Dr. José Antonio Pinto TasendeComplejo Hospitalario Universitario de A Coruña

ARTRITIS PSORIÁSICACLÍNICA

Wednesday 08.06.2016 15:00 - 16:30Clinical Science Session - Hall DAxial spondyloarthritis and psoriatic arthritis: Emerging pathways

Baeten Dominique (Netherlands) SP0006 The IL17-pathway

Elewaut Dirk (Belgium)The IL 22/23-pathway

Lories Rik (Belgium) The role of mechanostress

Wednesday 08.06.2016 15:00 - 16:30Clinical Science Session - Hall DAxial spondyloarthritis and psoriatic arthritis: Emerging pathways

Baeten Dominique (Netherlands) SP0006 The IL17-pathway

IL-17 y neoformación ósea

1. IL17 inhibe la diferenciación osteoblástica (Shaw AT, 2016)2. IL17 inhibe la función osteocitica (Uluckan O, 2016)3. IL17, como otras cks de las céls T, contribuye a la curación de las

fracturas (Nam, 2012)4. IL17A aumenta la regeneración ósea, sobretodo en combinación

con BMP2, al aumentar la mineralización (Ono, 2016)5. IL17 promueve la diferenciación osteogénica de CMM (Osta, 2014)6. IL17A y E + BMP2, promueven la diferenciación de CMM humanas

(Croes, 2016)7. IL17A + TNF, promueven la diferenciación osteogénica de los SFL

humanos (Lavaocat, 2016)8. IL17A + TNF, promueven la diferenciación osteogénica en SFL

humanos en SpA (ACR 2015)

Resumen

El daño estructural es combinación de destrucción y neoformación ósea

TNF e IL-17 juegan un papel central mediando en la destrucción ósea

Aumenta la evidencia de que IL17 puede aumentar la formación ósea en condiciones específicas

Abstract El Miedany Yasser (United Kingdom)

OP0091 PSORIATIC ARTHRITIS COMORBIDITY INDEX: DEVELOPMENT AND VALIDATION OF A NEW SPECIFIC TOOL FOR CLASSIFYING PROGNOSTIC COMORBIDITY IN PSORIATIC ARTHRITIS PATIENTS

OP0091PSORIATIC ARTHRITIS COMORBIDITY INDEX: DEVELOPMENT AND VALIDATION OF A NEW SPECIFIC TOOL FOR CLASSIFYING PROGNOSTIC COMORBIDITY IN PSORIATIC ARTHRITIS PATIENTSY. El Miedany1,*, M. El Gaafary2, S. Youssef3, S. Bahlas4, I. Ahmed5, M. Hegazi61Rheumatology, Darent Valley Hospital, Dartford, United Kingdom, 2Community and Public health, 3Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt, 4Rheumatology, King Abdel Aziz University, Jeddah, Saudi Arabia, 5Medicine, Cairo University, Cairo, Egypt, 6Medicine, Adan Hospital, Kuwait, Kuwait

Background: Specific comorbidity index can guide the management of psoriatic arthritis (PsA) patients and optimize their outcomes. Sofar, no disease-specific models are currently available for this purpose.

Objectives: 1. identify comorbidities with greatest impact on PsA patients’ health status. 2. develop and validate a prospectively applicablecomorbidity index for classifying PsA patients according to their comorbid conditions which might alter their risk of hospitalization andmortality.

Methods: This was a retrospective multicenter cohort analysis of PsA patients in a rheumatology clinical registry, assessing the effect ofdifferent comorbidities measured at patients’ visits over 10-years period, on predicting future death and hospitalization. A weighted indexthat takes into account the number and seriousness of comorbid disease was developed in a cohort of 1707 PsA patients monitored over10-years. Logistic and Cox Regression analyses were implemented to estimate the risk of mortality. Regression coefficients were used todevelop the morbidity index score. ROC curve for the invented index was used to evaluate the discriminating ability of the index andidentify different cutoff values that can delineate patients at different stages for risk of death. Disease activity parameters wereconsidered.

