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Background Recent advances in rheumatoid arthritis (RA) treatment including the introduction of biologics have greatly affected treatment strategies for RA, achieving remission as a realistic treatment target. However, few reports have been concerned chronological changes in long-term physical dysfunction among large numbers of RA patients in daily practice. Objectives To evaluate chronological changes in Japanese version of Health Assessment Questionnaire score (J-HAQ) score and J-HAQ remission rates at 5 years after RA onset using the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) cohort. Methods RA patients who developed RA between 2000 and 2010 and who first visited our hospital during the year of RA onset were divided into two groups: 1) former onset group (RA onset between 2000 and 2005) and 2) recent onset group (RA onset between 2006 and 2010). J-HAQ scores and J-HAQ remission rates at baseline and at 5 years after onset were investigated for each group, and factors associated with J-HAQ remission after 5 years were assessed by logistic regression analysis. Methotrexate (MTX), corticosteroid (steroid) and biologic DMARDs user (bDMARDs) was defined as the patients if they were used each medication during the observation period. Results The former onset group and recent onset group included 357 and 291 RA patients, respectively. For the former onset group, the average J-HAQ score/J-HAQ remission rate at baseline and 5 years after the onset were 0.659/54.6% and 0.430/71.4%, respectively. The recent onset group showed significant improvements relative to the former onset group in J-HAQ score/J-HAQ remission rates at baseline and 5 years of 0.705/52.2% and 0.316/78.4%, respectively (p=0.011/0.044). The percentage of MTX and bDMARDs users was significantly higher in the recent onset group (former vs. recent onset group; MTX: 70.9% vs. 86.6% [p Conclusion In daily practice, J-HAQ scores for RA patients remarkably improved with recent advances in RA treatment strategies. To achieve J-HAQ remission at 5 years of RA onset, beginning treatment in the early disease stage is needed to prevent deterioration of J-HAQ and treatments that avoid steroid use appear to be important. Acknowledgement We thank all patients who participated in the IORRA survey and all of the members of the Institute of Rheumatology, Tokyo Women’s Medical University, for the successful management of the IORRA cohort. Disclosure of Interests Mai Abe: None declared, Eiichi Tanaka Speakers bureau: Abbvie, Asahi Kasei pharma co., Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo Co., Eisai Pharmaceutical, Janssen Pharmaceutical K.K., Nippon Kayaku, Pfizer, Takeda Pharmaceutical, Taisho Toyama Pharmaceutical Co., and UCB Pharma., Eisuke Inoue: None declared, Mika Kawano: None declared, Eri Sugano: None declared, Naohiro Sugitani: None declared, Kumiko Saka: None declared, Yoko Shimizu: None declared, Moeko Ochiai: None declared, Rei Yamaguchi: None declared, Naoki Sugimoto: None declared, Katsunori Ikari: None declared, Ayako Nakajima Grant/research support from: Asahi Kasei pharma co., Chugai Pharmaceutical, Daiichi Sankyo Co., Pfizer, Kissei Pharmaceutical Co., and Mitsubishi Tanabe Pharma Corporation., Atsuo Taniguchi: None declared, Hisashi Yamanaka Grant/research support from: AbbVie, Eisai, Bristol-Meyers, Novartis, Behringer, Astellas, Kaken, Nippon-Shinyaku, Pfizer, UCB, Ayumi, Ono, Daiichi-Sankyo, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, Torii, YLbio, Speakers bureau: Bristol-Meyers, Astellas, Pfizer, Daiichi-Sankyo, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, YLbio

Background Ulcertive colitis (UC) is associated with a variety of extraintestinal manifestations (EIMs) that may have negative effects on performance status and quality of life. EIMs frequently affect musculoskeltal systems (peripheral and axial arthropathies), skin, hepatobiliary tract and eyes1,2. Previous studies showed that peripheral and axial arthropathies were seen 4-23% patients with UC and they tend to have peripheral rather than axial arthropathies3. UC is generally thought to become in remission when patients undergo total colectomy. However, in clinical practice, patients often suffered from arthropathy which is thought as EIMs even after total colectomy. The distribution and risk factors for the occurrence of peripheral and axial arthropathies among UC patients after total colectomy have not been investigated yet. Objectives In this study, we aimed to clarify frequency and distribution of arthropathy and to investigate risk factors for developing arthropathy among UC patients after colectomy. Methods In this retrospective, single center, observational study, we investigated the backgrounds and risk factors for arthropathy using patients underwent total colectomy from January 2007 to February 2016 in Mie University. As backgrounds, age, sex, presence and distribution of arthropathy, other EIMs, and duration after colectomy, clinical activity (mild/moderate/severe), Matts classification (grade 1+2 vs 3+4), presence of massive hemorrhage and toxic megacolon, previous therapies for UC were collected from electronic medical records. Arthropathy was defined as joint pain or swelling without definite cause which was improved by using glucocorticoid. Background factors were described as median (IQR) for continuous variables or as percentage (%) for categorical variables and difference was analyzed by Wilcoxon for continuous variables and by chi-square for categorical variables. Factors with p-value Results We enrolled 219 patients (female; 40.2% and median age at operation; 38.0 [27.0, 53.0] years). Among them, 40 (18.3%) patients had arthropathy, peripheral type in 23 (57.5%), axial type in 3 (7.5%), mixed type in 14 (35.0%). Duration from operation to onset of arthropathy was 0.7 [0.4, 1.2] years. The risk factors for developing arthropathy by univariate analyses were Matts classicification (grade 3+4 vs 1+2) (p Conclusion About one fifth patients with UC who underwent colectomy developed arthropathy presenting predominantly peripheral type. Long follow up period, High disease activity by endoscopic classification, and ileal pouchitis were risk factors of developing arthropathy in UC patients after total colectomy. The frequency and risk factors for developing arthropathy even after colectomy was demonstrated in this study for the first time. References [1] Paraskevi VV, et al. Ann Gastroenterol. 2011; 24: 173-80. [2] Orchard TR, et al. Gut. 1998; 42: 387–91. [3] Das KM, et al. Dig Dis Sci1999;44:1–13. Disclosure of Interests Kentaro Noda: None declared, Yuki Mizutani: None declared, Naohiro Sugitani: None declared, Yasuo Suzuki: None declared, Toshimitsu Araki: None declared, Masato Kusunoki Grant/research support from: Chugai Pharmaceutical Co., Shionogi Pharmaceutical Co., Taiho Pharmaceutical Co., and Mitsubishi Tanabe Pharma Co., Ayako Nakajima Grant/research support from: Asahi Kasei pharma co., Chugai Pharmaceutical, Daiichi Sankyo Co., Pfizer, Kissei Pharmaceutical Co., and Mitsubishi Tanabe Pharma Corporation.