S. Apras Bilgen

AB0641 Comparing the Characteristics of Adult and Pediatric Patients with Polyarteritis Nodosa

Background Polyarteritis nodosa (PAN) as a necrotizing vasculitis of medium or small arteries without glomerulonephritis or vasculitis in arterioles, venules or capillaries and not associated with antineutrophil cytoplasmic antibodies. It is more common in middle-aged adults when compared with children. Objectives The aim of this study was to examine and compare the clinical characteristics of adult and pediatric patients with PAN. Methods Six pediatric (<18 years of age) and ten adult patients with a clinical diagnosis of PAN who were seen at the Departments of Rheumatology and Pediatric Rheumatology, Hacettepe University, Ankara, Turkey were included in the study group. The pediatric and adult patients were classified as PAN according to the Ankara 2008 and American College of Rheumatology (ACR) 1990 criteria, respectively. The clinical features and response to therapy were evaluated retrospectively. Results The characteristics of PAN patients were summarized in Table 1. According to the results with a statistical significance, female/male ratio was higher in children; neurologic and renal involvements were more common and the duration of induction treatment was longer in adults. 2/10 adult and 3/6 pediatric patients had accompanying familial Mediterranean fever. Ninety percent of adult patients had received cyclophosphamide plus corticosteroid for induction treatment while four pediatric patients received CYC and two received mycophenolate mofetil besides corticosteroid treatment. Conclusions Our study, although the number is limited, have shown that neurologic and renal involvement were more common in adults with PAN and the duration of induction treatment was longer when compared with pediatric patients. There is no previous study comparing the characteristics of pediatric and adult patients with PAN; however, according to the previous studies, juvenile PAN has a more benign course than adult onset PAN. Multicenter collaboration remains essential to determine the characteristic features of PAN in patients of different age groups. References Eleftheriou D, Batu ED, Ozen S, Brogan P. Vasculitis in children. Nephrol Dial Transplant 2014 Dec 30. pii: gfu393. [Epub ahead of print]. Ozen S, Pistorio A, Iusan SM, et al. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010;69:798-806. Lightfoot RW Jr, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum 1990;33:1088-1093. Disclosure of Interest None declared

AB1403-HPR Investigation of the validity of bety scale in patients with rheumatoid arthritis

Background The Cognitive Exercise Therapy Approach is a biopsychosocial model for the patients with rheumatic diseases.1 Cognitive Exercise Therapy Approach Scale (the authors request that the abbreviation stay as “BETY” as the original in Turkish) is a scale that evaluates the biopsychosocial status of the patients with rheumatic diseases. This scale needs validation studies in different rheumatic diseases.2 Objectives The aim of this study is to investigate the validation of the BETY scale in patients with Rheumatoid Arthritis (RA). Methods 120 RA patients were included in this study. To determine the functional status of the patient Health Assessment Questionnaire (HAQ) was used. Rheumatoid Arthritis Quality of Life Scale (RAQoL) and 36-Item Short Form Survey (SF-36) were used to measure quality of life. Hospital Anxiety and Depression Scale (HADS) was used to determine anxiety and depression levels. BETY scale was used to in addition to this questionaires for the validation. Results 120 RA patients including 13 men and 107 women were participated in the study. The average age of the participating patients was 28,47±11,39 years and the body mass index was 28.4±6,56. There was a very high correlation between the BETY scale and RAQoL (r=0,817, p<0,001). There was high correlation between the BETY scale and subscale of the HADS-Anxiety, HAQ and subscale of the SF-36 Pain (r=0,617, p<0.001; r=0,606, p<0.001; r= −0, 610, p<0.001, respectively). There was moderate correlation between the BETY scale and subscale of the HADS-Depression, subscales of the SF-36 form Physical Functioning, Role Limitations, Role Limitations Due to Emotioal and General Health Perception (r=-0,597, p<0,001; r=-0,576, p<0,001; r=-0,525, p<0,001; r=-0, 598, p<0,001; r=-0, 420, p<0,001, respectively) (Table 1–2). Conclusions There were high or moderate correlations between the BETY scale and valid and reliable scales that are developed for these parameters. The BETY scale can be considered as a valid scale in patients with RA. References [1] Kisacik P, Unal E, Akman U, Yapali G, Karabulut E, Akdogan A. Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis. Complementary therapies in clinical practice. 2016;22:38–43. [2] Ünal E, Arin G, Karaca Nb, Kiraz S, Akdoğan A, Kalyoncu U, et al. Romatizmalı hastalar için bir yaşam kalitesi ölçeğinin geliştirilmesi: madde havuzunun oluşturulması. Journal of Exercise Therapy and Rehabilitation. 2017;4(2):67–75. Disclosure of Interest None declared

