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Background Rheumatoid arthritis (RA) is a risk factor for the development of fragility fractures, but there is little quality data on its prevalence. Conversely, osteoporosis is one of the most frequent comorbidities of RA. Objectives To determine the prevalence of vertebral fractures in postmenopausal women with RA and to analyse their characteristics and associated risk factors. Methods We included 346 postmenopausal women diagnosed with RA according to the ACR/EULAR 2010 criteria in 19 Spanish Rheumatology Departments, randomly selected from the registry of RA patients in each center, recruited during 2018. Lateral radiographs of the dorsal and lumbar spine were obtained from all patients, to evaluate morphometric vertebral fractures. Expert rheumatologists identified vertebral fractures and classified them into mild (grade 1: reduction of height of 20-25%), moderate (grade 2: reduction of 26-40%) and severe (grade 3: reduction > 40%), according to the Genant grading scale. The spinal deformity index (SDI) was calculated by assigning numbers 1, 2 and 3 to each fractured vertebra and adding the total score of each patient. The study variables were: a) age, body mass index (BMI), b) factors related to RA: time of evolution, FR, ACPA, and c) fracture risk factors: prior fragility fracture, parental hip fracture, glucocorticoids, smoking, alcohol intake ≥3 units daily, secondary osteoporosis and time since menopause. Results The mean age was 66.8 (SD: 10.1) years and the median evolution of the disease, 8.00 [RIQ: 3.00-15.5] years. 77.2% (n: 267) and 75.7% (n: 252) had FR and ACPA +, respectively. The mean duration of the postmenopausal period was 15.0 (SD: 9.6) years. 23.4% (n: 79) of patients had at least one vertebral fracture; 10.7% (n: 36) had a single fracture and 12.7% (n: 43), multiple fractures. The most fractured vertebrae were D12, L1 and L2 (fractured in > 5% of patients). The median SDI was 3 [RIQ: 2-5]. The vertebrae with the highest mean IDE were D8, D10, D11 and L1 (all mean IDE ≥ 2).An association was found between the presence of vertebral fractures and age, height, postmenopausal period, time of disease progression, glucocorticoid treatment and parental hip. No linear association was found between SDI and age, time of evolution of the disease, BMI and time since menopause. Conclusion One out of every 4 postmenopausal women with RA has at least one vertebral fracture. Vertebrae of the dorso-lumbar hinge are the most frequently involved and the magnitude of the spinal deformity is relevant. Vertebral fractures are related to the time of evolution of RA and to the risk factors for fracture. Disclosure of Interests Carmen Gomez Vaquero: None declared, Dacia Cerda: None declared, Cristina Hidalgo: None declared, JA Martinez Lopez: None declared, Luis Marcelino Arboleya Rodriguez: None declared, Javier Aguilar del Rey: None declared, Silvia Martinez Pardo: None declared, Inmaculada Ros: None declared, Xavier Suris Speakers bureau: Lilly, Pfizer, MSD, Dolors Grados: None declared, Chesus Beltran: None declared, Evelyn Suero-Rosario: None declared, Inmaculada Gomez Gracia: None declared, Asuncion Salmoral: None declared, Irene Martin-Esteve: None declared, Helena Florez: None declared, Antonio Naranjo: None declared, Santos Castaneda Consultant for: Amgen, BMS, Pfizer, Lilly, MSD, Roche, Sanofi, UCB, Soledad Ojeda Grant/research support from: AMGEN, Speakers bureau: AMGEN, S Garcia Carazo: None declared, Alberto Garcia-Vadillo: None declared, Laura Lopez Vives: None declared, A Martinez-Ferrer: None declared, Helena Borrell: None declared, Pilar Aguado: None declared, Raul Castellanos-Moreira Speakers bureau: MSD, Lilly, Nuria Guanabens Consultant for: Advisory Boards from Amgen, Alexion and UCB, Speakers bureau: Fees and lectures from Eli Lilly