Results: PsA patients who had higher incidence of comorbid condition and were at high risk of hospitalization were men, with older age atdisease onset, high BMI at baseline (p < 0.05). The most prevalent comorbidities strongly associated with the 10-year death risk orhospitalization in PsA patients were: Cardiovascular (7 comorbidities), osteoporosis, falls, depression/ anxiety, diabetes mellitus, renal andliver diseases, lung and GIT affection, as well as infection (p < 0.001). Multivariate regression analysis identified Multidimensional DiseaseRelapse score (including 5 parameters: DAPSA, PASI, Functional disability score, ESR and CRP) as independent predictor for disease statusassociated with the 10-year death risk or hospitalization (Wald χ2=9.2, p=0.002, OR=24.6). Binary regression analysis revealed that: malegender, cardiovascular diseases, evident fall risk, diabetes, infection, anxiety, and the multidimensional relapse score were significantindependent factors affecting the 10-years outcome of the disease. A comorbidity index weighted according to the regression coefficientof the variables extracted through the logistic regression analysis was developed. The score ranges from 0 to 38. A cut off point of 14.5was associated with a sensitivity of 97.5% and a specificity of 87%. Validation using ROC curve revealed AUC of 98.5%.

Conclusions: The PsA-comorbidity index is a valid method for estimating risk of death in PsA patients. It enables the clinicians to includecomorbidities assessment and management in their standard practice. It can be used to predict resource utilization, identify targets forreducing high costs, by prospectively identifying PsA patients at high risk. Rigorous application of systematic evaluation of comorbiditiesmay permit earlier detection, which may ultimately result in an improved outcome of patients with PsA.

Abstract Højgaard Pil (Denmark)

THU0418 OBESITY IMPAIRS THE RESPONSE TO TUMOUR NECROSIS FACTOR-ALPHA INHIBITORS IN PSORIATIC ARTHRITIS: RESULTS FROM THE DANBIO AND ICEBIOREGISTRIES.

Background: TNF-α inhibitor (TNFI) treatment fails among half of patients with psoriatic arthritis (PsA) treated in routine care. Obesity is afrequent, pro-inflammatory condition in PsA that may affect pharmacokinetics, immunological processes and patient-reported outcomes.

Objectives: To investigate the impact of obesity on disease activity, treatment response and drug adherence among PsA patients initiatingtheir first TNFI treatment course in routine care.

Methods: Observational cohort-study based on the Danish (DANBIO) and Icelandic (ICEBIO) registries. Kaplan-Meier plots, Cox regression and logistic regression analyses studied the impact of obesity (body mass index (BMI) ≥30kg/m2) on drug adherence and TNFI response. Six-month response was defined according to ACR20/50/70 and EULAR criteria. Sub-analyses stratified according to gender and TNFI(adalimumab/etanercept/infliximab) were performed.

Results: Among 1943 patients (1750 Danish, 193 Icelandic) included in the study, 1271 (65%) had available BMI and 408 (32%) of thesewere obese (327 (80%) Danish, 81 (20%) Icelandic). Prescription rates were: adalimumab (39%), etanercept (26%), infliximab (24%),golimumab (7%) and certolizumab (4%). Median follow-up-time was 1.5 years, IQR: 0.5-3.9. At baseline obese patients smoked less (23%vs 30%), were older (49±12 vs 47±13 years, (mean (SD)) and had higher disease activity measured as DAS28 (4.6±1.2 vs 4.4±1.2), tenderjoint count (6 (3-13) vs 5 (2-11); median, (IQR)), C-reactive protein (9 (5-19) vs 7 (3-18)), HAQ score (1.1 (0.8-1.6) vs 0.9 (0.5-1.4)), Visual-Analogue-Scale (VAS) patient global (72 (54-87) vs 65 (50-80)) and VAS pain (66 (48-76) vs 60 (38-74)), compared with non-obese (allp<0.05). Obese patients had shorter treatment adherence than non-obese (Figure 1), especially among men (5.9 (4.1-7.7) vs 2.5 (1.7-3.2));median years(95%CI), (p<0.01). Similar results were found when Icelandic and Danish patients were analyzed separately. Obesity was anindependent predictor of TNFI withdrawal both overall: HR 1.6 (95%CI 1.3-2.0), in men: HR 1.8 (1.3-2.5), women: HR 1.5 (1.1-2.0) and forevery TNFI: adalimumab: HR 1.6 (1.2-2.2), etanercept: HR 2.0 (1.3-3.3), infliximab: HR 1.6 (1.1-2.5). The EULAR good-or-moderateresponse rate was significantly lower in obese than non-obese (55% vs 65%), (p=0.02). In men, obesity reduced the chance of both EULARgood response: OR 0.5 (95%CI 0.3-0.9) and EULAR good-or-moderate, ACR20 and ACR50 responses (all OR 0.4 (0.2-0.8)). Obesity alsopredicted a poorer EULAR good-or-moderate response overall (OR 0.6 (0.4-0.9)), in women (OR 0.5 (0.3-0.9)) and for all TNFI types (datanot shown).