THU0452 Anti-interleukin-6 (TOCILIZUMAB) experience in takayasu’s arteritis patients

Background Targeted therapies such as tumour necrosis factor inhibitors (TNFi) and anti-interleukin 6 (anti-IL-6) are increasingly being used in Takayasu’s Arteritis (TA) patients who are unresponsive to corticosteroids±conventional immunosuppressives. Objectives The aim of this study was to evaluate the indications and efficacy of anti-IL-6 (tocilizumab) therapy in a case series of TA patients. Methods In the prospective database of the Hacettepe University Vasculitis Centre (HUVAM), 105 TA patients meeting the 1990 modified American College of Rheumatology (ACR) criteria were registered at the end of July 2017. Total 28 (26,7%) patients were treated with biological therapy and 22 (21.0%) of them were taking tocilizumab. Patients were assessed using a combination of clinical, laboratory and radiological evaluation before and after Tocilizumab therapy. The demographic and clinical characteristics of the patients, the pre-tocilizumab and end of the follow–up acute phase values (Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)), visual analogue scales (VAS) (Pain, Fatigue, Patient Global), and concomitant therapies were recorded. Other clinical, imaging and laboratory results of the TA patients were obtained from hospital files. The comparative imaging (Computed Tomography and Magnetic Resonance Imaging) results of the patients just before the Tocilizumab therapy and during follow-up were recorded from the hospital data system. Results Twenty-two patients (86.4% female) were included in to the analysis. The median (minimum-maximum) age of the patients was 4024–63 years and the median disease duration (from diagnosis) was 4812–168 months. Before tocilizumab therapy; cyclophosphamide (8 patients (36.4%), conventional immunosuppressives (21 patients, 95.4%) and TNFi (7 patients, 31.8%) were used in addition to corticosteroid therapy. Main indications for tocilizumab therapy was as follows; radiological progression in 9 patients (acute phase was normal in 2 of them), acute phase elevation in 8 patients (4 of them radiologically stable, 4 of them had no radiologic evaluation), physician’s decision and clinical symptoms in 3 patients (acute phase normal; 2 of them radiologically stable, one had no radiologic evaluation), in two patients tocilizumab therapy was started out of our centre and data before tocilizumab was not available. Fifteen patients (median follow-up time 153–42 months) were evaluated for response to tocilizumab treatment. There was a significant decrease in ESR, CRP, and VAS-patient-global of patients after tocilizumab therapy; median (min-max) ESR (265–119 vs. 3 (2–49) mm/s, p=0.02), CRP (39.8 (2.4–149.0) vs. 7.9 (0–92,9) mg/L, p=0,017), VAS-patient-global (50 (0–90) vs. 30 (0–60), p=0,027), respectively. Total of 9 patients had follow–up imaging; 8 of them was radiologically stable and regression was seen in one patient (figure 1). Table 1 Conclusions The use of biological therapies in more than a quarter of TA patients suggests that the role of conventional therapies in TA is limited. Although imaging modalities and acute phase elevations are the main factors in the decision of change in treatment, presence of symptoms and physician opinion are also important. Significant response was obtained with the treatment of tocilizumab. Disclosure of Interest None declared

AB0953 Psaid-12 can be used to determine the anti-tnf treatment decision in the psoriatic arthritis registry

