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Objective: Satisfaction and preference properties differs in osteoporosis treatment agents. In our study we aimed to evaluate these properties in patients receiving denosumab treatment. Materials and Methods: Thirty female patients who had denosumab injections were included in our study. Demographic and general characteristics were recorded. General patient satisfaction, patient satisfaction of the drug and it's effect on quality of life was evaluated on a Likert scale. Patients' preference was evaluated with asking the reasons of switches to denosumab. Results: The mean age of patients was 59.30±12.86 years. Of the patients 30 (% 100.0) wanted to continue the same therapy, 25 (%83.3) patients stated that managing this treatment is extremely easy. 25 (% 83.3) patients stated that it was extremely well-suited with lifestyle.25 (% 83.3) patients were extremely convenient to take medication.25 (% 83.3) patients have extremely willed to continue to use the medication. Of 30 patients, 30(% 100) have been switched to denosumab due to physician recommendation. Physician recommended have been done to these patients due to ineffectivity of previous osteoporosis treatments or due to side effects of previous osteoporosis treatments. 22 (%73.33) of these patients have been switched to denosumab due to ineffectivity of previous osteoporosis treatments. About 8 (%26.66) patients have been switched to denosumab due to side effects of previous osteoporosis treatments. Conclusion: Denosumab treatment in osteoporosis is a convenient and well-tolerated therapeutic modality.

Objective: We aimed to evaluate work productivity on the quality of life and disease activity in ankylosing spondylitis. Material and methods: One hundred ankylosing spondylitis patients were included in the study. Disease activity was assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), quality of life was assessed by Ankylosing Spondylitis Quality of Life questionnaire, work productivity was assessed by work productivity and activity impairment questionnaire. Results: Absenteeism, presenteeism, work productivity loss and activity impairment scores were positively correlated with BASDAI. We found correlation between absenteeism, presenteeism, work productivty loss, activity impairment scores and poor quality of life. Conclusion: As a result of our study, work productivity should be considered in clinical practice. Assessment of work productivity in routine clinical practice can contribute to a better understanding of problems in patients' behavior to treatment.

Objective: Currently, concerning the evaluation of psoriatic arthritis (PsA), there is no agreement on a standardized composite index for disease activity that includes all relevant domains. The present study sought to assess the rates of remission (REM)/low disease activity (LDA) and disease states [minimal disease activity (MDA), very low disease activity (VLDA)] as defined by diverse activity scales (DAPSA, DAS28-ESR) in an attempt to display discrepancies across these assessment tools for peripheral PsA. Methods: The study involved 758 patients (496 females, 262 males; mean age 47,1 years) with peripheral PsA who were registered to the Turkish League Against Rheumatism (TLAR) Network. The patients were assessed using the DAS28-ESR, DAPSA, MDA, and VLDA. The overall yield of each scale was assessed in identifying REM and LDA. The presence or absence of swollen joints was separately analysed. Results: The median disease duration was 4 years (range 0-44 years). According to DAPSA and DAS28-ESR, REM was achieved in 6.9% and 19.5% of the patients, respectively. The rates of MDA and VLDA were 16% and 2.9%, respectively. Despite the absence of swollen joints, a significant portion of patients were not considered to be in REM (296 (39.1%) patients with DAS28-ESR, 364 (48%) with DAPSA, and 394 (52%) with VLDA). Conclusion: Patients with peripheral PsA may be assigned to diverse disease activity levels when assessed with the DAS28-ESR, DAPSA, MDA and VLDA, which would inevitably have clinical implications. In patients with PsA a holistic approach seems to be necessary which includes other domains apart from joint involvement, such as skin involvement, enthesitis, spinal involvement, and patient-reported outcomes. © 2021 Société française de rhumatologie

Patient-reported outcomes (PROs) provide a means for patients to communicate with their care teams about their disease. Polymyalgia rheumatica (PMR) is considered to be one of the most common inflammatory rheumatic diseases in older adults. The Visual Analogue Scale (VAS) of pain is the only PRO assessed by the PMR activity score (PMR-AS), which is still the only validated score for monitoring disease activity in patients affected with PMR. Other PROs such as fatigue, sleep disturbances, depressive symptoms, and patient’s perspective related to adverse effects of prednisolone are still unmet needs. This short communication suggests the gerontorheumatological outpatient clinic as an answer.

