control group (p<0.05). β-index and cIMT were higher in the gout group, but only β-index showed a statistically significant difference (11.12 ± 5.19 vs 8.68 ± 3.67, p=0.002). Multiple regression analyses showed that duration of gout was significantly associated with increased β-index and cIMT in the gout group (Table 1). Conclusions Patients with gout had increased carotid arterial stiffness, which was significantly related to gout duration rather than serum uric acid level or status of inflammation. References Richette P, Perez-Ruiz F, Doherty M, Jansen TL, Nuki G, Pascual E, Punzi L, So AK, Bardin T. (2014) Improving cardiovascular and renal outcomes in gout: what should we target? Nat Rev Rheumatol. 10(11):654–61. Perez-Ruiz F, Becker MA. (2015) Inflammation: a possible mechanism for a causative role of hyperuricemia/gout in cardiovascular disease. Curr Med Res Opin. 31 Suppl 2:9–14. Disclosure of Interest None declared

THU0393 Increased 18F-Fluoride Uptake Lesions at Vertebral Corners on Positron Emission Tomography Predict New Syndesmophytes Development in Ankylosing Spondylitis

Background 18F-fluoride uptake on positron emission tomography (PET) represents osteoblastic activity. Previous cross-sectional studies showed that increased 18F-fluoride uptake lesions at vertebral corners were associated with both inflammation and structural changes on magnetic resonance imaging (MRI) and radiography, respectively, in patients with ankylosing spondylitis (AS) 1,2. But, longitudinal studies that investigated the association between increased 18F-fluoride uptake lesions and future syndesmophytes formation are lacking. Objectives We aimed to demonstrate that increased 18F-fluoride uptake lesions on PET predict the development of new syndesmophytes. Methods In 12 patients with AS, 18F-fluoride PET-MRI (Philips Healthcare, Cleveland, OH, USA) was performed at baseline and radiography was performed at baseline and 2 years. We recorded 18F-fluoride uptake lesions on PET, acute (type A) and advanced (type B) corner inflammatory lesions (CILs) and fat lesions on MRI and syndesmophytes on radiography. An increased 18F-fluoride uptake lesion was defined as an uptake greater than the uptake in the adjacent normal vertebral body (Figure 1). Results Of 231 anterior vertebral corners without syndesmophyte at baseline, 13 type A CILs (5.5%), 2 type B CILs (0.9%) and 20 fat lesions (8.7%) on MRI and 6 increased fluoride uptake lesions (2.6%) on PET were observed. After 2 years, 16 new syndesmophytes (6.9%) in 8 AS patients (66.7%) occurred. New syndesmophytes developed significantly more frequently in anterior vertebral corners with increased 18F-fluoride uptake lesions (50%) or fat lesions (25%) at baseline, as compared with those without either feature (5.8% and 5.2%, respectively). In generalised linear latent mixed models after adjusting within-patient correlation, baseline increased 18F-fluoride uptake lesion significantly predicted the development of new syndesmophytes (OR=20.6, 95% CI=2.7–156.1, p=0.003). Fat lesions were also associated with new syndesmophytes development (OR=9.3, 95% CI=2.1–40.2, p=0.003), but this association was not observed in CILs. Conclusions Our findings indicate that increased 18F-fluoride uptake lesions can predict future new syndesmophytes formation in patients with AS. 18F-fluoride PET may be used to estimate structural damage in these patients. References Lee SG et al. Assessment of bone synthetic activity in inflammatory lesions and syndesmophytes in patients with ankylosing spondylitis: the potential role of 18F-fluoride positron emission tomography-magnetic resonance imaging. Clin Exp Rheumatol 2015;33:90–7. Buchbender C et al. Hybrid 18F-labeled Fluoride Positron Emission Tomography/Magnetic Resonance (MR) Imaging of the Sacroiliac Joints and the Spine in Patients with Axial Spondyloarthritis: A Pilot Study Exploring the Link of MR Bone Pathologies and Increased Osteoblastic Activity. J Rheumatol 2015;42:1631–7. Disclosure of Interest None declared

