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Background:RA is the most prevalent chronic inflammatory rheumatism, responsible of functional impairment.Objectives:To investigate the value of biological and imaging biomarkers on predicting good clinical response at 6 months, in RA patients initiating IV bDMARD.Methods:From 2008 to 2017, 317 RA patients fulfilling ACR 1987 and/or ACR-EULAR 2010 criteria for RA, initiated IV bDMARDs in our department of Rheumatology. Patients were excluded in cases of lack of information on disease activity assessment before and at 6 months of treatment and on immunological status and titers (ACPA, RF, ANA) at baseline. For patients receiving successive IV bDMARDs during this time period (n=30), a randomization permitted to select 1 treatment sequence for the analysis. On 173 patients eligible to the study, 4 were loss to follow-up and 14 stopped treatment due to adverse events before 6 months. Clinical, biological and imaging (US and RX) data were collected when available at baseline. US examination was performed on 12 joints (wrist, MCP2-3-5 and MTP2-3-5) with qualitative and quantitative evaluation on B mode and Power Doppler (PD) for synovitis, tenosynovitis and erosion. The modified Sharp/van der Heijde erosion score was performed by 2 independent readers blindly from clinical and US informations. Good clinical response was defined by a DAS 28 < 3.2 and/ or DAS 28 decrease > 1.2 at 6 months. Only variables with a pResults:On 155 RA patients, 11 present a disease duration < 2 year, 44 (28.3%) were on first line of IV bDMARDs and 111 patients received at least one IV bDMARD (mean 2.5 (1.3)).Table 1.Characteristics of the patients (n=155) at baselineVariablesN (%)Mean (SD)Clinical characteristicsAge (years)54.8 (12.2)Female113 (72.9)Disease duration (months)166.9 (118.8)DAS 285.2 (1)TreatmentCorticosteroids / dose (mg/day)99 (85.3)10.9 (6)Monotherapy56 (36.1)IV bDMARDAbatacept27 (17.4)Infliximab11 (7.1)Rituximab84 (54.2)Tocilizumab33 (21.3)ImmunologyACPA + /titer(IU)132 (85.2)618.5 (791.0)RF + /titer (IU/ml)114 (74.5)184.7 (351.3)ANA + / level87 (56.1)1453 (3836)RadiographySharp’s erosion score (n=110)49.4 (46.2)USNb Erosion (n=95)3.0 (2.3)Nb B mode Synovitis (n=128)6.0 (4.1)Nb PD+ Synovitis (n=130)4.8 (3.8)Nb B mode Tenosynovitis (n=129)1.6 (2)Nb PD+ Tenosynovitis (n=129)1.3 (2.1)At 6 months, 87 patients (56.1%) were in good clinical response. Predictive values of biomarkers are presented in table 2.Table 2.Variables predictive of a good clinical response at 6 monthsBiomarkersResponseMultivariate Logistic regression AnalysisAllN = 101Response(N=60)OR (CI95%)P valueImmunology RF +7551 (68.0%)5.1 (1.8-14.4)0.002 ACPA +8756 (64.4%) ANA +5536 (65.5%)Radiography Erosive RA7448 (64.9%)Ultrasonography Erosive RA8855 (62.5%) Nb B mode synovitis10160 (59.4%)1.2 (1.1-1.4)0.002 Nb PD+ synovitis10160 (59.4%)All qualitative variables with a p value Conclusion:We showed that positive RF was predictive of good clinical response to IV bDMARDs. For the first time, we demonstrated that number of US B-mode synovitis was also predictive to good clinical response.Disclosure of Interests:Stephane Giuliani Grant/research support from: BMS, Benjamin Laurent Grant/research support from: BMS, Hella MEZGHANI Employee of: BMS, Isabelle Duprat-Lomon Employee of: BMS, Amandine Luc Grant/research support from: BMS, Marcelo De carvalho Bittencourt Grant/research support from: BMS, Cedric BAUMANN Grant/research support from: BMS, Isabelle CHARY VALCKENAERE: None declared, Damien LOEUILLE: None declared

Background:Most patients with chronic inflammatory rheumatism (CIR) have a physical activity (PA) level below recommendations [1,2]. Currently, adapted structures offer a range of activities supervised by adapted physical activity educators. To the best of our knowledge, Argentinean tango is not yet offered in these structures.Objectives:The objective of this pilot study was to study the effect of 24 consecutive sessions of Argentinean tango on the total PA level in patients with CIR, including rheumatoid arthritis (RA) and spondyloarthritis (AS).Methods:In this controlled, randomized, open-label, clinical trial with two parallel arms, patients were required to attend two tango sessions per week, 48 sessions from 0 (M0) to 6 months (M6) for the intervention group (IG) and 24 sessions from 3 months (M3) to M6 for the control group (CG). Total PA time was measured at M3 using the Global Physical Activity Questionnaire (GPAQ) [3].Results:A total of 27 patients (23 women) were included, including 15 with RA and 12 with AS. Mean age was 59 ± 12 years, and median disease duration was 10 years (IQR: 3-19). The majority of patients had background treatment (conventional and/or biological). At M3, 22 patients could be evaluated (11 GC patients and 11 GI patients), as 3 patients were lost to