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Background The clinical importance of rheumatoid arthritis-associated interstitial lung disease has been increased because the usual interstitial pneumonia (UIP) is the most common subtype of interstitial lung disease (ILD) on high-resolution computed tomography (HRCT) in rheumatoid arthritis (RA)and has poor survival rate compared to other forms of ILD related to connective tissue disease. Objectives The clinical characteristics and laboratory data of RA patients with and without ILD were compared in order to clarify the risk factors for ILD in RA patients. Furthermore, risk factors of mortality in the RA patients with ILD group were analyzed. Methods A total of 77 RA patients with ILD and 231 age/sex-, and disease duration-matched RA patients without ILD who were followed from 1991 to 2011 at Seoul National University Hospital were enrolled in this study. Epidemiologic, clinical, and laboratory information including rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) were obtained through medical chart review. The erythrocyte sedimentation rates (ESR), C-reactive protein (CRP) levels, presence of erosion on joint X-rays, and mean corticosteroid doses were examined in order to compare RA outcomes between the RA patients with and without ILD. Cox proportional hazard models were used to estimate the risk of mortality in the RA patients with ILD. Results In the RA with ILD group, the titers of the RF and the anti-CCP were significantly higher compared with those in the RA without ILD group (p=0.001 for both). The RA patients with ILD had higher frequency of a history of tuberculosis or nontuberculous mycobacteria (NTM) (p=0.022). In addition, the RA with ILD group exhibited higher levels of CRP at the time of RA diagnosis (p=0.014) and higher ESR (p=0.022) and CRP levels (p Conclusions The RA patients with ILD had higher RF and anti-CCP titers and baseline CRP levels compared with those without ILD. A UIP subtype on HRCT and older age at the time of the diagnosis of ILD were significantly associated with mortality of RA with ILD. Disclosure of Interest None declared

Background Red blood cell distribution width (RDW) is a biomarker quantifying the variability of red blood cell size (anisocytosis) in the peripheral blood. High RDW is associated with inflammatory burden and it has been suggested as a potential marker for cardiovascular prognosis, mortality, or reflecting renal function in the various clinical conditions 1 . A recent study found the significant association between serum uric acid level and RDW in patients with untreated essential hypertension 2 . Gouty arthritis is an acute and severe inflammatory arthritis attributable to hyperuricemia, and closely associated with renal dysfunction and cardiovascular diseases. However, few studies have yet investigated the clinical significance of RDW in patients with gout. Objectives The aim of this study was to investigate the potential association of RDW value with clinical features in patients presenting with acute gout attack. Methods The medical records of patients who visited emergency room of Seoul National University Bundang Hospital for acute gout attack, from March 2003 to April 2014, were retrospectively reviewed. Cases were stratified into three groups according to the RDW tertiles ( 13.4%) and clinically relevant differences were evaluated by the ANOVA test or the chi-square test. The Pearson9s correlation approach was used to analyze the correlation between two continuous variables. To identify significant determinants influencing RDW, we used multiple linear regression analysis. Results Two-hundred and thirty-six patients with acute gout attack were included. The mean age was 49.38±16.85 years and the male ratio was 92.3% (n=218). The patients in the highest RDW tertile tended to be older, had higher levels of hemoglobin and lower levels of albumin, and had more recurrence of gout attack and renal impairment. RDW showed significant weak positive correlation with age (γ=0.224, p =0.001) and creatinine level (γ=0.237, p p p p =0.009) (Table 1). Conclusions Our data shows that high RDW in acute gout attack is related to the recurrence of gout attack and coexistence of chronic kidney disease. In acute gout attack, RDW, an easy and quick measurable index, may represent renal dysfunction rather than inflammatory burden or uric acid level, and physicians who treat acute gouty arthritis with high RDW should pay attention to the recurrence of gout attack and treatment. References Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009;133:628-32. Luo M, Li ZZ, Li YY, Chen LZ, Yan SP, Chen P, et al. Relationship between red cell distribution width and serum uric acid in patients with untreated essential hypertension. Sci Rep 2014;4:7291. DOI: 10.1038/srep07291 Disclosure of Interest None declared

Background Patients with rheumatic diseases (RD) have underlying immune dysregulation and receive long-term immunosuppressive mediations which might negatively affect the outcome of a cancer in those patients. Conversely, autoimmune cells might help eliminate the cancer cells with a better outcome in RD patients. Objectives This study was aimed at systematically investigating effects of RD on the long term outcome of four most common cancers in a retrospective cohort study. Methods A total of 167 patients with RD and cancer and 501 age-, sex-, and cancer-matched controls without RD (1:3 ratio)who received their medical care at Seoul National University Hospital from 1992 to 2012 were included in this study. Survival curves were generated using the Kaplan-Meier plots and compared using log-ranks tests. Results The mean age of patients with RD was 57.2±11.5 years old. Female was dominant (75.0%). Rheumatoid arthritis was most common with 114 (68.4%) cases, followed by dermatomyositis/polymyositis (10.8%), systemic lupus erythematosus (10.8%), systemic sclerosis (10.2%). There were 42 (25.1%) gastric, 28 (16.8%) colon, 49 (29.3%) lung, and 48 (28.7%) breast cancers. One patient had 2 cancers. There was no significant difference in 5-year (90.0 % vs. 91.2%) and 10-year survival rates (84.3% vs. 85.0%, P=0.983) between the cancer patients with RD and the controls (Figure 1). In a subgroup analysis by cancer types, 5-year (100% vs. 92.2%) and 10-year cancer survival of gastric cancer were significantly better in the RD group as compared to the control group (100%, vs. 82.8%, P=0.026), whereas those of colon, lung, and breast cancer did not differ between them. Image/graph Conclusions This study clearly demonstrates that the cancer survival was not worse in patients with rheumatic diseases despite the additional presence of underlying defective immune system and concurrent use of immunosuppressive medications. Disclosure of Interest None Declared

Background Ankylosing spondylitis (AS) is a rheumatologic disease for which anti-TNF agents are effective. Tuberculosis (TBc) is one of the serious infectious complications of anti-TNF agents. However, clinical characteristics of anti-TNF agents-related TBc in AS are not well described. Objectives To investigate the clinical characteristics of active TBc which develops in AS patients after taking anti-TNF agents. Methods We enrolled all the patients with AS or rheumatoid arthritis (RA) who took anti-TNF agents at Seoul National University Hospital between Jan 2001 and Aug 2011. Medical records were reviewed for all the patients. TBc was defined as presence of M. tuberculosis in culture or typical radiographic findings and clinical response to anti-TBc medication. Clinical characteristics of AS patients who developed TBc were compared with those of RA. Results Median follow-up duration (range) were 30.7 (1.9∼48.9) months for AS and 19.6 (8.6∼47.2) months for RA. Conclusions When anti-TNF agents are prescribed in AS, TBc can develop as frequently as in RA. TBc developed later in AS than in RA after initiation of anti-TNF agents. Extrapulmonary tuberculosis was prevalent as in RA. Current prophylaxis method does not seem to adequately prevent tuberculosis in AS. Disclosure of Interest None Declared