Explore the vast range of titles available.

Aims To evaluate the efficacy of methotrexate (MTX) in preventing the recurrence of acute anterior uveitis (AAU). Methods This prospective, open, longitudinal study included patients from June 2002 to March 2005 who had either three or more episodes of AAU in the previous year, or a recurrence of AAU within 3 months before starting the trial. We excluded uveitis of infectious origin, masquerade syndromes, and patients with contraindications to MTX. The response criteria were defined as an absence of symptoms and the presence of a normal ophthalmologic examination. The study outcome compared the number of flare-ups of uveitis over an MTX-treated for 1 year to the number of flare-ups of the same group during the previous year without MTX. Results A total of 571 patients with uveitis were evaluated during the period of the study, and 10 fulfilled the inclusion criteria. One patient refused the treatment, and nine completed the study. The mean number of recurrences in the pre-MTX year was 3.4 (SD: 0.52), which was significantly reduced to 0.89 (SD: 1.17) in the year of treatment ( P =0.011). Conclusion MTX treatment seems to reduce the number of flare-ups in patients with recurrent AAU.

Purpose To develop and validate a Bayesian belief network algorithm for the differential diagnosis of anterior uveitis. Patients and methods The 11 most common etiologies were included (idiopathic, ankylosing spondylitis, psoriasic arthritis, reactive arthritis, inflammatory bowel diseases, sarcoidosis, tuberculosis, Behçet, Posner-Schlossman syndrome, juvenile idiopathic arthritis (JIA), and Fuchs’ heterochromic cyclitis). Frequencies of association between factors and etiologies were retrieved from a systematic review of the literature. Prevalences were calculated using a random sample of 200 patients receiving a diagnosis of anterior uveitis in Moorfields Eye Hospital in 2012. The network was validated in a random sample of 200 patients receiving a diagnosis of anterior uveitis in the same hospital in 2013 plus 10 extra cases of the most rare etiologies (JIA, Behçet, and psoriasic arthritis). Results In 63.8% of patients the most probable etiology by the algorithm matched the senior clinician diagnosis. In 80.5% of patients the clinician diagnosis matched the first or second most probable results by the algorithm. Taking into account only the most probable diagnosis by the algorithm, sensitivities for each etiology ranged from 100% (7 of 7 patients with reactive arthritis and 5 of 5 with Behçet correctly classified) to 46.7% (7 of 15 patients with tuberculosis-related uveitis). Specificities ranged from 88.8% for sarcoidosis to 99.5% in Posner. Conclusions This algorithm could help clinicians with the differential diagnosis of anterior uveitis. In addition, it could help with the selection of the diagnostic tests performed.

The influence of the liquid fraction (prehydrolysate) generated during steam-explosion pretreatment (210 degrees C, 15 min) of barley straw on the enzymatic hydrolysis was determined. Prehydrolysate was analyzed for degradation compounds and sugars' content and used as a medium for enzymatic hydrolysis tests after pH adjusting to 4.8. Our results show that the presence of the compounds contained in the prehydrolysate strongly affects the hydrolysis step (a 25% decrease in cellulose conversion compared with control). Sugars are shown to be more potent inhibitors of enzymatic hydrolysis than degradation products.

Objectives To compare the efficacy and safety of infliximab (IFX) versus adalimumab (ADA) as first biologic drug in refractory uveitis due to Behçet's disease (BD) for 1-year period. Methods Multicenter study of 125 patients with BD's uveitis refractory to conventional treatment including high-dose corticosteroids and at least one standard immunosuppressive agent. IFX (3-5 mg/kg at 0, 2, and 6 weeks and then every 4-8 weeks) was used in 75 cases and ADA (usually 40 mg every 2 weeks) in 50 cases. The main comparative outcome measures were improvement of visual acuity (VA) (at least 20%), complete inactivity of anterior chamber inflammation, vitritis, and retinal vasculitis as well as macular thickness <250 microns. A bivariate and logistic regression analysis was performed for every previous outcome between ADA vs IFX (SPSS20.0 package). Results 125 patients (223 affected eyes) were studied. No statistically significant differences at baseline were observed between IFX vs ADA groups in sex (♂/♀; 41/34 vs 29/21; p=0,71), mean age (39,2±9.39 vs 36,14±12,7; p=0.12), HLA B51 positive (75% vs 75%), uveitis duration before anti TNF-α onset (median [IQR]; 36 [12-71] vs 24 months [12-60]; p=0.4), VA (0,47±0,26 vs 0,52±0,27; p=0,29), anterior chamber cells (median [IQR]; 0,5 [0-2] vs 1,5 [0-2]; p=0,2), retinal vasculitis (73,2% vs 75%; p=0,95); macular thickness (285,90±90,15 vs 312,02±106,57; p=0,25), combined treatment (82.7% vs 77,6%; p=0.481), basal degrees of immunosuppression (mean ± SD; 11.35±5.67 vs 9.65±4.68; p=0.09). There were a better non-statistical respond with ADA in improvement of VA, complete inactivity of anterior chamber inflammation, and macular thickness <250 microns, and with IFX in inactivity of vitritis, and retinal vasculitis (Table) Conclusions Our study suggests that ADA and IFX do not show statistical differences at one year in refractory uveitis of BD. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4766