THU0418OBESITY IMPAIRS THE RESPONSE TO TUMOUR NECROSIS FACTOR-ALPHA INHIBITORS IN PSORIATIC ARTHRITIS: RESULTS FROM THE DANBIO AND ICEBIO REGISTRIES. P. Højgaard1,2,*, B. Glintborg3, L. E. Kristensen2, T. J. Love 4,5, B. Gudbjornsson 4,5, L. Dreyer1,2,6

1Department of Rheumatology, Gentofte Hospital, Rigshospitalet, Copenhagen, 2The Parker Institute, Frederiksberg Hospital, Frederiksberg, 3Department of Rheumatology, Gentofte Hospital, Rigshospitalet and the DANBIO registry, Copenhagen, Denmark, 4Center for RheumatologyResearch (ICEBIO), Landspitali, University hospital of Iceland, 5Faculty of Medicine, University of Iceland, Reykjavík, Iceland, 6Faculty of Medicine, University of Copenhagen, Copenhagen, Denmark

Conclusions: Obesity is associated with increased disease activity and attenuatesresponse and adherence to TNFIs in PsA.

Abstract Coates Laura (United Kingdom)

THU0419 RAPID3 PERFORMS WELL IDENTIFYING TREATMENT EFFECT IN THE TIGHT CONTROL OF PSORIATIC ARTHRITIS STUDY

THU0419RAPID3 PERFORMS WELL IDENTIFYING TREATMENT EFFECT IN THE TIGHT CONTROL OF PSORIATIC ARTHRITIS STUDYL. C. Coates1,2,*, W. Tillett3, T. Pincus4, A. Kavanaugh5, P. S. Helliwell1,2

1Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, 3Royal National Hospitals for Rheumatic Diseases, Bath, United Kingdom, 4School of Medicine, Rush University, Chicago, 5Rheumatology, Allergy and Immunology, University of California, San Diego, San Diego, United States

Background: RAPID3 is a patient completed outcome measure assessing disease activity in inflammatory arthritisconsisting of the health assessment questionnaire (HAQ) and two VAS scales. It is feasible for use in clinical practiceand has been well validated in rheumatoid arthritis (RA) and other conditions, but there is little data on its use inpsoriatic arthritis (PsA).

Objectives: To investigate the responsiveness and discrimination of RAPID3 and a modified version with skin VAS inthe Tight Control of Psoriatic Arthritis (TICOPA) trial.

Methods: Data from the TICOPA trial were used to assess the performance of the RAPID3 index. RAPID3 wascalculated using the HAQ-DI, patient completed pain VAS and global disease activity VAS. Due to concerns aboutskin involvement in PsA, we also calculated a novel RAPID3Ps score which also included a skin activity VAS to see ifperformance was superior.Results from the RAPID3 measures were correlated with the PsA disease activity score (PASDAS) a compositedisease activity score already validated by GRAPPA. Change in the RAPID3 measures and other outcome measureswere compared between the tight control arm and the standard care arm of the TICOPA study using t-test forcontinuous variables and chi-squared for categorical measures of disease state.

Results: RAPID3 scores strongly correlated with PASDAS (Pearson correlation 0.794, p<0.01) at all baseline andfollow up visits. The change in score at follow up was also moderately correlated with the change in PASDAS (0.636,p<0.01). Correlation was similar for the RAPID3Ps at 0.831.When looking at differentiation between treatment groups, change in RAPID3 score at 48 weeks was highlydiscriminant (t value -3.43, p<0.001) and was higher than all other PsA measures (DAPSA and other individualoutcome measures) except for PASDAS (t value -3.75, p<0.001) as shown in the table.Looking at specific cutpoints, RAPID3 “near remission” was also highly discriminant between treatment groups (chisquared 7.48, p=0.006) although with a lower value than the minimal disease activity criteria for PsA (chi squared10.11, p=0.001).

