BackgroundRheumatoid arthritis (RA) affects approximately 1.5% of the population worldwide and 0.5-3.3% of the Mexican population1. Anti-carbamylated proteins (anti-CarP) antibodies are identified in RA patients with a prevalence up to 44%2, early arthritis, first-degree relatives (FDR) of patients with RA with a prevalence of 18%, and healthy controls with a prevalence of 4.7%. There is no evidence regarding the prevalence of the three different isoforms of anti-CarP antibodies worldwide.ObjectivesEstablish the prevalence of the different isoforms of anti-CarP antibodies (IgA, IgM, IgG) in FDRs of patients with RA.MethodsIt is an observational descriptive cohort. Subjects underwent a complete physical examination, made by a certificated rheumatologist, which included clinical and serological measurements. The serological measurements included anti-citrullinated peptides antibodies (ACPA), RF, and anti-CarP detected by ELISA using carbamylated fetal calf serum, according to Shin J et al with some modifications. The cut-offs for the anti-CarP IgA isoform was >125 U/mL, for the IgG isoform was >90 U/mL, and for the IgM isoform was >300 U/mL. The FDRs were classified as: suspicious arthralgia for progression according to Van Steenvergen criteria; undifferentiated arthritis (UA) and RA according to ACR/EULAR 2010; and soft tissue rheumatic diseases.ResultsA total of 144 FDRs from 99 RA patients were enrolled. The demographic characteristics are shown in Table 1. The prevalence (Table 2) for anti-CarP was 2.8% for IgA, 4.2% for IgG, whereas IgM was not detected. The serologic association was for RF/ACPA 4.48%, RF/anti-CarP 2.7%, FR 64.5%, ACPA 1.3%, ACPA/anti-CarP 0.69%, anti-CarP 3.4%, and no RF/ACPA/anti-Carp was observed.The group of suspicious arthralgia for progression had to 2 subjects positive for IgG anti-CarP, the group of UA had 1 subject positive for IgA anti-CarP, albeit no anti-CarP for the RA group was present. Soft tissue rheumatic diseases group had 5 subjects positive for IgG anti-CarP, while the asymptomatic group had 2 subjects positive for IgA anti-CarP. Table 1 Population, n (%)144 (100%)Age (years), median (IQR)45.25 (18-76)Weight (kg), median (IQR)70 (42-117)Height (meters), median (IQR)1.61 (1.44-1.88)BMI, median (IQR)26.19 (16.7-47.3)Female, n (%)119 (82%)HAQ, median (IQR)0.29 (0-2.15)IQR: interquartile range, Kg: kilograms; BMI: body mass index, HAQ: Health Assesment QuestionareAbstract AB1277 Table 2POSITIVE, n (%)MIN/MAXMEDIANCRP, mg/dL19 (13%)0.0-2.270.36ESR, mm/H; mean (SD)37 (25.3%)1-7213.0 (11.95)Anti-CarP, U/mLIgA4 (2.8%)0.0-8182.0IgM0 (0.0%)0.0-565.45IgG6 (4.2%)0.0-1878.0Rheumatoid Factor, U/mLIgA31 (21.5%)1-2196.96IgM64 (44.4%)1-20515IgG14 (9.7%)1-1603.04ACPA-IgG, U/mL10 (7%)1-2001.21CRP: C Reactive Protein; ESR: erythrocyte Sedimentation Rato; anti-CarP: Anti-Carbamylated Protein; SD: Standard Deviation; ACPA: anti-Citrullinated Peptides Antibodies.ConclusionEven though we used the 3 isoforms of anti-CarP antibodies, the prevalence of these antibodies in our cohort showed less positi...

Background:Cognition is the ability to learn, process and remember information to be used later.(1) Cognitive impairment reflects a decrease in one or more cognitive domains: memory, language, reasoning, among others.(2) It has been reported in rheumatic diseases such as systemic lupus erythematosus, rheumatoid arthritis, fibromyalgia, and it is frequently found in young patients during the first years of their illness correlating the disease progression.(3) This condition can lead to anxiety and depression, compromising the quality of life. Given the lack of consensus regarding the best test to diagnose cognitive impairment, multiple tools have been used to address this problem.Objectives:To describe the systematical assessment in a Cognitive Evaluation and Rehabilitation Clinic in rheumatic patients from a University Hospital in Mexico.Methods:Observational and descriptive study. A multidisciplinary team met for 6 months to establish the structure a Cognitive Evaluation and Rehabilitation Clinic in a University Hospital in Mexico (Figure 1). As a pilot group we included outpatients from a Rheumatology clinic, referred by their physician (Table 1). The following psychological tests were used: Montreal Cognitive Assessment (MoCA) and Neurobehavioral Cognitive Status Examination (NCSE). After results (Table 2), the team decided to extend the evaluation with Automated Neuropsychological Assessment Metrics (ANAM), Wechsler Adult Intelligence Scale (WAIS-IV) and International Neuropsychiatric Interview (MINI) (Figure 2). Statistical analysis was performed with SPSS v.24, descriptive statistic were used with measures of central frequency trend.Table 1.Demographic characteristicsN=21Age, mean (SD)43.62 (14.68)Female, n (%)14 (66.66)Years of education, mean (SD)15.24 (2.70)Psychiatric disorderDepression, n (%)4 (19.04)Rheumatic diagnosisSystemic lupus erythematosus, n (%)13 (61.90)Rheumatoid arthritis, n (%)3 (14.30)Others, n (%)5 (23.80)Table 2.Comparison of MoCA and NCSE results.MoCAN=21NCSE N=21Total score, mean (SD)24.24 (3.49)38.52 (1.69)Level of cognitive impairmentNormal, n (%)7 (33.3)17 (81)Mild, n (%)13 (61.9)1 (4.8)Moderate, n (%)1(4.8)3 (14.2)Severe, n (%)0 (0)0 (0)MoCA, Montreal Cognitive Assessment; NCSE, Neurobehavioral Cognitive Status Examination.Figure 1.Pilot program of the Neurocognitive AssessmentFigure 2.Final Program of the Neurocognitive AssessmentResults:We evaluated 21 patients (66% females) with an average age of 43.62 years (SD 14.6) (Table 1). The total number of patients with cognitive impairment was 15 (71%), 14 (66%) diagnosed with MoCA, 6 (28%) with NCSE and a coincidence of both tests in 4 (19%) patients (Table 2).Conclusion:A high percentage of patients with cognitive impairment was found, also a discrepancy between the MoCA and NCSE results. We realized those tests were not enough to get a detail cognitive functioning, for this reason it was decided to make a more extensive evaluation adding ANAM, WAIS-IV and MINI. Neuropsychological evaluation should be performed as part of a multidisciplinary management for the patient and the rheumatologist should be aware of this manifestation and the importance of cognitive testing.References:[1]Gutierrez Rodriguez J, Guzman Gutierrez G. Definition and prevalence of mild cognitive impairment. Rev Esp Geriatr Gerontol. 2017;52 Suppl 1:3-6.[2]Quijano JP-CyTdS. Evaluación Neuropsicológica y Funcional de la Demencia. Barcelona1996.[3]Wijbrandts CA, Tak PP. Prediction of Response to Targeted Treatment in Rheumatoid Arthritis. Mayo Clin Proc. 2017;92(7):1129-43.Disclosure of Interests:None declared