Introduction: The low frequency of cases and deaths from the SARS-CoV-2 COVID-19 virus in some countries of Africa has called our attention to the unusual behavior of this disease. Aims: Describe SARS-CoV2 infection and death rates in African countries that participated in an intensive Ivermectin mass campaign carried out to control onchocerciasis and compare them with those of countries that did not participate. Methods: Data from 19 countries that participated in the WHO sponsored African Programme for Onchocerciasis Control (APOC), from 1995 until 2015, intended to treat over 90 million people annually and protect an at-risk population of 115 million, were compared with thirty-five (Non-APOC), countries that were not included. Information was obtained from https://www.worldometers.info/coronavirus/ database. Results After controlling for different factors including the Human Development Index, APOC countries, show statistically significant 28% lower mortality (0.72 IC 95% 0,67-0,78) and 8% lower rate of infection (0.92 IC95% 0,91-0,93) due to COVID-19. Conclusions: The incidence in mortality rates and the number of cases is significantly lower among the APOC countries compared to non-APOC countries. That a mass public health preventive campaign against COVID-19 may have taken place, inadvertently, in some African countries with massive community ivermectin use is an attractive hypothesis. Additional studies are needed to confirm it.

BackgroundUveitis is the most frequent extra-articular manifestation (EAM) of spondyloarthritis (SpA). Its prevalence is approximately 30% and increases with the duration of the SpA. The characteristic pattern is anterior, acute, recurrent and unilateral uveitis. However, the frequency and characteristics of uveitis in SpA treated with biological therapy (BT) are unknown.ObjectivesThe main target is to describe the frequency and characteristics of uveitis in SpA with BT in a single centre.MethodsDescriptive and retrospective study (January 2003-December 2017) of SpA that develops uveitis in a reference hospital. The epidemiological variables, type of SpA, presence of uveitis and its characteristics, presence of BT at the time of onset and treatment received are collected. For the analysis, frequencies and percentages were used in qualitative variables, and mean and standard deviation (SD) for quantitative variables. Statistical analysis was performed with IBM SPSS v.23.ResultsWe studied 246 patients with SpA. The subtypes of SpA were: ankylosing spondylitis (AS) (n=125, 50.8%), psoriatic arthritis (PsA) (n=101, 41.1%), undifferentiated SpA (n=13, 5.3%), non-radiographic axial Spa (n=3, 1.2%), enteropathic arthropathy (n=3, 1.2%) and reactive arthritis (n=1, 0.4%).Uveitis was observed in 41 patients (16.7%) after an average time of development of 109.47 (73.9) months of the SpA. The incidence rate was 5.5 cases of uveitis/100 patients-year of follow-up. 70.7% were men and the mean age(SD) was 47.4 (12.06) years. 87.8% of the cases were HLAB27 positive and had a family history of SpA 41.5%.Uveitis was observed in 33 patients (80.5%) with AS, in 6 (14.6%) with PsA, in 1 (2.4%) with non-Rx axial SpA and in 1 (2.4%) with undifferentiated SpA. (table 1)The uveitis pattern was anterior (100%), acute (92.7%), unilateral (87.8%) and in 12.2% bilateral (80% in PsA). At the time of onset of uveitis, the mean ESR was 30.11 mm1ªh, CRP 3.56 mg/dL, DAS28 3.66 and BASDAI 3.21.Regarding the diagnosis of SpA, uveitis was after (85.4%), before (12.2%) and simultaneous (2.4%).At the time of the onset of uveitis, 14 patients (34.1%) were with BT (35.7% etanercept, 28.6% infliximab, 21.4% adalimumab, 7.1% golimumab and 7.1% certolizumab). BT was modified in 3 of the cases.The treatment of uveitis was topical (78%), corticoids in oral regimen (57.5%), conventional DMARDs (12.5%), with methotrexate predominating in 60% of cases and BT (15%). The most used biologics were adalimumab (50%), infliximab (33.3%) and sekukinumab (16.7%).Abstract THU0259 – Table 1Characteristics of the UVEITIS in SpA subtypesConclusionsIn our series, uveitis was observed in 16.7% of patients with SpA of which 80.5% were AS and 14.6% PsA. The most frequent uveitis was anterior, unilateral, acute and recurrent. In PsA, the association with HLA B27 was less frequent and was more bilateral. In most cases, the diagnosis was later than the SpA.Disclosure of InterestNone declared