Conclusions: RAPID3 shows good correlation with other validated measures of disease activity inPsA and addition of a psoriasis measure does not seem necessary in this population. The RAPID3score and “near remission” definition are able to effectively discriminate between two activetreatment groups in an interventional trial.

Abstract Chandran Vinod (Canada)

THU0421 SERUM-BASED SOLUBLE MARKERS MAY DIFFERENTIATE PSORIATIC ARTHRITIS FROM OSTEOARTHRITIS

THU0421SERUM-BASED SOLUBLE MARKERS MAY DIFFERENTIATE PSORIATIC ARTHRITIS FROM OSTEOARTHRITISV. Chandran1,2,*, A. V. Perruccio2,3, S. Li2, F. Abji2, R. Gandhi3, D. D. Gladman2,3

1Medicine, Laboratory Medicine and Pathobiology, Institute of Medical Science, UNIVERSITY OF TORONTO, 2Krembil Research Institute, 3UNIVERSITY OF TORONTO, Toronto, Canada Background: It is often difficult to differentiate psoriatic arthritis (PsA) from osteoarthritis (OA) in clinical practice. Objectives: To aid clinical diagnosis, we aimed to identify soluble biomarkers that differentiate PsA from OA. Methods: Serum samples from 201 patients with OA (mean age 65 years, 43.3% males, no history of inflammatory disease), 77

patients with PsA satisfying CASPAR criteria (mean age 45 years, 54.5 % males) and 76 healthy controls (mean age 37 years,50% males) were obtained from the respective biobanks of the Arthritis Program, University Health Network, and theUniversity of Toronto PsA Program. Samples were obtained at the time of joint replacement surgery (OA) or at the time ofclinical assessment (PsA, healthy controls), and stored at -80°C until laboratory assays were conducted. Soluble markers ofcartilage metabolism (COMP, hyaluronan), metabolic syndrome (adiponectin, adipsin, resistin, HGF, insulin, leptin) andinflammation/immune response (CRP, IL-1b, -6, -8, TNF-α, MCP-1, NGF) were assayed in the samples using Luminex multiplexassay. Marker levels in serum were compared across the 3 groups using the Kruskal-Wallis test. Pair-wise comparisons weremade with Wilcoxon rank sum test. To identify markers that differentiate PsA from OA, multivariate logistic regression analyseswith backward elimination, adjusted for age and sex, were constructed using markers determined to be significant at a p≤0.1from univariate analyses. Discriminative ability was assessed by way of receiver operating characteristic (ROC) curves based onfindings from multivariate models. The final model was further validated in an independent set of 73 PsA and 75 OA samplesusing predicted probabilities estimated using coefficients from the model developed on the training set.

Results: Univariate analyses revealed the following markers significantly differed across groups (p<0.001): COMP, hyaluronan;resistin, HGF, insulin, leptin; CRP, IL -6, -8, TNF-α, MCP-1, NGF. When comparing PsA to OA, the following markers significantlydiffered (p<0.001): COMP, hyaluronan; resistin, HGF, insulin; CRP, IL-6, -8, TNF-α, MCP-1, NGF. Multivariate analysisdemonstrated that COMP (OR 1.24, 95% CI 1.06, 1.46), resistin (OR 1.26, 95% CI 1.07, 1.48), MCP-1 (OR 1.10, 95% CI .07, 1.48)and NGF (OR <0.001, 95% CI <0.001, 0.25) were independently associated with PsA vs. OA. The area under the ROC curve(AUROC) for this model was 0.99. Internal cross-validation of the model consistently identified MCP-1 as a PsA marker. Furthervalidation of the model including COMP, resistin, MCP-1 and NGF showed an AUROC of 0.98.

Conclusions: A panel of 4 biomarkers (COMP, resistin, MCP-1, NGF) may distinguish PsA from OA. Clinical utility of thesemarkers will need to be determined in prospective studies.

