ObjectivesThe relationship between osteoarthritis (OA) and osteoporosis has exhibited contradictory features over the past four decades. The aim of this study was to evaluate this relationship using separate analysis of the radiographic features of OA whether various radiographic features of OA were associated differently with bone mineral density (BMD) in the Korean elderly.MethodsData were derived from the Dong-gu cohort; 2,354 subjects were enrolled in the present cross-sectional study. Baseline characteristics, the BMDs of the lumbar spine and femoral neck which was measured by DXA, and X-rays of knees and hands, were collected. A semi-quantitative grading system was used to estimate the severities of individual radiographic features. We adjusted for confounders using multiple linear regression modeling to analyze the relationships.ResultsAfter adjustment for confounders, hand and knee OA total scores were negatively associated with the BMDs of the lumbar spine and femoral neck, except for the total knee OA score and lumbar spine BMD. In detail, hand osteophytes and sclerosis exhibited positive relationships with the BMDs of the lumbar spine and femoral neck, except for hand osteophytes and femoral neck BMD. On the contrary, however, knee joint space narrowing (JSN), hand JSN, and hand subchondral cysts were negatively associated with the BMD of the lumbar spine and femoral neck. Knee JSN and hand subchondral cysts exerted the greatest effects on BMD.ConclusionsSeparate analysis of the radiographic features of OA better reveals associations of OA with the BMD of the lumbar spine and femoral neck.Disclosure of InterestNone declared

Objectives To investigate whether patients with Sjögren’s syndrome(SS) can be distinguished based on the positivity of anti-centromere antibody (ACA) and if so, whether the subgroups differ in their clinical and laboratory features. Methods Eighty two consecutive patients with SS were included, with a median age of 43 years (range 15 - 71). All patients had minor salivary gland biopsy and sociodemographic, glandular, and extraglandular manifestations, and laboratory findings including autoantibodies, complement, and immunoglobulin levels, were analyzed. EULAR SS disease activity index (ESSDAI) and SS disease damage index (SSDDI) were also measured. Results The prevalence of ACA among SS patients was 13.4%. ACA positive SS patients had higher age at diagnosis (p=0.023), shorter disease duration (p=0.014), higher prevalence of Raynaud’s phenomenon (p<0.001), sclerodactyly (p=0.017) and Hashimoto’s thyroiditis (p=0.005) compared to ACA negative patients. The prevalence of anti-SSA/Ro and anti-SSB/La antibodies were significantly lower in ACA positive patients than ACA negative patients (p=0.002, both). Although SSDDI were not different between the two groups, ESSDAI was significantly lower in ACA positive patients than ACA negative patients (p=0.008). None of patients originally having ACA didn’t evolve to full blown systemic sclerosis. Conclusions These findings suggest that patients with SS who have ACA differ from classic SS patients in several clinical and laboratory parameters. ACA should be considered as one of the pathogenically relevant autoantibodies for SS. Disclosure of Interest None Declared

ObjectivesTo identify the potential predictors of a lupus low disease activity state (LLDAS), and the relationship between LLDAS and disease flare, organ damage, and quality of life in Korean patients with systemic lupus erythematosus (SLE).MethodsThe study followed 181 SLE patients from a single centre for three years. LLDAS was defined as follows:1 SLE Disease Activity Index (SLEDAI)−2K≤4, with no activity in major organ systems;2 no new lupus disease activity compared with the previous assessment;3 SLEDAI Physician Global Assessment≤1;4 a current prednisolone (or equivalent) dose ≤7.5 mg daily; and5 well-tolerated standard maintenance doses of immunosuppressive drugs. We assessed data annually and divided 4 groups according to the number of LLDAS; LLDAS=0, 1, 2, and 3. Univariate and multivariate analyses were performed to identify predictors of LLDAS.ResultsOf the 181 patients, 16.0% attained LLDAS on three consecutive years. Each group shows as follows; no LLDAS (n=30), LLDAS=1 (n=60), LLDAS=2 (n=62), and LLDAS=3 (n=29). The patients who had higher number of LLDAS had shorter duration of symptoms, lower anti-histone antibody positivity, lower cumulative prescribed dose of prednisolone at baseline, lower mean PGA, lower mean SLEDAI, lower mean Mental Component Summary in SF-36, lower change in SLICC/ACR damage index, and a lower frequency of flare. In the multivariate analysis, LLDAS was significantly associated with lower mean PGA (OR=0.671, 95% CI: 0.112–0.989, p=0.019) and a reduced risk of flare after adjusting for confounders (OR=0.012, 95% CI: 0.001–0.448, p=0.017).ConclusionsAttaining LLDAS was associated with an improved outcome, as represented by a decreased rate of disease flare, lower organ damage accrual, and better quality of life in Korean patients with SLE.Disclosure of InterestNone declared

