Katalin Gulyás

Anti-mutated citrullinated vimentin (anti-MCV) and anti-65 kDa heat shock protein (anti-hsp65): New biomarkers in ankylosing spondylitis

INTRODUCTION Citrullination as well as anti-citrullinated protein/peptide antibodies (ACPA) have been implicated in the pathogenesis of rheumatoid arthritis (RA). While ACPAs are specific and sensitive markers for RA, there have been hardly any reports regarding ACPAs in ankylosing spondylitis (AS). The possible role of antibodies to Mycobacterial 65 kDa heat shock protein (hsp65) has not been characterized in AS. As new laboratory biomarkers of AS are needed, we investigated the prevalence of anti-mutated citrullinated vimentin (MCV) and anti-hsp65 antibodies in AS. METHODS Altogether 43 AS and 44 healthy controls were included in the study. Anti-MCV and anti-hsp65 were determined in sera by commercial and in-house ELISA, respectively. Serum autoantibody levels were correlated with ESR, CRP, HLA-B27 status, smoking habits, pain intensity, BASDAI, BASFI and BASMI indices. RESULTS Patients with AS had significantly higher serum anti-MCV levels (17.3 U/mL, range: 8.3-31.5 U/mL) in comparison to healthy subjects (8.9 U/mL, range: 5.4-13.3 U/mL) (p<0.01). Sixteen of the 43 AS patients (37%) and none of the 44 healthy controls (0%) were anti-MCV positive using the cut-off value recommended by the manufacturer (>20 U/mL). The mean anti-hsp65 concentration in AS sera was 124.8 AU/mL (range: 27.2-1000 AU/mL), while controls exerted significantly lower anti-hsp65 levels (mean: 51.8 AU/mL; range: 22.5-88.5 AU/mL) (p<0.001). Correlation analysis revealed that both anti-MCV positivity (r=0.613; p=0.012) and absolute serum anti-MCV levels (r=0.553; p=0.021) correlated with anti-hsp65 levels. Anti-MCV positivity also correlated with ESR (r=0.437; p=0.03). CONCLUSIONS Anti-MCV and anti-hsp65 may be novel biomarkers in AS.

Effects of targeted therapies on the bone in arthritides

Inflammatory arthritides, such as rheumatoid arthritis (RA) and spondyloarthritides (SpA) have been associated with both localized bone resorption and/or formation, and generalized osteoporosis. Systemic inflammation may be the major driver for bone loss in arthritis. In RA and peripheral SpA the RANK-RANKL-OPG network is involved in bone resorption, while in axial SpA the Wnt-β-catenin axis and its inhibitors (DKK-1, sclerostin) are the most relevant. Targeted therapies including biologics and small molecule tyrosine kinase inhibitors may interfere with inflammatory bone metabolism. Most of these compounds are able to slow down radiographic progression and osteoporosis in arthritides. In very early cases of non-radiological SpA, there may be a window of opportunity allowing to prevent syndesmophyte formation. The inability of targeted therapies to increase the production of DKK-1 and sclerostin may explain the lack of efficacy of TNF inhibitors to halt syndesmophyte formation in SpA. Further clinical trials are needed to better understand the bone effects of targeted therapies.

A4.3 Effects of anti-TNF therapy on markers of bone homeostasis in rheumatoid arthritis and ankylosing spondylitis

