ObjectivesTo compare the presentation of seropositive and seronegative early rheumatoid arthritis (RA) in disease-modifying antirheumatic drug (DMARD)-naïve patients classified according to the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) criteria.MethodsAll patients had symptom duration from first swollen joint <2 years and were DMARD naïve with an indication for DMARD treatment. Patients were stratified as seropositive (positive rheumatoid factor (RF)+ and/or anticitrullinated peptide antibody (ACPA)+) or seronegative (RF− and ACPA−), and disease characteristics were compared between groups.ResultsA total of 234 patients were included, and 36 (15.4%) were seronegative. Ultrasonography (US) scores for joints (median 55 vs 25, p<0.001) and tendons (median 3 vs 0, p<0.001), number of swollen joints (median 17 vs 8, p<0.001), disease activity score (DAS; mean 3.9 vs 3.4, p=0.03) and physician global assessment (mean 49.1 vs 38.9, p=0.006) were significantly higher in seronegative patients compared with seropositive. Total van der Heijde-modified Sharp score, Richie Articular Index and patient-reported outcome measures were similar between groups.ConclusionsSeronegative patients had higher levels of inflammation, assessed both clinically and by US, than seropositive patients. These differences may reflect the high number of involved joints required for seronegative patients to fulfil the 2010 ACR/EULAR classification criteria for RA.Trial registration numberNCT01205854; Pre-results.

Textured 0.94Na0.5Bi0.5TiO3–0.06BaTiO3 (NBT–6BT) ceramics were fabricated by templated grain growth (TGG) using anisotropically shaped Na0.5Bi0.5TiO3 (NBT) templates. Platelet NBT was synthesized by the topochemical technique, using precursor Na0.5Bi4.5Ti4O15 (NBIT). The NBT particles have an average length of 10–15 μm and a thickness of 1 μm, which are suitable templates for obtaining textured ceramics (especially NBT‐based ceramics) by the TGG process. This study revealed that the NBT templates are effective in inducing grain orientation in NBT–6BT ceramics. For NBT–6BT ceramics textured with 5 vol% NBT templates, a Lotgering factor of 0.87 and a d33 of 299 pC/N are given.

Background Predictors of response to biologic therapy in rheumatoid arthritis (RA) are needed to achieve a more individualized therapy. Seropositivity has been associated with better response to rituximab (RTX). Objectives To assess the 6-month response to the first RTX course in RA according to RF and ACPA status. Methods Ten European registries submitted anonymized datasets from RA patients who had started RTX, and datasets were pooled and analysed. Chi-square test for comparison of categorical variables and t-test for continuous data were used. Predictors of response were identified by logistic regression analysis. Results 3266 patients were included in the cohort. 79.9% of patients were RF (+) (2041 out of 2553) and 73.2% were ACPA (+) (877 out of 1198). 718 patients were double positive (DP) and 147 double negative (DN). 2200 patients were RF (+) and/or ACPA (+). Improvements of DAS28 (ΔDAS28) at 6 months were significantly better for RF (+) than RF (–) patients as well as for ACPA (+) than ACPA (–), DP vs. DN and RF and/or ACPA (+) vs. DN (table 1). A significantly higher percentage of ACPA (+) and DP patients achieved EULAR Good Response at 6 months compared to ACPA (–) and DN, respectively (table 1). The completeness of data was very similar for seropositive and seronegative patients, with the percentage of missing data at 6 months being approximately 50% in all groups. A significantly higher percentage of seronegative patients received retreatment by 6 months than seropositive patients. In univariate analyses adjusted for age and gender ACPA positivity (OR=2.03, p=0.016) and DP (OR=2.43, p=0.03) but not RF positivity (OR=1.53, p=0.07) predicted EULAR good response to therapy with RTX at 6 months after the first treatment. Table 1. Clinical outcomes at 6 months for RTX treated patients according to RF and ACPA status RF (+)RF (–)p-valueACPA (+)ACPA (–)p-value Baseline DAS285.85±1.365.63±1.340.001*5.8±1.355.68±1.32NS DeltaDAS28 6m1.94±1.51.65±1.340.0051.93±1.511.40±1.47<0.0001 EULAR Good/Moderate/No 6m21.5/62/16.5%17.4/63.4/19.2%0.0623.9/58.7/17.4%14.9/62.9/22.2%0.009 Remission 6m13.8%11.3%NS13.5%10.9%NS DPDNp-valueRF and/or ACPA (+)DNp-value Baseline DAS285.81±1.365.65±1.36NS5.84±1.355.65±1.36NS DeltaDAS28 6m1.95±1.541.41±1.510.0071.93±1.491.41±1.510.005 EULAR Good/Moderate/No 6m24.7/58.4/16.9%13.8/65/21.2%0.0621.4/61.9/16.7%13.8/65/21.2%0.038 Remission 6m13.9%12.5%NS13.7%12.5%NS *Corrected for baseline DAS28. Conclusions In this large observational cohort of RA patients treated with RTX, seropositive patients achieved significantly greater reductions in DAS28 at 6 months compared to seronegative patients. Baseline ACPA positivity may be a better predictor for good response to RTX than RF positivity. Disclosure of Interest None Declared

