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BackgroundTakayasu arteritis (TAK) is a granulomatous vasculitis that involves aorta and/or its main branches and usually affects young or middle-aged women (before 50 years of age). Tocilizumab (TOCI) (monoclonal antibodies to IL-6 receptor) is a promising agent for treatment of refractory TAK, also clinical experience is very limited.ObjectivesTo evaluate the efficacy and safety of short-term treatment with TOCI in patients with TAK refractory to standard immunosuppressive treatment.MethodsWe enrolled in our case series all patients with TAK who were treated with TOCI. Diagnosis of TAK was established according to the ACR criteria and CHCC2012. TOCI was administered intravenously at a dosage of 8 mg/kg every 4 weeks. Criteria of efficacy included complete and incomplete remission and relapse of arteritis. Activity of disease was evaluated using the NIH criteria. In all patients, we calculated the Indian Takayasu Clinical Activity Score (ITAS2010).ResultsTen patients with TAK (all females, median age 23.5 years (19-56), type 5 (generalized) in nine patients) were included in retrospective study. Median duration of disease was 48.5 months (29-146). High activity of disease was confirmed by standard laboratory tests (median ESR 56 mm/h, CRP 15.4 mg/L) and MRA/PET/US. Median ITAS score was 5 (3-12), median Kerr index was 2 (1-4). Prior to tocilizumab administration all patients were treated with combination of immunosuppressive drugs (PRED + MTX or MMF or TNF inhibitors (n=3)) for 41 months (16-140).Average duration of TOCI treatment was 6 months (3-15). Complete and partial remission was achieved in 4 (40%) and 3 (30%) patients, respectively. Median PRED dose was reduced from 30 mg (10-60) to 9.5 mg daily (≤10 mg daily in 5 patients). In 3 patients we observed carotodynias and PRED dose was increased to 10-20 mg. After treatment average ESR and CRP were 12 mm/h and 0.8 mg/L, respectively. Repeated MRA and US confirmed low activity of disease in 5 (71.4%) of 7 patients while in 2 patients (28.6%) MRA showed persistent active vascular inflammation. Median ITAS score declined to 1 (1-5) and median Kerr index to 0 (0-2). TOCI infusions were well-tolerated; we observed 3 cases of carotodynia in few days after infusions; 2 patients developed community-acquired pneumonia and 1 – Herpes zoster infection and purulent bronchitis, with subsequent TOCI dose reduction to 4 mg/kg. In 2 patients surgical vascular intervention was performed (before treatment it was impossible due to active vasculitis). Two patients developed relapse of arteritis when we attempted to increase the dosing interval of TOCI to 6–8 weeks.ConclusionsTOCI is effective in case of active systemic inflammation in patients with refractory TAK. The risk of infections should be taken into account. We observed high rate of carotodynias after TOCI infusions, that requires further confirmation. Long-term results with clinically important end-points (vascular interventions, risk of stenosis progression, long-term outcomes etc.) are awaited.Disclosure of InterestNon...

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О р и г и н а л ь н ы е и с с л е д о в а н и я 1 Национальный Центр кардиологии и терапии (НЦКТ) им. академика М. Миррахимова, Бишкек, Кыргызская Республика; 2 ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»,

BackgroundFatigue is a frequent, disabling issue in systemic lupus erythematosus (SLE). It is, however, difficult to quantify. The Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale has been validated in SLE and has been successfully used to assess fatigue.ObjectivesTo evaluate the application and influence factors of the Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue) scale in patients with systemic lupus erythematosus (SLE)Methods1061 SLE pts who fulfilled SLICC 2012 [1] criteria were enrolled into the study. The SLEDAI 2K index activity, SLICC damage index, fatigue was assessed by the FACIT-Fatigue scale from 0 to 52 (no or little fatigue 40-52, some fatigue 27-39, quite a lot of fatigue 14-26, extreme fatigue 0-13) [2]Results1061 Lupus pts were studied, respectively. The pts were predominantly female (92%) and of indigenous nationality (Kazakh 10%,/ Kirghiz 54%/Russian 36%)with a mean±SD age 34,6±11,8 years. The mean disease duration (Мe) was 4 [1;9], the disease activity (SLEDAI 2K) 13,23±8,74, SLICC damage index 1,36±0,82. Fatigue was detected in 828 (79%) of 1061 patients with SLE.1061 pts were divided into two groups. The first group included 447 pts with quite a lot of fatigue and extreme fatigue (from 26 up to 0 by Facit -fatigue scale). The second one included 615 SLE pts with no or little fatigue and some fatigue). The first group pts were with higher SLE activity by SLEDAI 2 K (16,4±9,3 versus 11,5±8,4; p=0,0001), had a higher level of dsDNA (131,7±23,9 versus 94,5 ± 11,7; p=0,002), were treated with higher doses of glucocorticoids (22,33±12,3 versus 19,5±17,0 mg per day; p=0,001).Table 1.Frequency of fatigue in different ethnic groupsFacit fatigue,ScoreRussian1, N = 386, n (%)Kirghiz2, N = 573,n (%)Р1-2Kazakh3, N = 102,n (%)Р1-3All pts, N = 1061, n (%)no or little fatigue, 52–40146 (37%)81 (14%)< 0,00016 (6%)< 0,0001233 (21%)some fatigue, 39–27147 (38%)222 (39%)–13 (13%)< 0,0001382 (37%)quite a lot of fatigue, 26–1480 (21%)172 (30%)0,0152 (51%)< 0,0001304 (29%)extreme fatigue, 13–013 (4%)99 (17%)< 0,000131 (30%)< 0,0001143 (13%)Fatigue was significantly more common among Kazakhs (94%) and Kyrgyz (86%) than among Russians (63%) pts (Table 1). Extreme fatigue was significantly more common among Kazakhs (30%) than among Russians (4%) and Kyrgyz (17%) pts.ConclusionFatigue are common (79%) in SLE pts and significantly higher among Asians pts (86-94%). Fatigue strongly associated with SLE activity.References[1]Petri, M., et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis & Rheumatism 64.8 (2012): 2677-2686.[2]Pilgaard, T et al. Severity of fatigue in people with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis - Results of a cross-sectional study. PLoS One. 2019, 28;14(6):e0218831Acknowledgements:NIL.Disclosure of InterestsNone Declared.