Background Both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients are associated with an increased and premature prevalence of atherosclerosis. This has been characteristically attributed to the inflammation present in both diseases Objectives To analyze the differences in the role of traditional cardiovascular risk factors in the subclinical atherosclerosis between the two diseases. Methods Cross-sectional study encompassing 602 subjects, 276 SLE and 326 RA patients. Carotid plaques were assessed by ultrasonography. A multivariable regression analysis was performed to evaluate if classic cardiovascular-related risk factors influence differentially on subclinical carotid atherosclerosis in SLE compared to RA patients. Results Traditional cardiovascular risk factors were found to be prevalent in RA and SLE patients. Age (interaction factor p=0.000), hypertension (interaction factor p=0.034), and diabetes (interaction factor p=0.037) were found to have a higher effect on cIMT in RA patients compared to SLE subjects. No differences between RA and SLE were discovered in the effect of traditional cardiovascular factors over the presence of carotid plaque when univariate interaction was performed. After final adjustment for demographics, the presence of others traditional cardiovascular factors, and disease related data, no differences were found in the influence of hypertension, diabetes, dyslipidemia or current smoking over cIMT or the presence of carotid plaque. Moreover, the effect of the addition of various cardiovascular risk factors on the subclinical carotid atherosclerosis did not differ between both diseases. Conclusion The influence of traditional cardiovascular risk factors (hypertension, diabetes, dyslipemia and smoking) over cIMT and carotid plaque is equal in RA and SLE. No interaction was found between traditional cardiovascular risk factors and disease related data in the effect of the former on subclinical atherosclerosis. Disclosure of Interests Hiurma Sanchez-Perez: None declared, Juan Carlos Quevedo-Abeledo: None declared, Inigo Rua-Figueroa: None declared, Beatriz Tejera-Segura: None declared, Vanessa Hernandez-Hernandez: None declared, Antonia de Vera-Gonzalez: None declared, Alejandra Delgado-Gonzalez: None declared, Raquel Lopez-Mejias: None declared, Soledad Ojeda Grant/research support from: AMGEN, Speakers bureau: AMGEN, Miguel A Gonzalez-Gay Grant/research support from: Prof. MA Gonzalez-Gay received grants/research supports from Abbvie, MSD, Jansen and Roche., Speakers bureau: Consultation fees/participation in company sponsored speaker’s bureau from Pfizer, Lilly, Sobi, Celgene, Novartis, Roche and Sanofi., Ivan Ferraz-Amaro: None declared

Background: Oral and/or genital aphthous ulcers are the most common symptoms of Behcet’s disease (BD), and are often refractory to conventional treatment. The inhibitor of phosphodiesterase-4 Apremilast (APR) has demonstrated efficacy in the treatment of this manifestations. Objectives: To assess the efficacy and safety of APR in BD patients with oral and/or genital ulcers refractory to conventional treatment. Methods: National multicenter open-label study on 49 BD patients treated with APR at maintained standard dose of 30 mg twice daily, with the initial 5-day titration schedule in 38 cases. The main outcome was achievement of oral and/or genital ulcers remission. Results: We included 49 patients (35 women/14 men), mean age of 44.5±13.4 years. Before APR, all patients had received several systemic conventional and/or biological drugs: oral corticosteroids (n=45), colchicine (n=48), NSAIDs (n=21), methotrexate (n=27), azathioprine (n=23), cyclosporine (n=9), dapsone (n=6), adalimumab (n=12), infliximab (n=8), tocilizumab (n=3), etanercept (n=3), sulfasalazine (n=2), cyclophosphamide (n=2) and/or others (pentoxifylline, thalidomide, mycophenolate mofetil, hydroxychloroquine, golimumab, 1 each). The main clinical symptoms for starting APR were oral (n=18) and genital (n=2) aphthous ulcers or both (n=29). After a mean follow-up of 8.3±6.8 months, most of the patients experienced main clinical improvement and prednisone dose was reduced or discontinued (TABLE). In this period of time, 31 patients developed any side-effect, most of them transitory: nausea (n=12), diarrhea (n=11), dyspepsia (n=9), abdominal pain (n=7), headache (n=5), loss of appetite (n=4), weight loss (n=3), halitosis (n=1), dry mouth (n=1), palpitations (n=1) and/or depression (n=1). Six patients had to reduce the dose to 30 mg/day. APR was discontinued in 11 patients due to: not obtaining the expected improvement (n=5), intense gastrointestinal adverse effects (n=3), desire of pregnancy (n=1), persistent erythema nodosum (n=1) and development of neurological involvement (n=1). Conclusion: Our data show a rapid and maintained improvement with APR in patients with mucocutaneous ulcers of BD refractory to several systemic drugs, including biologic therapy. References: [1] Davatchi F, et al. The International Criteria for Behcet’s Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatology Venereol. 