The CREATE-ECLA Randomized Controlled TrialThe CREATE-ECLA Trial Group Investigators* See also pp 427 and 489.

Patients with acute myocardial infarction had increased levels of oxidative stress associated with a reduction in enzymatic antioxidant reserve. Administration of GIK solution did not improve these abnormalities among patients undergoing primary angioplasty.

Target BP was reached in more than 70% of patients receiving monotherapy with either formulation. Both formulations were tolerated well.

Background:The goal of treatment with biological DMARDs (bDMARDs) should be the use for a limited period of time, during the called “therapeutic window of opportunity” to induce disease remission, followed by the maintenance of low activity with conventional DMARDs. We study if we achieve this goal in a cohort of patients treated by objectives in the last 6 years.Objectives:To assess the frequency and characteristics of patients with rheumatoid arthritis (RA), spondyloarthropathies (SA) and psoriatic arthritis (PsA)) treated with FB / SD who achieve remission without FB / SD.Methods:Observational and prospective study, which included a cohort of patients with RA, SA and PsA treated by objectives with FB / SD and optimized from January 2014 to December 2019. Optimization, defined as the reduction or prolongation of the interval of at least one dose, it was indicated when patients had received> 6 months of treatment and were in clinical remission / low activity defined as DAS28 <3.2 for RA and PsA, and BASDAI <4 for SpA. All patients who managed to maintain remission without receiving FB / SD were also collected.Results:A total of 260 patients (115 RA, 69 SA and 76 PsA) were included in the study. Of the total of these patients, 32.7% received at least two treatments (“switch”). Of all the patients, 53% were optimized and according to the diagnosis: 60.9% had RA, 52.2% SA and 39.4% PsA.5.3% of the patients were free of FB / SD: 5 patients with RA (4.34%), 8 patients with SA (11.6%) and 1 patient with PsA (1.3%). Among patients who entered clinical remission without FB / SD, 57% had received only one treatment with FB / SD while 43% of the patients had received two or more FB / SD. Only 3 of the patients with RA and 1 patient with PsA managed to be free of treatment without FB / SD or conventional DMARD.Conclusion:Remission without FB / SD treatment was rare, being higher in SA than in RA and in PsA, maintaining the same severity and frequency patterns in achieving optimization according to different pathologies (EspA> AR> APs). Except in the APs, more than 50% of the patients with RA and SA entered into optimization. Clinical remission without FB / SD was less frequent in the PsA probably because the MDA is more demanding than the other outcome measures and because it is a more complex and heterogeneous disease with domains controlled by various cytokines. Patients with disease-free RA or APs without FB / SD or conventional DMARD were the exception.Disclosure of Interests:None declared

Background:The use of biological therapies during pregnancy has been contraindicated since the beginning of the use of these drugs. In recent years several studies have demonstrated the minimal-to-no transfer of certolizumab pegol (CZP) to the placenta and breast milk, which has allowed its approval for use in pregnancy and breastfeeding if clinically necessary. However, there are no studies evaluating the use of CZP during this period in real life or the characteristics of this subgroup of patients.Objectives:To describe the profile of women of childbearing age diagnosed with chronic inflammatory rheumatic disease (CIRD): Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) and axial Spondyloarthritis (axSpA), who initiate CZP by gestational desire using the GESTAMAD registry (multicenter study of women with chronic inflammatory rheumatic disease of childbearing age who are initiated on CPZ by gestational desire from the Madrid community).Methods:Prospective multicenter study that aims to know the characteristics of women of childbearing age diagnosed with CIRD and gestational desire to which CZP is initiated for this reason. The comorbidities of the patients such as hypertension, diabetes and cardiovascular disease were collected. Disease activity was measured by DAS28 using CRP in RA and PsA and BASDAI in axSpA. The present study presents preliminary data from the initial cohort and will be followed prospectively for 24 months to assess the efficacy and safety of the drug during pre-conception, pregnancy and lactation.Results:A total of 45 patients have been recruited in 6 Madrid hospitals from June to December 2019. Patients had a mean age of 35.9, (36.6 in RA, 35.2 in PA and 35.1 in SPA). Fifty-one percent had RA, 20.0 percent had PA and 28.8 percent had SPA. The mean disease duration for RA, PA and SPA was 9.5, 7.3 and 6.9 years, respectively. 48.9% of women were nulliparous. The abortion rate of patients diagnosed with spondyloarthropathy was upper of 25%. 33.3% of the patients had been treated with previous biologicals, with gestational desire/pregnancy being the reason for the change.75.5% of the patients had been treated with synthetic disease modifying antirheumatic drugs (DMARD) previously. With regard to disease activity, the mean DAS 28 at the start of treatment was 4.5 in RA and 3.8 in PA and BASDAI 7.0 in axSPA.In RA the highest values of CRP and ESR were found prior to initiation with CZP, but this difference was not statistically significant (p=0.644 and 0.605, respectively). 22.2% of patients had previous comorbidities.Conclusion:The mean age of patients with gestational desire in CIRD is high. Women diagnosed with PsA and axSpA have a high rate of previous abortions, upper than 25%. The duration of the disease is equally long at the time of manifesting gestational desire. The use of treatments such as CZP, compatible with pregnancy and lactation would allow a better control of inflammatory joint disease in this period of life, encouraging patients not to postpone their gestational desire.Disclosure of Interests:None declared