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Background:Spondyloarthropathies are a heterogeneous group of similar diseases, with interrelated clinical manifestations, such as Psoriasis Arthritis (APs) and Ankylosing Spondylitis (EA). There are different treatments for this group of pathologies.Objectives:It is very important to differentiate between those that present predominantly axial (spine and/or sacroiliac) or peripheral involvement, since the response to treatment is very different.In some clinical trials, secukinumab significantly improved versus placebo, the symptoms and signs, physical function and quality of life, however, at present, we do not have enough data from secukinumab in real clinical practice.This is the real reason of this study: the use of secukinumab in clinical practice.Methods:Multicentric longitudinal observational study of 5 Hospitals in Madrid.Patients are over 18 years old and meet the following inclusion criteria: New York criteria for AS, ASAS for EA, CASPAR for APs, and all of them are with secukinumab or have received it.We will evaluate the effectiveness rate as well as its confidence interval at 95%. In addition, the effectiveness of secukinumab will be compared in the different pathologies by using χ2.Results:72 patients were collected, 41 of them were women (57,75%).12 patients (16,90%) had not received FAME before secukinumab and 22 patients (33,99%) were naive to biological treatment.In 4 patients, the reason for starting secukinumab was the patient’s comorbidities, in 2 the adverse effects of previous treatment and in the rest, was the lack of efficacy of the previous treatment.The patients were divided into 4 categories according to the level of DAS-28 or BASDAI, at the beginning of the treatment and the last recorded value, in: Absence of activity, mild, moderate and severe activity. Of the patients with data, they managed to improve the DAS-28 score (change category) by 30,95%, while only 4,76% worsened their score. With respect to BASDAI, of the total number of patients, only 3,03% worsened, while his score improved 27,27%.According to baseline diagnosis, a greater improvement of the disease activity in peripheral APs(66,67%) and mixed APs(61,54%) is achieved.Conclusion:In real clinical practice, treatment with secukinumab was effective in patients with spondyloarthritis, achieving improvement in previous activity rates. In this study, the most significant improvement was obtained in peripheral and mixed APs.Disclosure of Interests:None declared

Background:Secukinumab inhibits the interaction between Interleukin 17A (IL-17A) and its receptor. Clinical trials have demonstrated good data in efficacy and safety in patients with spondyloarthritis (SpA) as first biological choice or inadecuate response to other biological in SpA. However there is few evidence in real clinical practice.Objectives:Evaluate the drug survival in a real clínical practice, as an indirect way to show the efficacy and security of Secukinumab at 24 monthsMethods:A multicentric observational, longitudinal, retrospective study of 24 months conducted in five Madrid hospitals (Spain). Patients older than 18 years treated with Secukinumab which fullfilled ASAS criteria for SpA and/or modified New York criteria for ankylosing spondylitis (AS) and/or CASPAR criteria for psoriatic arthritis (PsA) were included. For evaluation of the drug survival, dates from starting until closing date or definite withdrawal of the treatment were determined. Kaplan-Meier function was used to estimate the drug survival and Wilcoxon test for the comparison of the survival rate between the different diagnoses, because of the survival curves did not reach the medianResults:A total of 71 patients were included. The mean age was 50.26 ys (SD 11.01), 57.75% women. 35 patients fullfilled classification criteria for PsA ant 36 fullfilled classification criteria for axSpA. 22 patients were naïve for biologic therapies and 49 patients had an inadecuate response to TNFi. 13 patients discontinued Secukinumab before the closing date, the main reason for the interruption was secondary failure (n= 6), and primary failure (n=2). Secukinumab survival rate was 81.95% up to 24 months in this cohort. The median of survival was 2.36 years (IC: 1.79-2.84). There were no significant differences about the drug survival related to diagnosis (p=0.976). The safety data were similar to those described in clinical trials.Conclusion:Secukinumab is an effective and safe treatment for the management of espondiloarthritis regardless of the subtypes, with a high survival rate. In this study naive patients show similar data obtained in clinical trials. In this cohort of patients, those who initiated secukinumab after failure to TNFi, showed a greater secukinumab survival than the data provided in clinical trialsDisclosure of Interests:None declared