Background and objectives Uncoupling of bone resorption and formation has been associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Generalised bone loss and erosions are characteristic for RA, while in AS, bone formation overrides resorption. The RANKL/OPG and the Wnt/DKK-1/sclerostin systems have been implicated in disturben bone homeostasis in arthritides. Anti-TNF biologics may beneficially influence erosions and bone loss in RA, however, they have little effect on bone formation in AS. In the present study, we assessed the effects of 1-year anti-TNF treatment on various bone biomarkers. Patients and methods Altogether 43 arthritis patients including 30 RA patients treated with either etanercept (ETN) or certolizumab pegol (CZP) and 13 AS patients treated with ETN were included in a 12-month follow-up study. Disease activity (DAS28 or BASDAI), CRP, IgM rheumatoid factor, anti-CCP, calcium (Ca), phosphate (P), osteocalcin (OC), P1NP, CTX, BNP, sclerostin (SOST), DKK-1, soluble RANKL (sRANKL), cathepsin K (cathK) and vitamin D3 (vitD) levels were assessed at baseline, as well as 6 and 12 months after treatment initiation. Results Anti-TNF treatment was highly effective in both diseases, as the mean DAS28 decreased from 6.32 to 3.16 (p = 0.02) in RA, mean BASDAI decreased from 5.87 to 1.84 (p < 0.001) in AS. In RA, anti-TNF treatment significantly decreased DKK-1 (60.5 ± 28.9 pM and 54.7 ± 20.8 pM, p = 0.036) and CathK (28.7 ± 6.2 pm and 26.8 ± 4.0 pm, p = 0.014) but increased SOST (107.0 ± 47.5 pM and 131.2 ± 85.2 pM, p = 0.04) levels from baseline to 12 months, respectively. In RA, ETN and CZP treatment also increased OPG/sRANKL ratio after 6 months (51.9) vs. baseline (43.9) (p = 0.01). In AS, ETN therapy significantly increased the bone formation marker P1NP (49.4 ± 19.0 pM and 56.9 ± 28.7 pM, p = 0.03) and SOST (70.6 ± 29.0 pM and 82.4 ± 48.3 pM, p = 0.022) levels from baseline to 12 months, respectively. ETN therapy also increased OPG/sRANKL ratio after 6 months (44.5) and 12 months (46.9) compared to baseline (34.5) in AS (p < 0.01). Both baseline and 12-month SOST levels were significantly lower in AS compared to RA (p < 0.001). When RA and AS data were pooled, TNF inhibition resulted in significantly decreased DKK-1 (p = 0.035) and cathK (p = 0.008) but increased P1NP (p = 0.04) and SOST (p = 0.04) after 12 months. In this study, biologics did not affect Ca, P, OC, CTX, BNP, vitD levels. Conclusions In a mixed cohort of RA and AS patients, anti-TNF therapy resulted in a restoration of bone homeostasis by decreasing DKK-1 and CathK, increasing P1NP, SOST and OPG/sRANKL ratio. Lower SOST levels in AS compared to RA, as well as the induction of bone formation over resorption may account for the inefficacy of TNF inhibitors on syndesmophyte formation in AS.

[Applicability of laser-based geological techniques in bone research: analysis of calcium oxide distribution in thin-cut animal bones].