2014;28(3):338–47. [2] Gulen Hatemi, et al. Apremilast for Behcet’s Syndrome — A Phase 2, Placebo-Controlled Study. N Engl J Med 2015; 372:1510-1518. Disclosure of Interests: Belen Atienza-Mateo: None declared, Jose Luis Martin-Varillas: None declared, J. Loricera: None declared, Vanesa Calvo-Rio: None declared, Jenaro Grana: None declared, Gerard Espinosa: None declared, Clara Moriano: None declared, Trinidad Perez-Sandoval: None declared, Manuel Martin-Martinez: None declared, Elvira Diez Alvarez: None declared, Maria Dolores Garcia-Armario: None declared, Esperanza Martinez: None declared, Ivan Castellvi Consultant for: I received fees less than 5000USD as a consultant for Kern and Actelion, Paid instructor for: I received fees less than 2000USD as a instructor for Boehringer -Ingelheim, Novartis and Gebro, Speakers bureau: ND, Patricia Moya: None declared, Francisca Sivera: None declared, Jaime Calvo Consultant for: Bristol-Myers Squibb, Janssen, Celgene, Sanofi Genzyme, Speakers bureau: Bristol-Myers Squibb, Isabel de la Morena Speakers bureau: Abbvie, Celgene, Pfzier, UCB, Ghebro, Roche, Sanofi, Janssen., Francisco Ortiz-Sanjuan: None declared, Jose Andres Roman-Ivorra: None declared, Ana Perez Gomez: None declared, Sergi Heredia: None declared, Alejandro Olive: None declared, Agueda Prior-Espanol: None declared, Carolina Diez: None declared, Juanjo J Alegre-Sancho: None declared, D Ybanez-Garcia: None declared, Angels Martinez-Ferrer: None declared, J. Narvaez Consultant for: Bristol-Myers Squibb, Ignasi Figueras: None declared, Ana Isabel Turrion : None declared, Susana Romero-Yuste: None declared, Pilar Trenor: None declared, Soledad Ojeda Grant/research support from: AMGEN, Speakers bureau: AMGEN, Santos Castaneda Consultant for: Amgen, BMS, Pfizer, Lilly, MSD, Roche, Sanofi, UCB, Monica Calderon-Goercke: None declared, D. Prieto-Pena: None declared, Inigo Gonzalez-Mazon: None declared, Lara Sanchez Bilbao: None declared, Miguel A. Gonzalez-Gay: None declared, Ricardo Blanco: None declared

Background Secondary prevention of osteoporotic fracture is more efficient with the Fracture Liaison Service (FLS) model. Objectives To describe the characteristics of male patients attended in a FLS Methods Prospective observational study. The program consists of: 1) recruitment from the emergency records, hip fracture admitted or referral to outpatient rheumatology; 3) baseline visit: questionnaire including demographCI variables, FRAX and previous treatments; 4) DXA; 5) patient education; 6) report of results to the patient and the PC doctor, with specifCI management recommendations; complex patients are referred to rheumatology; and 7) follow-up through telephone survey plus prescription check in electronCI records. The characteristCIs of male patients are described and compared with women. Results 2,135 patients have been included, 382 male (18%). The recruitment was in 300 cases (78%) from the emergency list, in 55 cases (14%) admission for hip fracture and in 25 cases (6%) from outpatient clinCI. The characteristCIs of the patients are shown in the table. The average age was similar in men and women. Hip fracture was more frequent in men (34% vs. 25%, OR 1.63 CI 95% 1.50-1.75) as opposed to forearm fracture (18% vs. 33%, OR 0.46 CI 95% 0.32-0.60). Male had previous DXA (6% vs 25%, OR 0.22 CI 95% 0.00-0.43) and previous treatment with bisphosphonate (4% vs 19%, OR 0.17 CI 95% 0, 0-0.44) less frequently. Of the variables included in the FRAX, in men was less frequent the previous fracture (13% vs 24%, OR 0.48 CI 95% 0.32-0.64), the hip fracture of the parents (9% vs. 13%; OR 0.66 CI 95% 0.47-0.85) and the use of corticoids (6% vs 10%, OR 0.61 CI 95% 0.39-0.84). However, active smoking was more frequent in men (21% vs 14%, OR 1.67 CI 95% 1.53-1.81) as well as consumption >2 daily units of alcohol (18% vs 5%; OR 3.96 CI 95% 3.78-4.13). The percentage of osteoporosis was lower in men compared to women (30% vs 46%, OR 0.49 CI 95% 0.30-0.68) as well as the percentage of patients with >1 fall in the last year (29% vs 45%, OR 0.51 CI 95% 0.30-0.71). In addition, after the visit to the FLS, a bisphosphonate was indicated less frequently to men than to women (68% vs. 77%, OR 0.64 CI 95% 0.51-0.76) and were referred less frequently to PC (64% vs. 76%; OR 0.55 95% CI 0.41-0.70). Finally, persistence at 12 months was lower in men