BackgroundOne in ten patients with hyperuricemia may develop gout over time, with urate deposition sometimes asymptomatic. Recent reviews support ultrasound (US) to assess asymptomatic hyperuricemic (AH) patients to detect gout lesions, showing double contour (DC) and tophus the highest specificities and positive predictive values. Hyperuricemia and gout are common in chronic kidney disease (CKD), especially with glomerular filtration rate (GFR) <60, and are associated with worse prognosis. US gout lesions have been found more frequently in AH (up to 35%) than in normouricemic (NU) patients, but evidence is scarce in CKD.ObjectivesTo assess the prevalence of urate deposit in stages 3-5 CKD detected by US, and to investigate if there are differences between AH and NU patients.MethodsCase-control study, recruiting patients aged ≥18 years with AH and stages 3-5 CKD in 4 hospitals from January 2020 to December 2021. Controls were patients with stages 3-5 CKD and NU. Exclusion criteria: previous diagnosis of gout, tophi. Hyperuricemia was defined as serum uric acid (sUA) >6.8 mg/dl, documented at least twice during the last 12 months. A standardized US exam of the knees and bilateral first metatarsophalangeal joints was performed to assess patients for DC/tophus as defined by OMERACT. Demographic, clinical and laboratory data were recorded. A descriptive analysis was performed using SPSS. Pre-clinical gout (PCG: DC and/or tophus) was considered as outcome variable. Chi-square and Fisher’s exact test were used for qualitative variables, and Mann-Whitney U test for quantitative variables; significant threshold p<0.05.ResultsForty-four patients with stages 3-5 CKD (59.6% stage 3, 19.1% stage 4, 21.3% 5) were recruited, 35 AH and 9 NU. Hyperuricemia was associated with a higher prevalence of US findings, with significant differences between cases (AH) and controls (NU): PCG 19 vs 1 (p=0.023), DC 13 vs 1, and tophus 11 vs 0. No significant differences were found in demographic variables, comorbidities and treatments. sUA levels, were higher in patients with PCG (8.3±1.4 vs 7.6±2.2; p=0.36), and these patients also showed lower GFR (31.4±14.1 vs 33.7±16.9; p=0.62). Patients with PCG also showed a non-significant trend towards shorter duration of CKD [6.3±5.7 vs 8.3±4.9 years; p=0.1] and younger age (66.4±15.1 vs 70.0 ±11.0; p=0.30).ConclusionWe found an outstanding prevalence of asymptomatic urate deposits in our cohort of patients with stages 3-5 CKD, that is higher in hyperuricemic than in normouricemic patients. The prevalence of DC and tophus in our cohort of AH patients with stages 3-5 CKD was higher than that reported in AH patients in studies conducted in general population (37% vs 16-31% and 31% vs 16%, respectively). Early diagnosis of pre-clinical gout by ultrasound might change therapeutic approach in CKD.References[1]Robinson PC, et al. Longitudinal development of incident gout from low-normal baseline serum urate concentrations: individual participant data analysis. BMC Rheumatol. 2021;5(1):33.[2]Jing J, et al.; GCKD Study Investigators. Prevalence and correlates of gout in a large cohort of patients with chronic kidney disease: the German Chronic Kidney Disease (GCKD) study. Nephrol Dial Transplant. 2015;30(4):613-21.[3]Stack AG, et al. Gout and the risk of advanced chronic kidney disease in the UK health system: a national cohort study. BMJ Open. 2019;9(8):e031550.[4]Stewart S, et al. Prevalence and discrimination of OMERACT-defined elementary ultrasound lesions of gout in people with asymptomatic hyperuricaemia: A systematic review and meta-analysis. Semin Arthritis Rheum. 2019;49(1):62-73.[5]Christiansen SN, et al. Ultrasound for the diagnosis of gout-the value of gout lesions as defined by the Outcome Measures in Rheumatology ultrasound group. Rheumatology 2021.[6]Peiteado D, et al. Value of a short four-joint ultrasound test for gout diagnosis: a pilot study. Clin Exp Rheumatol 2012.AcknowledgementsSpecial thanks to the Nephrology and Rheumatology departments of the 4 participating centers.Disclosure of InterestsEnrique Calvo-Aranda Speakers bureau: Menarini, Grünenthal, Laura Barrio Nogal: None declared, Boris Anthony Blanco Cáceres: None declared, Marta Novella-Navarro: None declared, Diana Peiteado: None declared, Jaime Arroyo Palomo: None declared, Eugenio de Miguel: None declared, Alejandro Prada Ojeda: None declared, Luis Sala Icardo: None declared, maria teresa navio marco: None declared, Mónica Vázquez Díaz: None declared, Claudia Maria Gomez-Gonzalez: None declared, Roberto Alcazar Arroyo: None declared, Juan Antonio Martin Navarro: None declared, Marco Vaga Gallardo: None declared, Milagros Fernandez Lucas: None declared, Martha Elizabeth Diaz Dominguez: None declared

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