Aim:We aimed to evaluate biological rhythm in rheumatoid arthritis (RA) patients using the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN).Methods:Eighty-five RA patients and 85 healthy controls were included in the study. Biological rhythm was evaluated using the BRIAN. Disease activity was determined by the Disease Activity Score in 28 joints in RA patients.Results:The BRIAN total score and sleep, activity, social rhythm and eating pattern scores were higher in patients with RA than in controls (BRIAN scale total score-44.8±8.6 vs 25.76±5.86 (p

This article aims to evaluate the possible effect of obesity on quality of life, psychological status, and other clinical variables in Psoriatic arthritis (PsA). PsA patients have been recruited by the Turkish League Against Rheumatism-Network from various centers in Turkey in this cross-sectional study. Patients with a body mass index (BMI) ? of 30 kg/m2 were considered obese. Differences among patients with regard to obesity status were assessed with health-related quality of life measures (PsA Quality of Life Questionnaire [PsAQoL]), psychological status (Hospital Anxiety and Depression Scale [HADS]), and disease activity parameters (the Disease Activity index for PSoriatic Arthritis [DAPSA], Disease Activity Score 28-C-reactive protein [DAS28-CRP], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Psoriasis Area and Severity Index [PASI]), physical functions (Ankylosing Spondylitis Functional Index [BASFI], Health Assessment Questionnaire [HAQ], and Health Assessment Questionnaire for the spondyloarthropathies [HAQ-S]). Pain was assessed using visual analog scale of pain (VAS-P), and fatigue was evaluated using visual analog scale of fatigue (VAS-F) and Functional Assessment of Chronic Illness Therapy (FACIT). A total of 1033 patients with PsA, 650 (62.9%) non-obese and 383 (37.1%) obese were included in the study. The PsAQoL, HADS-Anxiety, HADS-Depression, DAPSA, DAS28-CRP, BASDAI, BASFI, HAQ and HAQ-S scores of the obese group were higher than the non-obese group (p < 0.05). VAS-P and PASI scores were similar between group of patients with and without obesity. Obese patients had higher median scores of VAS-F and FACIT than non-obese patients (p < 0.05). Linear regression analysis showed that BMI affects the quality of life, depression, and disease activity. Consequently, obesity has significant associations with higher disease activity, lower QoL, risk of anxiety, depression, and fatigue. Therefore, obesity should also be taken into account in the management of PsA patients. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Objectives: This study aims to evaluate the effectivity of Familial Mediterranean Fever Quality of Life (FMF-QoL) Scale for the measurement of QoL in patients with FMF and to perform correlations between related clinical variables in Turkish patients. Patients and methods: This multicenter prospective study performed between December 2017 and November 2018 included 974 FMF patients (334 males, 640 females; median age: 35; range, 26 to 45 years). Sociodemographic characteristics and clinical features were recorded. All participants were asked to complete the FMF-QoL Scale, Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Health Assessment Questionnaire (HAQ), and Functional Assessment of Chronic Illness Therapy (FACIT) Scale. Results: The median FMF-QoL Scale score was 26. Higher FMF-QoL Scale scores were shown to be related to female sex, illiteracy or primary education, monthly low-income (US$20 years), a higher number of attacks per month (>1/month), and severe disease. FMF-QoL Scale scores were correlated negatively with subscales of SF-36, and positively with HADS-anxiety and HADS-depression scores, HAQ and FACIT. Conclusion: Female sex, smoking, lower educational status, more severe disease, fatigue, and functional impairment were associated with poor QoL. FMF-QoL Scale was noted as a valid and simple patient-reported outcome instrument and correlated with the SF-36 scale.

