Evaluate the prevalence of sarcopenia on patients with rheumatoid arthritis (RA), the influence of sarcopenia on disease activity and factors associated with sarcopenia. One hundred and twenty-three patients aged over 18 years with RA based on the 1987 ACR/EULAR classification criteria were enrolled. We performed a whole body DXA scan using a dual-energy X-ray absorptiometry (DXA) scanner lunar prodigy to measure fat mass, lean mass, and bone mass in the whole body and body parts. According to the anthropometric equation by Baumgartner et al., sarcopenia was defined as Relative skeletal mass index (RSMI) <5.5 kg/m on women and <7.26 kg/m on men. Body mass index (BMI) and waist circumference were measured and patients were classified according to World Health Organization. Disease activity was evaluated by: disease activity score 28 ESR (DAS28 ESR), disease activity score 28 CRP (DAS28 CRP), clinical disease activity index (CDAI), simplify disease activity index (SDAI). We measured functional disability by Health assessment questionnaire (HAQ). History and previous medication use including steroids were also checked, and comorbidities were recorded. We analyzed the relation between disease parameters and sarcopenia with the r of Pearson and Spearman. Factors associated and related to sarcopenia were assessed using multiple regression analysis and t independent test. We included 123 patients (107 women). 49 subjects (39.8%) where suffering from sarcopenia, of which 40 women. Most of the sarcopenic patients were between 41 and 50 years old. Sarcopenia on female subjects was not related to parameters of disease activity evaluated by DAS 28, CDAI and SDAI. Most of the sarcopenic patients had normal BMI and abnormal waist circumference. In simple regression analysis sarcopenia was related to BMI, DAS 28 ESR, bone erosion, waist circumference and HAQ. In multiple regression analysis, sarcopenia was positively related to an increase cardiometabolic risk [p = 0.025, OR 0.176, CI (0.038-0.980)], normal BMI [p = 0.004, OR 12.3, CI (2.27-67.6)], over fat BMI [p = 0.004, OR 12.3, CI (2.27-67.6)] and bone erosion [p = 0.012, OR 0.057 CI (0.006-0.532)]. No statistical difference was found according to disease duration and steroids use between sarcopenic and non sarcopenic patients. Sarcopenia is prevalent and related to age, bone erosion, normal/over fat BMI and high cardiometabolic risk according to waist circumference but not with disease activity.

BackgroundClinical disease activity index (CDAI) and simplified disease activity index (SDAI) are useful tools for the evaluation of disease activity in patients with rheumatoid arthritis (RA), but have not been comparatively validated in Moroccan population. Therefore, this study was designed to assess validity and reliability of CDAI and SDAI in comparison to disease activity score-28 joints (DAS-28) in Moroccan patients with RA.MethodsPatients with RA were included in a cross-sectional study. Patient characteristics and RA were collected. The disease activity was assessed by DAS-28, CDAI and SDAI. Patients were splitted into groups of remission, low, moderate and high activity on the basis of predefined cut-offs for DAS-28, CDAI, and SDAI. A Spearman correlation between composite indexes and inter-group comparison of the indexes were performed. Using DAS-28 as a gold standard, the Receiver operator characteristic (ROC) curve was used to assess the performance of a screening test at different levels.ResultsThe study was conducted with 103 patients of female predominance (87.4 %). Mean age was 49.7 ± 11.4 years. Median disease duration was in the order of 8 years [3-14]. There was an excellent correlation between DAS-28 and CDAI (r = 0.95, p <0.001), CDAI and SDAI (r = 0.90, p <0.001), and DAS-28 and SDAI (r = 0.92, p <0.001). There was a good inter-rater alignment between the DAS-28 and CDAI (Weighted kappa =0.743) and there was a moderate inter-rater alignment between the DAS-28 and SDAI (Weighted kappa =0.60), and also between the SDAI and CDAI (Weighted kappa = 0.589). There was no statistically significant difference between AUROC of CDAI and SDAI as both were performed equally well.DiscussionThis study is the first Moroccan case study to compare the performance of both CDAI and SDAI in evaluation of disease activity in patients with RA. Our study showed that there was a direct and excellent correlation between DAS-28 and CDAI, and SDAI and DAS-28.ConclusionOur study shows a strong positive correlation between DAS-28, CDAI and SDAI. The cut-off values for CDAI and SDAI used in western literature can be used with minor modifications in Moroccan scenario.