Background The use of ultrasonography (US) in RA is rapidly increasing. Currently, there is no consensus regarding which joints should be systematically assessed. The comprehensiveness of joint examination as well as validity and responsiveness must be weighted against feasibility. Objectives To explore and validate different US joint scores of inflammation compared to a comprehensive US assessment in patients with early and established RA. Methods 230 DMARD naïve patients with early RA (according to 2010 ACR/EULAR criteria) with indication for methotrexate, and 212 patients with established RA with indication for biologic DMARDs were examined between January 2010 and June 2013. An extensive US examination was performed by experienced sonographers using a validated grey-scale (GS) and power Doppler (PD) semi-quantitative scoring system with ranges 0-3 for GS and PD in each of the following 36 joints: MCP 1-5, PIP 2-3, radiocarpal, distal radioulnar, intercarpal, elbow, knee, talocrural and MTP 1-5 bilaterally. An US atlas was used as reference1. Previously published 32-1, 12-2, 7-3 and 6-4 joint scores as well as a new 30-joint score were assessed. This 30-joint score was based on the 36 examined joints with exclusion of the 6 largest joints (elbow, knee and talocrural bilaterally), due to low prevalence of US PD findings and improved feasibility (shorter examination time (≤10 min) and no need to remove patient's clothes). We estimated % coverage (with 95% CI) of each of the reduced joint scores to estimate the proportion of patients with inflammatory findings compared to the 36-joint score. Results A total of 442 patients were included, 230 with early and 212 with established RA; 81.5% vs 82.0% were anti-CCP positive, mean (SD) age was 51 (14) vs 58 (12) years, DAS28 4.7 (1.2) vs 4.8 (1.4), median (25-75 percentile) 28-swollen joint count 6 (3-11) vs 5 (2-10), CRP mg/L 7 (3-18) vs 8 (3-22), disease duration 0.5 (0.2-0.9) vs 7 (3 -11) years. The mean (95% CI) 36-joint US GS score was 23 (21-25) vs 28 (25-30) (p=0.003) and the 36-joint US PD score 11 (10-12) vs 13 (11-15) (p=0.2) in the early vs established RA cohort. Conclusions Reduced joint scores of 12, 7 or 6 joints seem to be suitable for detecting most of the inflammatory pathology in established RA. However, the loss in sensitivity to detect patients with pathological findings was more pronounced in early RA, and a more comprehensive assessment may be warranted to improve coverage of affected joints. A novel 30-joint score that is feasible (time to score US GS and PD in both hands and feet takes ≤10 min), might improve sensitivity. References Rheum Dis 2011 70:11 1995-8. Clin Exp Rheumatol 2005;23:881-4. Arthritis Rheum 2009;61:1194-201. Rheumatology 2012;51:866-873. Disclosure of Interest A.-B. Aga: None declared, H. B. Hammer Grant/research support: AbbVie, Roche, Pfizer, E. Lie: None declared, I. C. Olsen: None declared, T. Uhlig: None declared, D. van der Heijde: None declared, T. K. Kvien Grant/research support: AbbVie, BMS, ...