Background and Objectives: Laboratory liver abnormalities can be observed in patients affected with polymyalgia rheumatica (PMR) and/or giant cell arteritis (GCA), especially with a cholestatic pattern. The first objective of our review article is to discuss the potential link between antimitochondrial antibodies (AMA) and/or primary biliary cholangitis (PBC) and PMR/GCA, according to the evidences of literature. The second objective is to discuss the association of PMR/GCA with the other rheumatic diseases having PBC as a common manifestation. Materials and Methods: A literature search was performed on PubMed and Medline (OVID interface) using these terms: polymyalgia rheumatica, giant cell arteritis, antimitochondrial antibodies, primary biliary cholangitis, primary Sjogren’s syndrome, systemic sclerosis, and systemic lupus erythematosus. The search was restricted to all studies and case reports published in any language. Reviews, conference abstracts, comments, and non-original articles were excluded; however, each review’s reference list was scanned for additional publications meeting this study’s aim. When papers reported data partially presented in previous articles, we referred to the most recent published data. Results and Conclusions: Our literature search highlighted that cases reporting an association between AMA, PBC and PMR/GCA were very uncommon; AMA antigenic specificity had never been detected and biopsy-proven PBC was reported only in one patient with PMR/GCA. Finally, the association of PMR/GCA with autoimmune rheumatic diseases in which PBC is relatively common was anecdotal.

Şahin, Nilay (Balikesir Author), Objectives: This study aims to compare the clinical characteristics, disease activity, and quality of life (QoL) of patients with psoriatic arthritis (PsA) who use biological and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) in a nationwide cohort throughout Turkey. Patients and methods: A total of 961 patients (346 males, 615 females; mean age: 46.9+/-12.2 years; range, 18 to 81 years) with PsA according to the classification criteria for PsA were included in the study. The patients demographic and clinical characteristics, physical examination results, Disease Activity Score 28, Disease Activity Index for Psoriatic Arthritis and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Psoriasis Area and Severity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, Hospital Anxiety and Depression Scale, Health Assessment Questionnaire, Psoriatic Arthritis Quality of Life (PsAQoL), and Short Form-36 scores were all recorded. Results: Of the patients, 23% underwent biological DMARD (bDMARD) monotherapy, 42% underwent conventional synthetic DMARD (csDMARD) monotherapy, 10% underwent a csDMARD combination therapy, and 10% underwent a combination bDMARD and csDMARD treatment. The Visual Analog Scale (VAS pain), patient global assessment, physician global assessment, and BASDAI scores were found to be lower among patients using combination treatment of csDMARD and bDMARD, while the swollen joint count was found to be lower among patients using bDMARD. The PsAQoL score was found to be the lowest among patients not using any medication and the highest among those using bDMARD. Conclusion: In our study, patients with PsA were successfully treated with both csDMARD and bDMARD monotherapy. When the biological treatments used for PsA were compared with csDMARD, it was found that biological treatments had a positive effect on both disease activity and the QoL. Combinations of csDMARDs and bDMARDs were preferred in cases in which the disease activity was still high or increased. Because of the highest efficacy of the combined treatment, we highly suggest increasing the number of patients on combined treatment.

