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Background With the today`s advanced magnetic resonance imaging (MRI) techniques, the pathologic features of ankylosing spondylitis (AS) can be detected early and promptly treatment. Objectives This study aimed to determine the value of diffusion-weighted MR imaging (DWI) in determined of AS treatment strategy and assess the role of quantitative MRI in the evaluation of AS treatment outcome. Methods 52 patients with the diagnosis of early AS were included in this study. Disease activity was measured according to clinical instruments and laboratory tests. For each patient, both inflamed sacroiliac (S-I) joint lesion was checked quantitatively at first diagnosis by diffusion-weighted MR imaging (DWI) and measured the apparent diffusion coefficient (ADC). Based on ADC value, low ADC value group were treated with conventional NSAIDs and high ADC value group were treated with TNF-α inhibitor. all subjects were revaluated continuously by pelvis multi-directional computer tomography (MDCT) for bone change in sacroiliac joint, after treatment. Results The high ADC value patient had higher BASDIA score, ESR and CRP than low ADC value patients relatively. The clinical parameters diminished significantly with regression of the inflammatory activity after treated with TNF-α inhibitor or NSAIDs. But paradoxically, one patient who was low ADC value and treated with NSAID had radiologic change of S-I joint and no change of ADC value in follow up MRI. Conclusions The ADC value measured by DWI maybe predicted treatment response. References Braun J, Sieper J. Ankylosing spondylitis. Lancet 2007;369:1379–90. Disclosure of Interest None declared

Background A randomised controlled trial (RCT) and its open label extension trial (OLE) demonstrated comparable pharmacokinetics (PK), efficacy and safety between CT-P10 and innovator rituximab (RTX) (including switched from RTX to CT-P10) up to 2 years in rheumatoid arthritis (RA) patients (NCT01534884 and NCT01873443). 1,2 Objectives To compare time to retreatment and confirm clinical similarity in efficacy and safety by the number of treatment courses in the RCT between CT-P10 and RTX in RA patients up to 2 years. Methods One hundred fifty three patients were randomised in 2:1 ratio and received up to 2 treatment courses of either CT-P10 or RTX in RCT, and they had a chance to receive up to 2 additional courses of CT-P10 in OLE. Retreatments were given based on disease activity. Post-hoc analyses using combined data obtained from the RCT and OLE studies were performed in 2 different groups according to the number of treatment courses in RCT as following; Group 1: patients who received 2 courses in RCT; Group 2: patients who received 1 course in RCT. Results A total of 82 patients (59 received CT-P10 and 23 received RTX) were in Group 1 and 20 (13 received CT-P10 and 7 received RTX) were in Group 2. Time to retreatment was similar between CT-P10 and RTX (including switched to CT-P10) in each group (Figure 1). DAS28 improvement at Week 24 of each course was similar between CT-P10 and RTX (including switched to CT-P10) in both groups (Table 1). Infusion related reactions by treatment course up to 2 years was similar between the CT-P10 and RTX groups and tended to decrease over time in line with RTX historical data. 3 Incidence rate of adverse event, serious adverse event and infection was comparable between CT-P10 and RTX groups. Conclusions The results of the post-hoc analyses demonstrated comparable duration of disease control between CT-P10 and RTX (including switched to CT-P10) with clinical similarity in efficacy for 2 years. The safety profile of CT-P10 was similar to that of RTX and in line with RTX historical data. References Yoo DH, et al. Arthritis Rheum 2013; 65 (Suppl10): S736 Yoo DH, et al. Arthritis Rheum 2015; 67 (Suppl10): 2449–245 van Vollenhoven RF, et al. EULAR 2013 (Madrid, Spain): Poster SAT0131 Disclosure of Interest W. Park Consultant for: CELLTRION,INC., D. H. Yoo Consultant for: CELLTRION,INC., C. H. Suh Consultant for: CELLTRION,INC., S. C. Shim Consultant for: CELLTRION,INC., S. J. Lee Employee of: CELLTRION,INC., S. Y. Lee Employee of: CELLTRION,INC., T. S. Kwon Employee of: CELLTRION,INC., S. M. Kim Employee of: CELLTRION,INC.

