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Background:Systemic lupus erythematosus is a rare multisystemic disease that often requires lifelong treatment and affects various aspects of life. Patient education is an essential pillar of disease management but is often impaired by physician’s lack of time and staff. To provide high quality patient information, the initiative Lupus100.org was launched[1]. Here, lupus experts and Lupus Europe listed and answered the 100 most important questions on lupus. The creation of such information collections needs a lot of time and resources. With the wide availability of large language models (LLM) such as ChatGPT, the question arises to what extent they could support physicians in the care of patients.Objectives:To assess the capability of the LLM ChatGPT-4 vs. physician-generated responses to answer the 100 most frequently asked patient questions related to lupus.Methods:ChatGPT-4 responses were generated by entering the English questions from https://lupus100.org/ in a fresh session on October 16th, 2023. Three senior rheumatologists who were blinded concerning authorship evaluated responses from ChatGPT-4 and Lupus100 independently. The evaluation criteria were quality, empathy (Likert scale 1-5 each) and the selection of a preferred answer. Differences between the scores were analysed using a two-tailed Student’s t-test. The relationship between quality and empathy scores and word count was conducted using Spearman’s Rank Correlation Coefficient. A one-sample Chi-Square test was performed to assess whether there was a preferred source for the answers. Additionally, rates of responses below important thresholds (quality “poor” or “very poor”, empathy “not empathetic”) were compared. All statistical analyses were conducted in SPSS, the significance threshold used was p <0.05. Ethical approval was granted by the ethical committee of the Philipps University Marburg, Germany (23-300 ANZ).Results:Across the 100 questions, evaluators scored the mean quality of ChatGPT-4 significantly higher than that of Lupus100.org (t = 4.25; p = 0.001) (Table 1). Empathy ratings were comparable between both sources (t = 1.14; p = 0.26). Very few answers were rated as of poor quality or empathy (Figure 1). The preferred response was significantly more likely to come from ChatGPT-4 (57% vs. 43%; χ2 = 5.88, p = 0.02).Mean (SD) word count of replies was significantly lower for Lupus100.org than for ChatGPT-4 (241 [135] vs. 372 [52]; t = 9.08; p = 0.001). Word count was positively correlated with quality and empathy in Lupus100.org (r = 0.52; p = 0.001 and r = 0.34; p = 0.001). If only answers longer than median word count by Lupus100.org were analyzed, evaluators rated the two sources as equivalent in terms of quality (t = 0.65; p = 0.51) and Lupus100.org significantly better in terms of empathy (t = -2.17; p = 0.03).Conclusion:In this study, ChatGPT-4 was able to generate responses with high quality and empathy to patient questions concerning lupus. The length of the response seems to influence these parameters and can be produced faster by LLM, while physicians can probably optimize empathy by a thorough edit of answers. Collaboration between LLM and physicians has the potential to improve the availability of high quality and empathic patient information in times of physician shortage.REFERENCES:[1] Lupus100.org [Internet]. [cited 2023 Dec 27]. Available from: https://lupus100.org/enTable 1.Comparison of ChatGPT-4 and Lupus100.org in terms of quality and empathyChatGPT-4Lupus100.orgmean (SD)mean (SD)p-valueEffect size [95% CI]Complete set of 100 questions Quality score4.55 (0.65)4.31 (0.72)0.0010.35 [0.17 – 0.51] Empathy score4.14 (0.82)4.07 (0.84)0.270.09 [0.07 – 0.25]questions with Lupus100.org answer length > median Quality score4.51 (0.69)4.46 (0.72)0.510.08 [-0.15 – 0.30] Empathy score4.09 (0.82)4.29 (0.77)0.03-0.25 [-0.48 – -0.02]Acknowledgements:NIL.Disclosure of Interests:Isabell Haase Abbvie, AstraZeneca, Boehringer Ingelheim, Galapagos, GSK, Janssen, Lilly, Medac, Novartis, UCB, AbbVie, Boehringer Ingelheim, Medan, AbbVie, Celgene, Chugai, Hexal, Janssen, Medac, UCB, Tingting Xiong: None declared, Antonia Rissmann: None declared, Johannes Knitza: None declared, Julia Greenfield: None declared, Martin Krusche Novartis, Abbvie, Lilly, Galapagos, Pfizer, Medac, GSK, Novartis, Roche, Abbvie, Lilly, Galapagos, Pfizer, Medac, Novartis, Sobi, Sanofi.