Background Psoriatic Arthritis Impact of Disease (PsAID-12) score has 12 questions and each question has its own weight. PsAID-12 is developed to be used in daily practice. However, in the daily practice, there has been no information on the utilisation of determining the response of the biological DMARD treatment. Objectives The assessment of utilisation of PsAID-12 for PsA patients on determination of the efficiency and inefficiency of anti-TNF treatment in a biological registry. Methods In this study patients were taken from Hacettepe University biological database (HUR-BIO). Since January 2013 PsAID-12 score was built in HUR-BIO database. PsAID-12 score was known for 116 patients before starting off the first anti-TNF treatment and 88 patients whose PsAID-12 score was 4 and above were included in the enquiry. Overall, 70 PsA patients included to analysis. Demographic data before anti-TNF treatment of PsA patients were noted. The decision of continuation, stopping or switching to another anti-TNF drugs were performed by both clinicians and the patients agreement. According to baseline evaluation, decrease of 20 mm and above on pain-VAS score and PGA, improvement of 0.22 unit and above on HAQ-DI score, or decrease of 1.2 unit and above on DAS-28 score were considered favourable to the anti-TNF treatment. Stopping or switching the anti-TNF treatments due to inefficiency was definitely a negative response. Pain-VAS score being under 15 mm or below, global-VAS score being 20 mm and below, HAQ-DI score being 0.5 and below, DAS-28 score being 2.6 and below were determined as targeted goals. Changes were analysed comparing to baseline level in PsAID-12 score, in compliance with the favourable and unfavourable responses to Anti-TNF treatments. In determining the response of the treatment, standardised response mean (SRM) was used. Results Seventy (78.6% female) patients were analysed, mean age was 45.5 (12.0). Mean follow-up duration was 18.3 (12.6) months, and total of 213 clinical visits were performed, median 31–8 control visits were done. At baseline, the mean (SD) DAS-28 4.07 (1.22), HAQ-DI 0.86 (0.53), pain-VAS 6.9 (2.1), PGA-VAS 6.4 (1.7), and PsAID-12 6.6 (1.5) were as follows. Anti-TNF treatments were stopped due to inefficacy in 43/210 (20.5%) outpatient visit during the follow-up period. The results of anti-TNF stopped and continuing patients; Δ PsAID-12 were 0.38 (1.71), and 3.12 (2.14), respectively and PsAID-12 baseline/control visits 0.96 (0.29) vs 0.50 (0.33), respectively. Level of favourable response and achieving to goal according to ΔPsAID-12 and PsAID-12 Baseline/control visit were shown table 1. On the follow up visits, among measured parameters one of the highest SRM was detected in PsAID-12; PsAID-12 (1.10), DAS-28 (1.14), PGA (0.88), Pain (0.85), and HAQ-DI (0.51), respectively.Abstract AB0953 – Table 1 Goals and responses of Anti-TNF treatment Conclusions Having 3.5 unit or 50% decrease in the PsAID-12 score indicates a favourable response to anti-TNF treatment, 4 unit or 70% decrease indicates level of targeted response. PsAID-12 appears to be an effective composite index for retaining the response of the treatment in biological registry. Disclosure of Interest None declared

SAT0608 How to differentiate adult onset still’s disease from overall other causes of fever of unknown origin: results of a prospective study from a tertiary referral centre

