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Objectives:To develop an ultrasound enthesis score and to assess its validity in the diagnostic classification of the spondyloarthropathies (SpAs).Methods:Twenty-five patients with SpA and 29 healthy controls participated in a blinded, gender-matched, cross-sectional study involving ultrasound assessment. The following entheses were explored bilaterally: proximal plantar fascia, distal Achilles tendon, distal and proximal patellar ligament, distal quadriceps and brachial triceps tendons. The ultrasound score evaluated enthesis thickness, structure, calcifications, erosions, bursae and power Doppler signal. The value of each elemental lesion was calculated using a three-model analysis. Validity was analysed by receiver operating characteristic (ROC) curves. Inter-reader and interexplorer intraclass correlation coefficients (ICCs) were calculated.Results:The logistic regression model overestimated the score of three elemental lesions: calcification (0–3), Doppler (0 or 3) and erosion (0 or 3), while scoring tendon structure, tendon thickness and bursa as 0 or 1. ROC curves established an ultrasound score of ⩾18 as the best cut-off point for differentiation between cases and controls. This cut-off point was exceeded by 5/29 controls (17%) and by 21/25 patients with SpA (84%). The sensitivity, specificity, positive and negative likelihood ratios (LR+, LR−) were 83.3%, 82.8%, 4.8% and 0.2%, respectively. The inter-reader and interexplorer ICCs were 0.60 and 0.86, respectively.Conclusion:The findings suggest that the ultrasound enthesis score could be a valid tool in the diagnosis of SpA.

Background Scientific congresses have become the most expedient method to communicate novel findings on any research topic. However, an important question is whether this information will be published in peer-reviewed journals. Our aim was to determine the publication rate of the abstracts presented at the European Society for Surgery of the Shoulder and Elbow Congress and analyze factors that may influence this rate. Methods A total of 398 abstracts reported in the Abstract Book from the 2008 European Society for Surgery of the Shoulder and Elbow Congress were examined and categorized by oral and poster presentations, topic, and the number of authors listed. A search in PubMed and Google Scholar for subsequent peer-reviewed publications was performed in September 2015. The time to publication after the meeting had been held; the type of journal and its impact factor at the time to publication were recorded for those abstracts that reached peer-reviewed journal publication. Results The overall publication rate for the 2008 European Society for Surgery of the Shoulder and Elbow oral and poster presentations was 45.20% after 7 years. The mean time to publication was 18.53 months, and the mean impact factor value was 2.32. Oral presentations were significantly better represented in journals than posters (64.40 vs. 35.40%, p  < 0.001). Abstracts with a greater number of authors listed had better publication rates ( p  < 0.001). Conclusion Less than half of the oral presentations and posters at the 21st European Society for Surgery of the Shoulder and Elbow Congress were published in peer-reviewed journals. Oral presentations with a higher number of authors had an increased likelihood of being published.

BackgroundUveitis is an ocular disease that is a major cause of morbidity and blindness in the developed world. Although Immunosuppressive drugs and biologic therapy have been shown to be effective in their treatment there are no clear protocols for their use.ObjectivesTo describe the characteristics of patients with uveitis associated with immunologic or idiopathic disease who require immunosuppressive treatment and their response in real clinical practice.MethodsObservational, descriptive, longitudinal, and retrospective study of a cohort of patients diagnosed with uveitis associated with immunologic or idiopathic diseases attended in a multidisciplinary consultation between January 2011 and February 2022. To assess the response to treatment, we evaluated the change in visual acuity and vitritis and the presence of macular edema.ResultsWe included 356 patients (mean age at diagnosis 42.8 ± 15.8 years, 50% female). Of the total, 157 (44%) had a single flare and 164 (46%) more than three. The involvement was bilateral in 85 patients (24%) and anterior (73%) and idiopathic (43%) were the most frequent. Twelve percent required treatment with systemic corticosteroids and 66 patients (18.5%) immunosuppressive/biological treatment, methotrexate being the most used (55%). Ten patients of the 66 (15%) started treatment with biologics and 34 (48%) required them at some point during the disease, adalimumab being the most used. Thirty-five patients (53%) needed to change drug due to lack of response. There were no differences between different drugs in the resolution of vitritis and improvement of vision. Disappearance of macular edema was achieved in all patients treated with tocilizumab.ConclusionThe use of systemic corticosteroids and immunosuppressive/biologics was necessary in a high number of patients with non-infectious uveitis. In our series tocilizumab proved to be significantly more effective in the resolution of macular edema.Reference[1]Gómez-Gómez A, Loza E, Rosario MP, Espinosa G, de Morales JMGR, Herrera JM, et al. Efficacy and safety of immunomodulatory drugs in patients with non-infectious intermediate and posterior uveitis, panuveitis and macular edema: A systematic literature review. Seminars in Arthritis and Rheumatism. 2020;50(6):1299-306.Figure 1.Timeline of immunosuppressive treatments and/or biologics administered in patients with non-infectious uveitis who required at least two treatments, according to diagnosis.Shaded: treatment that resolved the uveitis. RAAU: recurrent acute anterior uveitis AS: axial spondyloarthropathy MTX: Methotrexate. ADA: adalimumab MFM: mycophenolate mofetil IFX: infliximab TCZ: tocilizumab SAR: sarilumab CYA: Cyclosporine. SSZ: sulfasalazineAcknowledgements:NIL.Disclosure of InterestsNone Declared.