A csontszovet es a geologiai kepződmenyek szerkezeti felepitese kozotti hasonlosag lehetőve teszi, hogy a csontszovet szervetlen reszet matematikai modellekkel kozelitsuk. Az elemi osszetetel ellenőrizhető a lezerindukalt plazmaspektroszkopiai es induktiv csatolasu plazmaoptikai emisszios spektrometrias meresekből meghatarozott elemoxidkoncentracio-ertekekkel. A szamitasokbol es a laboratoriumi meresekből egyertelműen kovetkezik, hogy a csontszovet tulajdonsagait elsősorban a hidroxiapatit hatarozza meg. A szervetlen csontszerkezet igen jol tanulmanyozhato a lezerindukalt plazmaspektroszkopiai technikaval megbizhatoan merhető kalcium-oxid-koncentracioertekek eloszlasainak segitsegevel. Jelen tanulmanyban a szerzők him szarvasmarha labszarcsontjaibol keszult vekonycsiszolatokon szelveny menti, lezerindukalt plazmaspektroszkopiai meresekből szamitott kalcium-oxid-koncentracio eloszlasai mutatjak be. A kalcium-oxid-koncentracioertekek feluleti eloszlasait, „gyakorisagi eloszlasi” gorbek tamasztjak ala. A tobb csoportba sorolt kalcium-oxid-koncentracioertekek alapjan a corticalis es trabecularis csontszerkezet elesen megkulonboztethető. A szerzők a csontokon elvegzett kvantitativ komputertomografiai meresekből szamitott attenuacios egyutthato (osszsűrűseg) es geologiaban hasznalt „ρ”-sűrűseg kozott szignifikans pozitiv korrelaciot talaltak. Tovabba a kiszamitott „ρ”-sűrűseg es a meghatarozott atlag-kalcium-oxid-koncentracioertekek inverz korrelaciot mutattak. Orv. Hetil., 2014, 155(45), 1783–1793. | The structural similarities between the inorganic component of bone tissue and geological formations make it possible that mathematic models may be used to determine weight percentage composition of different mineral element oxides constituting the inorganic component of bone tissue. The determined weight percentage composition can be verified with the determination of element oxide concentration values by laser induced plasma spectroscopy and inductively coupled plasma optical emission spectrometry. It can be concluded from calculated weight percentage composition of the inorganic component of bone tissue and laboratory analyses that the properties of bone tissue are determined primarily by hydroxylapatite. The inorganic bone structure can be studied well by determining the calcium oxide concentration distribution using the laser induced plasma spectroscopy technique. In the present study, thin polished bone slides prepared from male bovine tibia were examined with laser induced plasma spectroscopy in a regular network and combined sampling system to derive the calculated calcium oxide concentration distribution. The superficial calcium oxide concentration distribution, as supported by “frequency distribution” curves, can be categorized into a number of groups. This, as such, helps in clearly demarcating the cortical and trabecular bone structures. Following analyses of bovine tibial bone, the authors found a positive association between the attenuation value, as determined by quantitative computer tomography and the “ρ” density, as used in geology. Furthermore, the calculated “ρ” density and the measured average calcium oxide concentration values showed inverse correlation. Orv. Hetil., 2014, 155(45), 1783–1793.A csontszovet es a geologiai kepződmenyek szerkezeti felepitese kozotti hasonlosag lehetőve teszi, hogy a csontszovet szervetlen reszet matematikai modellekkel kozelitsuk. Az elemi osszetetel ellenőrizhető a lezerindukalt plazmaspektroszkopiai es induktiv csatolasu plazmaoptikai emisszios spektrometrias meresekből meghatarozott elemoxidkoncentracio- ertekekkel. A szamitasokbol es a laboratoriumi meresekből egyertelműen