L. Coladonato

Early Lupus Project - A multicentre Italian study on systemic lupus erythematosus of recent onset

Background Systemic lupus erythematosus (SLE) is an autoimmune disease with a high degree of variability at onset that is problematic for a correct and prompt diagnosis. We undertook this project with the purpose of collecting an inception cohort of Italian patients with recent-onset SLE, in order to obtain information on the main clinical and serological characteristics at the beginning of the disease. In this first report we describe the characteristics of this cohort at study entry. Methods All patients with a diagnosis of SLE (1997 ACR criteria) and a disease duration less than 12 months were consecutively enrolled between 1 January 2012 and 31 December 2013 in a multicentre prospective study. Information on clinical and serological characteristics at study entry and then every six months was collected into a specific electronic database. Statistical analysis was performed by means of the Openstat program. Results Among 122 patients enrolled (103 F) 94.3% were Caucasians. Mean age (SD) of patients at study entry was 37.3 (14.3) years, mean age at disease onset was 34.8 (14.3) years, mean age at diagnosis was 36.9 (14.3) years, and mean disease duration was 2.9 (3.9) months. The frequency of the manifestations included in the 1997 ACR criteria was as follows: ANA 97.5%, immunologic disorders (anti-dsDNA, anti-Sm, antiphospholipid antibodies) 85.2%, arthritis 61.8%, haematologic disorders 55.7%, malar rash 31.1%, photosensitivity 29.5%, serositis 27%, renal disorders 27%, oral/nasal ulcers 11.5%, neurologic disorders 8.2%, and discoid rash 5.7%. The cumulative frequency of mucocutaneous symptoms was 77.8%. At enrolment, autoantibody frequency was: ANA 100%, anti-dsDNA 83.6%, anti-SSA 28%, anticardiolipin 24.5%, anti-nRNP 20.4%, anti-beta2GPI 17.2%, lupus anticoagulant 16.3%, anti-Sm 16%, and anti-SSB 13.1%. Conclusions In this paper we describe the main clinical and serological characteristics of an Italian inception cohort of patients with recent-onset SLE. At disease onset, mucocutaneous manifestations, arthritis and haematologic manifestations were the most frequent symptoms; ANA, anti-dsDNA and complement reduction were the most frequent laboratory findings. Our data confirm that the diagnosis of SLE is a challenging one, and that SLE is a severe disease even at onset, since the majority of patients require at least a hospitalization before the diagnosis.

AB0191 Anti-ssa and anti-jo1 levels in interstitial lung disease related to idiopathic inflammatory myopathies

Background The lung is the most frequently involved extramuscular organ in idiopathic inflammatory myopathies (IIMs); the most common form of lung involvement is interstitial lung disease (ILD). Some autoantibodies are strongly associated with ILD and with specific phenotypes and prognosis of ILD. Among myositis-specific auto-antibodies (MSAs), antibodies against aminoacyl-tRNA-synthetases (AsAb) are the strongest predictive factors for ILD, and anti-Jo-1 is the most common AsAb. Among myositis-associated auto-antibodies (MAAs), anti-SSA/Ro52 is frequently found in sera of patients with IIM and ILD, often associated with anti-Jo-1. The coexistence of anti-SSA/Ro52 and anti Jo-1 seems to be related to a more severe and extensive pulmonary fibrosis with higher score in HRCT compared with the patients with only anti-Jo-1 antibodies. Furthermore, some reports suggest that presence of anti-Jo-1 could be a biomarker for good prognosis1. The significance of antibodies levels for the prognosis of ILD in IIMs was not widely investigated. Objectives To investigate the relationship between antibody levels and clinical manifestations, laboratory data, pulmonary function tests (PFTs), disease activity indices in ILD associated to IIMs. Methods Among 130 IIMs admitted to Rheumatology Unit of Bari from January 2010 to January 2018, we retrospectively examined 49 patients (40 F; 22 PM, 25 DM, 1 IBM; mean age at ILD onset 51 years, range: 23–83) because of ILD defined by high resolution computed tomography (HRCT). Clinical manifestations, laboratory data, HRCT pattern, PFTs (FVC, FEV1 and DLCO), therapy, disease activity as Manual Muscle Test (MMT-12), Health Assessment Questionnaire (HAQ), Physician Global Assessment (PGA) at ILD onset, were obtained from medical records. Ferritin levels and autoantibodies were detected in serum samples collected at ILD onset. ANA were tested by IIF on HEp-2 cell substrates, MSAs (JO1, EJO, OJ, PL7, PL12, SRP, HMGCR, Mi2, TIF1γ, MDA5, NXP2, SAE) and MAAs (Ro52, Ku, PM/Scl 75–100, RNP, Scl70) by line-blot method. Anti-SSA and anti-Jo1 were also detected by CLIA method. Correlation analysis were run using parametric and non-parametric test according to data distribution. Results 45 of 49 (91,8%) patients were positive for MSAs and/or MAAs. 40 of 45 (88%) were positive at least one of MSAs. The double presence of MSAs and anti-Ro52 was observed in 21 of 40 (52,5%), showing anti-Jo1/SSA in most cases (15/21, 71,4%). Among all correlations studied between anti-Jo1 or anti-SSA levels and PGA or PFTs, we found a significantly correlation between anti-Jo1 and PGA (p=0,03, R=0,46). We didn’t find significantly correlation between autoantibodies and ferritin serum levels. Conclusions These findigs confirm that ILD was associated with autoantibodies positivity. Further studies in larger cohort need to investigate if autoantibodies levels have a prognostic role in global outcome. Unlikely some controversial works in literature, serum ferritin does not seem a biomarker of severity of lung involvement in IIMs. Reference [1] Labirua A, et al. Interstitial lung disease and idiopathic inflammatory myopathies: progress and pitfalls. Curr Opin Rheumatol2010. Disclosure of Interest None declared

