BackgroundPsoriatic arthritis (PsA) has a genetic background, approximately 40% of patients having a family history of psoriasis or PsA in first-degree relatives, which may impact the disease features.ObjectivesThe aim of this study was to evaluate the effects of family history of psoriasis or PsA on the disease phenotypes.MethodsThe demographic and clinical data were retrieved from the longitudinal, multicenter PsArt-ID (Psoriatic Arthritis-International Database). Family history of psoriasis and PsA were investigated for 1st and 2nd degree relatives separately. The effect of the family history of psoriasis and/or PsA on disease phenotypes and severity were analysed, calculating the relative risks (RR).Results1393 patients had the data for family history, 444 (31.9%) of whom was positive for psoriasis and/or PsA. The majority of the family history was only psoriasis (333/444; 75%) and 58.5% (260/444) of the patients had first-degree relatives affected. There was no differences in maternal or parental transmission rates however women had more psoriasis and/or PsA in their family (67.3% vs 32.7% p: 0.028). Patients with a family history had an earlier onset of age for psoriasis (29±14.8 vs 31±14.9 p: 0.007), more frequent nail involvement (50.7% vs 29.6% p: 0.032), more frequent enthesitis (28.2% vs 17.7% p<0.001) and deformities (25.2% vs 19.9% p: 0.05) and were able to achieve minimal disease activity (MDA) less often. (38.6% vs 49.5% p: 0.045). Plaque psoriasis was more common if the family history was positive for psoriasis whereas pustular psoriasis was more frequent when the family history was positive for PsA (figure 1). Family history of psoriasis were found as a risk factor for a younger onset (RR: 1.138), for nail disease (RR: 1.179), for enthesitis (RR: 1.504) and for not achieving MDA (RR: 1.246) whereas family history of PsA was a risk factor for having deformities (RR: 1.215) (table 1).Abstract THU0285 – Table 1Relative Risks in patients with or without family history of psoriasis or PsAFamily historypRR95% CI Onset of psoriasis before 40 years agePsoriasis<0.051.1381.063–1.219PsA>0.051.0230.879–1.191Nail involvement (ever)Psoriasis<0.051.1791.04–1.335PsA>0.051.1570.917–1.461Enhesitis (ever)Psoriasis<0.051.5041.192–1.898PsA>0.051.3500.871–2.092Not achieving MDAPsoriasis<0.051.2461.003–1.547PsA>0.051.0440.655–1.666Presence of deformitiesPsoriasis>0.051.2150.928–1.592PsA<0.051.7861.170–2.727PsA: Psoriatic Arthritis; MDA: Minimal Disease ActivityFigure: Distribution of skin lesions according to the family history in patients with PsA. Numbers are given as percentages. PsO: Psoriasis; PsA: Psoriatic ArthritisConclusionsThe family history of psoriasis and PsA has impacts on skin phenotypes, musculoskeletal features and the disease severity. The differences between family history of psoriasis and PsA and pustular vs plaque phenotypes may point out to a different genetic background and pathogenic mechanisms in these subsets.Disclosure of InterestNone declared

BackgroundThe environmental and genetic factors play a crucial role in the pathogenesis of psoriatic arthritis (PsA) which may cause a difference in disease characteristics for patients from different geographical regions.ObjectivesThe aim of the study was to explore the disease characteristics, treatment choices and comorbidities in patients with PsA in different countries to see the impact of geographic factors.MethodsPsArt-ID (Psoriatic Arthritis- International Database) is a prospective, multicentre registry in PsA, which was initially developed in Turkey in 2014, with participation of Canada since 2015 and Italy since 2017. Patients with PsA are consecutively