Background Adult onset Still’s disease (AOSD) is a rare, auto-inflammatory disease that commonly presents as fever of unknown origin (FUO), and most common rheumatologic cause of FUO. Clinical and/or laboratory parameters that can discriminate AOSD from other causes of FUO need to be clarified in current literature. Objectives To determine clinical and/or laboratory parameters that help to differentiate AOSD from other causes of FUO and demonstrating a clinician-friendly algorithm for this purpose. Methods Data from patients who admitted to Hacettepe University Hospitals, inpatients sections of department of internal medicine with the complaint of FUO, who eventually had a certain diagnosis, collected prospectively during 30 months. AOSD patients followed at Hacettepe University department of rheumatology were included. Clinical and laboratory data were collected at the time of diagnosis of AOSD and time of admission of patients with FUO. Results Total 156 patients (n=69, for AOSD; n=87, for FUO) were included. FUO group were also divided into three subgroups: rheumatologic (n=31, 35.6%), infectious (n=28, 32.2%) and malignant (n=28, 32.2%) causes. While 51 (74%) patients were female in AOSD group, 43 (49,4%) patients were female in FUO group (p=0.03). Frequency of rash, arthralgia, arthritis, sore throat, fever at night (p<0.001 for each), history of hemophagocytosis (p=0.037) were significantly higher in AOSD group. Fever peak number equal and/or higher than 3, presence of lymphadenopathy (p=0002 and p=0,001,respectively) were significantly higher in FUO group. While leukocytosis, neutrophilia, thrombocytosis, hyperferritinemia, higher lactate dehydrogenase and complement 3 levels (p<0.001 for each) were significantly more frequent in AOSD group, albumin levels lower than 3 g/dl and positive rheumatoid factor (p=0.009 and p=0.002,respectively) were significantly more frequent in FUO group. Results of univariate and multivariate analysis are given in table 1. Algorithm for discrimination of AOSD and FUO is given at Abstract SAT0608 – figure 1.Abstract SAT0608 – Table 1 Results of univariate and multivariate analysis Univariate Analysis Multivariate Analysis Variables Odds Ratio Confidence Interval p value Odds Ratio Confidence Interval p value Favours Still’s Fever at night 7,66 3,53–16,5 <0001 Rash 10,08 4,80–21,2 <0001 31,3 3,6–271,9 0002 Arthritis 6,58 3,09–14,01 <0001 Arthralgia 36 10,46–123,8 <0001 158,1 4,3–5755,8 0006 Sore throat 27,72 11,58–66,33 <0001 20,8 2,8–154,7 0003 Hemophagocytosis 4,79 0,96–23,89 0079 Neutrophilia 10,87 4,90–24,13 <0001 18,4 2,6–132,3 0004 Ferritin≥5 x UNL 4,88 2,34–10,16 <0001 132,8 7,1–2502,9 0001 LDH 7,12 2,35–21,59 <0001 6,2 0,76–50,9 0087 C3 3,20 1,47–7,00 0003 Female 2,90 1,46–5,73 0002 Favours FUO Pleuritis 2,04 0,68–6,12 0,19 Fever peak number≥3 3,66 1,16–11,52 0019 69 2,2–2114,4 0015 Lymphadenopathy 3,39 1,72–6,79 <0001 UNL: Upper normal limit (for ferritin: 336 ng/ml) Conclusions Presence of arthralgia, hyperferritinemia, sore throat and neutrophilia strongly favour AOSD in patients presenting as FUO. This study demonstrates a clinician-friendly algorithm for the first time in current literature. Disclosure of Interest None declared

AB0463 Therapeutic plasma exchange (TPE) for refractory SLE: a comparison of outcomes between different sub-phenotypes?

Background Therapeutic plasma exchange (TPE) offers an alternative therapeutic modality for patients with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (APS). However, there is conflicting evidence regarding its efficacy in different sub-phenotypes. Objectives This study aims to investigate the main clinical characteristics and outcomes of patients with different phenotypes of SLE and APS treated with TPE at a tertiary care centre. Methods Database of Blood and Apheresis Unit between 2001–2013 was screened for patients with SLE and primary APS. SLE disease activity index (SELENA-SLEDAI), the indications for treatment, complications and outcomes were obtained from review of medical records and phone calls. A total of 24 patients (SLE: 20, APS: 4) were recruited for the study. Results Mean ages of SLE (M/F: 1/19) and primary APS (PAPS) patients (M/F: 2/2) were 32.4±12.89 and 52.0±10.7, respectively. The main indications for TPE were haematologic, neurologic, pulmonary involvement and APS-related. TPE was preferred in 8 patients because of leukopenia, and co-infection. SLEDAI was significantly decreased after TPE (16.7±8.3 vs. 8.8±3.1, p=0.001). Both primary APS and SLE related CAPS patients had completely responded to TPE. Success rate of TPE in patients with thrombocytopenia were lower than patients with haemolytic anaemia. Median (IQR 25%>75%) TPE sessions were 6.5 (5–10.5).Table 1. Clinical, disease activity, treatment findings and TPE outcomes of SLE patients Conclusions This study suggests catastrophic antiphospholipid syndrome (CAPS) and other APS related problems respond well to the TPE treatment. TPE should be kept in mind for the treatment of patients with other features of SLE, especially those resistant to other agents and in the presence of leukopenia and psychosis Disclosure of Interest None declared