than in women (53% vs. 68%, OR 0.53 CI 95% 0.30-0.76). Conclusion Compared with women, men seen in an FLS present hip fracture more frequently and a forearm fracture less frequently. Men also have a lower frequency of personal and family history of fracture and a greater frequency of smoking and alcohol intake. The percentage of patients who are candidates for treatment and persistence is lower than in women. These data should be taken into account in the identification and treatment of fragility fracture in men. Acknowledgement Fabiola Santana and Carmen Alonso Disclosure of Interests Antonio Naranjo Grant/research support from: Amgen, Consultant for: UCB, Speakers bureau: Amgen, UCB, Soledad Ojeda Grant/research support from: AMGEN, Speakers bureau: AMGEN, Aida Saavedra: None declared, Cristina Sepulveda: None declared, Francisco Rubino: None declared, Amparo Molina Speakers bureau: AMGEN, Olga Suarez: None declared, Casimira Dominguez: None declared, Jose A. Lorenzo: None declared, Nieves Martin: None declared, Carlos Rodriguez-Lozano: None declared

Background: The antisynthetase syndromes (ASSD) are characterized by the presence of anti-aminoacyl transfer RNA synthetase (ARS) autoantibodies; which difficult the binding of amino acids to the transfer RNA during the protein synthesis. ARS can be detected by indirect immunofluorescence (IIF), and can be identified by immunoblot assay and ELISA (Enzyme-Linked ImmunoSorbent Assay) and immunoblotting. The main clinical features of the ASSD are myositis, arthritis, interstitial lung disease, Raynaud’s phenomenon, mechanic hands, and fever. Two ASSD diagnosis criteria have been developed; those proposed by Connors, and the stricter criteria proposed by Solomon (1, 2). Objectives: To evaluate the performance of the ARS and their IIF patterns in the ASSD diagnosis. Methods: We performed an observational retrospective study in one center during the period 06/2008-06/2018. We searched all the myositis immunoblots (Euroimmun assay) requested by the Rheumatologists under suspicion of ASSD or myositis. We assessed: 1) the rate of cases with positive ARS; 2) the rate of cases with Connor’s or Solomon’s diagnosis criteria fulfillment; and 3) their relation with the IIF patterns (Hep-2 cells; ≥1/80) evaluated by an expert in autoimmune tests. Results: A total of 140 myositis immunoblots were searched. Twenty-seven cases (19.3%) presented positive ARS: anti-Jo1 (n=13), anti-PL-12 (n=7), anti-PL-7 (n=1), anti-EJ (n=2), and anti-OJ (n=4). Twenty-five of these (17.9%) fulfilled Connors’ criteria, and 15 (10.7%) additionally met Solomon’s criteria. Thus, the fulfillment of Connor’s and Solomon’s criteria in patients with a positive ARS was of 92.6% and 55.5%, respectively. All cases (100%) with positive ARS presented positive immunofluorescence: 19 (70.4%) showed a cytoplasmic pattern (10 of them with an associated nuclear pattern) and 8 cases (29.6%) presented only a nuclear pattern. On the other hand, 99 of the 113 cases (87.6%) with negative ARS presented positive IIF: 29 (25.7%) showed a cytoplasmic pattern (21 of them with an associated nuclear pattern) and 42 cases (37.2%) presented only a nuclear pattern. Correlating the ARS positivity, IIF pattern and the diagnosis criteria fulfillment: - 13 of 15 cases (86.6%) with positive ARS and Solomon’s criteria fulfillment presented a cytoplasmic pattern; and 2 of 15 cases (13.3%) presented only a nuclear pattern. - 13 of 19 cases (68.4%) with positive ARS and cytoplasmic pattern fulfilled Solomon’s criteria; and 6 only fulfilled those from Connors’. Conclusion: One-fifth of the immunoblots requested by Rheumatologists presented positive ARS; almost all these cases fulfilled Connor’s criteria, and more than a half fulfilled the stricter Solomon’s criteria. All patients with positive ARS, and a high rate of those without ARS, presented positive IIF. The presence of a cytoplasmic pattern was considerably higher in patients with ARS positivity and in those that met Solomon’s criteria. Thus, our results suggests that in patients evaluated by a Rheumatologist, with clinical suspicion of ASSD or myositis and with ARS positivity, the probability of fulfilling Solomon’s criteria is higher when the IIF presents a cytoplasmic pattern than when only a nuclear pattern is observed. Nevertheless, presenting only a nuclear pattern does not exclude the detection of ARS in the myositis immunoblot and the fulfillment of Solomon’s criteria. References [1] Solomon J, et al. Jornal brasileiro de pneumologia. 