BackgroundThe Periodontitis (PD) is currently recognized as a risk factor of occurrence of the rheumatoid arthritis(RA). The porphyromonas gingivalis (P.gingivalis) figure among the main germs incriminated in the occurrence of the PD. Previous studies have shown that antibodies to P. gingivalis are associated with anti-CCP antibody in patients with RA. However others studies have not demonstrated this association.ObjectivesThe aim of this study was to seek for a possible association between clinico-biological parameters of the RA and the presence of the P.gingivalis.MethodsWe conducted a prospective study of 69 patients with early rheumatoid arthritis (≤2 years), naive of biotherapy. Smokers, diabetics, and subjects who received dental care and those who used antibiotics in the previous 6 months were not included. Periodontal status, demographic, clinical activity, and anticyclic citrullinated peptide antibodies (anti-CCP) parameters were determined. The P. gingivalis has been searched in patients with a PD. We sought to investigate an association between Rheumatoid disease activity (DAS28), anticyclic citrullinated peptide antibodies (anti-CCP) and P.gingivalis.ResultsThe mean age of our patients was 40.75 ± 12.04, the mean duration of the illness was 14.30±6.76 months (extremes: 1-24 months). ACPA was detected in 88% of patients and the mean titre was 255.57±409.78. 43% of patients have presented a PD. The P.gingivalis has been detected in 59% of PD. The means DAS28 of patient with and without P.gingivalis is respectively 4.40±1.32 and 4.15±1.45, and there was no significant difference (p=0.65). There was also no association observed between anti CCP and the presence of P.gingivalis(the mean titre of anti CCP was 249.47±294.58 with P.gingivalis and 258.67±93.48 without P.gingivalis, p= 0.74).ConclusionThis study showed that periodontitis is frequent in rheumatoid arthritis. More than half of our patients suffering of periodontitis were infected by porphyromonas gingivalis. Rheumatoid disease activity does not seem to be related to porphyromonas gingivalis. In addition there was no association between anti-CCP antibody and the presence of porphyromonas gingivalis.References[1] Johansson L, Sherina N, Kharlamova N, Potempa B, Larsson B, Israelsson L, Potempa J, RantapÄÄ-Dahlqvist S, Lundberg K. Concentration of antibodies against Porphyromonas gingivalis is increased before the onset of symptoms of rheumatoid arthritis. Arthritis Research & Therapy 2016;18: 201.[2] Bello-Gualtero JM, Lafaurie GI, Hoyos LX, et al. Periodontal Disease in Individuals With a Genetic Risk of Developing Arthritis and EarlyRheumatoid Arthritis: A Cross-Sectional Study. J Periodontol. 2016;87(4):346-56.[3] Fisher BA, Cartwright AJ, Quirke AM, de Pablo P, Romaguera D, Panico S, et al. Smoking, Porphyromonas gingivalis and the immune response to citrullinated autoantigens before the clinical onset of rheumatoid arthritis in a Southern European nested case-control study. BMC Musculoskelet Disord. 2015;16:331.[4] Cheng Z, Meade J, Mankia K, E...

Background:Biological therapies have significantly improved the management of rheumatoid arthritis (RA). These molecules are very effective, but are known for their specific risks, especially infectious. It depends on several factors including the type of molecule used.Objectives:The objective of our study is to compare the rate of infection in RA patients treated with rituximab and anti-TNFα.Methods:Prospective, observational, monocentric study. Were included RA patients (ACR / EULAR 2010 criteria) treated with rituximab and anti-TNFα (adalimumab, infliximab and Etanercept) after inadequate response to DMARDs.Demographic characteristics, comorbidities, association with methotrexate and corticosteroids were collected and compared for each group.The number, type and severity of the infections in both cases were noted.SPSS (Statistical Package for Social Science) was used for data analysis.Results:40 RA patients treated with rituximab and 31 patients who received anti-TNFα were included.Patient characteristics and Comparison of rate of infection in RA patients between the two groups are summarized in Table 1Table 1.ParametersRituximabAnti-TNFαpNumber of patients4031Average age (years)56,2846,060,01Sexratio0,140,110,7Average duration of evolution (years)15,8313,740,3Patients under corticosteroid (%)97,587,10,08Average corticosteroid dose6,415,480,3patients under methotrexate (%)37,545,20,5Diabetes (%)2016,10,7Patients with infection (%)32,551,60,1Number of infections18240,4Number of serious infections500,04Conclusion:The rate of infections in patients with RA treated with rituximab or anti-TNF was similar. However, the infections observed were more serious in patients with RA treated with rituximabReferences:[1]Fabiola Atzeni MD PhD and al. Infections and Biological Therapy in Patients with Rheumatic Diseases. IMAJ . VOL 18. march-APRIL 2016.[2]Huifeng Yun and al. Comparative Risk of Hospitalized Infection Associated with Biologic Agents in Rheumatoid Arthritis Patients Enrolled in Medicare. ARTHRITIS & RHEUMATOLOGY. Vol. 68, No. 1, January 2016, pp 56–66.[3]Manjari Lahiri and al. Risk of infection with biologic antirheumatic therapies in patients with rheumatoid arthritis. Best Practice & Research Clinical Rheumatology (2015) 1-16.Disclosure of Interests:None declared

