Background:Giant cell arteritis (GCA) is treated with high dose glucocorticoids and progressively reduced over months to years.Objectives:We undertook an audit to evaluate self-reported adherence to the original recommended glucocorticoid course and explored reasons for any variation.Methods:We recruited patients attending a single rheumatology department over 18 months. Respondents were given two self- administered questionnaires to record information regarding their use of glucocorticoids during the “last 7 days” and during the “last 6 months”. We retrieved 132 questionnaires (of whom 6 were discarded as incomplete). All data was analyzed using SPSS Statistics v22.Results:Of the 126 patients (mean age 74.9 ± 7.7 years), 59% were female. The mean duration of disease was 22.5 ± 19.1 months in patients with GCA and 32.9 ± 29.9 months in those with GCA and polymyalgia rheumatica (PMR). The mean daily number of medications taken was 9.2 ± 5.2 (range: 1 - 30); the mean number of types of daily tablets taken was 5.0 ± 2.1 (range: 1 - 10). The mean daily number of glucocorticoid tablets taken was 3.2 ± 2.6 (range: 0 - 12), with a mean daily dose of 11.1 ± 10.3 mg (range: 0 - 60 mg). Overall, in the last 7 days, 22% and in last 6 months, 40% of patients were not following their original recommended steroid regimens (Table 1). The total mean glucocorticoid dose in the “last 7 days” group (n=81) was 77.8 ± 70.1 mg/week (11.1 ± 10.1 mg/day) whilst the total mean glucocorticoid dose in the “last 6 month” group (n=45) was 1782.0 ± 1543.3 mg/6 month (9.9 ± 8.6 mg/day). Most respondents stated their glucocorticoid non-adherence was due to medical advice; other reasons included forgetting, fear of side e ects, or confusion about di erent preparations of prescribed glucocorticoids. The presence of PMR did not influence glucocorticoid adherence.Table 1.Glucocorticoid used compared to original regimen in GCALast 7 days (%)Last 6 months (%)Higher than prescribed1622Lower than prescribed618Same as prescribed7860Conclusion:There is significant variation in the use of glucocorticoids compared to the original starting regimen in patients with GCA, with or without PMR. However, the amount of the discrepancy is small. The commonest reason for non-adherence was medical advice received from either primary or secondary care.References:[1]Glucocorticoids for management of polymyalgia rheumatica and giant cell arteritis. Matteson EL et al. Rheum Dis Clin North Am. 2016[2]Giant cell arteritis: Current treatment and management. Christina P et al. World J Clin Cases. 2015[3]Methods to improve medication adherence in patients with chronic inflammatory rheumatic diseases: A systemic literature review. Matthieu L et. al. RMD Open. 2018[4]Compliance, adherence, and concordance: implications for asthma treatment. Horne R. Chest. 2006[5]Steroid dependency and trends in prescribing for inflammatory bowel disease – a 2-year national population-based study. V. Chhaya et al. Aliment Pharmacol Ther. 2016[6]The predictors and reasons for non-adherence in an observational cohort of patients with rheumatoid arthritis commencing methotrexate. Holly HF et. al. Rheumatology. 2019Disclosure of Interests:HAIRUL HADI ARIFF: None declared, Abid Awisat: None declared, JACK ARNOLD: None declared, Hudaifa Al Ani: None declared, Lorraine O’Neill: None declared, Mar Pujades Rodriguez: None declared, Raashid Luqmani Grant/research support from: Arthritis UK, the Medical Research Council, the University of California San Francisco/Oxford Invention Fund, the Canadian Institutes of Health Research, The Vasculitis Foundation, GSK, Consultant of: GSK, Medpace, MedImmune, Roche

Background Work-related musculoskeletal disorders have been perceived as one of the reasons of declining work productivity in relation to absenteeism, sick leave or early retirement. We have determined the prevalence of musculoskeletal symptoms among current working civil servants and have assessed the health impact of musculoskeletal disorders towards them or other people surrounding them. Methods Participants were given a self-administered questionnaire consisting of demographic data, experience of musculoskeletal disorders, perceptions, knowledge and attitudes towards musculoskeletal disorders. Out of 174 participants, 147 returned completed forms (response rate: 84.5%). Data were analysed using SPSS Statistics v22. Results The average age of the respondents with standard deviation was 39.9 ± 9.82 years and a majority were female (78.2%). Mean body mass index between the participants were 26.36 ± 5.26, normal to obese range. Most of the participants described their type of job as active in nature (51.7%) with a majority working 5-8 hours per day. Mean duration for years of working in service were 16.20 ± 9.53. Half of them had musculoskeletal pain within the last 3 months prior to the study date, with highest frequency over the knee joint (29.9%) followed by lower back (21.8%) and shoulder area (21.1%). From the multivariate logistic regression analyses, only 2 factors in the knowledge section showed statistical associations regarding questions asking whether the participants knew what arthritis was (p = 0.005), and if they experienced arthritis themselves (p = 0.002). We found that there were no significant associations between the race, education level, marital status, type of work, duration of work or body mass index (BMI) with the prevalence of musculoskeletal pain within the participants. Conclusion The majority of respondents had knee pain followed by lower back pain and shoulder pain. Although there is strong correlation between knowledge of arthritis among participants, majority of them cannot specify the type of arthritis correctly. As such, continuous health education and promotion of the programme is vital. Disclosures H. Ariff None. N. Shahril None. L. Eow None. W. Wan Musa None. S. Rajalingam None. M. Jeffrizal None. A. Ramlan None. S. Selvadurai None. D. Ang None. D. Suahilai None. L. Mohd Isa None.