registered to this registry with the aim of investigating the real-life data. Patient characteristics across Turkey (n=1283) and Canada (n=119) are compared for this analysis.Abstract SAT0353 – Table 1The demographics and clinical characteristics in two countriesTURKEYCANADAp value Female*827/1283 (64.5)60/119 (50.4)0.002Age (years)47 (36–56.7)49 (34–61)<0.001BMI (kg/m2)27.47 (24.5–31.2)29 (23.7–33.5)0.013At onset age for PsA36 (29–49.7)39 (30–48)0.058Smoking (package/years)10 (3–19.7)14.5 (5–26.25)0.007Education years8 (5–12)15 (13–16)<0.001SJC2 (1–5)2 (1–7)0.461TJC4 (2–8)6.5 (2–17)0.340TEP2 (1–2)1 (1–2)0.021BSA5 (1–13.75)1 (0–5)<0.001BASDAI37 (20–54)38 (22–58) 0.027Pt GA45 (20–60)31 (12–70)<0.001PGA30 (20–50)34 (18–66)<0.001Pain VAS40 (20–60)33 (18–78)<0.001TJC: tender joint counts; TEP: tender entheseal points; BSA: body surface area; PtGA: patient global activity; PGA: physician global activity. All data were given n/total n (percentage (%))* or median (first-third percentiles).Abstract SAT0353 – Figure 1The distribution of the treatment choices in Turkey and Canada, excluding patients with new diagnosis at the time of recruitment. DMARD: Disease-modifying anti-rheumatic drug; anti-TNF: anti-tumour necrosis factor. All data were given n/total n (percentage (%).ResultsCanadian patients were older at the time of recruitment (Table). They also were more frequently smokers, had higher duration of education and higher BMI than patients in Turkey. Patients in Canada had more frequent polyarthritis (66.7% vs 39.6%, p<0.001), DIP joint disease (34.2% vs 16%, p<0.001), dactylitis (38.1% vs 29%, p=0.037) nail involvement (55.9% vs 45.7%, p=0.008) and higher number deformed joints (29.3% vs 20.7%, p=0.035) whereas Turkish patients had oligoarthritis more often (37.6% vs 24.8%, p=0.016). For disease activity, tender and swollen joint counts were similar for whereas the skin activity was higher in Turkish patients. There were no major differences between countries regarding treatment choices with similar frequencies of patients on biologic therapies (34.5% vs 30.2%, p=0.339) (figure 1). Although the numbers were very low, there was more frequent cancer in Canada than Turkey (4.3% vs 1.4%, p=0.022) whereas all the other comorbidities were similar.ConclusionsGeographical differences have impacts on the disease features in PsA, which may be due to genetic, environme...

BackgroundRheumatoid arthritis (RA) can have a major impact on health related quality of life (HRQoL). The revised AIMS-2 is the main outcome measure that has been used for measuring HRQoL in patients with rheumatic diseases. Guillemin et al. developed a short form of AIMS-2 (AIMS-2 SF) (1) which is more practical and less time consuming compared to AIMS-2.ObjectivesThe purpose of this study was to investigate validity and reliability of the Turkish version of AIMS2-SF (TR AIMS-2 SF).MethodsTurkish AIMS2-SF was developed after translation and back-translation method. Culturally adapted version preserved 5 component-structure (upper limb function, lower limb function, affect, pain and social interaction) with 26 items according to the original article (1). Subjects fulfilling ACR/EULAR 2010 classification criteria for RA were consecutively enrolled into the study. Patients with malignancy, fibromyalgia syndrome and other systemic inflammatory diseases were excluded. Demographic data, the body mass index (BMI), severity of pain (VAS), disease duration (month) and other clinical features was evaluated. Reliability was investigated with test-retest reliability (intraclass correlation coefficient-ICC) and internal consistency (Cronbach's alpha). Spearman's rank correlation