Background/Aims Psoriatic Arthritis (PsA) is a type of chronic inflammatory arthritis with diverse extra-articular manifestations and complications, including an increased burden of cardiovascular (CV) disease. Traditional CV risk factors are more common in PsA patients, leading to not only overt but also subclinical CV disease. Endothelial dysfunction and altered handling of low-density lipoproteins (LDL) lead to atherogenesis. Oxidized LDL (Ox-LDL) and antibodies against it (Anti Ox-LDL) may reflect the in vivo inflammatory burden in systemic vasculature in PsA. This study aimed to assess subclinical atherosclerosis in PsA patients and compare them with healthy controls, by assessing carotid intimal medial thickness (CIMT) and laboratory surrogates of dyslipidemia. Methods This was a cross-sectional, case-control study. Between January 2019 and May 2020, adult patients classified as PsA as per the CASPAR criteria, with symptom duration of at least 2 years, were included in this study. An equal number of age- and gender-matched controls were enrolled. We excluded patients on lipid-lowering drugs for more than the past 3 months. Demographic details, clinical and laboratory parameters (including Ox-LDL and Anti Ox-LDL antibodies), and bilateral CIMT assessment using B-mode Doppler Ultrasonography by a single, blinded cardiologist, were assessed for each participant. The study was approved by the Institutional Ethics Committee. Results Fifty PsA patients consented to the study, with a median age of 43.92 ± 10.79 years. Fifty healthy controls were also enrolled. 57% of the cases were male, with plaque psoriasis in 94%, and polyarthritis in 54%. Compared to the controls, PsA patients had significantly higher mean body mass index (BMI, 26.5 vs 24.6, p = 0.004), mean VLDL (25.6 mg/dl vs 20.5 mg/dl, p = 0.01), mean bilateral CIMT (0.62 mm vs 0.46 mm, p < 0.001), and mean Anti Ox-LDL antibody levels (29 U/ml vs 22.4 U/ml, p < 0.001). There was a significantly greater proportion of PsA patients with total cholesterol to HDL ratio >3.5 (86% vs 68%, p = 0.03), obesity (18% vs 6%, p = 0.01), and Anti Ox-LDL >30 U/ml (32% vs 6%, p = 0.02). CIMT and Anti Ox-LDL levels did not show any significant correlation. Univariate and multivariate analyses revealed that older patient age, total cholesterol level, and presence of PsA were risk factors for increased mean CIMT as a proxy for subclinical atherosclerosis. Conclusion This study used a novel biomarker, the Anti-Ox-LDL antibody, as a proposed surrogate marker for atherosclerotic risk stratification in patients with PsA. To our knowledge, this is the first such study in PsA. We found an increased prevalence of subclinical atherosclerosis in PsA patients compared to age- and gender-matched healthy controls. Age, total cholesterol levels, and the presence of PsA were independent predictors of atherosclerotic risk. Anti-Ox-LDL antibodies are significantly elevated in PsA patients compared to controls, but they may not correlate well with CIMT values. Disclosure D. Yadavalli: None. S. Ghosh: None. S. Dhuria: None. K. Telang: None. L. Sharma: None. R. Bajaj: None. V. Singal: None. R. Gupta: None.