Background The use of nonsteroidal anti-inflammatory drugs (NSAIDs) and Cox-2 inhibitor are known to inhibit synthesis of prostaglandins and may prevent bone loss, but there is no study that shown the distinction between NSAIDs and COX-2 inhibitor on bone mineral density (BMD).We hypothesized the subject of NSAIDs use would be associated with increased BMD than the subject of Cox-2 use. Objectives The purpose of this study was compared the change of the BMD between NSAID use group and COX-2 inhibitor use group. Methods Between January 2005 and September 2011, we identified postmenopausal women with osteoporosis (T score >-2.5) and osteoarthritis treated with Cox-2 inhibitor (Celebrex, n=319) and NSAIDs (aceclofenac, n=104), who underwent a BMD measurement by dual-emission X-ray absorptiometry (DXA) every one year and structured interview in the 5th year of this study. The all subjects were taken bisphosphonate and the outcome measure was present difference in BMD (g/m 2 ) and T-score. The affecting factors for elevated BMD evaluated included sex, age, BMI, disease duration, cumulative period of NSAIDs, COX-2 inhibitor and bisphosphonate. After extracting possible affecting factors through univariate analysis, multivariate logistic regression analysis was performed with backward selection to derive affecting model for increased BMD in patients with osteoarthritis. Results After adjustment for possible confounders, daily use of NSAIDs users were associated with a higher BMD at whole L-spine (2.54% 1.7-3.1 CI) and both hip (1.21%, 0.6-2.4 CI) than Cox-2 inhibitor users. Also, T-score was higher in NSAIDs users than Cox-2 inhibitor users. Univariate analysis revealed that old age (P=0.008), low BMI (P=0.001), and cumulative period of NSAIDs, COX-2 inhibitor and bisphosphonate (P Conclusions Daily use of NSAIDs is synergistic effect on BMD than daily use of Cox-2 inhibitor in postmenopausal women with osteoporosis treated with bisphosphonate. so our results suggest that NSAIDs use is preferred to use cox-2 inhibitor in patients with osteoporosis and osteoarthritis. References Osteoporos Int (2006) 17:1410–1419. Disclosure of Interest None declared

Background Infliximab, a chimeric anti-TNF antibody, is well known to potentially induce anti-drug-antibodies (ADA), which may result in loss of efficacy and cause side effects such as infusion reactions. However, it is not well known which factors affect ADA formation. Objectives A retrospective analysis for factors related to immunogenicity was performed using the data sets of two recent randomized controlled trials documenting biosimilarity between innovator infliximab (INX) and CT-P13 (PLANETRA and PLANETAS). Methods A total of 852 patients (602 patients with rheumatoid arthritis (RA) in PLANETRA and 250 patients with ankylosing spondylitis (AS) in PLANETAS) were treated with either 3mg/kg (RA) or 5mg/kg (AS) of CT-P13 or INX. ADA assessment was performed at weeks 14, 30 and 54. The determination of ADA utilized an electrochemiluminiscence assay (ECLA, MSD, Rockville, Maryland, USA). Age, gender and race as intrinsic factors and methotrexate (MTX) or glucocorticoid (GC) as extrinsic factors were analyzed with a logistic regression. Results The immunogenicity results were overall similar between CT-P13 and INX during the study period in both trials whilst there was a noticeable difference between patients with RA and AS (1). In PLANETRA, gender, race, GC and MTX did not impact on ADA positive rate but the impact of age was statistically significant (Table 1). In PLANETAS, none of age, gender, race or GC had impact on ADA positive rate (Table 1). The interactions between treatment and each factor showed that the effect of factors (age, gender, race, GC and MTX) on ADA development was not statistically different between CT-P13 and INX. Conclusions On the basis of similar immunogenicity between CT-P13 and INX in AS and RA patients, we only found age as an influencing factor in patients with RA. This finding may be related to the immunosenecence in the elderly. Furthermore, no influence by medication was detected: neither GC nor MTX seemed to have an impact on ADA formation in these two trials. References Jurgen Braun et al., Striking Discrepancy in the Development of Anti-Drug Antibodies (ADA) in Patients with Rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS) in Response to Infliximab (INF) and Its Biosimilar CT-P13, ACR 2014 Disclosure of Interest J. Braun Grant/research support from: CELLTRION, Inc., Consultant for: CELLTRION, Inc., Speakers bureau: CELLTRION, Inc., W. Park Grant/research support from: CELLTRION, Inc., Consultant for: CELLTRION, Inc., Speakers bureau: CELLTRION, Inc., D. H. Yoo Grant/research support from: CELLTRION, Inc., Consultant for: CELLTRION, Inc., Speakers bureau: CELLTRION, Inc., C. H. Suh Grant/research support from: CELLTRION, Inc., Consultant for: CELLTRION, Inc., S. C. Shim Grant/research support from: CELLTRION, Inc., Consultant for: CELLTRION, Inc., S. J. Lee Employee of: CELLTRION, Inc., S. Y. Lee Employee of: CELLTRION, Inc., J. H. Yun Employee of: CELLTRION, Inc., S. Y. Kim Employee of: CELLTRION, Inc., S. M. Lee Employee of: CELLTRION, Inc.