Current research in the field of systemic lupus erythematosus (SLE) and pregnancy focuses on predictors of adverse pregnancy outcomes, the safety and efficacy of hydroxychloroquine (HCQ) in pregnancy and the importance of preconception counselling. In particular, the prospective predictors of pregnancy outcome: biomarkers in antiphospholipid antibody syndrome and SLE (PROMISSE) study adds to the understanding of risk factors for adverse outcomes. There is increasing evidence of the numerous benefits associated with continuing HCQ treatment in pregnancy and for the use of low-dose acetylsalicylic acid in the prevention of preeclampsia. The European League Against Rheumatism (EULAR) has published evidence-based recommendations for the treatment of women with SLE and/or antiphospholipid syndrome before, during and after pregnancy. Rheumatologists caring for women with SLE should be familiar with the current state of knowledge in order to help optimize the management and thus the outcome of pregnancy in their patients.

In living cells the mechanical properties of the actin cytoskeleton are defined by the local activation of different actin cross-linking proteins. These proteins consist of actin-binding domains that are separated and geometrically organized by different numbers of rod domains. The detailed molecular structure of the cross-linking molecules determines the structural and mechanical properties of actin networks in vivo. In this study, we systematically investigate the impact of the length of the spacing unit between two actinbinding domains on in vitro actin networks. Such synthetic crosslinkers reveal that the shorter the constructs are, the greater the elastic modulus changes in the linear response regime. Because the same binding domains are used in all constructs, only the differences in the number of rod domains determine their mechanical effectiveness. Structural rearrangements of the networks show that bundling propensity is highest for the shortest construct. The nonlinear mechanical response is affected by the molecular structure of the cross-linker molecules, and the observed critical strains and fracture stress increase proportional to the length of the spacing unit.

Next-Generation Sequencing (NGS) is widely used to investigate genomic variation. In several studies, the genetic variation of Mycobacterium tuberculosis has been analyzed in sputum samples without previous culture, using target enrichment methodologies for NGS. Alignments obtained by different programs generally map the sequences under default parameters, and from these results, it is assumed that only Mycobacterium reads will be obtained. However, variants of interest microorganism in clinical samples can be confused with a vast collection of reads from other bacteria, viruses, and human DNA. Currently, there are no standardized pipelines, and the cleaning success is never verified since there is a lack of rigorous controls to identify and remove reads from other sputum - microorganisms genetically similar to M . tuberculosis . Therefore, we designed a bioinformatic pipeline to process NGS data from sputum samples, including several filters and quality control points to identify and eliminate non- M . tuberculosis reads to obtain a reliable genetic variant report. Our proposal uses the SURPI software as a taxonomic classifier to filter input sequences and perform a mapping that provides the highest percentage of Mycobacterium reads, minimizing the reads from other microorganisms. We then use the filtered sequences to perform variant calling with the GATK software, ensuring the mapping quality, realignment, recalibration, hard-filtering, and post-filter to increase the reliability of the reported variants. Using default mapping parameters, we identified reads of contaminant bacteria, such as Streptococcus , Rhotia , Actinomyces , and Veillonella . Our final mapping strategy allowed a sequence identity of 97.8% between the input reads and the whole M . tuberculosis reference genome H37Rv using a genomic edit distance of three, thus removing 98.8% of the off-target sequences with a Mycobacterium reads loss of 1.7%. Finally, more than 200 unreliable genetic variants were removed during the variant calling, increasing the report’s reliability.

