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Behçet's disease (BD) is a systemic vasculitic disorder of unknown aetiology characterised by recurrent oral and often genital ulcers, which may be associated with ocular, cutaneous, articular, neurological or vascular involvement. We report a 52-year-old woman diagnosed of neuro-BD who was treated with infliximab with a dramatic response to this treatment.

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BackgroundUstekinumab is a monoclonal antibody that inhibits IL-12 and 23 that has demonstrated efficacy and safety for the treatment of patients with psoriatic arthritis, plaque psoriasis and Crohn’s disease.ObjectivesTo evaluate the efficacy of subcutaneous Ustekinumab (USTE) in patients with psoriatic arthritis in a real-world clinical setting in Spain.MethodsDescriptive, prospective, longitudinal and open study of 66 patients diagnosed with psoriatic arthritis: 63 patients received subcutaneous USTE 45 mg and 3 patients received USTE 90 mg every 12 weeks, both groups received a first dose of induction according to technical specifications. The following variables were collected: age, sex, years of evolution, previous treatment with Synthetic Disease Modifying Anti-Rheumatic Drugs (DMARDs) and/or biologic DMARD, counting of painful and swollen joints, determination of C-reactive protein, presence of dactylitis, onychopathy and cutaneous psoriasis. Clinical efficacy was evaluated by EULAR response criteria and Disease Activity Score (DAS28) according to low activity criteria (DAS28 >2.6–3.2) and remission clinical (DAS28 <2.6) at 6 and 12 months of treatment. Efficacy was compared between 2 subgroups; one group was: patients with USTE monotherapy vs USTE in combination therapy with DMARDs and the other group was: naïve patients vs patients who received previous treatment with biologic DMARD. Enthesis affectation was evaluated with the MASES index.Results66 patients were included, 51.5% were female. The mean age was 47.2±11.3 years and the mean disease duration was 6±7.76 years. USTE was prescribed in 44% as a first line therapy and was administered in combination with DMARDs in 51.5% of the patients (mostly, methotrexate). In our cohort, 74.2% of patients had exclusively peripheral involvement, 10.6% had axial involvement and 15.2% had mixed involvement. 21% of our patients had dactylitis and 36% enthesitis, as well as cutaneous psoriasis (74%) and onicopathy (42%). At 6 and 12 months of treatment, we observed a statistically significant decrease in the count of painful and swollen joints, in the DAS28 index and in the MASES index. DAS28 low disease activity rates were 38% at 6 months and 21% at 12 months of treatment. DAS28 remission rates were 21% and 14% at 6 and 12 months respectively. When comparing efficacy by subgroups, we observed higher EULAR response rates in patients with USTE in combination therapy with DMARDs (figure 1) and biologic DMARD-naïve patients (Figure 2) at 6 and 12 months of treatment.Abstract AB0924 – Figure 1EULAR response rates (%) at 6 (p=0.027) and 12 monthsConclusionsUstekinumab is effective for the treatment of psoriatic arthritis and constitutes an alternative to treatment with anti-TNFα. The dose of Ustekinumab 90 mg may improve the response to treatment in some patients, but we would need a greater number of studies in clinical practice.Disclosure of InterestNone declared

BackgroundThe fetal Congenital Heart Block (CHB) is thankfully a rare occurrence. It can develop during pregnancy in women with Rheumatic Diseases who have positive autoantibodies anti-Ro/La.ObjectivesTo evaluate the efficacy of hydroxychloroquine (HCQ) treatment and the monthly control in a multidisciplinary unit of Rheumatic Diseases and pregnancy on the pregnancy outcomes in women with positive anti-Ro/La.MethodsDescriptive, prospective, longitudinal and open study of 28 pregnant patients with positive anti-Ro/La. They were attended in a specialised multidisciplinary unit of Rheumatic Diseases and pregnancy and 46 pregnancies were developed with no complications. The following variables were collected: age, maternal pathology, presence of anti-Ro52, anti-Ro60 y anti-La, prior abortions, prior babies born with CHB, result of fetal echocardiograms, treatment during pregnancy, obstetric outcomes births/abortion, pregnancy length and maternal/fetal complications.Results28 pregnant women were included in the study. 64.3% were diagnosed with Systemic Lupus Erythematosus, 21.4% with Sjögren’s syndrome, 10.7% with undifferentiated connective tissue and 3.6% with rheumatoid arthritis. Our patients were an average of 32.24±5.34 years old and the 35% were elder than 35 years. 46 pregnancies were developed during the monitoring with an average of 1.61±0.74 pregnancies per patient. Before the inclusion in our unit, the following fetal history was collected: 1 baby with CHB and 11 abortions. Nevertheless, during the multidisciplinary evaluation and treatment there was no baby developing CHB and only 2 abortions occurred during the first trimester. The positivity of anti-Ro52, anti-Ro60 y anti-La was 89.3%, 32% and 29% respectively. Besides, 2 patients had triple positive autoantibodies and 6 patients double positive autoantibodies. 18% of our patients were diagnosed with lupus nephritis and 29% were diagnosed with secondary antiphospholipid syndrome and/or thrombophilia. The immunosuppressive therapy received during the 46 pregnancies is specified in figure 1. Also, 50% pregnant women received treatment with acetylsalicylic acid, 24% with low-molecular-weight heparin and 41% with corticoid. The mean gestational age was 38 weeks and 11% births were caesarean. 11% babies were preterm with an average birth weight of 2871.6±494.8 grams. 87% of our patients did not have complications in the puerperium. All of our patients were monitored with periodic fetal echocardiograms from the 16th week of gestation and none had a baby with CHB or neonatal lupus (100% of the babies were born healthy).Abstract AB0580 – Figure 1Immunosuppressive therapy received during the 46 pregnancies (%)ConclusionsOur results demonstrate that both treatment with hydroxychloroquine and close control in a multidisciplinary unit are effective in the prevention of congenital heart block development, in the decrease in the number of abortions and in a reduction of maternal and fetal morbidity and mortality. The multidisciplinary evaluation is essential in women ...