Background CT-P13 is the first biosimilar product of innovator infliximab (INX) approved in 55 countries including EU, and there is a need of better understanding for the safety of CT-P13 compared with INX in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Objectives To compare safety profiles of CT-P13 and INX in the treatment of RA and AS, we systematically reviewed published literatures and conducted meta-analysis. Methods We conducted a systematic search for clinical trials of INX in patients with RA and AS by using PubMed database. We included the published safety profiles in randomized controlled trials (RCT) of INX for RA and AS. Eight of 660 articles in RA and 6 of 52 articles in AS were relevant RCTs and included. Safety parameters provided by INX trials were assessed, and the incidences reported in 1454 patients with the same dose regimen were used. Results were calculated using meta-analysis of incidence and compared with the safety data of CT-P13 clinical programs. Results Overall, the safety profiles of CT-P13 were within the range of historical data of INX in both RA and AS. In the combined RA and AS studies with CT-P13, 42.4% of patients reported infections which was comparable with the rates reported in historical studies with INX (55.2%; range 35.3 – 68.5%), and 3.6% of patients with CT-P13 reported serious infections which was also in line with the rates reported in historical studies with INX (3.2%; range 1.0 – 8.5%). The rate of infusion related reaction was 9.2% and aligned with historical data with INX (18.5%; range 0.0 – 67.4%). Malignancies/lymphoma was reported in 0.5% of patients treated with CT-P13, and the respective incidence with INX was 0.7%; range 0.0 – 1.2%. In addition, there is no noticeable risk in safety of CT-P13 based on the comparison with the historical data of INX in the incidences of the adverse events (100 patient-years) (Table 1). Conclusions The meta-analysis of published clinical studies of INX provides good evidence that the overall safety profiles of infliximab biosimilar, CT-P13, is consistent with that of the historical safety data of INX in RA and AS patients. References Maini et al. Lancet 1999; 354:1932-9. Abe et al. J Rheumatol 2006; 33:37-44. Schiff et al. Ann Rheum Dis 2008; 67:1096-103. Braun et al. Lancet 2002; 359:1187-93. van der Heijde et al. Arthritis Rheum 2005; 52:582-91. Breban et al. Arthritis Rheum 2008; 58:88-97. Lipsky et al. N Engl J Med 2000; 343:1594-602. St Clair et al. Arthritis Rheum 2004; 50:3432-43. Westhovens et al. Arthritis Rheum 2006; 54:1075-86. Marzo-Ortega et al. Ann Rheum Dis 2005; 64:1568-75. Quinn et al. Arthritis Rheum 2005; 52:27-35. Giardina et al. Rheumatol Int 2010; 30:1437-40. Disclosure of Interest W. Park Grant/research support from: CELLTRION, Inc., Consultant for: CELLTRION, Inc., Speakers bureau: CELLTRION, Inc., D. H. Yoo Grant/research support from: CELLTRION, Inc., Consultant for: CELLTRION, Inc., Speakers bureau: CELLTRION, Inc., C. H. Suh Grant/research support from: CELLTRION, Inc., Consultant for: CELLTRION, Inc., S. C. Shim Grant/research support from: CELLTRION, Inc., Consultant for: CELLTRION, Inc., S. J. Lee Employee of: CELLTRION, Inc., S. Y. Lee Employee of: CELLTRION, Inc., J. H. Park Employee of: CELLTRION, Inc., Y. M. Bae Employee of: CELLTRION, Inc., S. H. Kim Employee of: CELLTRION, Inc., S. G. Lee Employee of: CELLTRION, Inc.