Evolving the management of rheumatoid arthritis (eRA) is a European-wide educational initiative aiming to support improved patient care through practical and educational tools addressing specific unmet needs. The aims of the eRA program were: (1) To identify priority unmet needs with the greatest impact on disease outcomes; (2) To develop practical, educational and guidance tools in line with EULAR recommendations to address identified unmet needs; and (3) To improve RA management and patient care. To describe the process by which local adaptations were made of materials derived from evidence-based recommendations in a training programme in rheumatoid arthritis (RA). A multidisciplinary Steering Committee (17 members, 12 countries) identified unmet needs within the management of RA and prioritised those with the greatest impact on patient outcomes. Practical educational tools addressing priority needs were then developed for dissemination and implementation by the rheumatology community across Europe, including shared decision making practises and a checklist for managing comorbidity in RA, among others. These materials were evaluated in detailed and discussed in small regional groups by practicing rheumatologists. Voting, open discussions and recommendations were extracted from the meetings. Thirty-five Spanish rheumatologists from diverse geographic regions discussed a comorbidity checklist and a shared decision making tool. The results of the local meetings were synthesised as (1) a judicious commitment to check agreed comorbidities, and (2) a list of barriers and facilitators for the implementation of shared decision making at the local settings. With regards to ways to implement the agreed list and periodicity, two issues standed-out: (1) patient education and (2) the need of easy access to information and the use of local organisational systems in place. With respect to shared decision-making, issues raised included messages for self-awareness, challenges, and practical facilitators. Discussion, adaptation, and planning are needed before implementing any evidence-based recommendation and materials if we want to achieve a successful implementation. Further studies should demonstrate whether this initiative was successful in achieving the goals of improved patient care. Our experience could be used as a guidance or example for implementation elsewhere. None declared

The disease modifying antirheumatic drugs (DMARD) impair the immune response of patients with immune-mediated inflammatory diseases (IMID). To analyze the seroprevalence of SARS-CoV-2 in patients with IMID treated with biological disease modifying antirheumatic drugs (bDMARD) or targeted synthetic (tsDMARD). An ambispective cross-sectional study was performed in patients with IMID treated with bDMARD or tsDMARD. Seroprevalence was compared by measuring IgG against SARS-CoV-2 between October 2020 and May 2021. A total of 550 patients with IMID were studied, all of them on bDMARD or tsDMARD therapy, none of them vaccinated at that time against SARS-CoV-2. Patients receiving anti-TNFα therapy had a higher seroprevalence than other biologic and synthetic targeted therapies (OR= 1.792; 95% CI 1.088-2.951; p= 0.021). Patients with bDMARD or tsDMARD treated concomitantly with some type of conventional synthetic DMARD (csDMARD) presented a lower seroprevalence compared to patients treated in monotherapy, 10.7 vs. 19.9% (p= 0.003). When analyzing the treatments with the different csDMARD separately (methotrexate, leflunomide, sulfasalazine, azathioprine, hydroxychloroquine and the others), methotrexate was determined to influence in a lower seroprevalence, compared to those who did not receive any csDMARD, 9.8 vs 19.9% (OR= 0.439, 95% CI 0.232-0.828; p= 0.011). When evaluating the influence of methotrexate on seroprevalence among the different groups of bDMARD or tsDMARD, a lower seroprevalence was demonstrated in the group of patients receiving anti-TNFα and methotrexate in combination, versus patients on this bDMARD in monotherapy, 10.1 vs 24.1% (OR= 0.355, 95% CI 0.165 - 0.764; p=0.006). No significant differences were identified with the other bDMARD. Regarding the patients' IMIDs, no differences in seroprevalence were observed when compared by disease groups with each other. Seroprevalence in the group of patients with IMID is influenced according to the therapy received, being higher in patients receiving anti-TNFα monotherapy, but significantly lower if concomitant to this drug they receive methotrexate. These differences are not seen with the other b/tsDMARD and csDMARD. [1]Muñoz-Fernández S, Cebrian L, Thuissard IJ, Martina Steiner M, García-Yubero C, Esteban AV et al. Incidence of COVID-19 in 902 Patients With Immunomediated Inflammatory Diseases Treated With Biologics and Targeted Synthetic Disease-Modifying Antirheumatic Drugs-Findings From the BIOCOVID Study. J Clin Reumatol. 2022 Mar 1; 28(2): e348-e352. [2]Favalli EG, Gobbini A, Bombaci M, Maioli G, et al. The Impact of Anti-rheumatic Drugs on the Seroprevalence of Anti-SARS-CoV-2 Antibodies in a Cohort of Patients With Inflammatory Arthritis: The MAINSTREAM Study. Front Med (Lausana), March 2022. [3]Simon D, Tascilar K, Kleyer A, Fagni F, Krönke G, Médeet C et al. Impact of cytokine inhibitor therapy on the prevalence, seroconversion rate and longevity of the humoral immune response against SARSCoV- 2 in an unvaccinated cohort. Arthritis & Rheumatology Vol. 74, No. 5, May 2022, pp 783–790 Olga Reillo from Hospital Universitario Infanta Sofía (Librarian - Documentalist) None Declared.