OP0129 Drug survival on anti-tnf-alpha in psoriatic arthritis patients with axial involvement and analysis of predictors

Background A few studies have focused on the clinical outcomes in predominant axial Psoriatic Arthritis (PsA) patients treated with anti-TNF-α agents1–3 in real-life settings. Objectives Primary endpoint: to evaluate drug survival on anti-TNF-α agents in PsA patients with axial involvement or axial and either polyarticular or oligoarticular peripheral arthritis. Secondary endpoints: to evaluate the presence of any predictor of discontinuation of anti-TNF in PsA patients with axial involvement and to investigate whether peripheral arthritis may impact the discontinuation for ineffectiveness in patients with axial disease. Methods 415 biologic therapy-naive PsA patients (CASPAR criteria) starting a first TNF-inhibitor from January 2010 to December 2016 were screened. Among these, 87 had axial involvement (ASAS criteria) with imaging arm (X-ray or MRI) and were enrolled: 40 with axial and polyarticular peripheral PsA (Axe +Poly PsA), 38 with axial and oligoarticular peripheral PsA (Axe +Oligo PsA) and 9 with only axial disease (Ax-PsA). At baseline and at last available visit or drug discontinuation, we collected age, gender, disease duration, BMI, HLA-B27, nail psoriasis and/or dactylitis, TJC, SJC, ESR, CRP, enthesitis, LEI, DAPSA, BASDAI, ASDAS-CRP, PASI, HAQ, intake of glucocorticoids and DMARDs, anti-TNF therapy discontinuation and reasons of discontinuation. Drug survival was evaluated by Kaplan-Meier life table method, comparison of survival curves with Log-rank test and baseline predictors of drug discontinuation with Cox regression analysis. Results At baseline, Axe +Poly PsA patients had significantly higher peripheral (DAPSA) and axial disease activity (BASDAI, ASDAS-CRP). Stratifying patients by subset of disease, the median of treatment was 51 months (95% IQR 24.87–77.13) for Ax-PsA group, 50 months (95% IQR 28.39–71.61) for Axe +Oligo PsA group, 30 months (95% IQR 11.84–48.15) for Axe +Poly PsA group (figure 1). Axe +Oligo PsA patients had significantly higher persistence on TNFi rather than Axe +Poly PsA patients (log rank test, p=0.03). Axe +Poly PsA patients had higher risk of stopping TNFi (Cox regression, HR 3.75) and significantly higher percentage of discontinuation for ineffectiveness rather than for an adverse event (χ2 test, p=0.0009). At last observation, Axe +Poly PsA patients had higher DAPSA but no difference in axial disease activity (t-STUDENT test, Mann-Whitney test).Abstract OP0129 – Figure 1 Drug survival on TNF-inhibitor in Ax-PsA, Axe+Oligo-PsA and Axe+Poly-PsA patients (Kaplan-Meier life table method, log rank test) Conclusions PsA subsets seems to have different features, behaviour, clinical response and drug survival on TNF-inhibitors. Axe +Poly PsA subset seems to be more aggressive and difficult to treat. Anti-TNF-α blockers may perform differently in PsA: a more accurate analysis of the clinical disease subsets may improve our knowledge and better management of PsA in daily practice. References [1] Lubrano E, et al. Clin Exp Rheumatol2011Jan-Feb;29(1):80–4. [2] Lubrano E, et al. J Rheumatol2016May;43(5):918–23. [3] Perrotta FM, et al. J Rheumatol2016Feb;43(2):350–5. Disclosure of Interest None declared

