The aim of this study was to assess the impact of tocilizumab on bone oedema in rheumatoid arthritis (RA) as shown by magnetic resonance imaging (MRI). In this longitudinal study, patients with rheumatoid arthritis according to the American College of Rheumatology (ACR) 2009 criteria with inadequate response or intolerance to disease-modifying anti-rheumatic drugs (DMARDs), treated with tocilizumab, were included. Sociodemographic characteristics and clinical and laboratory data for the disease were collected at baseline (M0) and 06 months (M6) of treatment. Disease activity was assessed using disease activity score in 28 joints (DAS28), simplified disease activity index (SDAI) and clinical disease activity index (CDAI). MRI of the dominant hand was performed at baseline and M6 of treatment. The primary outcome measure was the assessment of bone oedema by rheumatoid arthritis MRI scoring system (RAMRIS) bone oedema. Secondary outcomes included RAMRIS synovitis, DAS28, C-reactive protein (CRP) and SDAI at baseline and M6. Twenty-two patients with RA were included, 19 females (86.4 %), with a mean of age 42 ± 13.7. The mean disease duration was 8 ± 5.2 years. The mean DAS28 was 5.78 ± 0.87. The median CRP was 16 mg/l (6.7 to 36.3). The average SDAI was 90 ± 34. Three patients were excluded from the study for serious side effects. At baseline, bone oedema was present in 41 % of patients (N = 9), with a median bone oedema RAMRIS 0 (0 to 7.2). At M6, bone oedema decreased or disappeared in 32 % (N = 7) with a significant improvement in the RAMRIS bone oedema score (p = 0.04). Moreover, there is a significant improvement in RAMRIS synovitis (p < 0.0001) as well as in activity parameters: DAS28 (p < 0.0001), CRP (p < 0.0001) and SDAI (p < 0.0001). This study suggests that tocilizumab is associated with a significant improvement on MRI-determined bone oedema in the short term. This improvement in bone oedema is correlated with improved parameters of disease activity, in which early structural effect could be discussed. Further studies are needed to confirm these results.

Objectives Evaluate the association between corticosteroid therapy, body composition and bone mineral density in patients with juvenile idiopathic arthritis. Methods Our study was a cross-sectional study including Moroccan patients with juvenile idiopathic arthritis according to the International League of association of Rheumatology (ILAR) criteria, seen in rheumatology consultation or hospital. Sociodemographic and clinical data of the patients were collected. Bone mineral density of patients (BMD g/cm2) was measured by DXA X-ray Lunar Prodigy scanner. It was measured in two sites: the lumbar spine (L1, L4) and the whole body. Lean and fat mass were measured by the same device at the whole body and expressed in grams. Results 33 patients were included, the mean of their age was 10±4.35 years old, with a male predominance (54.5%), the median of disease evolution was 2 (1 - 4.5) years. Twenty for percent had a systemic JIA, 27% had an oligoarticular JIA and 48% had a polyarticular JIA. nineteen (57.6%) of our patients were receiving corticosteroid therapy, the median of daily intake dose was 10mg (0-15), the median of treatment duration was 3 years (1-6) and the median of cumulative dose was 10950mg (5475 -21 900). The median of BMD in the whole body, lumbar spine, lean mass and fat mass were respectively 0.720 g/cm2 (0700-0900) 0.620 g/cm2 (0530-0900), 20.49g (15.96-33.45), 4.97g (3.63-15.09). There was no significant correlation between the daily dose of corticosteroids and lean body mass (p=0.23), fat mass (p=0.21), BMD of the lumbar spine, p=0.82 or BMD of whole body p=0.86. We didn't find a significant correlation between the cumulative dose of corticosteroids and lean body mass (p=0.079), fat mass (p=0.05), lumbar spine BMD (p=0.27) and the hole body BMD (p=0.36). Conclusions This study suggests that taking steroids does not affect the BMD or body composition in children with JIA. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5806