Background/Aims Studies in autoimmune inflammatory myositis (AIM) have shown a strong role of autoantibodies in the diagnosis and prognosis of patients with myositis. This ongoing study shares the preliminary data of 139 patients with AIM from a North Indian tertiary care centre. This prospective, observational study was conducted at a 1250-bedded hospital to assess the prevalence of myositis-specific antibodies (MSA) and myositis-associated antibodies (MAA) in patients from the Indian subcontinent with AIM and the correlation of these antibodies with clinical features. Methods From November 2016 to September 2022, patients with AIM (satisfying the Bohan and Peter criteria of 1975) attending the Rheumatology and Clinical Immunology Department of Medanta Hospital were included after taking their informed consent, and divided into subgroups as dermatomyositis (DM), polymyositis (PM), CTD-associated myositis (CTD-M), cancer-associated myositis (CAM), and juvenile myositis (JM). The Institutional Ethics Committee approved the study. Clinical data and sera from patients were collected and analysed. Results The study included 139 individuals with a mean age of 45.4 years. Fifty-two had DM, 49 had PM, 25 had CTD-M, 6 had CAM, and 7 had JM. ANA positivity was found in 67.70%, MSA in 22.3%, MAA in 25.4%, and both in 12.3%. Antibodies against Mi-2 were identified in 13 (28.9%) patients, Jo-1 in 14 (32.50%), PL-7 in 3 (6.7%), PL-12 in 4 (8.9%), SRP in 9 (20%), and MDA-5 and NXP2 in 1 (2.2%) patient each. Antibodies against Ro were found in 28 (57.1%) of the patients, RNP in 8 (16.3%), and PM-Scl in 9 (18.4%). Mi-2 antibodies were mostly identified in DM patients and were significantly associated with skin rash. SRP positivity was mostly found mainly in PM. Raynaud's and ILD were linked to the presence of Jo-1 and Ro antibodies. Malignancy screening was negative in NXP2 and TIF1γ antibody-positive patients. Conclusion MSA was found in 22.3% of cases and MAA in 25.4%. Mi-2 antibodies were linked to rash, but none had ILD, whereas Jo-1 antibodies were linked to mechanic hands, arthritis, and ILD. We aim to gather more strong results in the future as additional patients are recruited in this continuing trial. Disclosure S. Dhuria: None. P. Khatri: None. N. Negalur: None. K. Telang: None. S. Ghosh: None. D. Yadavalli: None. V. Singal: None. R. Gupta: None.

Background/Aims Takayasu’s arteritis (TA) is a form of predominantly large vessel vasculitis affecting young individuals. Signs of vascular insufficiency or systemic inflammation may be seen in the vast majority of patients, with cardiac involvement noted in more than one-third of the cases. Previous histopathologic studies from India have revealed the presence of myocarditis in up to 50% of patients. We conducted this study to assess myocardial dysfunction using Speckle Tracking Echocardiography (STE), a novel method to assess global longitudinal systolic strain (GLSS), in TA patients and healthy controls. Methods This was a cross-sectional, case-control study. Between August 2018 and May 2021, all consenting adult patients classified as per the ACR 1990 Criteria as Takayasu’s arteritis were included in the study after taking their informed consent. Age and gender-matched healthy controls without known comorbidities like hypertension, diabetes, or coronary artery disease were included for comparison. Demographic, clinical, and laboratory parameters were assessed. All enrolled participants underwent 2D echocardiography with speckle tracking and GLSS evaluation as well as B-mode ultrasonography to measure carotid intimal medial thickness (CIMT) of bilateral carotid arteries, by a single, blinded cardiologist with over 20 years of experience in his field. The study was approved by the Institutional Ethics Committee. Results Fifty patients with TA who consented to the study were included, with fifty healthy controls. 66% of the cohort were female. TA patients had significantly lower mean LVEF (56% vs 60%, p < 0.0001), worse mean GLSS (-19.3% vs -20.9%, p = 0.003), more patients with GLSS >-19.7 (48% vs 24%, p = 0.01), and higher mean CIMT values (0.58mm vs 0.44mm, p = 0.001) than the healthy controls. Cases with GLSS less negative than -19.7% (24 out of 50) were significantly older (mean age 42.8 vs 35.4 years, p = 0.049), had more cardiac (62.5% vs 19.2%, p = 0.02) and coronary artery involvement (37.5% vs 7.7%, p = 0.011). Mean CIMT values were significantly more in patients with active disease as per the ITAS 2010 score. GLSS could not differentiate between active and inactive disease, nor did they correlate with raised inflammatory markers. There was no significant correlation between higher CIMT values and worse GLSS. Conclusion This is a pilot study comparing TA cases with healthy controls using STE and CIMT values. While mean CIMT values and GLSS were increased in patients with TA, GLSS did not correlate with disease activity status. Older age and a greater proportion of patients with cardiac involvement were the only significant differences noted in patients with worse GLSS. Longitudinal studies based on STE may help us document changes in subclinical myocarditis in TA. Disclosure R. Bajaj: None. S. Ghosh: None. D. Tanna: None. D. Yadavalli: None. W. Kazi: None. V. Singal: None. R. Gupta: None.