SAT0217 Axon Reflex Vasodilatation of Digital Arteries in Systemic Sclerosis Patients, Evaluated by Laser-Doppler Fluxmetry

Background Systemic sclerosis (SSc) is a connective disease characterized by severe microvessels vasculopathy. The important role of endothelial dysfunction in SSc pathogenesis is widely demonstrated, but the SSc related autonomic nervous system impairment is controversial and rarely described. The dysregulation of axon reflex vasodilatation of fingertip microvessels in SSc has been reported in some studies, but the functional involvement of digital arteries in SSc patients had never been investigated. Objectives We aimed at evaluating the blood flux changes mediated by axon reflex response upon heating stimulus in SSc patients. Methods 87 SSc patients (SSc pt) and 22 healthy controls (HC) were recruited in this study. The SSc patients were aged 52,7±16,2 yrs, with disease duration of 8,23±7,8 yrs. The LD Flowmetry (Periflux System 5000, Perimed) with 4 LD heating probes was used to measure the skin blood flux of the middle phalanx of the 2nd, 3rd, 4th and 5th fingers of the left hand. The skin fingers flux was recorded at pre-heating period with probes temperature fixed at 34 °C (PHF) and after 5 min heating at 44 °C (IHF). Therefore, the heating test assesses the variation of digital artery flux in response to local heating stress at 44 °C. The ratio IHF/PHF evaluates the axon reflex mediated vasodilatation (ARMV). The results are expressed as average across 4 fingers at each time. The flux was expressed in perfusion unit (PU) and HC and SSc patients responses were compared by the t-student test. Statistic significance was set at p≤0,05. The data analysis was performed using IBM SPSS statistic 20. Results The ARMV was significantly reduced in SSc patients (2,2±1,4) in comparison with HC (4,8±2,7, p=0,0001). IHF was lower in SSc patients (118,6±54,3) than HC (168±78, p=0,001). Dividing the SSc pts group by the presence of pitting scars (PS), digital ulcers (DU) and digital necrosis (DN), we observed a lower IHF in SSc pts with PS (103,2±48,6) than in SSc pts without (138,1±56, p=0,003), and in SSc pts with DU (97,8±47,6) than in SSc pts without (160,27±120,1, p=0,002). Moreover, SSc pts with ND showed a lower ARMV (1,8±1) than SSc pts without (2,6±1,5, p=0,006), and a lower IHF (98,3±49,1 vs 133,2±54,5, p=0,004). The age, sex, concomitant therapy with Ca-antagonist or Bosentan or cardioaspirin did not influence the digital artery flux. Conclusions This study provided evidence that a functional impairment of DA occurs in SSc, and it worsens with increasing severity of vascular clinical manifestations. Disclosure of Interest None declared

SAT0216 Chest Ultrasound Signs of Interstitial Lung Disease in Systemic Sclerosis Patients: A Comparison between High Resolution Chest Computed Tomography Findings

