BackgroundThe situation with a treatment of juvenile idiopathic arthritis (JIA) is complicated in Ukraine. Mainly due to financial reason biological therapy is hardly accessible for Ukrainian patients. Nevertheless, some patients with JIA receive biologics within governmental programme. Clinical data of these patients were scattered and not systematized until 2014. The Task Force of Ukrainian Association of rheumatologists, by analogy to other European registries, has developed a registry of JIA patients receiving biologics. Ukrainian register of JIA patients is an observational, prospective, non-interventional clinical study.ObjectivesThe main aim of Ukrainian register of JIA patients is an assessment of long-term safety, efficacy and cost of biological treatment of JIA. in the routine clinical practice.Methods33 clinical sites from different regions of Ukraine are participating. Inclusion criteria: i) diagnosis of JIA: ii)age ≤2 years old, iii)planned start of biological therapy due to JIA; iv)negative screening for tuberculosis; v)provided informed consent. Patients have undergone standard clinical assessment every 3 months. Disease activity is measured using JADAS27 in all age groups. ANA, HLAB27, RF and anti-CCP detection are highly recommended. Uveitis and other comorbid conditions should also be fixed.Results339 patients were enrolled into the study during 3 years. 64% of patients are girls. Mean age–10.98±4.41 years, with mean disease duration –5.81±3.48 years. The duration of the period between diagnosis and biologics start was 54.31±40.28 months. Comorbid conditions were found in 41.03% patients. In 14.65% of the patients uveitis was diagnosed. Most common JIA subtypes in patients receiving biologics are pJIA with negative RF (45%), sJIA (20%), enthesitis-associated JIA (11%) and persistent oligoarthritis (11%). 67.3% of enrolled patients received adalimumab (ADA); 27.9%>tocilizumab (TOZ) and 4.8%>etanercept, respectively. During observational period biologics was discontinued in 19.8% of patients due to different reasons: adverse events were observed in 6.7% (ADA) and 16.7% (TOZ), insufficient efficiency of 23.3% (ADA) and 33.3% (TOZ), remission - 6.7% (ADA); drug absence - 63.3% (ADA) and 50% (TOZ), respectively. Comparative analysis of ADA and TOZ efficacy was performed in the 144 patients with pJIA with negative RF. Administration either ADA or TOZ resulted in statistically significant reducing of disease activity according to JADAS27. In ADA group after 3 months of administration JADAS27 decreased from 16.3±10.3 to 10.0±7.8 (p<0.00001). In TOZ group after 3 months of administration JADAS27 reduced from 22.2±12.2 to 13.1±9.1 (p=0.0012). The functional disability of the patients also statistically significant decrease in both treatment group starting from 3 months of administration: 1.1±0.8 to 0.7±0.7 (p=0.0081) in ADA and 1.6±1.0 to 1.0±0.7 in TOZ, respectively.ConclusionsUkrainian national registry of JIA patients provides real-life long-term data concerning safety, efficacy, outcomes and comparativ...

Рак мочевого пузыря занимает 9-е место среди злокачественных опухолей других локализаций и 2-е-после рака предстательной железы среди урологических новообразований [1, 2]. Около 30 % случаев рака мочевого пузыря диагностируются в мышечно-инвазивной стадии. Методом выбора при лечении рака мочевого пузыря с мышечной инвазией является радикальная цистэктомия [3]. В то же