Background:The use of hydroxychloroquine (HCQ) has long been established in Systemic Lupus Erythematosus (SLE) and especially as applicable drug during pregnancy. Recently, beneficial effects and safety of HCQ have been re-discussed in the light of a change in the summary of product characteristics in some countries. More current studies are required to provide patients with evidence-based advice regarding this essential drug when counselling for pregnancy.Objectives:To examine the impact of HCQ on pregnancy outcomes of SLE women.Methods:Pregnancies of women with SLE from an outpatient pregnancy clinic were prospectively evaluated before and throughout gestation. Maternal and fetal outcomes in women without HCQ therapy (group A) were compared to pregnancies under HCQ treatment from 1st trimester on (group B). A multiple logistic regression was performed with adjustment for confounding factors.Results:We enrolled 184 live births from singleton pregnancies in 145 women (n=77 with HCQ and n=107 w/o HCQ). One neonatal death (group B) occurred after severe preeclampsia at 24 weeks of gestation (w/g) linked to noncompliance in a woman with high-risk aPL profile. One child (group B) was born with mycophenolate mofetil embryopathy.Women in the HCQ group had a significantly lower rate of preterm births [aOR 0.31 (95%-CI: 0.15-0.64), p = 0.026]. Regarding preeclampsia, we found a tendency towards less incidence with the use of HCQ [aOR 0.49 (95%-CI: 0.23-1.03), p = 0.24]. These improved outcomes are opposed by a higher frequency of risk factors in group B (lupus nephritis, high-risk aPL profile, slightly more hypertension) and a tendency towards more severe SLE (expressed in terms of increased use of Azathioprine) (Table 1). Nevertheless, women with HCQ therapy experienced significantly less flares during pregnancy [aOR 0.18 (95%-CI: 0.09-0.38), p = 0.013].Table 1.Patient characteristicsAll pregnancies (n=184)No HCQ in pregnancy (n=107)HCQ during pregnancy (n=77)Age (years), median (IQR)31.0 (28.0-34.0)31.0 (29.0-34.0)30.0 (27.0-33.0)Hypertension, n (%)29 (15.8%)16 (15.0%)13 (16.9%)Preconception counselling, n (%)122 (66.3%)69 (64.5%)53 (68.8%)SLE disease & therapy characteristicsDisease duration (years), median (IQR)6.7 (2.9-10.3)7.0 (3.0-10.0)6.7 (2.1-11.0)Lupus nephritis*1, n (%)51 (27.7%)25 (23.4%)26 (33.8%)High-risk aPL profile*2, n (%)39 (21.3%)21 (19.8%)18 (23.4%)SLEDAI*1, median (IQR)2.0 (0-4.0)2.0 (0.0-4.0)2.0 (2.0-4.0)Anti-dsDNA, n (%)102 (55.7%)47 (44.3%)55 (71.4%)Anti-SSA/Ro and/or Anti-SSB/La, n (%)91 (49.7%)55 (51.9%)36 (46.8%)Azathioprine*1, n (%)38 (20.7%)18 (16.8%)20 (26.0%)Low dose Aspirin*3, n (%)74 (41.1%)34 (32.7%)40 (52.6%)Obstetrical historyNulliparous, n (%)113 (61.4%)63 (58.9%)50 (64.9%)Previous fetal loss, n (%)39 (21.2%)22 (20.6%)17 (22.1%)Previous (pre-)eclampsia or HELLP, n (%)14 (7.6%)8 (7.5%)6 (7.8%)Previous congenital heart block, n (%)1 (0.54%)-1 (1.3%)Pregnancy outcome(mild-moderate) flare*4, n (%)44 (29.5%)30 (34.9%)14 (22.2%)Preterm birth*5, n (%)46 (25%)30 (28.0%)16 (20.8%)Preeclampsia, n (%)24 (13%)15 (14.0%)9 (11.7%)Intrauterine growth restriction, n (%)3 (1.7%)1 (1.0%)2 (2.6%)Congenital heart block, n (%)1 (0.54%)-1 (1.3%)*1last visit before pregnancy, *2according to the 2019 EULAR recommendations, *3until 16 w/g, *4increase in SLEPDAI ≥ 4 or increase in prednisolone ≥ 5mg/d, *5< 37 w/gConclusion:In our cohort, SLE women with additional risk factors achieved a favourable pregnancy outcome. This encouraging result is in part attributable to pregnancy counselling with the advice to continue HCQ throughout gestation.Disclosure of Interests:Isabell Haase Grant/research support from: Abbvie, Medac, Hexal, Pfizer, Ralph Brinks: None declared, Matthias Schneider Grant/research support from: GSK, UCB, Abbvie, Consultant of: Abbvie, Alexion, Astra Zeneca, BMS, Boehringer Ingelheim, Gilead, Lilly, Sanofi, UCB, Speakers bureau: Abbvie, Astra Zeneca, BMS, Chugai, GSK, Lilly, Pfizer, Sanofi, Rebecca Fischer-Betz Consultant of: UCB, Speakers bureau: Abbvie, Amgen, Biogen, BMS, Celgene, Chugai, GSK, Janssen, Lilly, Medac, MSD, Novartis, Roche, UCB, Pfizer.