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Objectives This study aimed to evaluate the frequency of sleep disorders in patients with rheumatoid arthritis (RA) and to explore the determinants of these disorders. Methods It is a cross-sectional study including patients with RA. Patients with a known psychiatric disorder were excluded from the study. The demographic characteristics of patients and the characteristics of RA were collected. Pain and fatigue were assessed by a visual analogue scale (0-100 mm), the disease activity by DAS28 - ESR (Disease Activity Score), the Functional Disability by the Arabic validated version of the Health Assessment Questionnaire (HAQ), the quality of life by Euroqol 5D and psychological state by the Arabic validated version of the questionnaire Hospital Anxiety and Depression (HAD) with its two items anxiety and depression. Participants completed the self-rated questionnaire “Pittsburgh Sleep Quality Index (PSQI)” that assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven “component” scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The total score ranges from 0 (no disorder) and 21 (major problems) 1. Univariate and multivariate linear regression was performed to determine factors associated with poor sleep quality. Results 103 patients were included with a mean age of 49.7±11.4 years and a female predominance (90 (87.4%)). The median of RA duration was 8.16 years [3.25 to 14.16]. The median of global score PSQI was 5 [2-9]. Poorer Sleep quality was significantly associated with high disease activity (r =0.381, 95% CI [0.465, 1.320], p<0.001), lower quality of life (r = -0.327, 95% CI [-5.396 - 1.474], p=0.001), greater functional disability (r =0.289, 95% CI [ 0.323, 1.539], p=0.003), greater pain severity VAS (r =0.350, 95% CI [0.023, 0.075], p<0.001), increased fatigue VAS (r =0.380, 95% CI [0.030, 0.084], p<0.001), higher levels of anxiety (r =0.385, 95% CI [0.178, 0.498], p<0.001) and depression (r =0.310, 95% CI [0.103, 0.417]. In multivariate analysis, sleep disorders were associated with only higher levels of anxiety (r =0.254, 95% CI [0.033, 0.413], p=0.022). Conclusions Our study suggests that sleep disorders, in rheumatoid arthritis, are more frequently found in patients with associated anxiety disorders. References Sleep Quality and Functional Disability in Patients with Rheumatoid Arthritis; FS Luyster, ER Chasens, MCM Wasko et al; Journal of Clinical Sleep Medicine, Vol. 7, No. 1, 2011 Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4772

Objectives We aimed to analyze in children suffering from chronic haemophilic arthropathy relation between there functional impact and there quality of life. Methods Twenty- three children (mean age of 10.9±3.5 years [4-18]) suffering from severe haemophilia (median disease duration of 12 months (6; 18),median diagnosis delay of 0 months (0, 7)) were included. Functional impairment and quality of life were respectively assessed by the Moroccan versions of Children Health Assessment Questionnaire (CHAQ) and the European Quality of Life (the EUROQOL). A statistical analysis was conducted to determine the correlation between these two parameters using the r of Spearman Results Chronic haemophilic arthropathy affected knee, elbow, ankle and wrist in respectively 50, 27.5, 20 and 2.5%. Median CHAQ was 0.37 (0, 1.25). EUROQOL domains were affected as following: Mobility (69.6%),usual activity (65.2%), self-care (65.2%), anxiety/depression (43.4%) and pain (34.7%) Table 1 summarize correlation between the CHAQ and the 5 domains of EUROQOL. Table 1 Domains of EUROQOL CHAQ P r Mobility 0.04 0.432 Self care 0.004 0.579 Usual activity 0.01 0.484 pain 0.2 0.147 Anxiety/depression 0.7 0.146 Conclusions This study suggests that the functional impact of chronic haemophilic arthropathy in children affected by severe hemophilia seems mainly related to the domains of mobility, self-care and usual activity of the EUROQOL. Further studies are required to verify those results. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4867