Background Interstitial lung disease (ILD) is a typical clinical manifestation in Systemic Sclerosis (SSc). The high resolution chest computed tomography (HRCT) is the gold standard to evaluate and grade ILD. The presence of fibrotic tissue in the lung, or other structures beside the air, allows obtaining specific sonography images (such as ultrasound lung comet, higher pleural line thickness, irregular pleural margins and subpleural cysts) by chest ultrasound. In previous studies it was demonstrated that the ultrasound comets number increases in SSc patients. Objectives We aimed at correlating the specific lung sonography signs with ground glass and honeycombing pattern detected by chest HRCT. Methods A total of 60 SSc outpatients (54 female, mean age 56,2 ± 13,8 ys and disease duration of 9,57±8,7 ys), who fulfilled ACR/EULAR 2013 SSc classification criteria, were recruited. All patients underwent chest HRCT and US examination. The US examination was performed with 7,5 Mhz probe and conducted with patients in sitting position from paraspinal line to anterior axillary line, for each intercostals space. The presence of typical ultrasound signs as lung comets (pathological if >35), higher pleural line thickness (pathological if >2mm), irregular pleural margins, subpleural cysts and pleural effusion was detected. The sensitivity, specificity and accuracy of US patterns (compared to chest HRTC) were evaluated by ROC analysis. Statistic significance was set at p<0.05. All results are expressed as mean ± 1 standard deviation. Results 23 patients had the CT honeycombing pattern, of which 92% had the US irregular pleural margins, 70% had US higher pleural line thickness and sub-pleural cysts, just 54% had US lung comets. 16 patients had the CT ground glass pattern, of these in 94% the US irregular pleural margins, in 87% US lung comets, in 60% US higher pleural line thickness were found. As regard the CT ground glass pattern the US sign with the highest specificity (91%), sensibility (85,7%) and accuracy (88%) was the lung comets; while regarding the CT honeycombing pattern the US sign with the highest specificity (92%), sensibility (69,6%) and accuracy (82%). Conclusions The lung US is a good diagnostic technique for its repeatability, low cost and risklessness. Although HRCT remains the best imaging technique to assess the ILD, in SSC the lung US could be a useful tool to detect the presence or the evolution of ILD and to improve the timing of HRTC without exposing the patients to high radiation doses over time. Disclosure of Interest None declared

OP0050 Serum Levels of Adipokines in The Categories of Body Mass Index (BMI) in Patients with Systemic Sclerosis

Background Adipose tissue is a source of factors stimulating the pro-oxidative-antioxidant system, such as adipokines, whose functions are closely associated with metabolic abnormalities and damage by oxidative stress. There are only few reports in literature about the correlation between body mass index (BMI), serum levels of adipokines and clinical manifestations of SSc. Objectives We evaluated serum levels of adipokines (leptin, resistin, visfatin, adiponectin) and cytokines (TNFα, IFNγ, IL-2, IL-10, IL-17) in SSc and controls (HD) and their pattern according the clinical and laboratory SSc features. Methods 89 SSc pts satisfying ACR EULAR criteria (age 52 ± 14.4 years and disease duration of 8.14 ± 6.6) and 26 HD were enrolled. Serum levels of Adiponectin, Leptin, Resistin, Visfatin, TNFα, IFNγ, IL-2, IL-10, IL-17A were measured using Bio-Rad kits and Multiplex Immunoassay tool. In all participants we collected clinical and laboratory features, such as visceral involvement, BMI, WHR (Waist to Hip Ratio), index of cardiovascular risk, acute phase reactants, cholesterol, triglycerides, smoking status, comorbidity and therapy. Data were analysed using IBM-SPSS Statistics 20 software. Mann-Whitney U-test or t-Student for unpaired data or Kruskal-Wallis test or ANOVA were used for comparison between groups. Spearmans or Pearsons test were used for correlations. A p-value ≤0.05 was considered statistically significant. Results The weight of SSc and HD differed (p<0,05) which was higher in HD. Serum levels of Leptin, Resistin, Visfatin and IL-10, IL-17 were increased in SSc compared to HD (p<0.05). In SSc, TNFα serum levels were not different from HD. Leptin levels positively correlated with body weight and BMI that in turn correlated with the values of ESR, CRP, WHR, triglycerides and cholesterol serum levels. Increased levels of IL-2, IL-10, IL-17, IFNγ, Leptin and Visfatin were found in overweight/obese SSc pateints (p<0.05) in respect to HD. TNFα was significantly increased in underweight patients (p=0.03) and there was a significant difference compared with normal weight (p=0.018). TNFα levels correlated with IL-2, IL-10, IL-17 and IFNγ levels and with esophageal involvement. There were no differences in cytokine levels between groups when correlated to skin subset, disease duration (Early/Late) and different class of cardiovascular risk. In HD, no statistically significant correlation between weight, TNFα and Leptin levels was detected. Conclusions Adipokines may play a role in inflammatory and immune pathways in SSc pathogenesis. The present data suggest a role for Leptin and TNFα as new potential SSc related circulating biomarker. Categories of modified BMI (underweight and obesity) seem to be associated to a different and a significant organ involvement in SSc. In underweight subjects, the increase of TNFα may be involved in the cachectic status, thus the role of TNFα needs be confirmed in further prospective longitudinal studies investigating also its correlation with disease severity and activity. References Pehlivan Y et al. Serum leptin, resistin and TNFa levels in patients with systemic sclerosis: the role of adipokines in scleroderma, Int J of Rheum Dis 15, 374–379, 2012 Disclosure of Interest None declared