BackgroundSpondyloarthritis (SpA) is an umbrella term for a group of clinically heterogeneous chronic inflammatory diseases, with Ankylosing Spondylitis (AS) having the characteristic radiographic features of sacroiliitis and spinal deformities, while the other subtypes of SpA have some common as well as unique articular and extra-articular manifestations. Recent advances in early diagnosis have differentiated axial SpA into radiographic and non-radiographic subsets but the exact differences between them are debatable.ObjectivesThis study was conducted to assess and compare the clinical, laboratory, and radiologic characteristics of Indian patients with radiographic and non-radiographic axial SpA.MethodsThis was a cross-sectional, observational, comparative study conducted at a 1250-bedded tertiary care hospital. Between February 2020 and December 2021, all consecutive adult patients classified as having Axial Spondyloarthritis as per the Assessment of Spondyloarthritis international Society (ASAS) 2009 Classification Criteria and with symptom duration of at least 3 years were included in the study after taking their informed consent. Patients were classified as radiographic (AS) or non-radiographic Axial SpA (nr-Axial SpA) by two independent and blinded rheumatologists with over twenty years of experience in their field each, based on findings on anteroposterior plain radiographs in the supine position. Demographic details, articular and extra-articular manifestations, comorbidities, and relevant family history were assessed along with the levels of inflammatory markers and HLA B27 status. The study was approved by the Institutional Review Board and the Institutional Ethics Committee.Results209 patients consented to this study, with 160 being classified as radiographic and 49 as non-radiographic axial SpA. 79.4% of the patients were male. The mean age at symptom onset was 27.69 ± 9.33 years for our cohort, with a median duration of 50 months. There was a significantly higher proportion of males (85% vs 15%, p <0.001), patients with enthesitis (74% vs 41%, p 0.05), and hypertension among the radiographic subgroup. 44% of our patients had bilateral Grade 2 changes on their sacroiliac joint radiographs according to the modified New York Criteria, and there was a significant positive correlation between increasing symptom duration and worsening radiographic grades of sacroiliitis, but there were no significant differences in the remaining clinical features, HLA B27 positivity, or age at symptom onset among the AS and nr-Axial SpA patients. Mean values of BASDAI, BASMI, and ASDAS-ESR scores were also significantly higher in patients with radiographic Axial SpA.ConclusionData from our Indian cohort of axial Spondyloarthritis revealed a significant association of radiographic disease with male gender and the presence of enthesitis, as well as higher mean values of inflammatory markers and composite scores. However, non-radiographic axial SpA was similar to AS as far as most other features were concerned. With increasing symptom duration, the majority of patients may develop radiographic disease, and they may be considered as two ends of the same spectrum, justifying early therapy even in nr-axial SpA.References[1]Baraliakos X, Braun J. Non-radiographic axial spondyloarthritis and ankylosing spondylitis: what are the similarities and differences?. RMD open. 2015 Aug 1;1(Suppl 1):e000053.[2]López-Medina C, Molto A, Claudepierre P, Dougados M. Clinical manifestations, disease activity and disease burden of radiographic versus non-radiographic axial spondyloarthritis over 5 years of follow-up in the DESIR cohort. Annals of the rheumatic diseases. 2020 Feb 1;79(2):209-16.[3]Poddubnyy D, Rudwaleit M, Haibel H, Listing J, Märker-Hermann E, Zeidler H, Braun J, Sieper J. Rates and predictors of radiographic sacroiliitis progression over 2 years in patients with axial spondyloarthritis. Annals of the rheumatic diseases. 2011 Aug 1;70(8):1369-74.Acknowledgements:NIL.Disclosure of InterestsNone Declared.