follow-up and 2 were unable to come in due to health or professional reasons. The 11 GI patients attended a median of 16 sessions (IQR: 8-22), i.e., approximately one session per week. At M3, the total PA time was not increased, regardless of the measurement method, GPAQ questionnaire (effect size and 95% confidence interval (CI): 0.03 [-0.60; 0.67], p=0.91) or accelerometer (effect size and 95% CI: 0.43 [-0.37; 1.24], p=0.26), and regardless of the intensity of the PA. No significant change was found for sedentary time, disease activity, fatigue, or anxiety. However, improvements were found in body appreciation as assessed by the Body Appreciation Scale 2 questionnaire (p=0.016), balance (p=0.053), wrist bending angle (p=0.092), and shoulder amplitude (p=0.093). The few participants in this study is explained by the geographic distance of the classes and their homes, the lack of availability of patients in professional activity, fatigue, or not liking dance (mainly among men).Conclusion:The results of this pilot study suggest that one Argentinean tango session per week in CIR patients is more achievable than two sessions as originally planned. As the practice of classes in hospitals is constrained due to geographic distance, the sessions could be offered in adapted structures. Nevertheless, our pilot study shows that the Argentinean tango is beneficial for body appreciation in patients with CIR. A qualitative study is needed to better understand these effects.References:[1]Haute Autorité de Santé (2007). Rheumatoid arthritis: therapeutic aspects excluding drugs and surgery - medico-social and organizational aspects. Professional recommendations service - Medical-economic evaluation and public health service.[2]Haute Autorité de Santé (2008). Spondylarthritis: guide - long-term condition. Good Professional Practices Department - Communication Department.[3] Cleland CL, Hunter RF, Kee F, Cupples ME, Sallis JF, Tully MA. (2014 Dec). Validity of the global physical activity questionnaire (GPAQ) in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour. BMC Public Health. 10;14:1255. doi: 10.1186/1471-2458-14-1255.Disclosure of Interests:None declared

Objectives:To identify factors predicting the progression of early inflammatory arthritis (EIA) to rheumatoid arthritis (RA)Methods:This was a prospective longitudinal study of inflammatory rheumatism that could not be classified according to defined rheumatism criteria. Demographic, biological, immunological and radiographic data were collected at the time of inclusion in the study. Disease activity as determined by the Disease Activity Score 28-CPR (DAS28-CPR: 4 variables), functional handicap as calculated by Heath Assessment Score (HAQ), and bone and joint damage as evaluated by Sharp-Van der Heijde (SVDH) score. ultrasound joint imaging were evaluated at the beginning of the study and then 1 year later. Logistic regression was performed to identify predictive factors for progression to RA.Results:One hundred seventy two patients were included (24 men, 148 women), with an mean age 43.13±14.07 years and an mean time to diagnosis 10.24±6.84 months The mean ESR was 46.81±31.16 mm/1st hour, and the mean CRP level was 22.84±39.8 mg/l. Rheumatoid factors (RFs) and anti-citrullinated protein antibodies (ACPAs) were present in 48.8% and 53% of patients, respectively. The erosion, joint space narrowing, and total SVDH scores were 3.38±3.48, 5.08±3.32, and 5.95±4.94, respectively. One hundred sixty one patients were followed up for 12 months. Multivariate regression analysis showed that a DAS28-CRP level >5.2 (OR=28.6; CI95% 8.7-94.5), an RF level >60 IU/L (OR=11.2; CI95% 4.3-87.5), and an ACPA level >60 IU/L (OR=5.4; CI95% 1.9-15.3) were predictive for progression to RA.Conclusion:Our study suggests that clinical evaluation of EIA by DAS28-CRP from the time of diagnosis, as well as evaluating the presence of RA auto-antibodies, can predict progression to RA.Disclosure of Interests:None declared

Background:It is recommended to target remission when treating a patient with a chronic inflammatory rheumatism. To date, drug-free (DF) remission has been poorly investigated in axial Spondyloarthritis (axSpA).Objectives:1/To estimate the frequency of patients in DF remission after 5 years of follow-up in a cohort of early axSpA and 2/to assess the factors associated with 5-year DF Remission.Methods:Patients: All patients included in DESIR (DEvenir des Spondyloarthrites Indifférenciées Récentes) cohort were selected for this analysis.Definition of 5-year DF Remission: 1/all patients in ASAS partial remission and/or ASDASCovariates analysed: age, gender, smoking status, body mass index, disease classification criteria (ASAS, Amor, ESSG, New York), presentation at onset (peripheral or extra-articular features), disease activity at onset (BASDAI, ASDAS-CRP, CRP, MASES, TJC