Objectives: Uric acid has an important role in the production of various inflammatory cytokines such as tumor necrosis factor-α (TNF-α). Although serum uric acid levels in various rheumatic diseases have been performed the relationships between serum uric acid levels with inflammatory markers and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores in ankylosing spondylitis patients treated with anti-TNF-α and nonsteroid anti-inflammatory drugs (NSAIDs) have not been described yet. The aim of this study was to compare the relationships between serum uric acid levels, inflammatory markers and BASDAI scores in ankylosing spondylitis patients treated anti-TNF-α and NSAIDs. Methods: A total of 132 ankylosing spondylitis patients fulfilling the 1984 Modified New York Criteria who had serum uric acid, erythrocyte sedimentation rate and C-reactive protein levels in medical records were included in this retrospective cross-sectional study. Patients were divided in two groups (anti-TNF-α and NSAIDs). Their files were examined in detail. Later demographic and laboratory features were recorded to the research form. Results: Serum uric acid levels were significantly lower in the anti-TNF-α group (mean: 4.9 mg/dL, range: 4.10-5.45 mg/dL) than in the NSAIDs group (mean: 5.20 mg/dL, range 4.70-5.90 mg/dL) (p = 0.021). Also, positive correlations were found between C-reactive protein (p = 0.003) and BASDAI (p = 0.009) with serum uric acid. Conclusions: According to this study, we can consider that serum uric acid level could be used as an inflammatory laboratory marker, such as C-reactive protein in ankylosing spondylitis patients. However, we believe that more studies are needed about this research.

Juvenile ankylosing spondylitis (JAS) coexisting with Familial Mediterranean Fever (FMF) or Takayusu’s arteritis (TA) together with JAS have been reported in the literature. However, co-existance of these three diseases has not been reported yet. Here, we present a 17-year- old female patient presenting with JAS who was subsequently diagnosed with FMF and TA. To the best of our knowledge, this is the first case of JAS presenting with FMF and TA.

Lichen planus and lupus nephritis with late-onset systemic lupus erythematosus (LO-SLE) may occur concomitantly. However, coexistence of LO-SLE with focal segmental glomerulosclerosis and lichen planus has not been defined. In this article, we report a 57-year-old male patient presenting with lichen planus and focal segmental glomerulosclerosis who was subsequently diagnosed with LO-SLE. To the best of our knowledge, this is the first case of LO-SLE presenting with lichen planus and focal segmental glomerulosclerosis.

WOS: 000511872800013, PubMed: 31773391, Psoriatic arthritis (PsA) is an inflammatory arthritis with distinct phenotypic subtypes. Enthesitis is assigned as a hallmark of the disease, given its significant relations to disease activity and quality of life. Our objective is to evaluate the prevalence of enthesitis and its association with some clinical parameters, particularly quality of life, using data from a national registry. Patients with PsA meeting ClASsification criteria for Psoriatic Arthritis (CASPAR) were enrolled by means of a multi-centre Turkish League Against Rheumatism (TLAR) Network Project. The following information was recorded in web-based case report forms: demographic, clinical and radiographic data; physical examination findings, including tender and swollen joint counts (TJC and SJC); nail and skin involvement; Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte Sedimentation Rate (DAS 28-ESR); Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Maastricht Ankylosing Spondylitis Enthesitis Score (MASES); Psoriasis Area Severity Index (PASI); Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s); Health Assessment Questionnaire (HAQ); Bath Ankylosing Spondylitis Functional Index (BASFI); Health Assessment Questionnaire for the spondyloarthropathies (HAQ-s); Psoriatic arthritis quality of Life scale (PsAQoL); Short Form 36 (SF-36); Hospital Anxiety Depression Scale (HADS); Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); and Fibromyalgia Rapid Screening Tool (FiRST) scores. The patients were divided into two groups, namely with and without enthesitis, based on the triple Likert-type physician-reported statement of 'active enthesitis', 'history of enthesitis' or 'none' in the case report forms. Patients with active enthesitis were compared to others in terms of these clinical parameters. A total of 1130 patients were enrolled in this observational study. Of these patients, 251 (22.2%) had active enthesitis according to the clinical assessment. TJC, HAQ-s, BASDAI, FiRST and PsAQoL were significantly higher whereas the SF-36 scores were lower in patients with enthesitis (p < 0.05). Chronic back pain, dactylitis, and tenosynovitis were more frequent in the enthesopathy group (59.4%/39%, 13.1%/6.5% and 24.7%/3.4%, respectively). Significant positive correlations between the MASES score and the TJC, HAQ, DAS 28-ESR, BASDAI, FiRST and PsAQoL scores, and a negative correlation with the SF-36 score were found. When linear regression analysis was performed, the SF-36 MCS and PCS scores decreased by - 9.740 and - 11.795 units, and the FiRST scores increased by 1.223 units in patients with enthesitis. Enthesitis is an important involvement of PsA with significant relations to quality of life determined with PsAQoL and SF-36 scores. Our study found higher frequency of dactylitis and chronic back pain, and worse quality of life determined with SF-36 and PsAQoL scores in patients with enthesitis.