Background Giant cell arteritis (GCA) is treated with high dose glucocorticoids and progressively reduced over months to years. We undertook an audit to evaluate self-reported adherence to the original recommended glucocorticoid course and explored reasons for any variation. Methods We recruited patients attending a single rheumatology department over 18 months. Respondents were given two self-administered questionnaires to record information regarding their use of glucocorticoids during the last 7 days and during the last 6 months. We retrieved 132 questionnaires (of whom 6 were discarded as incomplete). All data was analysed using SPSS Statistics v22. Results Of the 126 patients (mean age 74.9 ± 7.7 years), 59% were female. The mean duration of disease was 22.5 ± 19.1 months in patients with GCA and 32.9 ± 29.9 months in those with GCA and polymyalgia rheumatica (PMR). The mean daily number of medications taken was 9.2 ± 5.2 (range: 1 - 30); the mean number of types of daily tablets taken was 5.0 ± 2.1 (range: 1 - 10). The mean daily number of glucocorticoid tablets taken was 3.2 ± 2.6 (range: 0 - 12), with a mean daily dose of 11.1 ± 10.3 mg (range: 0 - 60 mg). Overall, in the last 7 days, 22% and in last 6 months, 40% of patients were not following their original recommended steroid regimens (Table 1). The total mean glucocorticoid dose in the last 7 days group (n = 81) was 77.8 ± 70.1 mg/week (11.1 ± 10.1 mg/day) whilst the total mean glucocorticoid dose in the last 6 months group (n = 45) was 1782.0 ± 1543.3 mg/6 month (9.9 ± 8.6 mg/day). Most respondents stated their glucocorticoid non-adherence was due to medical advice; other reasons included forgetting, fear of side effects, or confusion about different preparations of prescribed glucocorticoids. The presence of PMR did not influence glucocorticoid adherence. Conclusion There is significant variation in the use of glucocorticoids compared to the original starting regimen in patients with GCA, with or without PMR. However, the amount of the discrepancy is small. The commonest reason for non-adherence was medical advice received from either primary or secondary care. Disclosures H. Ariff: None. A. Awisat: None. J. Arnold: None. H. Al ani: None. L. O' neill: None. M. Rodriguez: None. R. Luqmani: None.

Background:Systemic lupus erythematosus (SLE) and Rheumatoid Arthritis (RA) often affects women in their reproductive years. These women are faced with a life-long illness that may have considerable impact not only on their physical health, but also on their reproductive potential. Fertility of these women may also be affected by the disease, treatment and/or organ damage.Objectives:To determine the role of infertility, pregnancy loss and childbearing decision and patients concerns on family size in women with SLE and RAMethods:A cross sectional study using a self-administered reproductive history questionnaire completed by woman with SLE/RA attending Rheumatology clinic follow up in Hospital Putrajaya, Hospital Tengku Ampuan Rahimah, and Hospital Raja Permaisuri Bainun, Malaysia from 1 January 2017 to 30 June 2017.Within each disease cohort, women were identified into 3 groups, those with fewer children than planned (group A), those with same number of planned children (group B) and those with completed family or not interested in having any children (group C). Data on number of children, pregnancies, misscariges and self reported infertility were recorded.For group A, data on patient concerns and the factors that could impact family building were also obtained.Results:Total of 110 women with SLE and 91 women with RA were surveyed. The mean age of women with SLE and RA were 37.6 years (+/- SD 7.4) and 45.37 years (+/- SD 11.7) respectively. Majority of women (48.8%) with SLE and RA were in group A with 59% (n=65) of women with SLE and 33% (n=33) of women with RA had fewer children than originally planned.The average numbers of pregnancies were similar in both cohorts, but women with SLE had 1 less child and were more likely to report infertility and had higher rate of miscarriages (Table 1). SLE group A had a similar number of pregnancies, but 1 less child compared to SLE group B and C (Table 2). Similarly, among women with RA, group A had 1 less child with similar number pregnancies and miscarriage rate (Table 2). In both groups of women, concerns about inability to care for a child, damage from medications, and genetic transmission of their disease were associated with a lower pregnancy rate.Table 1Number of pregnancies, live births, miscarriages and rate of infertility among women with SLE and RA* SLE RA P No. of pregnancies2.28 ±1.6262.60 ±1.9490.128No. of children1.85 ±1.2352.19 ±1.731 0.019 No. of miscarriages0.46 ±0.8090.36 ±0.659 0.040 No reporting infertility (%)5 (4.5)2 (2.2)0.366*values are the mean +/- SD unless otherwise indicatedTable 2Pregnancy outcomes for women with SLE (n=110) and RA (n=91) *Fewer children than desired(group A)Expected number of children(group B)completed family (group C) SLE RA SLE RA SLE RA No. of woman, n (%)65 (59.1)33 (36.3)20 (18.2)31 (34.1)25 (22.7)27 (29.7)No. of pregnancies2.11 ± 1.5922.03 ± 1.7232.3 ± 0.8652.81 ± 2.122.72 ± 2.0923.07 ±1.9No. of children1.57 ± 1.2121.55 ± 1.4162.1 ± 0.5532.39 ± 4.8562.36 ± 1.4972.74 ± 1.745No. of miscarriages0.51 ± 0.8310.36 ± 0....