Abstract Harrold Leslie (United States)

THU0423 TIME TO REBOUND IN JOINT SYMPTOMS FOLLOWING DISCONTINUATION OF TNFI THERAPY AFTER ACHIEVING LOW DISEASE ACTIVITY OR REMISSION IN PSORIATIC ARTHRITIS PATIENTS ENROLLED IN THE US CORRONA REGISTRY

THU0423TIME TO REBOUND IN JOINT SYMPTOMS FOLLOWING DISCONTINUATION OF TNFI THERAPY AFTER ACHIEVING LOW DISEASE ACTIVITY OR REMISSION IN PSORIATIC ARTHRITIS PATIENTS ENROLLED IN THE US CORRONA REGISTRYL. R. Harrold1,*, B. Stolshek2, S. Rebello1, D. Collier2, A. Mutebi2, S. W. Wade3, W. Malley1, J. D. Greenberg1, C. J. Etzel11Corrona, LLC, Southborough, 2Amgen, Inc., Thousand Oaks, 3Wade Outcomes Research Consulting, Salt Lake City, United States

Background: The treatment goal for patients (pts) with psoriatic arthritis (PsA) is to suppress disease activity. Little is knownabout clinical outcomes in pts who stop TNFi therapy after achieving low disease activity (LDA) during routine care.

Objectives: We evaluated time to rebound (i.e., increase in joint symptoms after therapy discontinuation) in pts with PsA whoachieved LDA prior to stopping TNFi therapy as well as changes in measures of disease activity at the first visit following TNFidiscontinuation.

Methods: In the Corrona registry, we identified pts with PsA who initiated a TNFi (adalimumab, etanercept, infliximab,golimumab), achieved LDA based on Clinical Disease Activity Index (CDAI) ≤ 10 on TNFi therapy, discontinued TNFi altogetherwhile still in LDA (persistence on conventional disease modifying medication was allowed) and had at least 1 follow-up visitwhile off TNFi. Demographic and clinical characteristics were assessed at discontinuation date (index date). To assess time torebound, pts were followed until earliest of the following events: rebound of symptoms (CDAI >10), initiation of anotherbiologic/small molecule or last follow-up visit. Kaplan-Meier curves were generated for time to rebound (CDAI >10). To assessimpact of TNFi discontinuation, change in disease activity measures including CDAI, modified Health Assessment Questionnaire(mHAQ), pt and physician global assessments, and pt pain were assessed between discontinuation and first post-index visit.

Results: There were 94 pts (57% female, 51% biologic-experienced at TNFi initiation) who met study criteria. At TNFidiscontinuation, mean (standard deviation [SD]) age and disease duration were 52.6 (12.7) and 9.8 (7.4) years, respectively.Over time, 67 (73%) pts had a rebound in symptoms, with median time to rebound of 8 months (95% CI 6-12). At first post-index visit, there was a significant mean increase in all measures of disease activity except mHAQ (Table).

Conclusions: Rebound of symptoms in PsA patients occurred frequently with the majority of patients having worsening ofdisease activity by the next visit after TNFi discontinuation. These results suggest careful consideration before stopping theseagents after achievement of low disease activity.

Abstract Michelsen Brigitte (Norway)

THU0426 ACHILLES ENTHESITIS DEFINED BY ULTRASOUND IS NOT ASSOCIATED TO CLINICAL ENTHESITIS IN PATIENTS WITH PSORIATIC ARTHRITIS

THU0426ACHILLES ENTHESITIS DEFINED BY ULTRASOUND IS NOT ASSOCIATED TO CLINICAL ENTHESITIS IN PATIENTS WITH PSORIATIC ARTHRITISB. Michelsen1,*, A. P. Diamantopoulos1,2, D. M. Soldal1, H. B. Hammer3, A. Kavanaugh4, G. Haugeberg1,5,61Dept. of Rheumatology, Hospital of Southern Norway Trust , Kristiansand, 2Dept. of Rheumatology, Haugesund Rheumatism Hospital, Haugesund, 3Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 4Dept. of Rheumatology, Allergy, Immunology, Univeristy of California San Diego, San Diego, United States, 5Dept. of Rheumatology, University of Science and Technology, Trondheim, 6Dept. of Rheumatology, Martina Hansens Hospital, Baerum, Norway

Background: Clinical examination may overestimate Achilles enthesitis. Ultrasonography (US) is a valuable tool forassessment of musculoskeletal inflammation including subclinical enthesitis.

Objectives: The aim of our study was to compare clinical and US evaluation of Achilles enthesitis in patients withpsoriatic arthritis (PsA).