BackgroundChildren and adolescents with juvenile idiopathic arthritis are at high risk of developing some particularly anxious psychological disorders. Although it is a common mental health problem in children with chronic rheumatic diseases in our country, it is not sufficiently studied.ObjectivesThe purpose of this study was to translate an assessment questionnaire of an anxiety disorders in children (SCARED) into classical Arabic and to measure its reliability and psychometric validity.MethodsA classic Arabic version of SCARED was developed and evaluated using a sample of 47 children suffering from juvenile idiopathic arthritis. A questionnaire of 41 items (5 areas) was completed by our patients at two different moments in time with a 48 hours interval. Studies on test-retest reliability and internal consistency were performed using the intra-class correlation coefficient (ICC) and the Cronbach's coefficient α. The validity of the Arabic version of the SCARED was assessed using a sample of 47 children matched for age and sex.Criteria of judgment: The primary outcome was the reliability and psychometric validity of the SCARED.ResultsA total of 47 children with juvenile idiopathic arthritis (according to the criteria of the ILAR 2001) were tested along with 47 other children without JIA who formed the control group. The first group had a mean age of 11.5±3.3 years, with a male predominance (59.6%), 31% had joint Oligo form, the median duration of disease was 4 years [2–6]. The median Jadas of our patients was 8 [3; 14], indicating moderate disease activity. We demonstrated high test-retest reliability (ICC >0.994) and high internal consistency (Cronbach's α of 0.997). We have shown that the overall coefficients of test-retest reliability were high for the total score and for each SCARED domain. In terms visible validity, the questionnaire was understandable and was able to accurately measure the various aspects of anxiety within children. We found a strong correlation with measures of depression, sleep disorders and quality of life assessed by CDRS (r =0.096 and p=0.04), the CSHQ (r =0.304/p=0.03) and PedsQL4, 0 (r =0.252/p=0.04). We found significant differences in the total scores and domains between the JIA group and the control group, denoting a good discriminate validity of the SCARED.ConclusionsThe results provided evidence of the validity and reliability of the Arabic version of the SCARED for Moroccan children with juvenile idiopathic arthritis. The questionnaire is an appropriate instrument to detect anxiety within children and could be useful in clinical practice, research and teaching.Disclosure of InterestNone declared

BackgroundObesity is a major risk factor for osteoarthritis of the knee. However, the fat and muscle have different effects on the pathogenesis of the disease.ObjectivesThe purpose of this study was to examine the relationship between body composition and knee structure especially cartilage defects, osteophytes and bone marrow lesions (BMLS).MethodsThis is a cross-sectional study including patients with primary knee OA. Demographics, clinical and laboratory characteristics for the disease were collected. All patients underwent magnetic resonance imaging (MRI) of the dominant knee. The results were interpreted according to WORMS system [1] (whole organ magnetic resonance imaging score). The body composition was measured using DEXA (dual energy X-ray absorptiometry). The regression was used to assess the association of body mass (fat mass and musculoskeletal mass) with MRI data in particular: cartilage defects, osteophytes and BMLs.ResultsTwenty patients with osteoarthritis of the knee were included in the study, 85% were female. The mean age was 59.3±10.3 years. The patients had a mean body mass index 30.1±4.7 kg/ m2. The functional discomfort of patients assessed by the WOMAC averaged 38.3±11.3. The mean of total fat mass was 32.6±10.8 kg. The mean of musculoskeletal mass was 15.8±2.5 kg. The fat mass was associated with increased cartilage defects in univariate analysis (p=0.04). However, musculoskeletal mass was not significantly associated with cartilage defects or osteophytes or BMLs.ConclusionsThis study suggests that there is an association between fat mass and increased cartilage defects, however we do not find an association between body composition in particular musculoskeletal mass and knee injuries in OA. Further studies are needed to confirm these results.ReferencesOsteoArthritis and Cartilage (2004) 12, 177–190Disclosure of InterestNone declared