Background:In Germany, as in many other countries, there is an increasing shortage of rheumatologists, which jeopardises the provision of needs-based care for people with inflammatory rheumatic diseases (iRMDs).Objectives:To provide current data on rheumatology healthcare resources, workforce supply, access to care, quality of care, economic burden, education and training in rheumatology in Germany. The project was initiated by the German Society for Rheumatology (DGRh), with participation of the Professional Association of Rheumatologists (BDRh), the Association of Acute Rheumatology Clinics (VRA), the German Rheumatism Research Centre (DRFZ) and the patient organization German League against Rheumatism (DRL).Methods:Currently available data were collected on the prevalence of iRMDs, the number of rheumatology departments, rheumatologists and work settings including in-/outpatient care, rehabilitation, full-/part-time work, female/male ratio and regional variation. Quality and gaps of care, the number of academic departments, rheumatology trainees and nurses, and healthcare costs of iRMDs were assessed.Results:About 1.8 million adults in Germany suffer from an iRMD. The prevalence is increasing due to the demographic change. At least two rheumatologists per 100,000 adults are regarded to be required for needs-based care, currently there is only one rheumatologist per 100,000 adults, with considerable regional variation. One third of rheumatologists are older than 60 years. Part-time employment and the proportion of females is increasing. The current average working hours are above the defined full-time employment. Every year, around 60 trainees take the rheumatologist examination. Specialized rheumatologic nurses are increasingly involved in outpatient care. The average waiting time for a first appointment is often more than three months. The direct costs in Germany for the treatment of inflammatory polyarthropathies (ICD-10GM M05-M14) alone totalled €3 billion in 2020.Conclusion:The current training rate is not sufficient to compensate for the increasing workload and the loss of patient care capacity due to retirement of many rheumatologists and increase in part-time work. Alongside financial and structural support for rheumatological training, team-based care needs to be financially supported. Research is ongoing on further ways of reducing the work load through digitally supported rheumatological care. Demands are being addressed to policy-makers to overcome the supply shortage.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:Katinka Albrecht: None declared, Juergen Braun: None declared, Johanna Callhoff Janssen, Pfizer, Idorsia, Abbvie, AstraZeneca, BMS, Galapagos, GSK, Medac, MSD, Pfizer, UCB, Lilly, Sanofi-Aventis, Isabell Haase Abbvie, AstraZeneca, Boehringer Ingelheim, Galapagos, GSK, Janssen, Lilly, Medac, Novartis, UCB, AbbVie, Celgene, Chugai, Hexal, Janssen, Medac, UCB, Andreas Krause: None declared, Heinz-Jürgen Lakomek: None declared, Dirk Meyer-Olson: None declared, Rotraud Schmale-Grede: None declared, Anna Voormann: None declared, Ulf Wagner: None declared, Jan Zeidler: None declared, Silke Zinke: None declared, Christof Specker: None declared.

Background:Artificial intelligence (AI) is revolutionizing all medical disciplines, including rheumatology. It is unclear to what extent AI is already used in rheumatology in clinical routine. Additionally, the perceived barriers, potentials, and expectations regarding AI by rheumatologists have not yet been studied.Objectives:The study investigates the current usage and perception of AI among German rheumatologists.Methods:A web-based survey was designed by the Working Group Young Rheumatology of the German Society for Rheumatology. The prospective survey with 17 questions regarding previous usage, barriers, potentials, and expectations was distributed at the Congress of the German Society for Rheumatology, as well as via email, social media and QR Code from August 30th through November 4th, 2023.Results:Of the 172 participating rheumatologists, the majority had not yet used AI (126/172, 73 %) in their clinical routine. AI knowledge was rated as very low to intermediate by 88% (151/172), and 84% (144/172) would appreciate dedicated AI training. Rheumatologists consider AI helpful for diagnostics (125/172, 73%), writing medical reports (121/172, 70%), data analysis (120/172, 70%), or documentation (119/172, 69%). Most rheumatologists (141/172, 82%) preferred a transparent AI-based diagnostic decision support compared to an AI-based diagnostic decision support with improved diagnostic accuracy but with a non-transparent decision algorithm. A positive influence of AI on patient care (104/172, 60%) as well as on reduction of daily workload (106/172, 62%) was anticipated. Most