Methods: Patients with PsA were included consecutively in a clinical setting during 1.5 years. The Achilles insertionwas examined by clinical assessment of tenderness by a trained nurse, and an experienced ultrasonographerperformed US evaluation of 1) inflammatory activity defined as power Doppler (PD) signal, tendon thickening,hypoechogenicity and bursal swelling as well as 2) structural damage defined as erosions at tendon insertion,calcifications and enthesophytes. US sum scores of inflammatory activity and structural damage were assessed.Demographic variables and US scores were assessed by descriptive statistics. Proportions were analysed by Chi-Square test. Correlations were assessed by Spearman’s rank correlation test (non-parametric distribution of thedata).

Results: A total of 141 PsA patients were included. They all fulfilled the CASPAR criteria. Mean (SD) age was 52.4(10.2) years, disease duration 9.5 (6.6) years, BMI 28.3 (4.3) kg/m2, 50.4% were females, 10.6% used steroids,57.4% conventional synthetic disease modifying drugs (csDMARDs), 32.6% tumor necrosis factor inhibitors (TNFi)and 20.6% both TNFi and csDMARDs.

Of 282 Achilles tendons, 88 (33.2%) were tender on palpation. By US, 6 (17%) had hypoechogenicity, 37 (13.1%)thickening, 2 (0.8%) PD activity, 14 (5%) bursal swelling, 112 (39.7%) calcifications, 77 (27.3%) enthesophytes and 4(1.4%) erosions at tendon insertion. Inflammatory activity was found in 55 (19.5%) of the examined Achillestendons and 148 (52.5%) had structural damage on US sum scores. No significant correlation was found betweenUS sum scores and tenderness on palpation. 36 (18.6%) of the Achilles tendons showed subclinical inflammation onUS. No significant difference of percentages of patients with Achilles inflammatory activity or structural damagewas found when comparing patients currently treated or not with TNFi, csDMARDs and steroids.

Conclusions: We report lack of association between palpation tenderness and US signs of Achilles enthesitis in PsA.US showed structural damage in 52.5% and subclinical inflammation in 18.6% of the examined Achilles tendons.

Abstract Queiro Ruben (Spain)

THU0427 STUDY OF PREVALENCE AND PREDICTORS OF MINIMAL DISEASE ACTIVITY (MDA) STATE IN A SPANISH POPULATION WITH PSORIATIC ARTHRITIS. MAAPS STUDY

THU0427STUDY OF PREVALENCE AND PREDICTORS OF MINIMAL DISEASE ACTIVITY (MDA) STATE IN A SPANISH POPULATION WITH PSORIATIC ARTHRITIS. MAAPS STUDYR. Queiro1,* on behalf of Juan D. Cañete, Juan C. Torre, Jose A. Román-Ivorra, Jesús Sanz, Carlos Montilla, Juan Salvatierra, Jaime Calvo, Susana Gómez, María Montoro, Ana Cábez.1Rheumatology. Coordinator center., HUCA, OVIEDO, Spain

Background: Biological therapies have greatly improved the management of psoriatic arthritis (PsA). Minimal diseaseactivity (MDA) has become the optimal target in the treatment of PsA, waiting for a standardized definition ofremission. Knowing the proportion of PsA patients in the MDA state could inform on the quality of management ofthese patients.

Objectives: To determine the prevalence of MDA (Coates et al.) in patients with PsA in Spain as well as its potentialpredictors. To evaluate the association between MDA and the impact of disease, as evaluated by the PsA Impact ofDisease questionnaire (PsAID).

Methods: This was a non-interventional, cross-sectional, multicenter study, which aimed to evaluate the prevalenceof MDA in a Spanish population with PsA. The study was carried out at 25 rheumatology outpatient clinics betweenMay/2014 and Feb/2015. A total of 238 adult patients diagnosed with PsA (CASPAR criteria) with at least one yeardisease duration and treated with biological and non-biological DMARDS were included. Finally, 227 were consideredevaluable. Clinical, demographic, treatment data, physical function (HAQ) and quality of life (PsAID) were obtained.According to the latter, the patient acceptable symptoms state (PASS) has been defined as a PsAID value < 4. Allpatients gave informed consent. An Ethics committee board approved the final version of this study.