Background The protective role of saliva in the case of esophageal exposition to gastric acid has long been studied but some contradictions still remain. Objectives The main end-point of this study was to evaluate if a qualitative and quantitative alteration in salivary secretion exists in sjogren syndrome patients affected by gastro-esophageal reflux disease (GERD). Methods 20 sjogren syndrome patients with endoscopically diagnosed GERD (LA classification A-D) and 10 sjogren syndrome patients without GERD have been evaluated; salivary tests (basal flow rate, stimulated flow rate, pH, [Na+] and [K+]) were performed, socio-demographical variables and oral GERD-related symptoms were taken into account. Results Sjogren syndrome patients with GERD and sjogren syndrome patients without GERD were found to have a similar basal flow rate but different stimulated salivary function [sjogren syndrome with GERD group mean value 0.989 ml/min (±0.48718) vs. sjogren syndrome without GERD group 1.2197 ml/min (±0.6108), pH [sjogren syndrome group mean value 8.935 (±0.471) vs. sjogren syndrome without GERD group 7.879 (±0.526)] and a higher K+ concentration. In sjogren syndrome with GERD patients we also registered a significant association with severe xerostomia [18/20 vs. 3/10] and severe an oral burning sensation [17/20 vs. 2/10]. ![Figure][1] Conclusions Our findings assess that variation of saliva is altered in sjogren syndrome with GERD patients and highlight the need for further investigations in order to define the role of saliva in the etiology of GERD in sjogren syndrome. References 1. Early events in Sjogren's Syndrome pathogenesis: The importance of innate immunity in disease initiation. Cytokine 67 (2014) 92–101. Disclosure of Interest None declared [1]: pending:yes

Background With the advanced MRI techniques, pathologic features can be detected at an early stage and quantitatively evaluated, resulting in the advantages of early diagnosis and prompt treatment. Objectives This study aimed to determine the value of diffusion-weighted MR imaging (DWI) in determined of ankylosing spondylitis (AS) treatment strategy and assess the role of quantitative MRI in the evaluation of AS treatment outcome. Methods 18 patients with the diagnosis of early AS were included in this study. Disease activity was measured according to clinical instruments and laboratory tests. For each patient, both inflamed sacroiliac (S-I) joint lesion was checked quantitatively at first diagnosis by diffusion-weighted imaging (DWI) measuring the apparent diffusion coefficient (ADC) and by dynamic contrast-enhanced imaging (DCEI) with evaluation of the enhancement factor (f enh ) and enhancement gradient (g enh ). All patients were revaluated by pelvis computer tomography (CT) for bone change in S-I joint, after two year. Results Clinical and quantitative MRI parameters diminished significantly with regression of the inflammatory activity. Median ADC values in AS patients were (1.118±0.122)×10 -3 mm 2 /s in S-I joint. The high ADC (>1.118±0.122)×10 -3 mm 2 /s, f enh (>1.65) and g enh (2.09%/S) were associated severe disease activity (high BASDIA), and early administration of biologics (p enh and g enh of S-I joint lesion was associated more severe localized pain than the other S-I joint, despite treatment (p enh , g enh and high disease activity, had minimal bone change of S-I joint, compared to only NSAIDs used group in pelvis CT finding. Conclusions Diffusion-weighted imaging and DCEI were shown to be effective in quantifying changes in inflammation in S-I joint at the diagnosis of AS, and could be convenient for assessing treatment strategy. To the best of our knowledge this is the first time DWI was used to evaluate the treatment strategy and treatment outcome of AS. Acknowledgements No Disclosure of Interest None declared

Background The blocking of IL-6 therapy is not effective treatment of ankylosing spondylitis (AS) in recent report, but the role of blocking IL-6 on peripheral joint in non-radiographic axial AS is unknown. Objectives we studied the blocking of IL-6 in peripheral arthritis of non-radiographic axial AS via Toll like receptors. Methods Synovial fibroblast (FLS) were obtained from knee of eight non-radiographic axial AS patients who were high BASDAI score (>6), and six RA patients who were moderate DAS28 score (>3.2). The expression of IL-6 was analyzed by real-time polymerase chain reaction and multiplex secretary protein analysis technology, Bio-plex assay, also the expression of toll like receptor (TLR) in FLS was detected by western blot. Results The expression of TLR 2 and TLR 4 were observed on AS and RA FLS. The administration of peptidoglycan for TLR 2 and LPS for TLR 4 increased the level of IL-6 in AS and RA FLS. The treatment of AS FLS with IL-6 inhibitor, tocilizumab, resulted in reduced expression of TLR 2 and TLR 4 in AS FLS and re-administration of peptidoglycan for TLR 2 and LPS for TLR 4 treatment did not increased the expression of IL-6, TLR 2 and TLR 4 in AS FLS. Conclusions Our results suggest that IL-6 maybe crucial role in peripheral arthritis of non-radiographic axial AS and blocking of IL-6 may ameliorate peripheral arthritis of AS by regulating TLR 2 and TLR 4, so inhibition of IL-6 maybe a potential therapeutic strategy in peripheral arthritis of non-radiographic axial AS. References Treatment of non-radiographic axial spondyloarthritis: it is only the beginning. Ann Rheum Dis June 2013 Vol 72 No 6 Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.3901