Background Ocular involvement is a well known serious complication of Juvenile Idiopathic Arthritis (JIA), sometimes refractory to conventional treatment. Objectives To assess the efficacy and safety of treatment with adalimumab therapy in patients with refractory Juvenile Idiopathic Arthritis (JIA) associated uveitis. Methods Multicenter study on 40 patients diagnosed as having JIA-associated uveitis refractory to treatment with corticosteroids therapy and at least another systemic immunosuppressive drug. Standard adalimumab therapy was started (40 mg subcutaneously every-other-week, for children aged between 4 and 12 years, the recommended dose was 24 mg/m2 body surface area up to a maximum single dose of 40 mg s.c. every other week. The associated immunosuppressive therapy and the prednisone dose were reduced if there was no evidence of inflammation. The degree of anterior and posterior chamber inflammation (SUN criteria), corticosteroid dose, and macular thickness (optical coherence tomography) were assessed. Definite outcomes were assessed at six months in all patients. All comparisons were performed between baseline and 6 months after the onset of adalimumab therapy (Wilcoxon test). Results Forty patients (11 males, 29 females), mean age of 11.4±7.9years (range: 4 to 44 years), with active intraocular inflammation at baseline were studied. Thirty-six of the 40 patients had inflammation in the anterior camera, and treatment with adalimumab achieved a significant improvement in the mean tyndall from 1.8±1.1 to 0.41±0.6; p=0.000001. Also, 17 patients (42.5%) had inflammation in the posterior camera with foveal Optic Coherence Tomography (OCT) >250 microns. These cases had a significant improvement in OCT from 370.8±133.9 to 249.3±28 microns; p=0.0007. In addition, 9 patients with Cystoid Macular Edema (CME) (OCT>300) also had a significant improvement in OCT (463.1±123.8 to 254.4±30.2, p=0.007). Following adalimumab, corticosteroid dose was decreased from 0.26±0.4 to 0.004±0.02mg/day (p=0.00061). Adalimumab was usually well tolerated, and only local minor side-effects at the injection site were observed. Twelve patients (30%) had a mild relapse during the 6 months of therapy whereas only 2 patients (5%) had a moderate-severe relapse. Conclusions Adalimumab seems to be an effective and safe drug for the treatment of refractory JIA-associated uveitis. In addition, adalimumab may help to reduce corticosteroid requirement. Further controlled studies are warranted. Disclosure of Interest None Declared

Objectives To assess the efficacy of anti-TNFα drugs in Sarcoid Uveitis (SU) refractory to conventional synthetic immunosuppressive drugs (CSISDs). Methods Multicenter study (12 hospitals) of refractory SU to oral corticosteroids and at least one CSISD. Ocular inflammation was evaluated according to \"SUN-2005\", and macular thickness by OCT. Results are expressed as mean ± SD (normal distribution), or as median [25th-75th interquartile range (IQR)] (not normally distributed) and Comparison by Wilcoxon test. Results We studied 16 patients/27 eyes (7men/9women) with a mean age of 38.4±17.2 years (range 13-76). They showed: elevated Angiotensin-Converting Enzyme (56.2%), bilateral hiliar lymphadenopathy (56.2%), lung parenchymal involvement (43.7%), and involvement of other organs (56.2%). A biopsy confirmed sarcoidosis in the 31.2% of cases. The most frequent pattern of uveitis was bilateral chronic remitting panuveitis and the most frequent ocular inflammatory findings were mutton-fat keratic precipitates and snow balls in vitreous. Besides oral corticosteroids and before anti-TNFα, patients had received i.v. methylprednisolone (n=1), methotrexate (n=12), cyclosporine A (n=5), or azathioprine (n=3). The first anti-TNFα was: adalimumab (n=9; 56.3%) (40 mg/sc/2 weeks) and infliximab (n=7; 43.7%) (5 mg/kg/i.v./every 4-8 weeks), and was used in combination (n=13) with MTX (n=10), AZA (n=2) and mycophenolate mofetil (n=1). Infliximab was successfully switched to golimumab (n=2) due to intolerance. The mean duration of anti-TNFα was 27.7±16.8 months. The results with anti-TNFα after 2 years were: Visual acuity: from a mean of 0.6±0.3 to 0.8±0.2 (p=0.03); Tyndall: from a median of 1 [IQR: 0-3] to 0 [IQR: 0-2] (p=0.017) and vitritis: from a median of 0 [IQR: 0-3] to 0 [IQR: 0-1] (p=0.03). Six patients (7 eyes) with cystoid macular edema (CME) (OCT>300μ) at baseline, improved from 372±58.3 to 241±1.4 microns at 2 years (p=0.17). Conclusions Anti-TNF therapy seems effective in SU refractory to CSISDs. Acknowledgements This study was supported by a grant from \"Fondo de Investigaciones Sanitarias\"PI12/00193 (Spain). This work was also partially supported by RETICS Programs, RD08/0075 (RIER) and RD12/0009/0013 from\"Instituto de Salud Carlos III\" (ISCIII) (Spain). Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.3829