AB0414 The use of rituximab in patients with rheumatoid arthritis: in which infusion intervals were given and how did they respond? HUR-BIO real life results

Background Rituximab is one of the treatment options in rheumatoid arthritis (RA) patients and officially recommended as a maintanance treatment given every 6 months after the initial loading of first course. Objectives In this real life study, it was aimed to investigate the infusion frequency of rituximab maintanance treatment and possible effects on disease activity. Methods The HUR-BIO is a single-center biologic registry of Hacettepe University which is established in Ankara and in which patients have been prospectively recorded since 2012. This database has 1235 RA patient records as of August 2016. Rituximab was prescribed at least once in 273 (22.1%) patients. The residence address of 85 those patients was within the boundaries of center city (Ankara) and they were included in to the study. In our clinic, the dates and the DAS-28 scores at the time of rituximab courses were recorded. Rituximab infusion compliance was classified as; “regular ” if there is less than one month delay, “slightly irregular” if less than 3 months delay and “irregular” if more than 3 months delay. Results The mean age of the 85 patients (80% female) was 59.1 (10.1), the mean disease duration was 12.9 (8.6) years and 74.1% of patients were seropositive. 39/85 (46%) patients previously used at least one biological agent (46 (54%) patients were biologic naive before Rituximab therapy). Median rituximab course number was 3 (1–8). A total of 211 rituximab courses were given to 85 patients. Rituximab course number and percentage is shown in figure. The mean interval time between rituximab courses was 7.9 (2.8) months. Total of 102 (52.6%) courses were admistred at normal times regularly, 60 (30.9%) were slightly irregular and 32 (16.5%) were irregular. There was no significant difference between the mean DAS-28 responses in the time of the courses and the rituximab infusion compliances [in regular group mean DAS-28 was 3.31 (1,19), in slightly irregular group mean DAS-28 was 3.26 (1.35) and irregular group mean DAS-28 was 3,57 (1.34), p>0.05]. Before rituximab courses, 33.7% of patients had remission, 19.1% had low disease activity, 36.3% had moderate disease activity and 10.9% had high disease activity. Conclusions Rituximab administration was approximately 2 months delayed in RA patients who were living in center-city boundaries. The pre-treatment mean disease activity scores were similar, even if there was a delay in rituximab administration. In our center, about 85% of patients were taking RTX courses regular and/or slightly irregular and about half of the patients before treatment were in remission and/or low disease activity. Disclosure of Interest None declared

THU0131 Premature coronary heart disease frequency in rheumatoid arthritis who are receiving biologic agents: hur-bio real life results