BackgroundRA doubles the risk of hip and vertebral fractures, regardless of the use of GCs, and disease activity is consistently associated with low BMD. But now, it is not clearly identified predictors of the individual risk of bone loss depends on sex and menopausal status patients with RAObjectivesTo compare BMD in man, pre- and postmenopausal women with RAMethodsThe study was performed on 145 patients: 117 women (mean age 45.4±13.0 years, mean disease duration 9.7±7.7 years, 41% (n=48) postmenopausal) and 28 man (mean age 46.4±16.9 years, mean disease duration 4.2±4.1 years) with RA. 91.6% have moderate/high disease activities by DAS 28. 68.4% women and 64.3% men received prednisolon ≤10 mg/day more than 3 month, 87% of patients received MTX. BMD was measured in 3 part of the skeleton: hip, lumbar spine, distal part of forearm. Female patients were divided in two groups by menopause: premenopausal (PreM) in mean age 36.9±9.3 years and postmenopausal (PM) in the mean age 57.6±5.9 years.ResultsBMD was decreased in 44.5% of women and 42.9% of man. BMD of hip, lumbar spine, distal part of forearm were respectively decreased in 26.1%, 26.1%, 18.8% PreM women and 66.7%, 70.8%, 79.2% PM women. 39.3% of man had decrease BMD in the hip and 42.8% – in the lumbar spine. In women the age was strong associated with BMD decrease, in man no association with age was found. In PreM women was not found association between BMD, disease duration, DAS28 and X-ray changes in hands and feet, only cortical index was correlated with BMD in all part of the skeleton. In PM women the disease duration was negatively correlated with BMD in total hip and forearm, in men – with BMD in lumbar spine and hip neck (p<0.01). It was found association between BMD and X-ray stage by Steinbrocker in PM women and man. DAS28 was strong associated with low hip and forearm BMD in PM women and low spine BMD in men. According to dispersion analysis PM women with III-IV X-ray stages has significantly lower BMD in the hip (total: Z=2.16, p=0.04; neck: Z=2.61, p=0.01) and medium part of forearm (Z=2.92, p=0.001). Man had significantly lower BMD in all part of the skeleton since II X-ray stage (p<0.001) and negative correlation between BMD and presence of erosion.ConclusionsA sexual differences in BMD loss was observed in different parts of the skeleton. In man the most affected part of the skeleton was spine and BMD changes were more likely to PreM women, had high association with disease activity by DAS28 and presence of erosion, and no association with age. In PreM women only cortical index had high predictive value for decrease BMD in all parts of the skeleton. Age, disease deration, duration of menopause, DAS28 and x-ray changes in hand and feet was strong associated with decreased BMD in the hip and forearm in PM women.References[1] Van Staa TP, Geusens P, Bijlsma JW, et al. Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis. Arthritis Rheum2006;54:3104–12.[2] Briot K, Roux C. Glucocorticoid-induced osteoporosis. ...

ObjectivesTo assess inflammatory factors and peripheral vessels involvement as markers of cardiovascular risk in female patients with RAMethods105 female patients who fulfill ACR/EULAR 2010 criteria were examined. Laboratory assessments consisted of biochemistry and hematology analysis, measuring of CRP level, rheumatoid factor, anti-CCP level, total cholesterol, HDL, LDL, thyroglobulin, apoliprotein, A1, apoliprotein B, uric acid, HbA1c, microalbuminuria. DAS28 was used in characterizing RA activity. CV risk was defined per mSCORE. Tibial artery and carotid artery ultrasonography examination included the measurement of cIMT in 3 points, detection of focal plaques in the extracranial carotid tree, blood flow velocity and morphology of the intima was performedResults83.3% reproductive age patients were without CV risk, 11.1% experienced middle level and 5.6% low level of CV risk on mSCOR. In 96.1% postmenopausal patients moderate, high and very high CV risk was detected. According to multiple logistic regression analysis we identified CV risk factors: high CRP and DAS28, swollen joint count, LDL cholesterol level, menopause, thickness of cIMT and tibial artery. Were identify a significant correlation between tibial artery thickness and age, BMI, RA duration, systolic and diastolic blood pressure, cholesterol, menopause (p<0.01, χ2=26.18). Also, we identified a significant relationship between tibial artery thickness and changes of the intima morphology (χ2=31,64; p<0,01), carotid plaques (χ2=26,179; p<0,01), sclerosis of the heart valves (χ2=25,78; p<0,01). A less significant relationship was between cIMT (χ2=8,507; p<0,01). The DAS28, age (p<0.001), thickness of cIMT and tibial artery (p<0.001) are predictive factors for the development of carotid plaques. The predictive factors for tibial artery thickness in female patients <45 age are: high CRP (p<0.004) and DAS28 (p<0.03), anti-CCP positivity (p<0.04), Vps internal carotid artery (p<0.04)ConclusionsThe results of our study indicate that high CRP and DAS28 score, swollen joint count, LDL cholesterol level, menopause, thickness of cIMT and tibial artery associated with the increased cardiovascular risk. Tibial artery thickness and Vps internal carotid artery may be assessed like the new predictive factors of CV diseases in RA female patientAcknowledgementsNoneDisclosure of InterestNone declared

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