coefficient was used to evaluate the relation between quantitative parameters and the validity. Construct validity was assessed by the correlation of TR AIMS2-SF with other clinical parameters (age, disease duration, VAS pain, DAS-28) and functional parameters such as Nottingham Health Profile (NHP), Health Assessment Questionnaire (HAQ), Beck Depression Inventory (BDI), Duruoz Hand Index (DHI). Statistical analyses were performed with SPSS version 20 and a value of p<0.05 was considered as statistically significant.ResultsSixty patients (6 males) were recruited into the study. The mean ± standart deviation (SD) of age (years) and disease duration (months) were 51.8±12.5 and 71.4±69.3, respectively. Mean scores of TR AIMS2-SF were; upper limb function 7.3±6.9, lower limb function 7.7±4.7, affect 7.4±3.2, pain 6±3.1, social interaction 4±2.3 and total score 35.5±16.6. The floor and ceiling effects of TR AIMS2-SF were 1.6 and 3.3, respectively. Both Cronbach's alpha and ICC were 0.83 indicating good reliability. There was significant correlation (rho, p value) with parameters that were directly related to HRQoL which were NHP subscales (energy level: 0.46, pain: 0.63, emotional reaction: 0.55, sleep 0.33, social interaction: 0.60, physical activity: 0.63; p<0.0001), HAQ (0.70, p<0.0001), BDI (0.54, p<0.0001), DHI (0.60, p<0.0001). Poor or not significant correlation was found with parameters that were not directly related to HRQoL such as age (-0.004, p=0.97), disease duration (0.21, p=0.09), vas pain (0.37, p<0.05); on the other hand, disease activity (DAS-28) correlated moderate (0.49, p<0.0001).ConclusionsTurkish version of AIMS2-SF is a reliable and valid tool that can be used to evaluate the quality of life in RA. This is a feasible measure that c...

BackgroundComorbidities are frequent in Psoriatic arthritis (PsA) and can have an impact on morbidity and mortality.ObjectivesWe aimed to investigate the frequency of different comorbidities in PsA, how comorbidities have an impact on PsA features and which factors were associated with the occurrence of comorbidities in a large number of patients, using PsART (Psoriatic Arthritis Registry of Turkey)registry.MethodsPsART is a national, web-based registry where consecutive patients with PsA are recruited and demographic, clinical and therapeutic information are collected as well as comorbidities. The following comorbidities are questioned: Hypertension (HT), hyperlipidemia, depression, diabetes mellitus (DM), hyperuricemia, coronary arterial disease, liver disease, cerebrovascular accident, cancer, and depression. BMI more than 30 is recorded as obesity. Patients with or without comorbidities were compared for their demographic features and outcome tools.ResultsOne thousand and sixty-nine patients whom comorbidity data were available were analyzed. Within these 693 (64.8%) were women. Mean (SD) age was 46.9 (12.8), with a median (range) PsA duration 45 (0–545) months. The number of patients with 1, 2 and 3 comorbidities were 642 (60.1%), 345 (32.3%), and was 191 (17.9%), respectively. Frequency of comorbidities was obesity in 327 (30.6%), HT in 256 (23.9%), hyperlipidemia in 199 (18.6%), depression in 188 (17.6%), DM in 161 (15.1%), hyperuricemia in 74 (6.9%), coronary artery disease in 39 (3.6%), liver disease 38 (3.6%), cerebrovascular event in 19 (1.8%), and cancer history 16 (1.5%). Patients with at least one comorbidity were older (51.1 (11.8) vs 40.9 (11.7), p<0.001) and had a higher disease activity (according to tender joint count (3.9 (5.2) vs 2.9 (4.2), p=0.001), pain (4.6 (2.6) vs 4.0 (2.6), p=0.006), patient global assessment (4.5 (2.4) vs 4.0 (2.5), p=0.014), fatigue (4.9 (2.5) vs 4.0 (2.6), p<0.001)). Education was found to contribute on comorbidities as patients with at least one comorbidity had less education in terms of school years (7.6 (4.4) vs 9.7 (4.4) years, p<0.001). This was also found separately for some of the comorbidities: Patients with DM (mean (SD) years of education 6.7 (4.2) vs 8.8 (4.5), p<0.001), HT (6.7 (4.3) vs 8.9 (4.5), p<0.001), cerebrovascular event (5.5 (2.9) vs 8.4 (4.5), p=0.012) and depression (7.5 (4.1) vs 8.6 (4.6), p=0.004) had less education compared to patients who don't have those comorbidities.ConclusionsOur registry supported that comorbidities are frequent in PsA increasing the complexity of the disease and have an impact on the disease severity. Patients with comorbidities are less educated showing that education and awareness are important to improve patient outcomes in PsA in long term.Disclosure of InterestNone declared

BackgroundPsART (PsA registry of Turkey) is a multicenter web-based registry.ObjectivesThe objective of this registry is to assess characteristics of PsA and compare the differences among genders in our population.MethodsPsART was established in 2014 including 32 rheumatology centers. Detailed data regarding demographics for the skin and joint disease, disease activity assessments and treatment choices were collected.ResultsOne thousand and eighty-one patients (64.7% women) with a median (range) PsA duration for 3.7 (0–45) years were enrolled. Median psoriasis duration was 13 (0–59) years. The most frequent type of PsA was polyarticular 437 (40.5%) followed by oligoarticular 407 (37.7%) and axial disease 372 (34.4%). Patients with a combination of axial and peripheral disease had a longer disease duration than patients with one type of joint disease (52 (0–545) vs 42 (0–486) months, p=0.008). Mean (SD) swollen and tender joint counts were 1.7 (3) and 3.6 (4.8). 38.6% of patients were on csDMARD monotherapy, 7.1% were anti-TNF monotherapy and 22.5% were using anti-TNF plus csDMARD combinations. Within items included in the minimal disease activity, only 17.6%>67% of patients had inactive disease state. The major differences among genders were women being older (48.3 (12.8) VS 44.4 (12.5), P<0.001), more fatigue and higher HAQ scores (Table). Women also had more frequent peripheral arthritis than men and less axial disease (only peripheral vs axial vs combined, n (%): women: 479 (68.5%), 62 (8.9%), 158 (22.6%) respectively; men: 222 (59.4%), 41 (11%), 111 (29.7%) respectively; p=0.011). Women had significantly more history of psoriasis in their family compared to men (34.8% vs 25.7%, p=0.003).All patients (n=1081)Female (n=702)Male (n=379)pInflammatory LBP n (%)275 (25.4)155 (22.3)120 (32.1)0.002Duration of morning stiffness37.9 (43.0)38.5 (43.8)36.7 (41.6)0.73Patient global assessment43.5 (24.9)44.3 (24.0)42.1 (26.6)0.22Fatigue VAS46.2 (26.2)48.5 (24.6)42.0 (28.6)0.002Pain VAS44.6 (27.1)45.5 (26.0)43.1 (28.9)0.21HAQ0.71 (0.65)0.74 (0.64)0.66 (0.67)0.014BASDAI39.4 (25.6)39.1 (24.5)39.9 (27.3)0.88BASFI29.0 (24.2)28.1 (23.7)30.7 (24.9)0.27PSI7.5 (7.2)7.4 (7.3)7.7 (7.1)0.57Physician global assessment35.6 (22.2)35.6 (21.1)35.8 (24.1)0.86Swollen joint counts1.7 (3.0)1.6 (3.1)1.8 (2.8)0.91Tender joint counts3.6 (4.8)3.7 (5.0)3.4 (4.3)0.93Body surface area6.1 (10.7)4.9 (8.0)8.4 (14.2)0.69Leeds enthesitis index0.2 (0.7)0.2 (0.8)0.2 (0.5)0.43ConclusionsPsART had similarities with the previously published registries, supporting its external validity. Women having more fatigue and worse functioning and as well as the high percentage of active disease state point out to the unmet need in treatment of PsA.Disclosure of InterestNone declared