BackgroundAllopurinol-induced severe cutaneous adverse reactions (SCARs) are relatively rare, but cause high rates of morbidity and mortality. Studies have shown that the HLA-B5801 allele and renal impairment are strongly associated with SCARs. Recent American College of Rheumatology guideline recommends that, prior to treatment with allopurinol, the HLA–B5801 genotype of gout patients at high risk for SCARs, including Korean patients with chronic renal insufficiency, should be determined. However, whether such genotyping is cost-effective is unknown.ObjectivesIn this study, we evaluated the cost-effectiveness of HLA-B5801 genotyping for treatment of gout in patients with chronic renal insufficiency in Korea.MethodsA decision analytic model over a time period of 12 months was employed to compare the cost and outcomes of treatment informed by HLA-B5801 genotyping with that of a conventional treatment strategy using a hypothetical cohort of gout patients with chronic renal insufficiency. Direct medical costs were obtained from real SCAR patients from two tertiary hospitals. Outcomes were measured as a total expected cost and an incremental cost-effectiveness ratio.ResultsIn the base model, the total expected cost and probability of continuation of gout treatment without SCARs with the conventional and HLA-B5801 screening strategies were US $1,193 and US $1,055, and 97.8% and 100%, respectively. The result was robust according to sensitivity analyses.ConclusionsOur model suggests that gout treatment informed by HLA-B5801 genotyping is less costly and more effective than treatment without genotyping, and HLA-B5801 genotyping could considerably reduce the occurrence of allopurinol-induced SCARs and related deaths.Disclosure of InterestNone declared

ObjectivesThe survival rate of patients with systemic lupus erythematosus (SLE) has improved in the last few decades, but the rate of hospitalization and health care costs for these patients remain higher than in the general population. Thus, we evaluated the rate of hospitalization and associated risk factors in an inception cohort of Korean patients with lupus.MethodsOf the 507 patients with SLE enrolled in the KORean lupus NETwork (KORNET registry), we investigated an inception cohort consisting of 196 patients with SLE presenting within 6 months of diagnosis based on the ACR classification criteria. We evaluated the causes of hospitalization, demographic characteristics, and laboratory and clinical data at the time of SLE diagnosis of hospitalized patients and during a follow-up period. We calculated the hospitalization rate as the number of total hospitalizations divided by the disease duration, and defined “frequent hospitalization” as hospitalization more than once per year.ResultsOf the 196 patients, 117 (59.6%) were admitted to hospital a total of 257 times during the 8-year follow-up period. Moreover, 22 (11.2%) patients were hospitalized frequently. The most common reasons for hospitalization included disease flares, infection, and pregnancy-related morbidity. In the univariate regression analysis, malar rash, arthritis, pericarditis, renal involvement, fever, SLE disease activity index >12, hemoglobin level <10 mg/dl, albumin level <3.5 mg/dl, and anti–Sjögren's syndrome A (SS-A) positivity were associated with frequent hospitalization. Finally, multivariate analysis showed that arthritis, pericarditis, and anti–SS-A antibody positivity at the time of diagnosis were risk factors for frequent hospitalization.ConclusionsOur results showed that frequent hospitalization occurred in 11.2% of hospitalized patients and arthritis, pericarditis, and anti–SS-A antibody positivity at the time of diagnosis were risk factors for frequent hospitalization.Disclosure of InterestNone declared