2011;37(1):100-9. [2] Connors GR, et al. Chest. 2010;138(6):1464-74. Disclosure of Interests: Martin Greco: None declared, Maria Jesus Garcia de Yebenes: None declared, Inmaculada Alarcon: None declared, Anahy Brandy-Garcia: None declared, Inigo Rua-Figueroa: None declared, Estibaliz Loza Grant/research support from: Roche, MSD, Pfizer, Abbvie, BMS, UCB, Actelion, Celgene, Grunenthal and Sanofi, Teresa Oton: None declared, Francisco Rubino: None declared, Juan Manuel Diaz: None declared, Felix Francisco: None declared, Soledad Ojeda: None declared, Loreto Carmona Grant/research support from: Abbvie, Actelion, Astellas, BMS, Eisay, Gebro Pharma, Grunenthal, Leo Pharma, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi-Aventis and UCB Pharma, Paid instructor for: Novartis

Background The enigma of fragility fracture with normal bone mass; Experience of a Liaison Service Fracture Unit Objectives To describe the characteristics of patients with fragility fracture and normal DXA treated in an FLS unit. Methods Prospective 6-year observational study of a FLS fracture unit. Demographic variables, FRAX items, DXA and TBS were collected. The characteristics of patients with normal and abnormal DXA are described. The statistical analysis was performed by means of a descriptive, comparing the normal DXA/osteopenia/osteoporosis groups by means of contingency tables, Fisher’s exact test, Student’s t test or ANOVA, as appropriate, as well as regression analysis. Results 1,631 patients were included, 205 with normal DXA (12.5%), 747 with osteopenia (45.8%) and 680 with osteoporosis (41.6%). Patients with normal DXA were characterized by a higher percentage of males, a younger age and a higher BMI. Hip fracture was less frequent in patients with normal DXA, while the frequency of other fractures was higher. The frequency of previous fracture, history of hip fracture of the parents and secondary osteoporosis was lower in patients with normal DXA. The TBS and FRAX values were higher in the cases of normal DXA compared to osteopenia and osteoporosis. In the multiple regression analysis, excluding TBS, remained significant associated with abnormal DXA age (OR 1.04; 1.03-1.06), sex (OR 2.48; 1.71-3.58), BMI (OR 0.91; 0.89-0.94),) and parent hip fracture (OR 1.99; 1.11-3.58). Including TBS Conclusion Patients with fragility fracture and normal DXA are younger, with more frequent males and with BMI and higher TBS values. Acknowledgement Fabiola Santana y Carmen Alonso Disclosure of Interests Antonio Naranjo Grant/research support from: Amgen, Consultant for: UCB, Speakers bureau: Amgen, UCB, Soledad Ojeda Grant/research support from: AMGEN, Speakers bureau: AMGEN, Aida Saavedra: None declared, Cristina Sepulveda: None declared, Amparo Molina Speakers bureau: AMGEN, Tatiana Marrero: None declared, Maria Pino Afonso: None declared, Margarita Ramirez: None declared, Nieves Martin: None declared, Alicia Olivares: None declared, Carlos Rodriguez-Lozano: None declared

Background in March 2012 was implemented a FLS Unit coordinated by Rheumatology Objectives communicate the results of the unit in the 2012–2017 period. Methods Patients>50 years with fragility fracture. The program consists of: 1) training of primary care doctors (GP), 2) recruitment from the emergency room or admitted with hip fracture; 3) Bone densitometry; 4) patient education by a nurse; 6) report to GP with recommendations of managing; and 7) follow-up of persistence of treatment (telephonic survey plus prescription in the electronic records) at 3, 6, 12 and 24 months. Results The FLS has attended 1739 patients: mean age 73 y, 81% women. The location of fractures was forearm (32%), hip (24%), humerus (21%), vertebra (10%) and other locations (12%). Previous treatment with bisphosphonate 17%, 10% of them at baseline. After the baseline visit, 75% of patients were sent to GP and 25% to rheumatology. Treatment with bisphosphonate or equivalent was recommended to 1264 patients (72%). Persistence of treatment (analysed at 3, 6, 12 and 24 months in 1,051, 823, 622 and 351 patients, respectively) was 74%, 72%, 75% and 69%, respectively. Conclusions Our FLS is effective in terms of beginning and persistence of antifracture treatment in the medium term. Disclosure of Interest None declared