rheumatologists (146/172, 85%) did not think AI could make their medical work redundant (Figure 1A–F). Barriers mentioned by the rheumatologists included the final responsibility for AI-based decisions (110/172, 64%) as well as data security (99/172, 58%).Conclusion:To the best of our knowledge, this is the first study to examine current use by rheumatologists and their perceptions of AI. While increased use of AI in clinical practice was welcomed, current AI use and knowledge were low. This suggests that dedicated AI training for rheumatologists is needed.REFERENCES:NIL.Acknowledgements:We would like to thank all participants as well as all members of the Working Group Young Rheumatology. MTH and AM share first authorship. JK and MK share last authorship.Disclosure of Interests:Marie-Therese Holzer Boehringer-Ingelheim, Anna Meinecke: None declared, Felix Mueller: None declared, Isabell Haase Abbvie, AstraZeneca, Boehringer Ingelheim, Galapagos, GSK, Janssen, Lilly, Medac, Novartis, UCB, AbbVie, Celgene, Chugai, Hexal, Janssen, Medac, UCB, Harriet Morf Novartis, Galapagos, Gsk, UCB, Abbvie, Thorben Witte: None declared, Hannah Labinsky Pfizer, Janssen, Philipp Klemm: None declared, Johannes Knitza Abbvie, Biogen, Boerhinger Ingelheim, AstraZeneca, Chugai, Galapagos, Gilead, GSK, Janssen, Lilly, Medac, Novartis, Pfizer, Rheumaakademie, Sanofi, Thermo Fisher, UCB, Vila Health, Werfen, Abbvie, ABATON, Biogen, Boehringer Ingelheim, AstraZeneca, Chugai, Galapagos, Gilead, GSK, Janssen, Lilly, Medac, Novartis, Pfizer, Sanofi, Thermo Fisher, UCB, Vila Health, Werfen, Abbvie, ABATON, BMBF, EIT Health, DFG, Novartis, Theramo Fisher, Martin Krusche Novartis, Abbvie, Lilly, Galapagos, Pfizer, Medac, GSK, Janssen, Novartis, Roche, Abbvie, Lilly, Galapagos, Pfizer, Medac, Novartis, Sobi, Sanofi.

BackgroundFatigue is a difficult subject for both physicians and patients. It is barely addressed during consultations and can therefore burden patient-physician-relations. To improve communication regarding fatigue, we developed a checklist that includes suggestions for evaluating possible causes for fatigue. In this analysis, we describe our study population and report first results 3 and 6 months after using the checklist.ObjectivesThe aims of our study are to validate the use of our newly developed fatigue checklist and to demonstrate that addressing fatigue in daily clinical practice and offering possible interventions can improve fatigue.MethodsWe recruited n=110 SLE patients with fatigue from our university hospital-based lupus reference centre in Duesseldorf. Fatigue was measured using the FSS (Fatigue Severity Scale). Our checklist included signs of depression and anxiety using the PHQ-4 (Patient Health Questionnaire), BMI (body mass index), physical activity, anemia, hypothyroidism and vitamin D deficiency. For each applicable cause, we listed possible interventions for free selection by the treating physician, such as replacement therapy (vitamin D, vitamin B12, iron, folic acid, erythropoietin), physical activity programs and psychosomatic consultations that were discussed with the patients. We re-evaluated our patients after 3 (T1) and 6 months (T2).ResultsBaseline characteristics of patients are summarized in Table 1.Table 1.BMI=body mass index, TSH=thyroidea stimulating hormone, PHQ4=patient health questionnaire (cut-off >3 points), HAQ=health assessment questionnaire, IMET= Index for measuring restrictions on social participation (higher scores point towards more restrictions on social participation), FSS=fatigue severity scale (≥4 points equal severe fatigue)N = 110n (%)Mean (SD)Age (years)49.0 (12.34)Female sex99.0 (90.0)BMI (kg/m2)25.9 (5.55)Disease duration (years)19.1 (10.05)TSH (µIU/ml)1.5 (1.05)25-OH-Vitamin D (ng/ml)39.5 (15.35)Haemoglobin (g/dl)13.0 (1.64)Sports activities>4h/week6.0 (5.5)2-4h/week18.0 (16.4)1-2h/week16.0 (14.5)<1h/week28.0 (25.5)No sport42.0 (38.2)Depression (PHQ4 score)2.3 (1.63)Anxiety (PHQ4 score)2.0 (1.71)Functional status (HAQ score)0.8 (0.49)Participation (IMET score)2.8 (2.31)Fatigue (FSS score)5.3 (1.35)After 3 and 6 months, we re-evaluated 83 patients and saw a significant reduction in fatigue measured by the FSS score (T1: mean difference estimate 0.367 and p-value <0.001; T2: mean difference estimate 0.305; p-value <0.005).Figure 1.Comparing FSS-Scores from T0, T1 and T2ConclusionThe preliminary analysis of our study shows for the first time that incorporation of a checklist procedure into the management of patients with fatigue may improve short-term outcome after 3 and 6 months of observation. The improvement of symptoms documented in our study occurred even though the suggested exercise program and psychosomatic counseling sessions were not available for use during the current observation period because of the COVID-19 pandemic. At present, the mechanisms behind the observed effect remain unclear. Our ongoing analysis will clarify whether an additional effect on fatigue will occur after all suggested interventions resulting from the use of the checklist have been executed. Finally, it will demonstrate whether the incorporation of our checklist into routine clinical practice is capable to reduce fatigue over a prolonged time period.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