BackgroundThe hip fracture is the most serious complication of osteoporosis. It is a public health issue in elderly because of its frequency, severity and economic impact. We report the result of an 18 months investigation.ObjectivesThe aim of this study was to determine the frequency of osteoporotic hip fractures and identify the risk factors of osteoporosis and falls leading to these fractures.MethodsCross-sectional, prospective, descriptive study. Were included patients with spontaneous or secondary low trauma hip fractures during 18 months, who consulted at trauma unit, Mohamed Lamine Debaghine hospital. Have been collected: patient characteristics, risk factors for osteoporosis and falls, type of treatment and length of hospital stay.Results115 cases of hip fractures were recorded out of a total of 486 fractures, with a frequency of 16.8%, from all the fractures operated, it represents 22.7%. We noted a female predominance (62.6%) with a sex ratio of 0.60, the average age is 76.44 +/- 11.71 years. The associated comorbidities are: cardiovascular (55.7%), diabetes (33%), dysthyroidism (11.4%), asthma (10.4%), chronic renal failure (5.2%) prostate adenoma (4.5%). The fracture mechanism is dominated by the fall (92%), it is most often a domestic accident: slipping (30%), stumbling (26%), ablution (11%), falling on the stairs (7%).%). The risk factors for osteoporosis identified are: age more than 70 years (72.8%), female sex (62.6%), low BMI (18%), sedentary lifestyle (15.3%), corticosteroid therapy 7.2%, smoking (6.3%), history of rheumatoid arthritis in 3.4% and early menopause in 2.1% of patients. The risk factors of fracture: visual disturbances (40%) neuromuscular disorders in 11, 9%, poor health (more than 3 chronic diseases) in 9% of patients, mother’s history of hip fracture (1.7%). A personal history of osteoporotic fracture was noted in 17.4%, 7 patients presented a contralateral hip fracture. The average duration of hospitalization is 5.2 +/- 2.5 days. The treatment is surgical in 81.6% (40.8% prostheses).ConclusionThrough this study, we found that osteoporotic hip fracture is frequent. The osteoporosis risk factors identified were female sex, advanced age, corticosteroid therapy and sedentary lifestyle. Fall risk factors were dominated by visual disturbances and neuromuscular disorders.References[1] Charles M. Court-Brown, Ben Caesar. Epidemiology of adult fractures: A review. Injury 2006.[2] Desmond Curran. épidémiologie des fractures liées à l’ostéoporose en France : revue de la littérature. Revue du rhumatisme77 (2010) 579–585.[3] Denise Grolimund Berset. Traumatologie de la personne âgée: une urgence nutritionnelle? Nutrition clinique et métabolisme 23 (2009) 129–132[4] Margaret stevens.preventing falls in older peoples: impact of an interventionto reduce environmental hazards in home. J Am Geratr Soc2001; 49: 1442-7.Disclosure of InterestsNone declared

BackgroundTocilizumab (TCZ) is a monoclonal antibody directed against the IL-6 receptors. This treatment (TRT) allows for the cortisone weaning in preventing of its complications.ObjectivesThe goal of this study is to evaluate the corticosteroid sparing in patients with RA treated with TCZ.MethodsProspective, descriptive study of patients hospitalized between 2012 and 2016, the diagnosis was made according to the ACR 1987 ACR/EULAR 2010 criteria. Included, are the patients treated with TCZ for at least 3 months associated with corticosteroids.We have studied the following: the epidemiology, the associated DMARDs, the average DAS28VS, the average dosage of prednisone-equivalent and the percentage of patients with decreased or interrupted corticosteroids at M0, M3, M6 and M12.Results26 patients (sex ratio: 0.7) treated with TCZ and corticosteroids, average age is 43.4 years (range 30–62). Average duration of the development of RA: 9.1±6.4 years. DMARDs was associated in 15 patient.At baseline, 46.2% of patients were on 10 mg/day of cortisone, the average dose of prednisone-equivalent was at 7.7±3.6mg at M0, 5.3±3.2 mg at M3, 4.6±2.3 mg at M6, 2.6±2.6 mg at M12 with a statistically significant difference (p=0.000003). The average DASVS28 activity index was 5.6±0.9 at M0, 3.5±1.3 at M3, 3.04±1.2 at M6 and 2.6 ± M6 at M12 with a statistically significant difference (p<0.000001). Corticosteroid treatment was stopped in 12 patients after 1 year of treatment.ConclusionsThrough this study we note that the TRT using TCZ has enabled a significant reduction in the dose of corticosteroids. Stopping prednisone was possible in 50% of patients after 1 year of biotherapy.Disclosure of InterestNone declared