BackgroundAccording to the 2009 ASAS classification criteria, a patient with chronic low back pain (CLBP) may be classified as axial spondyloarthritis (ax-SpA), with or without radiographic evidence of sacroiliitis, if at least one other SpA feature is present in the first case and positive HLA-B27 and at least two SpA features in the second one. There is concern about whether the classification ”axial non-radiographic spondyloarthritis” (ax-SpA-nr) includes patients with a mild disease that do not require treatment or special care by rheumatology.ObjectivesTo compare disease burden between patients fulfilling criteria for AS and ax-SpA-nr.MethodsSub-analysis of Spanish patients from the PROOF study, an international prospective observational longitudinal study conducted in rheumatology clinics. All patients who attended rheumatology clinics due to CLBP (≥3 months, start <45 years of age) from Jan 2015 to ,Feb 2017 not previously diagnosed were consecutively included. The ASAS criteria were applied to all, with centralised image reading. Patients with AS and ax-SpA-nr were compared.Results192 patients with CLBP were included, of whom 151 (79%) met criteria of SpA-axe, 56 (43%) of AS and 74 (57%) of ax-SpA-nr (21 patients had X-ray missing or no central reading had been done so far). The table shows the description of patients with AS and ax-SpA-nr and their comparison.Abstract AB0857 – Table 1*Only among actively employed.Abbreviations: m, mean; SD, standard deviation; BASDAI, Bath Ankylosing Spondylitis Disease Activity Score; ASDAS-CRP, Ankylosing Spondylitis Disease Activity Score calculated with C-reactive protein; BASFI, Bath Ankylosing Spondylitis Functional Index; SF-12, Short Form questionnaire, 12 items version; WPAI-SHP, Work Productivity and Activity Impairment Questionnaire related to disease; TNF, tumour necrosis factor.ConclusionsPatients referred by CLBP to rheumatology clinics meeting ASAS criteria for AS or ax-SpA-nr differ little in terms of impact and disease activity; therefore, non-radiographic forms of ax-SpA require as much attention as classic AS.AcknowledgementsThe PROOF study was sponsored by AbbVie. AbbVie contributed to the study design, research, and interpretation of data, writing, reviewing, and approving the publication. The authors wish to thank Loreto Carmona (InMusc) for providing medical writing and editing services in the development of this abstract. The financial support for these services was provided by AbbVie.Disclosure of InterestE. de Miguel Mendieta Grant/research support from: Abbvie, S. Muñoz Fernández Grant/research support from: Abbvie, C. Montilla Morales Grant/research support from: Abbvie, J. Ruiz Martín Grant/research support from: Abbvie, D. Reina Sanz Grant/research support from: Abbvie, C. Aguilera Cros Grant/research support from: Abbvie, M. Á. Belmonte Serrano Grant/research support from: Abbvie, J. R. Noguera Pons Grant/research support from: Abbvie, C. Barbazán Álvarez Grant/research support from: Abbvie, M. Arranz Employee of: Abbvie, V. Díaz Employee of: Abbvie

To evaluate bone mineral metabolism in HIV infected and asymptomatic patients receiving highly active antiretroviral therapy (HAART) containing protease inhibitors (PI) and naïve patients. We studied 30 asymptomatic HIV infected male patients, 13 in the naive group and 17 in the IP group, both without differences in demographics characteristics. We excluded women and patients with any known factor associated to osteopenia. We did a nutritional questionnaire, a DEXA scan in lumbar spine and femur, a study of CD4 lymphocytes, viral load and an analysis of bone formation and resorption markers in all patients. We compared vitamin D and PTH levels with a control group of healthy male volunteers age-pareated. For the statistical analysis we used the SPSS program. Osteopenia was present in 17/30 (57%), 8/13 (61.5%) in the naïve group and 9/17 (53%) in the PI group (not significant differences). We found a vitamin D deficiency in 86% of patients, with mean serum levels that was found to be significantly lower than those from a healthy control group (p=0.04). Testosterone level was significantly related to bone mineral density in lumbar spine (p