or SJC), functional impairment at baseline (BASFI, HAQ-AS, BASMI), comorbidities, baseline imaging data (radiographic sacroiliitis, mSASSS, MRI sacroiliitis, spine MRI Berlin score), NSAID intake within 6 months before baseline visit and 5-year treatment intake (including DMARDs, corticoids and NSAIDs).Statistical analysis: The associations between each of these clinical factors and the 5-year DF remission were tested by logistic regression. A multivariate model was built, stepwise procedure, to identify the independent variables associated with 5-year DF remission.Results:Of the 708 patients included in DESIR cohort, 419 were seen at the 5-year visit and 72 (17.0%) were in DF remission (50% of males, aged of 33.08 years (SD:8.0), disease duration: 1.26 years (SD: 0.72), HLA-B27 in 71%, 26.4% had a MRI sacroiliitis). Patients in 5-year DF remission had lower symptom duration (1.3 year versus 1.6 year, p=0.01) had lower disease activity (BASDAI at baseline: 30.1 versus 46.1, pConclusion:DF remission is rare, 5 years after onset of axSpA. Patients with longer symptom duration, higher baseline ASDAS-CRP and NSAIDs scores were less often in DF remission, while imaging and biological data did not predict DF remission.Disclosure of Interests:Adeline Ruyssen-Witrand Grant/research support from: Abbvie, Pfizer, Consultant of: Abbvie, BMS, Lilly, Mylan, Novartis, Pfizer, Sandoz, Sanofi-Genzyme, Vanessa Rousseau: None declared, Agnès Sommet: None declared, Philippe Goupille Grant/research support from: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Lilly, Janssen, Medac, MSD France, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Consultant of: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Lilly, Janssen, Medac, MSD France, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Speakers bureau: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Lilly, Janssen, Medac, MSD France, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Yannick Degboe: None declared, Arnaud Constantin: None declared

Background The adhesion in treatments (Tts) does not exceed 80% in the chronic inflammatory rheumatisms. To improve this score, it is advisable to question the patients (Pts) about their perception of the treatment, its constraints, its side effects Objectives Explore the representations of Tts by Pts Methods A questionnaire was drafted by a group of 6 persons:2 patients, a fram of French Association of the chronic inflammatory rheumatisms (AFP-RIC), a rheumatologist,2 representatives of Pfizer Inc. The questionnaire was sent by e-mail to 1277 member of AFP-RIC, from 20 to 60 years old, with a link towards Survey Monkey between June 17th and July 8th, 2013. Results We received 525 answers, among which 519 exploitable. 88.9% of Pts are affected by rheumatoid arthritis (RA), 9.8% by spondyloarthritis (SP). 33.6% saw the first symptoms 6 - 12 years ago. 90.2% of the RA are women and 73,4% of the SP. The average age is 52. The rheumatologist prescribed the disease-modifying drug for 94.4% and assures the follow-up for 65.5%, in association with general practitioner for 32.1%. 56% of the Pts consult other healthcare professionals, among whom 62.2% the pharmacist. 51.9% are handled by biotherapy, 66,1% by DMARDS. 81.6% of Pts know the difference between DMARDS and biotherapy. 80.9% changed Tts among which 95,6% know why (72.9% for ineffectiveness, 30,7% for intolerance). Only 22.3% say themselves in remission. The biotherapy is considered binding at 5,13 (10 most forcing), because of the method of administration (44%), frequency (39.7%), mode of preservation (37.1%),displacements to the hospital (34.5%). DMARDS is considered binding in 4.68, corticoids in 5,29. 88.5% know the side effects, 73.6% are worried about it. 53% did not take the biotherapy in the planned day, by forgetting for 38%, because of displacement for 34.2%, by default of motivation for 32.7%, by fear of the side effects for 25.2%. 60,3% do not speak about it to physician. The efficiency of the Tt judges itself for 86.5% by an absence of pan, and for 90.14% by the possibility of attending to its occupations without constraints. 