No abstract

BackgroundUse of biologic therapy (BT) has been determinant in Rheumatoid Arthritis' (RA) change of management and outcomes improvement for the last decade. Classic extraarticular manifestations are now uncommon, except for the pulmonary involvement, which can occur due to different causes and can complicate our patients' treatment and prognosis.ObjectivesThe aim of this study is to evaluate the presence of pulmonary complication in RA patients under BT in our hospital, and assess its severity and the modifications required.MethodsReview of clinical records of 208 RA patients receiving BT in the last 5 years (January 2012 to December 2016). 23 cases of preexisting lung disease for other causes have been excluded and finally 26 patients have been finally included. Demographic data, characteristics of RA, types of pulmonary involvement, evolution and changes in treatment have been collected. Statistical analysis were performed using SPSS v22.Results73.1% are women, mean aged 59 years (31–80); 53.8% never smokers. They suffer from long term RA (median 176.92 months, SD 199.34); only 2 patientes have been recently diagnosed (less than a year). They are mainly seropositive (85% RF positive) with positive CCP antibodies in 69.2%, and with erosive disease in 70%. 25% have other extraarticular manifestations (3 rheumatoid nodules, 4 cardiac involvement).Half of the patients were in remission or low activity (DAS 28) at the time of pulmonary disease diagnosis, and the median of CRP was 0.52 mg/dL (SD 1.72). 90% had received Methotrexate and almost half of them Leflunomide; 30% had been treated with BT (50% TNF alpha inhibitors).Intersticial lung disease (ILD) was the most frequent pulmonary involvement (57.7%) and non-specific intersticial pheumonia (NSIP) the most prevalent pattern (>60%). We also found obstructive pulmonary disease (11.5%) and vascular involvement (7.7%). 40% of the patients had a normal radiograph (all of them a pathological CT).Treatment was modified in 53.8% of the cases (synthetic DMARD was kept in 68% and BT in 64%).The average time of evolution of pulmonary involvement is 37.85 months (1–156). 80% of the patients kept stable or improved from their arthritis and also from respiratory disease. Only one received a lung trasplant and another one died.We haven't found an association between different types of pulmonary involvement and the different variables analyzed in the study. We didn't show significant differences in prognosis related to pulmonary disease distinct patterns; up to 80% of patients with ILD stabilize or improve.ConclusionsPrevalence of pulmonary disease in our experience in RA patients under BT is similar to prevalence in other observational studies (10–20%), because diagnosis here is due to casual detection in a routine chest X-ray or for clinical suspicion for respiratory symptoms (cough, dyspnea, ...). The evolution has been good perhaps for the high prevalence of NSIP, which requires less therapeutic intervention. Protocols for systematic search of lung disease in RA patients seem...

BackgroundLupus nephropathy (NL) is an important cause of morbidity and mortality in patients with Systemic Lupus Erythematosus (SLE). The objective of the renal biopsy is to determine the type of glomerulonephritis that the patient presents to direct treatment. Considering that it is a specialised technique and not risk free, a proteomics study is proposed to determine biomarkers that help us to differentiate patients diagnosed with SLE with and without renal involvement.ObjectivesTo determine if there is a different pattern of proteins between patients diagnosed with SLE with and without renal involvement.MethodsWe selected 12 patients diagnosed with SLE with renal involvement and 14 patients diagnosed with SLE without renal involvement. There were no differences between groups according to race, gener and age. The patients were classified as high, low or negative level of proteinuria in the urine. A 24 hour urine sample was obtained for analysis.ResultsWe have done a Principal Component Analysis (PCA) where we can see differences between samples from patients who have high level of proteinuria in 24 hours and patients who have not renal involvement. Patients with positive proteinuria but not high level are a little confuse figure 1.A total of 292 proteins (identified with at least two peptides with a FDR<1%) were quantified and further considered in the analysis. The Student’s T-test analysis reflected the differential presence of 147 proteins (p<0.01). Of these, 130 were less abundant in the urine of the patients with renal damage, whereas 17 showed the opposite pattern, being more abundant in the patients with affected renal function.Consistent with the nature of the sample, the Gene Ontology (GO analysis) of the whole list of identified proteins revealed the presence of extracellular (277 proteins, p=2.25E-171) and secretion-related proteins (49 proteins, p=1.1E-09), among others. Proteins related to defensive processes were prominent among them. Interestingly, the subset of proteins whose abundance increases upon renal damage is comprised of typical highly-abundant serum proteins. These proteins render a large number of peptides, suggesting they are very abundant. This protein pattern may reflect the higher albuminuria characteristic of patients with affected renal function. On the other hand, a number of proteins became significantly less abundant upon renal damage. The presence of highly abundant serum proteins in the urine of patients with compromised renal function may explain this phenomenon, since this will provoke a dramatic reduction in the relative abundance of the proteins already present in their urine.Abstract AB1373 – Figure 1ConclusionsA different protein pattern is observed between the two groups of patients, so in a more detailed study we can indicate if some of these can serve as prognostic markers for this type of patients.Disclosure of InterestNone declared