Objectives To assess the efficacy and safety of Golimumab in patients with refractory uveitis to other anti-TNFα drugs. Methods Study of patients from a single center with refractory uveitis to previous standard synthetic immunosuppressive drugs and at least 1 anti-TNFα drug. Golimumab was given at the standard dose of 50 mg/sc/month. Results A total of 25 patients (39 affected eyes) (19 men/6 women); mean age, 32.5±8.9 years (range 11-47); fulfilled the above-mentioned criteria. In 14 cases uveitis was bilateral and in 11 cases it was unilateral. The underlying diseases were spondylarthritis (n=7), psoriatic arthropathy (n=4), juvenile idiopathic arthritis (n=4), sarcoidosis (n=3), Behcet disease (n=2), uveitis associated with HLA-B27 and ulcerative colitis (n=1), pars planitis (n=1) and Vogt-Koyanagi-Harada (n=1). Besides oral steroids and before Golimumab onset they had received: intraocular corticosteroids (n=10), methylprednisolone i.v. boluses (n=6), methotrexate (n=20), cyclosporine A (n=6), azathioprine (n=6), adalimumab (n=17), infliximab (n=14), abatacept (n=2) and certolizumab (n=1). Golimumab was started because inefficacy (n=23) and/or toxicity (n=2) to other biologics. Golimumab was used as monotherapy (n=9) or in combination with methotrexate (n=9), azathioprine (n=3), leflunomide (n=2) and mycophenolate (n=2). There was a rapid (from 1st week) and maintained (1st year) improvement of visual acuity, anterior chamber inflammation, vitritis and OCT. The mean OCT improved from 319.9±77.9 μm (baseline) to 270.2±54.8 μm (1st month) (p<0.01) and to 244.3±43.2 μm (1st year) (p=0.02). After a mean follow-up of 13.3±8.3 (range 2-30) months the most important side-effects observed were local erythema in injection area (n=1) and herpes zoster (n=1). Conclusions Golimumab seems an effective and safe treatment for those patients with uveitis even refractory to other anti-TNFα drugs. Acknowledgements This study was supported by a grant from \"Fondo de Investigaciones Sanitarias\" PI12/00193 (Spain). This work was also partially supported by RETICS Programs, RD08/0075 (RIER) and RD12/0009/0013 from \"Instituto de Salud Carlos III\" (ISCIII) (Spain). Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4758

Background Global crises inevitably increase levels of anxiety in postpartum populations. Effective and efficient measurement is therefore essential. This study aimed to create a 12-item research short form of the 51-item Postpartum Specific Anxiety Scale [PSAS] and validate it for use in rapid response research at a time of global crises [PSAS-RSF-C]. We also present the same 12-items, in five other languages (Italian, French, Chinese, Spanish, Dutch) to increase global accessibility of a psychometric tool to assess maternal mental health. Methods Twelve items from the PSAS were selected on the basis of a review of their factor loadings. An on-line sample of UK mothers ( N  = 710) of infants up to 12 weeks old completed the PSAS-RSF-C during COVID-19 ‘lockdown’. Results Principal component analyses on a randomly split sample ( n  = 344) revealed four factors, identical in nature to the original PSAS, which in combination explained 75% of the total variance. Confirmatory factor analyses ( n  = 366) demonstrated the four-factor model fit the data well. Reliability of the overall scale and of the underlying factors in both samples proved excellent. Conclusions Findings suggest the PSAS-RSF-C may prove useful as a clinical screening tool and is the first postpartum-specific psychometric scale to be validated during the COVID-19 pandemic. This offers psychometrically sound assessment of postpartum anxiety. By increasing the accessibility of the PSAS, we aim to enable researchers the opportunity to measure maternal anxiety, rapidly, at times of global crisis.

The safety and health effects for celiac people of a novel beverage (SOFB) developed from sprouted oat flour by fermentation with Lactobacillus plantarum was explored. In vitro reactivity against anti-gliadin antibodies (AGA) and antioxidant/anti-inflammatory potential of SOFB in RAW 264.7 macrophages and Caco-2 cells were evaluated. Immunoreactivity against AGA and antioxidant activity were not detected in SOFB, but it exhibited significant anti-inflammatory activity. The tolerability and impact of SOFB consumption for 6 months on nutritional status and intestinal microbiota composition were investigated in 10 celiac adults (five treated and five control). SOFB consumption did not adversely affect duodenal mucosa nor the total IgA or anti-tissue transglutaminase antibody (IgA-tTG) levels in celiac participants, but it significantly decreased total cholesterol levels at all sampling times and folic acid levels at the end of the study compared to the placebo beverage. SOFB administration also shifted gut microbiota, leading to a higher relative abundance of some beneficial bacteria including the genera Subdoligranulum, Ruminococcus and Lactobacillus in the SOFB group. This study provides supporting evidence of the safety of health benefits of a novel functional beverage produced from sprouted oat.