60.6% of the Pts wish to benefit from a tool of follow-up, rather from type memo of pocket than reminder by SMS Conclusions Pts does not take their treatment according to the modalities prescribed for an accumulation of reasons: fear of the side effects including still unknown, the denial of the disease, the fear of revealing the diagnosis in their more or less close circle of acquaintances. Even if the treatment is maintained, the absence of compliance in the rules of taking makes it less effective, even dangerous. The dialogue with the nursing deserves to be improved: the confidence has to allow to clarify the fears and the unspoken. The physician, but also the pharmacist, the nurses and all the healthcare professionals are concerned. They mean using a common language in agreement with what the patient expects from them and to create a reliable climate which establishes a dialogue on the reality of the treatment and not on what the nursing expects from the patient, which often tries not to disappoint him. The nursing remain the first information source before internet or the traditional media. The faith in the efficiency of the treatment improves the adhesion and depends on the quality of the relation established with the nursing. Disclosure of Interest D. Poivret Shareholder of: Pfizer, Lilly,MSD, D. Lebouc: None declared, S. Sfedj: None declared, P. Preiss: None declared, M. Jabri: None declared, C. Raynaud: None declared DOI 10.1136/annrheumdis-2014-eular.1305

Objectives The persistence in therapy is an important assessment tool of therapy efficacy in patient with chronic disease. The aim of this study was to evaluate drug survival (DS) of a patients cohort suffering from chronic inflammatory rheumatism treated with abatacept. Methods From September 2008 to March 2013, we retrospectively observed a total of 107 patients starting therapy with abatacept, in a single center of southern Italy. They were 88 females and 19 males, aged between 21 and 85 years (54.65) and with disease duration between 2 and 45 years (11,71). 60 patients were suffering from rheumatoid arthritis (RA; 56.07%), 6 from chronic undifferentiated polyarthritis (5.60%), 2 from juvenile idiopathic arthritis (1.86%), 1 from Still9s disease (0,93%) and 38 (35.51%) from seronegative spondyloarthritis (SpA). 91.58% (98 patients) had also comorbidities. 18.69% of the patients (20 patients) were naive to the treatment with biological drugs. 77.00% of patients took DMARDs and 69,39% were receiving steroid. Results DS resulted averaging 15.40 months, retention rate after 1 year (RR1) was 49.53% and after 2 years (RR2) was 25.23%. Half of the patients (53 patients, 49.53%) interrupted the therapy during the observation period, mostly due to inefficacy or loss of efficacy (64.15%) and only 3.77% due to side effects. DS, RR1 and RR2 were clearly higher in patients taking DMARDs compared to patients taking abatacept in monotherapy (14.58 vs 11.26 months, p= ns; 50.64% vs 30.43%, p=0.038 and 24.67% vs 8.69%, p=0.042, respectively). The RA patients showed higher values of the examined parameters compared to the patients with SpA (DS: 17.31 vs 11.36 months, p=0.029; RR1: 53.33% vs 44.73%, p= ns; RR2: 33.33% vs 7.89%, p=0.0001). Considering patients in first-line vs patients in subsequent lines of biological therapy DS resulted 12.50 vs 16.06 months, RR1 45.60% vs 50.57% and RR2 20.00% vs 26.43%; this result could be justified by the shorter period of observation of patients in first-line of biological therapy, due to the more recent use of abatacept in patients naive to biological therapy. 80.00% of these patients resulted in fact still in therapy at the end of the observation vs 43.67% of the patients in subsequent lines of biological therapy (p=0.0001).The average value of DAS 28 and good or moderate EULAR response achievement appeared better in patients in first line of biological treatment (3.59 vs 4.04, p=ns and 63.16% vs. 46.57%, p=0.0228, respectively). Conclusions Into a cohort of patients with chronic inflammatory rheumatism and treated with abatacept DS was in line with the results reported in few studies on the subject. The persistence in therapy was better in patients with RA compared to patients with SpA and in patients treated with DMARDs compared with patients taking abatacept in monotherapy. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.2669

Background There is several models to predict the development ofrheumatoid arthritis in patients with early undifferentiated arthritis (UA). No study have concerned the future of the patients with UA in the medium and long term. Objectives 1) to describe the population of UA at inclusion. 2) to identify predictive factors of the preservation of the status of UA. 3) to determine a time from which it is useless to try to classify a UA. Methods Community-based adults (n = 310) who had never taken disease-modifying antirheumatic drugs (DMARDs) or steroids with swelling of ≥2 joints persisting for >4 weeks and lasting Results according to the “academic” method, there were 180 UA / 312 patients at inclusion. There was 73,9 % of women versus 60,6 % to the CA ( p=0,014 ); the number of swollen joints/ 44 ( NSJ) was lesser (7,2 vs 12,1; p 3 times the normal (Hazard Ratio ( HR) 3,01, p 60 ′ (HR=1,64, p=0,002), a NSJ > median (HR=1,62; p=0,003), a swelling of upper limbs joints (HR=2,67; p=0,023), an involvement of the lower and upper limbs (HR=1,44; p=0,047). The protective factors were : swelling of the small joints (HR=0,17; p Conclusions UA distinguishes from CA by a lower level of activity. The predictive factors of the preservation of the status of UA are in touch with a less important severity of the rheumatism. It seems useless to try to classify a rheumatism after 6 years of evolution. Disclosure of Interest None Declared