Background There has been evidence that the well-known association between obesity and knee osteoarthritis (OA) is attributable not only to increased mechanical stress, but also to systemic metabolic effect of increased adiposity. Sarcopenic obesity (SO) is a body composition in which increase in adipose tissue is accompanied by decrease in skeletal muscle mass, offsetting the increase in body weight caused by increased adiposity. Objectives This study aims to analyze the strength of association with radiographic knee OA in four different body compositions (normal (NO), sarcopenia (SP), non-sarcopenic obesity (OB) and SO), in order to evaluate whether SO is more closely associated with radiographic knee OA than OB, although body weight is expected to be comparable in the two conditions. Methods A cross-sectional analysis was performed using data from 2893 participants (aged ≥50 years) of The Fifth Korean National Health And Nutrition Examination Survey (KNHENES V-1). Radiographic knee OA was defined as Kellgren-Lawrence grade of ≥2. Appendicular skeletal muscle mass (ASM) and total body fat mass was measured using dual energy X-Ray absorptiometry (DXA). SP was defined as skeletal muscle mass index (ASM/body weight, %) below -2 SD of sex-specific young reference group. OB was defined as BMI ≥27.5 kg/m 2 (the cut-off associated with increased mortality in Asians). Participants who were both sarcopenic and obese were classified as SO. Those who were neither sarcopanic nor obese were classified as NO. The association between the presence of radiographic knee OA and the four body compositions, controlling for important confounding factors, was analyzed using logistic regression analysis. Results Among the participants, the prevalence of each body composition was as follows; NO: 83.5%, SP: 4.3%, OB: 9.2% and SO: 3.0% At baseline, compared with participants with OB, participants with SO were older, had higher total body fat mass, higher abdominal circumference and lower ASM. (all differences, p-value 2 , SO: 29.9±2.3, p-value =0.831) When adjusted for age, sex, smoking, alcohol consumption, muscle strengthening exercise, and presence of vitamin D insufficiency, SO was more closely associated with radiographic knee OA (OR: 3.92, 95% CI: 2.36 – 6.51, p-value Conclusions SO was more closely associated with radiographic knee OA than OB, although both had equivalent body weight. This finding suggests the importance of systemic metabolic effect of obesity in knee OA. Disclosure of Interest None Declared

Background In humans, NSAIDs appear to slow bone loss in periodontal disease by inhibiting synthesis of prostaglandins, known stimulators of osteoclastic resorption. This suggest a possible clinical application for NSAIDs in prevention of bone loss Objectives To investigate the bisphosphonate effects on bone mineral density and T-score in NSAIDs used Patients, compared to COX-2 inhibitor used group Methods Between January 2005 and September 2011, 319 women and 104 men were enrolled who were osteoarthritis or rheumatoid arthritis(taken below prednisolone 5mg) with osteoporosis, treated with NSAIDs or COX-2 inhibitors. The subjects were taken bisphosphonate and bone mineral density was measured by Dual-emission absorptiometry every one year. We observed the difference of bone mineral density, T-Score in NSAIDs and COX-2 used groups, spacing 2 years Results The efficacy of bisphosphonate on bone mineral density and T-Score was better in NSAIDs group than COX-2 inhibitors group (P Conclusions In our single center study, we observed the combination bisphosphonate with NSAIDs was better response in osteoporosis treatment than COX-2 inhibitors. Further multicenter studies are needed to confirm our results References Journal of Bone and Mineral Research, Volume 13, Number 12, 1998 Osteoporos Int (2006) 17:1410–1419 Disclosure of Interest None Declared

