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Background Rheumatoid arthritis (RA) is a disabling chronic disease, regarded as the most frequent inflammatory rheumatism in adults, with a prevalence estimated between 0.3 and 1%, and a feminine ascendancy. In metropolitan France this prevalence is estimated from 0.3% to 0.5% of the general population. No precise data is available for French West Indies, and the prevalence of RA in this population of African ancestry is poorly evaluated. Objectives The objective of the study is to estimate RA prevalence in the FWI by a census forward-looking epidemiological survey in the hospital and liberal sectors for one year duration. Methods It is a unique tour with clinical examination, self-administered questionnaires and declaration. Secondary objectives are description of clinical and socio economical aspects of RA and cardiovascular comorbidities. We present the results for Martinique. Our survey was widely distributed (radio, press, patients9 associations…) to ensure a good completeness. Data were analysed using SAS 9.3 software (SAS Institute Inc., Cary, NC, USA). Throrough descriptive analysis of collected variables was conducted. Crude prevalence rates were adjusted to a standard population of Martinique (nationwide census in 2010). The 95% CIs were calculated using the Poisson distribution. Results Our completeness is good. 538 RA were collected, giving a prevalence in Martinique of 0.184% of the adult population (290 000), respectively 0.049 for men and 0.292 for women. 44% of these patients are treated in private practice and 56% in hospital. This cohort is composed of 88% women and 12% men; 92% were born in Caribbean and 7.7% elsewhere. Patients self declared of Afro Caribbean origin in 92.7%, Caribbean White in 1.7%, caucasian in 3% and other in 2.1%. Their mean disease duration was 9.7±10 years. RF and ACPA were positive in 82.2% (FR+ 392, ACPA+349, 35% low level, 65% high level): CCP+FR+ in 306, FR+CCP- in 77, FR-CCP+ in 41, FR-CCP- in 96. 17% had extra articular manifestations. ACR1987 and ACR2010 criteria were pos in 94.4% and 78%. HAQ was 1and 2 in 3%. DAS28 were respectively 5.1 in 3%. Less than 5% are ever smoker. Parodontopathy is infrequent. Cardiovascular risk factors were noticed in 89,4% with a mean of 2 CVRF beside RA. Conclusions This work clarifies the low prevalence of RA in this population of African origin. Some characteristics as: reduced prevalence, strong female representation, strong seropositivity, high levels of anti-CCP, no tobacco, differentiate our patients from other populations and evoke another etiology than tobacco. Disclosure of Interest None declared

Background Chick is an epidemic disease due to an arthropod-borne virus ( Alphavirus ) transmitted by Aedes mosquitoes. CHIKV causes an acute illness with a febrile phase, followed by a period of severe polyarthritis that can persist for long time. There is no specific treatment, the best prevention is mosquito control and avoidance of bites. Martinique (French West Indies) is currently experiencing an outbreak of CHIK with 170 000 reported cases (Dec 1st). Objectives No data is available regarding the prognosis of Chikungunya in patients under biologics. We have observed 22 patients with Chik infection while on biotherapy and DMARDS for rheumatic diseases, between January and May 2014. Methods Physicians prescribing biologics were asked to declare patients under biologics experiencing Chik. For each patient we collected diseases characteristics and course, current treatment (steroids, immunosuppressant, biologics…), changes in the treatment during infection, and outcome. 22 patients were included, all with a diagnosis confirmed by PCR (20/22) or serology. Results Among these patients were 19 women and 3 men, 3 Caucasians and 19 Afro-Caribbean9s. There were 5 spondyloarthritis (3 associated with Crohn), 1 psoriatic rheumatism, 2 systemic lupus, 1 antisynthetase syndrome and 13 RA. 17 had methotrexate (mean dose 21.6 mg), 3 Plaquenil, 2 Imuran, 1 cellcept, 2 cyclophosphamide. 11/22 were under steroids (mean dose of 8.6 mg/d). All experienced fever (mean duration 1.7 day), skin rash (15/22, mean duration 1.3 d), and acute disabling polyarthritis (mean pain VAS 8.4, mean SJC 9.6, mean TJC 6.8) for a mean 11.5 days duration. Nine had back pain and 4 tenosynovitis. None of them showed any organ failure, one single episode of transient thrombopenia was noted. None of them was hospitalized for Chik. Analgesic treatment (alone 4/22), associated with NSAIDs (17/22) or prednisone (1/22) and rest were sufficient to overcome the crisis. All but one patient maintained their previous treatment (DMARDS, Biologic, steroids…) without specific complication. All patients were able to differentiate between Chik related complains and those related to their preexisting condition. Mean clinical disease scores before and after Chik (DAS, BASDAI, SLEDAI) remained unchanged. Conclusions This is the first report of the occurrence of Chik in patients under biologics. Patients under biologics are at increased risk for serious infections either viral or bacterial, but no data has been published regarding Chik. This study was not conducted to discover all cases of Chik among patients under biologic. Chik does not seem to be deleterious in patients under biologics who do not exhibit more severe or prolonged disease than common forms. Chik does not seem to aggravate pre-existing disease. It does not seem necessary to modify the basic treatment of rheumatism in the announcement of a Chik as the clinical pictures observed in these patients are quite benign. NSAIDs and best rest are mostly effective. Chik does not seem harmful in patients receiving biological and this issue should be given to travellers. Disclosure of Interest None declared