FRI0410 Factors Associated with Early Damage Accrual in Patients with Systemic Lupus Erythematosus: 12-Month Preliminary Results from the Inception Cohort of the Multicenter Early Lupus Project

Background Preventing organ damage is a major challenge in management of Systemic Lupus Erythematosus (SLE). Few data are available on factors related to development of damage in early stages of the disease. Objectives To evaluate the early damage accrual and factors determining development and progression of damage in a prospectively followed cohort of SLE patients. Methods The Early Lupus Project comprises 8 Italian centers recruiting, from the 1st January 2012, an inception cohort of consecutive patients diagnosed with SLE. Patients were enrolled within 12 months of recognition of four or more 1997 ACR classification criteria for SLE. At study entry and then every 6 months a large panel of data was recorded. Here, we report on the development and progression of damage assessed by the SLICC/ACR Damage Index (SDI) at 6-month and 12-month of disease. Using univariate analysis, we assessed the contribution of covariates collected at baseline (demographic, serological, clinical by BILAG2004 domains, disease activity by ECLAM index and health related quality of life by visual analogic scale) in the development of damage (SDI from 0 to ≥1) and increase in pre-existing damage within 12 months from diagnosis. Stepwise regression models were fitted with covariates with p<0.1 to identify factors independently associated with prediction of damage. Results A total of 161 patients were enrolled in the Early Lupus Project inception cohort up to December 2014; 108 patients (93% Caucasians, 17 males) were eligible for this study having at least 12 months of disease. Mean age at recognition of 4 ACR criteria was 36.3±14.1 years, mean disease duration at recruitment was 2.8±4.3 months (median =1 month; interquartile range 0-3.8). At 6 months of disease, 22 (20.3%) patients had an SDI score of 1 or more (20 patients scored SDI=1; 4 patients scored SDI=2; 3 patients scored SDI≥3). At 12 months of disease, 27 (25.0%) patients had an SDI score of 1 or more and only one patient had increase in pre-existing damage. Age (p=0.01), dyslipidemia (p<0.001), number of active clinical domains according to the BILAG2004 index (p<0.01), active neuropsychiatric (p<0.01) or cardiorespiratory (p=0.02) involvement, familial history of ischemic cardiovascular events (p=0.02) registered at baseline resulted associated with development of damage. Age at diagnosis (p<0.001; OR 1.1 95% CI 1.0-1.3) and active neuropsychiatric involvement (p<0.01; OR 18.7 95% CI 3.1-110.9) were the only independent risk factors for early development of damage in this cohort. No influence of active renal involvement and medications prescribed at baseline was detected in our cohort, likely because they most contribute to development of late-onset damage. Conclusions Development of organ damage begins early in patients with SLE as effect of modifiable and non-modifiable risk factors. Addressing these since the very early stages of the disease may improve short-term outcome. Disclosure of Interest None declared

AB0714 Improvement of Refractory Dysphagia in Patients with Idiopathic Inflammatory Myopathies Receveing Immunoglobulin Intravenous Therapy