The small GTPase Rac1 is crucial for maintaining stem cells (SCs) in mammalian epidermis, and Rac1 activation leads to SC expansion. Loss or inhibition of Rac1 correlates with decreased frequency of skin cancer formation in a chemical carcinogenesis model. Here, we have addressed whether Rac1 activation would enhance carcinogenesis and result in tumor progression. We used K14ΔNLef1 mice, a model for differentiated sebaceous adenomas (SAs), and activated Rac1 in an epidermis-specific manner (K14L61Rac1). Surprisingly, Rac1 activation did not change the incidence and frequency of sebaceous tumors. However, tumors, which occurred exclusively in K14ΔNLef1/K14L61Rac1 double-transgenic mice, were poorly differentiated resembling malignant sebaceous tumors and were termed sebaceous carcinoma-like tumors (SCLTs). Compared with SAs, SCLTs showed an aberrant pattern of cell proliferation, invasive growth and less abundant expression of sebocyte differentiation markers, including stearoyl-CoA desaturase-1 and adipophilin. Interestingly, the adnexal SC marker Lrig1 was upregulated in SCLTs, showing that active Rac1 leads to the accumulation of sebocyte precursors in the context of K14ΔNLef1-induced skin tumors. In a search for targets of Rac1, we found cancer progression-related proteins, Dhcr24/Seladin1 and Nuclear protein 1/P8, to be strongly regulated in SCLTs. At last, Rac1 and Dhcr24/Seladin1 were detected in human sebaceous tumors demonstrating a potential high impact of our findings for human skin disease. This is the first study showing that Rac1 activity can lead to malignant progression of skin tumors.

BackgroundEpidemiological studies are important for understanding the etiology and burden of psoriatic arthritis (PsA). Currently, there are no data available about the incidence of PsA in Germany.ObjectivesThis study aims to estimate the age-standardised incidence of diagnosed PsA for German men and women during 2009 to 2012.MethodsEstimation of the incidence of a chronic disease from prevalence data is possible if information about the general mortality and excess mortality of diseased compared to non-diseased people are available in terms of the hazard ratio (HR).1 Prevalence was extracted from the complete diagnosis data (in- and outpatient) from about 80% of the overall German population during 2009 to 2012. Diagnoses are based on claims data from all insurances of the German statutory health insurance (SHI) system. After determining the age-standardised sex-specific prevalence of PsA for each of the four years, the age-standardised incidence for men and women has been estimated. General mortality was obtained from the Federal Statistical Office of Germany. Since the HR is unknown in Germany, we use different scenarios motivated from a systematic review2 in the range from 1.3 to 1.6.ResultsFor each of the years from 2009 to 2012, a total of 127, 138, 146 and 156 thousand patients with diagnosed PsA were identified in about 65 million people from the SHI, respectively. The age-standardised prevalence increases from 1.8 to 2.1 per mil in men, and from 2.1 to 2.5 per mil in women. The estimated age-standardised incidence over the study period is shown in the figure 1. Over the study period, the incidence rate of PsA decreases for both sexes and the rate of men is lower than the rate of women. The average incidence rates are 11.5 and 14.5 per 100’000 person-years for men and women, respectively. This means that about 4700 men and 5900 women contract PsA each year. The impact of the different scenarios in HR is small.ConclusionsThese data from about 65 million people insured in the German SHI for the first time allow an estimation of the incidence of PsA in Germany. A selection bias is likely to be present, because the roughly 20% of the overall German population who could not included in the analysis (mainly privately insured people) are known to have other health risks. However, the results refer to the vast majority of the German population. The analysis cannot be adjusted for potential confounders other than age and sex (e.g., socio-economic position or presence of co-morbidities).References[1] Brinks R, Landwehr S, DOI: 10.1093/imammb/dqu024[2] Gladman DD. Mortality in psoriatic arthritis, Clin Experim Rheuma26(5):S62.Disclosure of InterestNone declared