kovetkezik, hogy a csontszovet tulajdonsagait elsősorban a hidroxiapatit hatarozza meg. A szervetlen csontszerkezet igen jol tanulmanyozhato a lezerindukalt plazmaspektroszkopiai technikaval megbizhatoan merhető kalcium-oxid-koncentracioertekek eloszlasainak segitsegevel. Jelen tanulmanyban a szerzők him szarvasmarha labszarcsontjaibol keszult vekonycsiszolatokon szelveny menti, lezerindukalt plazmaspektroszkopiai meresekből szamitott kalcium-oxid-koncentracio eloszlasai mutatjak be. A kalcium-oxid-koncentracioertekek feluleti eloszlasait, „gyakorisagi eloszlasi” gorbek tamasztjak ala. A tobb csoportba sorolt kalcium-oxid-koncentracioertekek alapjan a corticalis es trabecularis csontszerkezet elesen megkulonboztethető. A szerzők a csontokon elvegzett kvantitativ komputertomografi ai meresekből szamitott attenuacios egyutthato (osszsűrűseg) es geologiaban hasznalt „ρ”-sűrűseg kozott szignifi kans pozitiv korrelaciot talaltak. Tovabba a kiszamitott „ρ”-sűrűseg es a meghatarozott atlag-kalcium-oxid-koncentracioertekek inverz korrelaciot mutattak.

FRI0547 Osteoporosis and bone metabolism in systemic sclerosis

Background Systemic sclerosis (SSc) has been associated with bone loss and increased risk for bone fractures. Disease-related factors, age, corticosteroid therapy may be associated with increased bone turnover and bone loss. Objectives Here we performed a detailed study on osteoporosis in SSc. We performed bone density assessment by DXA, as well as peripheral forearm quantitative CT (pQCT). In addition, we assessed bone biomarkers and correlated bone- and disease-associated measures. Methods Altogether 44 SSc patients (36 women, 8 men; age: 64.1 years; disease duration: 17.6 years) were randomly recruited for the study. Bone density was assessed by DXA at the lumbar spine and femoral neck. pQCT (Stratec) is able to assess total, trabecular and cortical density. We also determined FRAX, levels of vitamin D, as well as bone markers (Ca, PTH, osteoclacin, P1NP, beta-CTX), markers of autoimmunity (ANA, ACA and anti-Scl70) and clinical manifestations of the disease. Statistical analysis was performed by SPSS v22.0. Results Vitamin D levels were lower (53.9 +/- 36.8 nM) than the normal range (>75 nM). 34 out of 44 patients (77%) had D-hypovitaminosis. Abnormally increased PTH, P1NP, OC, CTX levels were observed in 10, 7, 2 and 6 patients, respectively. Previous fractures occurred in 19 patients (43%). The vertebral and hip FRAX values were 13.5% and 4%>respectively. By DXA, osteoporosis of the lumbar spine and hip was detected in 10 and 10 patients, while osteopenia were found in 16 and 20 patients, respectively. With respect to pQCT, total and trabecular bone density in SSc patients (248.4 and 150.9 mg/cm3) was significantly lower than in healthy controls (354 and 193 mg/cm3, respectively). Higher OC levels were assocated with the diffuse form of SSc (R=0.330, p=0.035). Longer disease duration correlated with lower pQCT total (R=-0.341, p=0.023) and trabecular density (R=-0.336, p=0.026). Interestingly, most bone markers (P1NP, OC, CTX) positively correlated with gastrointestinal manifestations. Furthermore, pQCT total bone density was siognificantly lower in patients with pulmonary involvement, digital ulcer and anti-Scl70+. Conclusions A high proportion of SSc patients have osteopenia or osteoporosis, as well as low vitamin D levels. As determined by pQCT, trabecular loss is more common. Both total and trabecular bone loss, as well as bone markers may be associated with disease duration, anti-Scl70 and some organ manifestations. SSc patients should be screened and treated for osteoporosis. Disclosure of Interest None declared