Background Currently, there are no data on the association between pulmonary hypertension and chest radiography changes specific for idiopathic pulmonary arterial hypertension in lupus. Therefore, we aimed to assessthe correlation of cardio-thoracic (CT) ratiomeasured by chest radiography for predicting pulmonary hypertension estimated by echocardiography in lupus patients. Objectives This study aims to determine whether CT ratio is increased in lupus patients with pulmonary hypertesion and its correlation with disease activity and other parameters. Methods 105 patients (median 42.75±2.14 years; 10 male) who had undergone chest radiography and echocardiography were divided into two groups (hypertensive and normotensive) based upon an echocardiography-derived pulmonary arterial systolic pressure (PASP) of 25 mmHg. CT ratio was measured twice. 1 st CT ratio was calculated at the time of enrolled trial and 2 nd CT ratio was calculated after two years later. Difference between 1 st and 2 nd measured CT ratio, 1 st CT ratio and 2 nd CT ratio were then correlated with PASP using regression analysis. The Area Under the Curve (AUC) for predicting pulmonary hypertension on CT ratio was calculated. Results In the pulmonary hypertensive group, the mean PASP was 53.13±7.76 mmHg (39-104 mmHg) and there was statistical strong correlation between the increased 2 nd cardiothoracic ratios and PASP (OR=0.228 p=0.002) but, not correlation with 1 st cardiothoracic ratio (OR=-0.055 p=0.462) and difference between 1 st and 2 nd CT ratio (OR=0.044 p=0.472). Interstitial lung disease in lupus patients were associated with PASP (OR=0.277 p=0.002) statistically. The intraobserver and interobserver correlation coefficients for cardiothoracic ratios were 0.990 and 0.892. The AUC for predicting pulmonary hypertension over 25 mmHg by echocardiography was 0.668 in 1 st CT ratio (P>0.05), 0.918 in 2 nd CT ratio and 0.919 in difference between 1 st and 2 nd CT ratio (P Conclusions Increased CT ratios of chest radiography was correlated statistically well with PASP estimated by echocardiography and could be used to predict pulmonary hypertension over 25 mmHg with high sensitivity and specificity. Acknowledgements Pulmonary hypertension in systemic sclerosis and systemic lupus erythematosus. S.R. Johnson, J.T. Granton, Eur Respir Rev 2011; 20: 122, 277–286. Disclosure of Interest None Declared

We aimed to evaluate whether methotrexate (MTX) in vitro induces apoptosis in synoviocytes obtained from rheumatoid arthritis patients and whether the apoptosis inducing effect of MTX to synoviocytes is correlated with the clinical responsiveness to MTX in patients with rheumatoid arthritis (RA). We evaluated 18 patients with RA taking MTX 15–20 mg/week as the subject group (nine responders and nine non-responders) and ten patients with osteoarthritis (OA) and nine patients with ankylosing spondylitis (AS) as the control group. Synoviocytes, cultured from the synovial fluid of the knee joint of each subject, were used for experiments between passages 4 and 6, and were treated with MTX. The induction of apoptosis was determined by the quantification of DNA hypoploidy by flow cytometry, nuclear morphology, caspases activation, DNA electrophoresis, and mitochondrial membrane potential measurements. The viability of synoviocytes treated with MTX was different between the MTX responders and nonresponders. MTX induced apoptosis in cultured synoviocytes by mitochondria- and caspase-dependent manners in the MTX responders but did not in the MTX non-responder, OA, and AS patients. The apoptotic responsiveness of the synoviocytes to MTX predicts the sensitivity to MTX treatment and provides a method determine the early application of an anti-tumor necrosis factor-α agent in RA treatment.