Background Polymyositis (PM) and Dermatomyositis (DM) are systemic inflammatory diseases affecting skeletal muscles and other organs, particularly hypopharynx and the upper tract of the esophagus, resulting in motility disfunction. The current treatment for PM and DM consists of steroids and immunosuppressants, but esophageal involvement is often refractory to standard therapies. Objectives To assess the efficacy and safety of intravenous immunoglobulins (Ig-iv) as therapy of refractory dysphagia in patients affected by idiopathic inflammatory myopathies (IIM) who have received conventional treatments for at least three months. Methods We enrolled 11 patients (9 F), 4 with DM, 7 with PM according to Bohan and Peter criteria. At baseline, all patients had received prednisone (5-10 mg/day) associated to Methotrexate (15 mg/wk) or Azathioprine (100 mg/day) for at least 3 months, without improvement of dysphagia. All patients received Ig-iv at a standard dose (2 g/kg/day only for a day). In all patients at entry and after each infusion VES 1h, PCR, LDH, CK levels were measured and Manual Muscle Strength Test (MMT12 e MMT-tight) was made. Dysphagia assessment included: Eating Assessment Tool (EAT; positive for score ≥3), Three-oz Swallow Test (3oST) and fibrolaryngoscopy (FEES –pharyngeal muscle propulsion, stasis of liquid and solid bolus). For the statistical analysis we used Wilcoxon Rank test, Fisher Exact Test, Chi-square test. Results At entry, there was evidence of correlation between MMT-12 and MMT-tight (p=0,005); CK and LDH levels were increased and EAT score was ≥3 in all patients. After the Ig-iv therapy we observed a statistically significant decrease in LDH levels (p=0,024), mainly between T0 and T1 (p<0,05); there was also a downward trend in CPK levels (p=0,098). Furthermore, we observed a statistically significant change of both MMT-12 (p=0,017) and MMT-tight (p=0,027). In addition we found a decrease of EAT score (p=0,186), an improvement of pharyngeal muscle propulsion and a partial resolution of liquid stasis. Conclusions According to literature, our findings indicate that Ig-iv therapy improves muscle weakness. Furthermore, a meaningful improvement of dysphagia also occurred, suggesting that Ig-iv may be considered an effective and safe treatment for refractory dysphagia in IIM patients. Further studies of larger cohort of patients are needed to confirm our results and evaluate the outcomes across time. References Marie I et al. Intravenous immunoglobulins for steroid-refractory esophageal involvement related to polymyositis and dermatomyositis: a series of 73 patients. Arthritis Care Res (Hoboken). 2010 Dec;62(12):1748-55. Dalakas MC. The role of high-dose immune globulin intravenous in the treatment of dermatomyositis. Int Immunopharmacol. 2006 Apr;6(4):550-6. Epub 2005 Dec 20. Belafsky PC et al. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008 Dec;117(12):919-24. Schindler A. et al. Reliability and validity of the Italian Eating Assessment Tool. Ann Otol Rhinol Laryngol. 2013 Nov; 122(11):717-24. Katz U et al. Safety of intravenous immunoglobulin (IVIG) therapy. Autoimmun Rev. 2007 Mar;6(4):257-9. Epub 2006 Aug 28. Disclosure of Interest None declared

THU0194 Lipid Profile of Rheumatoid Arthritis Patients Treated with Anti-TNF-Alpha Drugs Changes According to Disease Activity Response

Background Rheumatoid arthritis (RA) patients present increased mortality due to cardiovascular (CV) events, particularly by inflammation in addition to traditional CV risk factors (mainly changes in lipid profile). Although anti-TNF agents have been proven effective in controlling joint damage and systemic inflammation, nowadays there is still controversy about the real effect of anti-TNF treatment on the lipid profile. Objectives The aim of this study is to evaluate the evolution of the lipid profile after the onset of anti-TNF therapy. Methods Eighty RA patients (65 female, age 53±13 years, disease duration 7±5 years), who failed treatment with DMARDs, have been enrolled in this study, and evaluated, before and at 24 and 52 weeks from the start of anti-TNF treatment, for the following lipid profile: Total-cholesterol (Tot-C), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), triglycerides (TG), and cholesterol risk ratio (CRR) [Tot-C/HDL-C] was also calculated. At the same time the disease activity scores CDAI, SDAI, DAS44 and DAS28, four variables, were assessed. Twenty-nine patients were treated with etanercept, 19 with adalimumab, 18 with infliximab, 7 with certolizumab-pegol and 7 with golimumab. Results The levels of Tot-C, HDL-C, LDL-C and TG, as well as CRR, didn’t significantly changed during the follow-up period of treatment. Considering the disease activity according to CDAI, SDAI, DAS44 and DAS28, about 50% of patients achieved low disease activity/remission state after 24weeks and about 60% achieved this state after 52 weeks of treatment. In this latter group of patients we observed significantly lower levels of Tot-C, LDL-C, and TG, and a lower CRR compared to those observed in patients with moderate/high disease (see Table). No significant differences were found between the anti-TNF evaluated. Conclusions Our study suggest that anti-TNFα treatment per se do not interfere with the lipid profile of RA patients. While according to response to TNFα treatment, assessed by CDAI, SDAI, DAS44 or DAS28, patients that achieved low disease activity/remission seems to have a protective lipid profile for CV events, so a better control of the disease can also affect the lipid metabolism. Disclosure of Interest None Declared