Lézeralapú geológiai technikák felhasználhatósága a csontkutatásban: kalcium-oxid-eloszlás vizsgálata állati csont vékonycsiszolatain | Application of Laser-based geological techniques to bone research: Calcium oxide distribution analyses of animal bones

A csontszovet es a geologiai kepződmenyek szerkezeti felepitese kozotti hasonlosag lehetőve teszi, hogy a csontszovet szervetlen reszet matematikai modellekkel kozelitsuk. Az elemi osszetetel ellenőrizhető a lezerindukalt plazmaspektroszkopiai es induktiv csatolasu plazmaoptikai emisszios spektrometrias meresekből meghatarozott elemoxidkoncentracio-ertekekkel. A szamitasokbol es a laboratoriumi meresekből egyertelműen kovetkezik, hogy a csontszovet tulajdonsagait elsősorban a hidroxiapatit hatarozza meg. A szervetlen csontszerkezet igen jol tanulmanyozhato a lezerindukalt plazmaspektroszkopiai technikaval megbizhatoan merhető kalcium-oxid-koncentracioertekek eloszlasainak segitsegevel. Jelen tanulmanyban a szerzők him szarvasmarha labszarcsontjaibol keszult vekonycsiszolatokon szelveny menti, lezerindukalt plazmaspektroszkopiai meresekből szamitott kalcium-oxid-koncentracio eloszlasai mutatjak be. A kalcium-oxid-koncentracioertekek feluleti eloszlasait, „gyakorisagi eloszlasi” gorbek tamasztjak ala. A tobb csoportba sorolt kalcium-oxid-koncentracioertekek alapjan a corticalis es trabecularis csontszerkezet elesen megkulonboztethető. A szerzők a csontokon elvegzett kvantitativ komputertomografiai meresekből szamitott attenuacios egyutthato (osszsűrűseg) es geologiaban hasznalt „ρ”-sűrűseg kozott szignifikans pozitiv korrelaciot talaltak. Tovabba a kiszamitott „ρ”-sűrűseg es a meghatarozott atlag-kalcium-oxid-koncentracioertekek inverz korrelaciot mutattak. Orv. Hetil., 2014, 155(45), 1783–1793. | The structural similarities between the inorganic component of bone tissue and geological formations make it possible that mathematic models may be used to determine weight percentage composition of different mineral element oxides constituting the inorganic component of bone tissue. The determined weight percentage composition can be verified with the determination of element oxide concentration values by laser induced plasma spectroscopy and inductively coupled plasma optical emission spectrometry. It can be concluded from calculated weight percentage composition of the inorganic component of bone tissue and laboratory analyses that the properties of bone tissue are determined primarily by hydroxylapatite. The inorganic bone structure can be studied well by determining the calcium oxide concentration distribution using the laser induced plasma spectroscopy technique. In the present study, thin polished bone slides prepared from male bovine tibia were examined with laser induced plasma spectroscopy in a regular network and combined sampling system to derive the calculated calcium oxide concentration distribution. The superficial calcium oxide concentration distribution, as supported by “frequency distribution” curves, can be categorized into a number of groups. This, as such, helps in clearly demarcating the cortical and trabecular bone structures. Following analyses of bovine tibial bone, the authors found a positive association between the attenuation value, as determined by quantitative computer tomography and the “ρ” density, as used in geology. Furthermore, the calculated “ρ” density and the measured average calcium oxide concentration values showed inverse correlation. Orv. Hetil., 2014, 155(45), 1783–1793.A csontszovet es a geologiai kepződmenyek szerkezeti felepitese kozotti hasonlosag lehetőve teszi, hogy a csontszovet szervetlen reszet matematikai modellekkel kozelitsuk. Az elemi osszetetel ellenőrizhető a lezerindukalt plazmaspektroszkopiai es induktiv csatolasu plazmaoptikai emisszios spektrometrias meresekből meghatarozott elemoxidkoncentracio- ertekekkel. A szamitasokbol es a laboratoriumi meresekből egyertelműen kovetkezik, hogy a csontszovet tulajdonsagait elsősorban a hidroxiapatit hatarozza meg. A szervetlen csontszerkezet igen jol tanulmanyozhato a lezerindukalt plazmaspektroszkopiai technikaval megbizhatoan merhető kalcium-oxid-koncentracioertekek eloszlasainak segitsegevel. Jelen tanulmanyban a szerzők him szarvasmarha labszarcsontjaibol keszult vekonycsiszolatokon szelveny menti, lezerindukalt plazmaspektroszkopiai meresekből szamitott kalcium-oxid-koncentracio eloszlasai mutatjak be. A kalcium-oxid-koncentracioertekek feluleti eloszlasait, „gyakorisagi eloszlasi” gorbek tamasztjak ala. A tobb csoportba sorolt kalcium-oxid-koncentracioertekek alapjan a corticalis es trabecularis csontszerkezet elesen megkulonboztethető. A szerzők a csontokon elvegzett kvantitativ komputertomografi ai meresekből szamitott attenuacios egyutthato (osszsűrűseg) es geologiaban hasznalt „ρ”-sűrűseg kozott szignifi kans pozitiv korrelaciot talaltak. Tovabba a kiszamitott „ρ”-sűrűseg es a meghatarozott atlag-kalcium-oxid-koncentracioertekek inverz korrelaciot mutattak.