Background Patients with rheumatoid arthritis (RA) are at increased risk of coronary heart disease (CHD) overall, as well as death from CHD. A direct impact of chronic inflamation on the vascular system, secondary effects of physical inactivity and some drugs used in the management of RA are shown as the reasons for the increase in this comorbidity (1). Objectives We aim to determine the frequency of CHD in the RA patients who receive biological agents. Methods Hacettepe University Biologic Registry (HUR-BIO) includes demographic and clinical data of patients treated with biological agent since 2005. By August 2016, 1235 RA patients were recorded in the database. Age, smoking status, comorbidities, current and previous treatments were analysed in 1000 patients. Disease activity was estimated by the 28-joint activity calculator (DAS28-ESR) and DAS28-CRP. Functional assesment was evaluated by the Health Assessment Questionnaire (HAQ). Premature CHD should be defined if clinical CHD or sudden death is documented in male younger than 55 years of age and in female younger than 65 years of age. Results Overall 1000 patients (79,8% female) were enrolled in this study. Mean age was 53,1±12,6 years old, mean disease duration was 12,3±9,3 years. CHD was detected 57 (5,7%) patients and female/male was 38/19. Premature CHD was observed in 38 (66,7%) patients. CHD patients had more frequently male, older, higher classical risk factors, higher baseline ESR level and higher functional disability (Table). HAQ score also remained high in CHD group at last visit. Classical cardiovascular risk factors, sex, seropositivity, disease activity score and HAQ score were similar in the premature and other CHD group. Coronary artery stenting, coronary artery bypass surgery and medical treatment was applied in 12 (21%), 20 (35,1%) and 25 (43,9%) CHD patients, respectively. There was no statistical difference in treatment of premature and other CHD.Table 1. Characteristic of patients who have CHD or not CHD (n=57) No CHD (n=943) p Female n (%) 38 (66,6) 19 (80,6) 0,011 Hypertansion n (%) 38 (66,6) 271 (28,7) <0.001 Diabetes Mellitus n (%) 11 (19,3) 97 (10,3) 0.033 Smoking (current/past) n (%) 30 (52,6) 370 (39,2) 0.003 Age mean (SD) 64,7 (9,9) 52,4 (12,4) <0.001 Baseline Erythrocyte sedimentation rate (SD) 45,7 (30,3) 36,1 (24,6) 0.009 Baseline HAQ mean (SD) 1,27 (0,64) 1,02 (0,62) 0.025 Last HAQ mean (SD) 0,84 (0,64) 0,66 (0,58) 0.024 CHD: Coronary heart disease, HAQ: Health Assessment Questionnaire. Conclusions As a results CHD were detected in 5,7 percents of RA patients who are receiving biological agents. Importantly, two third of these patients have premature CHD. Classical risk factors are observed more frequently in CHD patients as expected but interestingly, no additional risk factors other than age were detected between premature and other CHD patients. This suggests that the primary factor triggers premature CHD is the underlying inflammatory rheumatic disease. The presence of CHD was determined by patient history which the limitation of our study. We did not assess to subclinical CHD in this study. References Comorbidity in rheumatoid arthritis, Carl Turesson, Swiss Medical Weekly, 2016. Disclosure of Interest None declared

SAT0216 Abatacept experience in biologic naive rheumatoid arthritis patients: hur-bio real life results

Background Abatacept (ABA), a T lymphocyte blocker, is one of the treatment options in rheumatoid arthritis (RA) patients who are resistant to initial therapy with non-biologic disease modifying drugs (DMARDs). Objectives Aim of this study was to evaluate the effectiveness, safety and drug survival rates of ABA in RA patients registered in HUR-BIO (Hacettepe University Rheumatology Biologic Registry) database. Methods HUR-BIO is a prospective,single center database of biological treatments including 1229 RA patients by August 2016. In total, 247 of patients had received ABA and in 175 (71%) of them ABA was the first biological agent. In this analysis, 158 patients were evaluated due to lack of first follow-up visit in 17 patients. Demographics, clinical and serological data were evaluated. DAS-28 and HAQ-DI scores before ABA and last follow-up visit were also assesed. Kaplan-Meier analysis was used to estimate drug survival rates. Results Among 175 (82% female) patients, mean age was 53.6±11.3 and mean disease duration was 10.3±7.3. Seropositivity for RF and/or ACPA was present in 74.8% of patients. Table 1 represents DAS-28 scores of patients before ABA and last follow-up visit. Mean duration from ABA initation to first and last follow-up visit was 4.5±3.1 and 15.1±10.2 months, respectively. Female gender was found as a risk factor in terms of remaining of DAS-28 above 3.2 at first control [OR 5,63 (%95 CI 1,72–18,41)]. In first follow-up visit, improvement in DAS-28 score of ≥1,2 from baseline was more frequent in ACPA positive patients (48/62 (77.4%) vs 17/33 (51.5%), p=0.01). HAQ score of >1.0 was observed in 57.8%, 36.3%and 26.1% of patients at baseline, first follow-up visit and last follow-up visit, respectively. ABA had been cessated in 60 (38.0%) patients during follow-up. The reason for ABA withdrawal was primary unresponsiveness in 22 (36.6%) patients and infection in 2 (3.3%) patients. Drug survival for ABA was shown in Figure 1. Log- rank between RF positive and negative patients was found as 0.067.Table 1. DAS-28 scores at first and last follow-up visits First control visit Last control visit (n=136) (n=136) Follow up duration, mean (SD) 4.5 (3.1) 12,3 (10.9) DAS-28 >5.1,n (%) 11 (8.2) 16 (11.8) DAS-28=3.2–5.1,n (%) 56 (41.8) 46 (33.8) DAS-28=2.6–3.2,n (%) 23 (17.2) 23 (16.9) DAS-28 <2.6,n (%) 44 (32.8) 51 (37.5) Remission or low disease activity among patients with at least one follow-up visit, n (%) 67 (50.0) 74 (54.4) Remission or low disease activity among all patients, n (%) (The worst scenario) 67/158 (42.4) 74/158 (46.8) Conclusions In our database, 70% of RA patients received ABA were biologic naive. Remission or low-disease activity was achieved approximately 50% of patients in first follow-up visit with an average of 4.5 months after begining of the treatment. Functional improvement was observed in two thirds of patients. Death or life threatening side effects were not seen during follow-up. ABA is an acceptable treatment option in DMARD resistant biologic naive RA patients. Disclosure of Interest None declared