Background Methotrexate (MTX) was the corner stone treatment of rheumatoid arhtirits. So for long time, MTX was used in rheumatoid arhtirits treatment with other Immunosuppressive drug. There were many hypothesis in mechanism of MTX on RA treatments, but accurate mechanism of MTX was not known Objectives To investigate the apoptotic mechanism of MTX in synoviocyte of rhuematoid arhtirits Methods Synovial cells were cultured from synovial fluid of Rhuematoid arhtirits (RA) patients and Osteoarhtirtis (OA) patients. In each group, the subculture was conducted for 5-6 passages and synovioctes was treated with 300μM 500μM MTX directly. In 400μM The cell viability was observed and apoptosis of synoviocyte was measured by flow cytometry Results MTX treated synovial cell death was higher RA than OA in 300μM 500μM MTX, In 400μM MTX, high Sub-G1 pick was observed and continued to 24 hours in RA synoviocytes Conclusions Apoptosis was the one of MTX mechasnism in RA treatment and RA synoviocytes apoptosis may be one of tool for RA treatment in the future References Determinants of Red Blood Cell Methotrexate Polyglutamate Concentrations in Rheumatoid Arthritis Patients Receiving Long-Term Methotrexate Treatment Lisa K. Stamp, John L. O’Donnell, Peter T. Chapman, Mei Zhang, Christopher Frampton, Jill James, Murray L. Barclay. Arthritis & Rheumatism Vol. 60, No. 8, August 2009, pp 2248–2256. Disclosure of Interest None Declared

Background Systemic sclerosis (SSc) may lead to pulmonary artery hypertension. Brain natriuretic peptide (BNP), a marker of cardiac failure, is a diagnostic marker of early pulmonary arterial hypertension (PAH) in patients with SSc. Obesity promotes a relative BNP deficiency because insulin resistance is associated with lower BNP level. So our aim was to analyzed affection of the body mass index (BMI) in level of BNP in screening for PAH in SSc Objectives To analyzed affection of BMI in level of BNP in screening for PAH in SSc Methods Between January 2010 and september 2011, outpatients referred to our unit and satisfying LeRoy criteria for SSc were assessed for PAH. Doppler echocardiography, BNP measurement, and BMI measurement were done concomitantly for a complete clinical, instrumental, and biochemical evaluation. Right-heart catheterization was carried out in cases of PAH Results Twenty-nine patients were enrolled (23 women, 6 men; 4 limited SSc, 25 diffuse SSc); precapillary PAH was found in 2 patients (0 limited SSc, 2 diffuse SSc). All subjects were divided into three group: Group A, BMI 30 (n=1). Group A: increased with BNP. while BNP decreased in group C. The estimated PAP correlated with BNP (R =0.3; 95% CI 0.14–0.44) but not with BMI (R =0.7, 95% CI 0.14–1.45). BNP (p=0.032) and creatinine (p=0.049) were independent predictors of PAH, while BMI was not (p=0.50). Conclusions In our single-center study, Low BMI was correlation with high BNP in SSC. So BMI affected the level of BNP in PAH of SSC. References Prevalence of Exercise Pulmonary Arterial Hypertension in Scleroderma. Jose Luis Callejas-Rubio, Eduardo Moreno-Escobar, Pilar Martin de la Fuente, Lourdes Lόpez Perez, Raquel Rios Fernandez, Daniel Sanchez-Cano, Jose Pomares Mora, Norberto Ortego-Centeno, July 15 2008; J Rheumatol 2008;35:1812–6. Disclosure of Interest None Declared

Background NK cellare approximately 10–15% of circulating lymphocytes and 5% of lymphocytes in lymphoid tissue and a subset of NK cells has been detected in the synovial fluid (SF) from rheumatoid arthritis (RA) patients recently. The best characterised NK cell activating receptor is NKG2D, is expressed on all human NK cells and the ligands for NKG2D are not expressed on normal, healthy tissue, but are in induced under conditions of cellular stress such as inflammation and malignant transformation Objectives To investigated expression of NKG2D ligands in synovial cell of rhuematoid arhtirits Methods Synovial cell was cultured from SF of RA patients. The subculture was conducted for 5-6 passages and the PCR was done for detection of NKG2D ligands. To evaluated NKG2D ligands in inflammatory RA synoviocytes, TNF-α were treated Results Five NKG2D ligands (MICA, MICB, ULPB1, ULBP2, ULBP3) were expressed in both RA synoviocytes and inflammatory RA synoviocytes Conclusions RA synoviocytes had NKG2D ligands, so NKG2D receptors in NK cell were associated with pathogenesis of RA. The blocking of NKG2D ligands was the one of method in RA treatment References Emerging role for NK cells in the pathogenesis of inflammatory arthropathies, Paola Conigliaro, Rossana Scrivo, Guido Valesini, Roberto Perricone. Autoimmunity Reviews 10 (2011) 577–581 Disclosure of Interest None Declared