Background Adherence to treatment in osteoporosis (OP) is not adequate, so that in the first year the percentage of suspensions is between 30% and 50%, up to an adherence of 20% at 3 years. In 2012, we started in Gran Canaria a Fracture Liaison Service (FLS). Objectives To describe the factors associated to an effective initiation of treatment after the baseline visit to our FLS. Methods Prospective observational study that consists of: 1) training of primary care physicians (GP), 2) capture of patients; 3) baseline visit: questionnaire including FRAX; 4) Bone densitometry; 5) patient education by a Nurse with special attention to adherence; 6) referral to GP with a report with management recommendations; those with multiple fractures or who require parenteral therapy were referred to rheumatology; and 7) follow-up by telephone survey to check whether the treatment was taking and confirmation of the prescription in the electronic records (both of which are necessary to consider an effective start of treatment). The variables included were: sex, age, type of fracture, use of previous bisphosphonate, type of prescribed treatment, prescribing physician and causes of non-adherence. Results Up to December 2017, the adherence of 887 patients with fragility fractures to whom a bisphosphonate or equivalent was prescribed, was recorded. Treatment was initiated in the following 3 months by 74% (n=656) of patients. The following variables were associated with the initiation of treatment: female sex, previous treatment with antiresorptives, prescription of denosumab vs bisphosphonate and treatment precribed by a rheumatologist vs GP (table 1). The causes of not initiating or withdrawing the treatment at 3 months are shown in table 2. In the regression analysis, we found a significant association with the effective initiation of treatment with a pevious treatment with bisphosphonate (p Conclusions 74% of patients seen in the FLS start treatment within 3 months of the baseline visit. The factors associated with the initiation of therapy were prior antiresorptive treatment, denosumab prescription and initial prescription by the rheumatologist. The reason of non adherence in half of the cases is the GP’s refusal to initiate or continue the FLS recommendation. Disclosure of Interest None declared

Background The utility of the trabecular bone score (TBS) is controversial. Objectives To analyse the clinical usefulness of FRAX-TBS in patients with fragility fracture seen in a Fracture Liaison Service (FLS) compared to FRAX without TBS. Methods Consecutive outpatients >50 y seen in our FLS were included, excluding patients admitted with hip fracture. The variables included were: age, sex, type of fracture, risk factors for FRAX, FRAX for major and hip fractures with and without TBS, bone densitometry (DXA) and indication of treatment to prevent new fractures. Results We included 251 patients, mean age 69 y, 86% women. The most frequent type of fracture was the forearm (n=122) followed by the humerus (n=64). The DXA scan results (taking the lowest value of column/hip) was osteoporosis in 41%. The average TBS was 1.307 (SD 0.103, range 0.961–1.550): forearm fracture 1.313 (SD 0.102), vertebra 1.281 (SD 0.131) and hip 1.291 (SD 0.103). 32% presented normal TBS result 53% partially degraded and 15% degraded (table 1). The results of FRAX with and without TBS were similar, with an average for major/hip fracture of 10.7/4.2 with DXA and 10.6/4.0 with TBS respectively (p>0.05). A high risk of hip fracture (FRAX ≥3) was observed in 43% of patients using FRAX-DXA and 41% using FRAX-TBS. Ans a high risk of major fracture (FRAX ≥10) in 40% of patients using FRAX-DXA and 41% using FRAX-TBS. In 241 cases (96%) there was concordance in level of risk for FRAX-DXA and FRAX-TBS, while the 10 discordant cases for high risk of fracture were distributed as follows: in 6 cases FRAX-DXA was high and FRAX-TBS was normal, and in 4 cases FRAX-DXA was normal and FRAX-TBS was elevated. In our FLS, a bisphosphonate was prescribed to 169 patients (67%). Regarding patients with a low FRAX risk (n=82), in one patient FRAX-TBS was in favour of treatment. Thus, in 1/251 fractures FRAX-TBS could have influenced the treatment indication compared to FRA-DXA. Conclusions In our FLS unit, TBS does not help to classify patients‘ risk. The values of FRAX-TBS are similar to those of FRAX-DXA, not offering advantages when classifying patients with high risk who are candidates for treatment. Disclosure of Interest None declared