Background Educational programs are key-part of inflammatory rheumatism management. Nevertheless, few studies have assessed practical skills and safety use of subcutaneous biological agents. Objectives To evaluate the impact of collective educational intervention (CEI) on good clinical practices and safety skills in patients with inflammatory rheumatism treated with subcutaneous biological agents. Methods A self-questionnaire was developed to assess expected behaviours (injection skills, clinical items supervision, attitudes in front of different practical situations), knowledge of vaccinal status, required medical follow-up and need for information of patients with inflammatory rheumatism requiring subcutaneous biological agents. First administration was made in the hospital where every single patients receive individual education. Our interventional group was composed by voluntary patients at the first administration, who participate at one CEI performed 3 to 6 months later. The CEI lasted 2 hours by small groups including from 6 to 12 patients. Baseline self-questionnaire was filled by patients before the CEI, then good technical and clinical pratices were reminded by the educational team. This self-questionnaire was also filled at a one-year follow-up visit by control group and intervention group. We compared the one-year questionnaires for each arm. Results From July 2009 to July 2012 : 64 and 305 patients, respectively included in the CEI and control groups, completed the one-year follow-up visit. At 12 months, the educational group showed significant better technical injection skills and better infectious risk management : pulmonary, urinary, cutaneous, Ear-Nose-Throat (ENT) (p Conclusions In this study, the collective educational intervention improvedsafety skills acquisition in biological treatments management, persisting at one-year follow-up compared to control group. References Albano MG, et al. Characteristics and development of therapeutic pateint education in rheumatoid arthritis : analysis of the 2003-2008 literature. Joint Bone Spine 2010;77:405-10 Riemsma R, et al. Patient education for adults with rheumatoid arthritis. Cochrane Database Syst Rev 2003;(2):CD003688 Disclosure of Interest None Declared

Background Rheumatoid arthritis (RA) requires immunosuppressive treatments. Patients who are taking these require a specific surveillance and need to be aware of related safety issues. Objectives The objective of our project was to produce easy-to-carry information fact-sheets containing relevant and medically-sound data on various RA treatements. Methods ANDAR, a French non profit patient organization, gathered RA patients to design the most convenient/efficient format for such patient information fact-sheets. Then, a scientific committee composed of rheumatologists produced the content with the help of ANDAR and a patient-centered medical information agency (EmPatient). Two taskforces belonging to the Societe Francaise de Rhumatologie contributed to the content : the Inflammatory Rheumatism Club (which is in charge of working on drug fact-sheets for healthcare professionals) and the Patient Education Taskforce. Results Selected RA patients chose a paper format which, once folded, fits in a wallet. Thus, the fact-sheets may be carried everywhere and are available at all time to answer safety-related issues. The scientific committee worked under this constraint to list essential information and key points. The goal was to produce a fact-sheet for each molecule prescribed against RA. These fact-sheets form a collection entitled « Things to know… for a better life with your treatment ». The collection was systematically sent to all hospital-based and independant rheumatologists to distribute to their patients. Fact-sheets are also available for free through ANDAR, nurses and local patient education programs. Each fact-sheet features « Key points to memorize », a detailed explanation of the molecule (action mechanisms, dosage, side effects, etc.), some FAQ and a card to be completed with the brand name and the prescribed dose, in French and in English. Conclusions Today, 8 fact-sheets have been produced and more than 34,000 copies (total) have been distributed. Patients and healthcare professionals have expressed their wish to see the missing molecules be included in the collection as soon as possible. Acknowledgements We would like to thank Dr Laure Gossec, Dr Laurent Grange, Dr S. Jousse Joulain, Dr Thao Pham, Claude Fares, Anne-Laure Roubaud, la SFR, and Stephane Korsia Meffre. Disclosure of Interest None Declared