AB0576 Ophtalmologic Findings in Patients with Takayasu's Arteritis

Background Takayasus Arteritis (TA) is a large vessel vasculitis of young females. Ophtalmologic findings as wreath-like arteriovenous anastomosis around the optic disc are the firstly described clues for TA. Opthalmologic pathologies could have negative impact on quality of life but, there are limited data about ocular manifestations of TA. Objectives To investigate the ophthalmologic manifestations of TA. Methods In this cross-sectional study 33 TA (F/M: 29/4) patients were evaluated. Demographic and clinical findings were recorded from hospital files. Addition to routine examination, anterior segment and fundus of eyes were assessed. Results The median age at the time of ocular examination was 38 (min-max:19–62) years and mean disease duration was 5.7±5.5 years. Two (6.1%) patients had diabetes mellitus, 13 (39.4%) patients had hypertension. Only one patient had cranial involvement of TA. Most of the patients had been taking immunosuppressive agents addition to corticosteroids [Methotrexate (n=11, (33.3%)), cyclophosphamide (n=9, (27.3%)), azathiopurine (n=5, (15.2%)), one patient for each mycophenolate mophetil, infliximab, tocilizumab] Of patients 15 (45.4%) had pathologic findings in opthalmologic examinations. Twelve patients (36.4%) had anterior segment pathology, 10 (30.3%) patients had posterior segment pathology. Of these patients 7 (21.2%) had both anterior and posterior segment pathology. Distribution of anterior segment pathologies were; 9 (27.2%) patients had cataract, 2 (6.1%) patients had dry eyes and one patient had congenital disgenesis. In fundoscopic examination of posterior segment, hypertensive retinopathy was the most frequent pathologic finding as 12.1% (n=4) Three of these patients have had diagnosis of essential hypertension and were treated with anti-hypertensive medication One patient had ocular ischemic syndrome which is typical for TA (Table 1).Table 1. The Fundoscopic Examination Findings of 33 patient with TA Fundoscopic Examination Findings N % Normal 23 69.7 Stage 1 hypertensive retinopathy 4 12.1 Foveal pigment epithelial alterations 1 3.0 Ocular ischemic syndrome 1 3.0 Hard exudate and microhemorrhage 1 3.0 Delayed mfERG (multiphocal electroretinography) responses 1 3.0 Drusen formation 1 3.0 Exudate and subretinal fluid 1 3.0 Conclusions In the early results of our study, disease or treatment related ocular pathologic findings were frequent in TA. Periodic consultation and ophthalmologic examination of TA patients might be rational approach in follow up of these patients. Disclosure of Interest None declared