Application of Laser-based geological techniques to bone research: Calcium oxide distribution analyses of animal bones

A csontszovet es a geologiai kepződmenyek szerkezeti felepitese kozotti hasonlosag lehetőve teszi, hogy a csontszovet szervetlen reszet matematikai modellekkel kozelitsuk. Az elemi osszetetel ellenőrizhető a lezerindukalt plazmaspektroszkopiai es induktiv csatolasu plazmaoptikai emisszios spektrometrias meresekből meghatarozott elemoxidkoncentracio-ertekekkel. A szamitasokbol es a laboratoriumi meresekből egyertelműen kovetkezik, hogy a csontszovet tulajdonsagait elsősorban a hidroxiapatit hatarozza meg. A szervetlen csontszerkezet igen jol tanulmanyozhato a lezerindukalt plazmaspektroszkopiai technikaval megbizhatoan merhető kalcium-oxid-koncentracioertekek eloszlasainak segitsegevel. Jelen tanulmanyban a szerzők him szarvasmarha labszarcsontjaibol keszult vekonycsiszolatokon szelveny menti, lezerindukalt plazmaspektroszkopiai meresekből szamitott kalcium-oxid-koncentracio eloszlasai mutatjak be. A kalcium-oxid-koncentracioertekek feluleti eloszlasait, „gyakorisagi eloszlasi” gorbek tamasztjak ala. A tobb csoportba sorolt kalcium-oxid-koncentracioertekek alapjan a corticalis es trabecularis csontszerkezet elesen megkulonboztethető. A szerzők a csontokon elvegzett kvantitativ komputertomografiai meresekből szamitott attenuacios egyutthato (osszsűrűseg) es geologiaban hasznalt „ρ”-sűrűseg kozott szignifikans pozitiv korrelaciot talaltak. Tovabba a kiszamitott „ρ”-sűrűseg es a meghatarozott atlag-kalcium-oxid-koncentracioertekek inverz korrelaciot mutattak. Orv. Hetil., 2014, 155(45), 1783–1793. | The structural similarities between the inorganic component of bone tissue and geological formations make it possible that mathematic models may be used to determine weight percentage composition of different mineral element oxides constituting the inorganic component of bone tissue. The determined weight percentage composition can be verified with the determination of element oxide concentration values by laser induced plasma spectroscopy and inductively coupled plasma optical emission spectrometry. It can be concluded from calculated weight percentage composition of the inorganic component of bone tissue and laboratory analyses that the properties of bone tissue are determined primarily by hydroxylapatite. The inorganic bone structure can be studied well by determining the calcium oxide concentration distribution using the laser induced plasma spectroscopy technique. In the present study, thin polished bone slides prepared from male bovine tibia were examined with laser induced plasma spectroscopy in a regular network and combined sampling system to derive the calculated calcium oxide concentration distribution. The superficial calcium oxide concentration distribution, as supported by “frequency distribution” curves, can be categorized into a number of groups. This, as such, helps in clearly demarcating the cortical and trabecular bone structures. Following analyses of bovine tibial bone, the authors found a positive association between the attenuation value, as determined by quantitative computer tomography and the “ρ” density, as used in geology. Furthermore, the calculated “ρ” density and the measured average calcium oxide concentration values showed inverse correlation. Orv. Hetil., 2014, 155(45), 1783–1793.A csontszovet es a geologiai kepződmenyek szerkezeti felepitese kozotti hasonlosag lehetőve teszi, hogy a csontszovet szervetlen reszet matematikai modellekkel kozelitsuk. Az elemi osszetetel ellenőrizhető a lezerindukalt plazmaspektroszkopiai es induktiv csatolasu plazmaoptikai emisszios spektrometrias meresekből meghatarozott elemoxidkoncentracio- ertekekkel. A szamitasokbol es a laboratoriumi meresekből egyertelműen kovetkezik, hogy a csontszovet tulajdonsagait elsősorban a hidroxiapatit hatarozza meg. A szervetlen csontszerkezet igen jol tanulmanyozhato a lezerindukalt plazmaspektroszkopiai technikaval megbizhatoan merhető kalcium-oxid-koncentracioertekek eloszlasainak segitsegevel. Jelen tanulmanyban a szerzők him szarvasmarha labszarcsontjaibol keszult vekonycsiszolatokon szelveny menti, lezerindukalt plazmaspektroszkopiai meresekből szamitott kalcium-oxid-koncentracio eloszlasai mutatjak be. A kalcium-oxid-koncentracioertekek feluleti eloszlasait, „gyakorisagi eloszlasi” gorbek tamasztjak ala. A tobb csoportba sorolt kalcium-oxid-koncentracioertekek alapjan a corticalis es trabecularis csontszerkezet elesen megkulonboztethető. A szerzők a csontokon elvegzett kvantitativ komputertomografi ai meresekből szamitott attenuacios egyutthato (osszsűrűseg) es geologiaban hasznalt „ρ”-sűrűseg kozott szignifi kans pozitiv korrelaciot talaltak. Tovabba a kiszamitott „ρ”-sűrűseg es a meghatarozott atlag-kalcium-oxid-koncentracioertekek inverz korrelaciot mutattak.

SAT0346 Simultaneous assessment of bone loss in rheumatoid arthritis using peripheral quantitative CT and DEXA

Background Rheumatoid arthritis (RA) has been associated with secondary bone loss leading to osteoporosis in 60-70% of patients. Bone loss involves both the trabecular and cortical compartment. Traditional DEXA is not sufficient to assess bone loss in various compartments, however peripheral quantitative CT (pqCT) is. Objectives Simultaneous assessment of bone density was performed using DEXA and pqCT. Bone assessments were correlated with clinical parameters and ACPA status. Methods pqCT assessment was performed by a Stratec XCT-2000 instrument. Altogether 48 RA female patients and 10 female healthy controls were recruited. Forearm pqCT, as well as lumbar spine and femoral neck DEXA assessments were performed. Anti-CCP was determined by a second generation ELISA. Results The mean age of patients was 53.6±13.8 years and the mean disease duration was 13.5 years. Altogether 75% of patients were anti-CCP positive. In RA, total, cortical and trabecular attenuation, as well as bone density were decreased compared to controls as determined by pqCT (p<0.005). Total and cortical pqCT density exerted inverse correlation with age, while total, cortical and trabecular pqCT showed positive correlation with lumbar and femoral neck BMD as determined by DEXA (p<0.05). Trabecular, but not cortical pqCT density inversely correlated with anti-CCP positivity (p=0.04). Conclusions In RA, pqCT revealed cortical and trabecular bone loss. Moreover, anti-CCP, a marker of autoimmunity and a prognostic factor associated with joint erosions, also correlate with trabecular osteoporosis. In RA, as well as primary osteoporosis, pqCT may be a useful tool to assess trabecular and cortical bone loss. Disclosure of Interest None Declared