SAT0305 Determinants of Erectile Dysfuction in Patients with Gout

Background Erectile dysfunction (ED) is prevalent among men with a variety of chronic medical conditions, including obesity, alcohol use, age, diabetes and cardiovascular disease. ED is caused by many factors such as psychogenic and organic (arteriogenic, cavernosal, neurogenic, anatomic and, endocrinologic) impairment. Gout is the most common inflammatory arthritis associated with subclinical endothelial dysfunction. Objectives We investigated the status of ED in patients with gout who were using uric acid lowering agents and did not developed a flare-up, compared to healthy controls and studied correlation of ED with brachial-ankle pulse wave velocity and medical conditions of patients with gout. Methods In this cross sectional study, total 208 male subjects were enrolled. Patients with well controlled gout (n=120) and health check-up controls (n=87). Erectile function was assessed by the International Index of Erectile Function (IIEF5) questionnaire. We checked brachial-ankle pulse wave velocity (baPWV), ankle brachial pressure index (ABI), heart rate variability (HRV) calculated by spectral analysis (high frequency (HF) and low frequency (LF)) and laboratory tests. Results IIEF (5–11) IIEF (12–30) P-value Moderate to severe (n=51) None to mild (n=157) Age, year 49.7±1.3 40.8±0.8 0.002 Smoking, % 37 44 0.452 Alcohol, % 56 64 0.439 Height, cm 167.0±1.3 169.1±0.5 0.039 Weight, kg 69.0±1.7 70.2±0.7 0.026 HF (ms2) 1.3±0.2 1.3±0.1 0.940 baPWV, cm/sec 1610±47 1371±26 <0.001 Ankle brachial pressure index 1.21±0.02 1.21±0.01 0.905 Duration of gout, year 9.7±1.2 5.0±0.5 <0.001 Serum uric acid 6.2±1.7?mg/dL 5.9±1.6?mg/dL 0.058 There was no significant difference in age, weight, smoking, alcohol, blood pressure, serum uric acid and HRV variables between patients group and healthy control group. In IIEF total score, control group was higher than gout patients (17.9±0.7 Vs 14.1±0.5, p<0.001). In patient group, IIEF total score 5 to 11, moderate to severe ED percent was higher than control group (34.3% Vs 11.4%, p<0.001). In moderate to severe ED group, age, duration of gout, and baPWV were higher than none or mild ED group (Table). In univariate and multiple logistic analysis for the prediction of ED, age (over 60), PWV (over 1550) represented high odd ratio (10.526, 7.152 respectively, p<0.001). After adjusted other variable factors, age and PWV were also independently associated with ED. Conclusions The prevalence of ED is higher in patients with gout. Moderate to severe ED is associated with age, duration of gout, baPWV. Age and baPWV are independently associated with ED. The result of baPWV that assesses arterial stiffness is significantly correlated with ED for patients with gout Disclosure of Interest None declared

AB0261 Drug Survival and the Associated Predictors Among Patients with Rheumatoid Arthritis Receiving Tacrolimus

Background Drug survival can be considered as a composite measure of efficacy and safety in clinical practice. Although the drug survival rate of biologic agents in the treatment of rheumatoid arthritis (RA) has recently been extensively studied, only few studies have examined the drug survival rate for tacrolimus (TAC) in such cases. Objectives The present study aimed to investigate the drug survival rate of TAC in the treatment of RA and to analyse the potential predictors of this rate in routine clinical care. Methods In this retrospective longitudinal study, we enrolled 102 RA patients treated with TAC for at least 1 year from April 2009 to January 2014 at a tertiary centre in South Korea. The causes of TAC discontinuation were classified as lack of efficacy (LOE), adverse events (AEs), and others (patient or medical decision and miscellaneous). The drug survival rate was estimated using the Kaplan-Meier method and the predictors of this rate were identified by Cox-regression analyses. Results TAC was discontinued in 27 of 102 RA patients (26.5%), after a mean duration of 34.1 months; the number of TAC discontinuations due to LOE, AEs, and others was 15 (14.7%), 11 (10.8%) and 1 (1%), respectively. The 2-year survival rate for TAC was 78.3% (Figure 1). Multivariable Cox-regression models indicated that compared to RA patients with low or moderate disease activity (Disease Activity Score 28-erythrocyte sedimentation rate [DAS28-ESR] ≤5.1), RA patients with high baseline disease activity had a significantly higher risk of TAC discontinuation, regardless of the cause (HR=2.49; 95% CI=1.16-5.35, p=0.019), or specifically, due to LOE (HR=3.55; 95% CI=1.25-10.09, p=0.02). Moreover, younger age (<60 years) at the start of TAC treatment was marginally associated with worse TAC survival due to LOE (HR=4.46; 95% CI=1.00-19.91, p=0.050). Conclusions In the present study, RA patients exhibited a good 2-year TAC survival rate of 78.3%. Moreover, a high baseline disease activity was a significant predictor for TAC withdrawal, regardless of the cause, or specifically, due to LOE. Disclosure of Interest None declared