Results: Overall, 133 out of 227 (58.6%) subjects achieved MDA at study entry. Seventy-seven (37.9%) and 137(64.4%) patients reached joint and skin remission, respectively. However, a fair relationship between MDA and jointremission (k=0.390) and a slight relationship between MDA and skin remission (k=0.178) were observed. Patients inMDA state had better functional capacity by HAQ (0.35 ± 0.47) vs non-MDA patients (0.79 ± 0.63), p < 0.001. Thesepatients also had a significantly lower impact of the disease as measured by PsAID: MDA patients (3.34 ± 3.05) vsnon-MDA patients (7.13 ± 5.21), p < 0.001. In multivariate logistic regression analysis, male gender (OR 2.74, p =0.001), sedentary lifestyle (OR 3.13, p = 0.002), familial history of PsA (OR 0.38, p = 0.036), CRP level (OR 0.92, p =0.010) and use of corticoids (OR 0.33 p = 0.007) were predictors of MDA. Painful entheses count ≤ 1 was the MDAcriterion met by the highest proportion of patients (80.5%), whereas reaching a global disease activity VAS score ≤ 20was achieved by only 43.2% of them.

Conclusions: MDA was achieved by nearly 60% of patients in this study reflecting clinicalpractice in agreement with results from earlier studies. These patients had better functionalstate and most of them reached an acceptable symptoms state according to the PsAID. Ourresults of predictors to achive MDA should be confirmed in further prospective studies.

Abstract Merashli Mira (United Kingdom) OP0127

LOW FREQUENCY OF US DETERMINED EROSIONS IN EARLY PSORIATIC ARTHRITIS:RESULTS FROM THE LEEDS SPARRO COHORT

OP0127LOW FREQUENCY OF US DETERMINED EROSIONS IN EARLY PSORIATIC ARTHRITIS: RESULTS FROM THE LEEDS SPARRO COHORTM. Merashli1,2,*, G. De Marco3, P. Helliwell1, L. Horton3, M. A. D'agostino4, D. Mcgonagle 2, R. Wakefield1, J. Freeston2, H. Marzo-Ortega2

1NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, 2NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK, Leeds, United Kingdom, 3Rheumatology, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK, 4Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK, Rheumatology Department, APHP, Hôpital Ambroise Paré, and Versailles-Saint-Quentin University, Saint-Quentin en Yvelines, France., Leeds, United Kingdom

Background: Ultrasound (US) is playing an increasingly important role in the earlyevaluation of psoriatic arthritis (PsA) being capable of detecting inflammatory changes atthe enthesis, synovium and extra capsular tissues. Peri-articular radiographic erosions inPsA and rheumatoid arthritis are associated with a worse outcome. Further, US is shownto be a more sensitive imaging technique than conventional radiography (CR) to identifyerosions in early RA. By contrast, there is a paucity of data in the literature on theprevalence of erosions and/or the capability of US to detect erosions in early PsA.

Objectives: To assess the prevalence of erosions in early PsA using CR and high resolutionUS.

Methods: We studied 860 joints of 43 patients (Table 1) with early PsA, all fulfillingCASPAR criteria from the Leeds Spondyloarthropathy Register for Research andObservation study (SpARRO) which is a prospective longitudinal observational cohort ofpatients with early spondyloarthritis. Radiographic and sonographic erosions of thewrists, MCPs (2, 3), PIPs (2, 3), and MTPs (1-5) bilaterally were independently evaluated.We looked at the frequency of erosions using both imaging methodologies. CR and USscoring systems used for defining erosions were the van der Heijde version of the Sharpand OMERACT respectively.

Conclusions:In keeping with the emerging data in PsA, these results show a low frequencyof erosions at clinical presentation on CR. Unlike studies in early RA, in thispreliminary study of early PsA the burden of erosive disease detected usingUS was not measurably different.

Results:Erosions were identified in a total of 8 patients, all negative for RF and CCPantibodies; 40% (3/8) of whom were ex-smokers. Four patients had sixerosions at MTP4, MTP5, and PIP3 by CR whilst six patients had six erosionson US. The exact agreement between the 2 methods was 99%. Agreementon absence of erosions in both CR and US was 99% while agreement on theirpresence was 17%. The proportions of joints where the CR and US disagreedin either direction (US>XR, US