Background Lumbar canal stenosis (LCS) is a clinicopathological and radiological disease first described in 1949, causing a neurovascular compression leading to back pain, radicular, sensory or motor deficit which treatment is difficult. Objectives The objectives of our study were appraisal of a protocolized treatment for 3 months and identification of predictive factors for failure of medical treatment. This is a prospective nonrandomized study with no control group. All patients satisfying inclusion criteria were included after clinical and radiological evaluation. Methods Clinical inclusion criteria were neurogenic claudication, radiculopathy at rest with or without back pain, mono or multirooted sensory, motor or reflex abnormalities of the lower limbs. Radiological inclusion criteria were: anteroposterior dural sac diameter 2 , reduction in the anteroposterior diameter of the spinal canal >25% on myelography in supine extended position. Results Included patients had at least one clinical and one radiological criteria. Treatment was 2 epidural injections of 125 mg hydrocortancyl 15 days apart, combined with NSAIDs or analgesic, associated with physiotherapy sessions over 2 months. 147 patients were included. Mean age was 62±13 years. F/M sex ratio is 1.3. Mean BMI was 27.5±4.3, overweight was present in 72.1%. At baseline, mean duration for back pain and radicular pain were 9.3±10.5 and 4.4±5.7years. Primary objective was evolution of the Oswestry [1] score (a low back pain disability questionnaire) at 3 months as compared to baseline. Secondary objective was the evolution of pain. At the end of treatment, the mean value for the Oswestry score decreased from 41.2 to 39.7 (p=0.17). Mean VAS for lumbar pain decreased from 53.6 to 42.1 (p BMI, duration of back and radicular pain, mean lumbar radicular VAS and mean Oswestry score at inclusion were not significantly different in improved and non improved patients. Predictors of good response to treatment were the initial presence of impulsivity cough and nocturnal pain. Conclusions In conclusion with this approach there was no significant decrease in Oswestry score, however there was a significant decrease in mean VAS lumbar and radicular pain. No predictor of poor response has been highlighted. Predictors of good response were the initial presence of impulsivity at cough and nocturnal pain. These results show the limits of medical treatment in the management of SCL. References Niskanen RO, The Oswestry Low Back Pain Disability Questionnaire. a two-year follow-up of spine surgery patients. Scand J Surg, 2002 91 (2):. P. 208-11. Disclosure of Interest None declared

Background No study describes the frequency of Behcet’s disease (BD) in the populations of African origin and its characteristics. Objectives To retrospectively assess by retrieval of multiple sources, the epidemiology and characteristics of BD in the mainly African descent population of Martinique, a French Island in the Caribbean. Methods In 2011 we consulted 5 different sources. Patients were included if they lived in Martinique, were classified as certain if they fulfilled the international criteria for BD. The diagnosis was considered only as probable if they had recurrent oral ulcers with at least one other international criteria but no other possible diagnosis. The incidence during the 1997-2011 interval and prevalence at December 31, 2010 were calculated. Basic and BD-related characteristics were recorded. Results 48 patients were indicated as BD. Only 36 (female, n=22; male, n=14) fulfilled the criteria. Mean age at diagnosis was 38.5 years old (range: 8-64), 36.6 for women and 41.6 for men. Disease onset was over 50 years old for 7 patients. Mean time between first signs and diagnosis was 4.2 years (range: 0-22). Twenty eight began their disease between 1997 and 2011 allowing a total crude mean annual incidence estimation of 0.72 new cases/10 5 inhabitants (0.79/10 5 for female and 0.59/10 5 for males, 0.37/10 5 for certain cases and 0.35/10 5 for probable). In December 2010, 28 patients were alive, 5 lost to follow up and 3 deceased: the crude prevalence was estimated as 7.04/10 5 inhabitants (Female: 7.49; male: 6.51). Genital ulcers were found in 75.6%. Dermatological manifestations were: pseudofolliculitis (52%), erythema nodosum (13.5%). Pathergy test was done for 6 patients and positive for 4. Nine patients had ophthalmologic involvement: anterior uveitis (55.5%, n=5), panuveitis and posterior uveitis (11.1%, n=1 each), conjunctival ulceration (22.2%, n=2). Parenchymal brain involvement was more frequent than non-parenchymal (7 versus 3 patients) without any cerebral venous thrombosis. Rheumatic manifestations were occurred in 20 patients (55.6%) mainly females (60%): polyarthritis (38.9%), monoarthritis and spondylarthropathy (11.1% each). Deep vein thromboses were seen in 2 cases and superficial in 1, central retinal artery occlusion in 1 patient. The colon was involved in 6 cases and the ileo-cecal region in one. Conclusions In Martinique, BD seems to be a rare disease compared to Mediterranean and most Asian countries. The incidence is comparable to Spain and Switzerland. The prevalence is higher than in most European countries and USA. Black population seems to have particular manifestations of BD: older age at onset and rare uveitis. Disclosure of Interest None Declared