Keskin, Yasar/0000-0003-4457-5917; KILIC, Erkan/0000-0003-4355-4356; Yurdakul, Ozan Volkan/0000-0003-4567-8133; cuzdan, nihan/0000-0001-7238-657X; gezer, halise hande/0000-0001-8790-304X; alkan, hakan/0000-0001-8461-9131 WOS:000541406200002 PubMed: 32564159 Fatigue is a substantial problem in patients with psoriatic arthritis (PsA) that needs to be considered in the core set of domains. This study aimed to evaluate fatigue and its relationship with disease parameters, functional disability, anxiety, depression, quality of life, and correlation with disease activity as determined by various scales. A total of 1028 patients (677 females, 351 males) with PsA who met the CASPAR criteria were included [Turkish League Against Rheumatism (TLAR) Network multicenter study]. The demographic features and clinical conditions of the patients were recorded. Correlations between fatigue score and clinical parameters were evaluated using the Disease Activity Score 28 (DAS28), Disease Activity in Psoriatic Arthritis (DAPSA), Clinical DAPSA (cDAPSA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Fibromyalgia Rapid Screening Tool (FiRST), minimal disease activity (MDA), and very low disease activity (VLDA). Fatigue was assessed with the Functional Assessment of Chronic Illness Therapy (FACIT-F) and a 10-point VAS (VAS-F). The mean age of the patients was 47 (SD: 12.2) years, and the mean disease duration was 6.4 (SD: 7.3) years. The mean VAS-F score was 5.1 (SD: 2.7), with fatigue being absent or mild, moderate, and severe in 12.8%, 24.6%, and 62.5% of the patients, respectively. Fatigue scores were significantly better in patients with DAS28 remission, DAPSA remission, cDAPSA remission, MDA, and VLDA (p < 0.001). Fatigue scores significantly increased with increasing disease activity levels on the DAS28, DAPSA, and cDAPSA (p < 0.001). VAS-F scores showed correlations with the scores of the BASDAI, BASFI, PsAQoL, HAD-A, FiRST, pain VAS, and PtGA. FiRST scores showed fibromyalgia in 255 (24.8%) patients. FACIT-F and VAS-F scores were significantly higher in patients with fibromyalgia (p < 0.001). In regression analysis, VLDA, BASDAI score, FiRST score, high education level, HAD-Anxiety, and BMI showed independent associations with fatigue. Our findings showed that fatigue was a common symptom in PsA and disease activity was the most substantial predictor, with fatigue being less in patients in remission, MDA, and VLDA. Other correlates of fatigue were female gender, educational level, anxiety, quality of life, function, pain, and fibromyalgia.

Objectives In this study, we aimed to evaluate the effect of gender on clinical findings, disease activity, functional status and quality of life in patients with axial involvement in Turkey. Methods Patients with PsA who met the CASPAR classification criteria were enrolled consequently in this cohort. Turkish League Against Rheumatism (TLAR)-Network was formed with the participation of 25 centres. The demographic variables, fatigue, diagnostic delay, the beginning of peripheral arthritis, enthesitis, dactylitis and spine involvement, inflammatory low back pain, BASFI, HAQ, HAQ-s, visual analogue scale-pain (VAS-pain), anxiety, depression and disease activity parameters (ESR, DAS28, BASDAI) were recorded. Axial involvement was assessed according to clinical and radiological data according to modified New York (MNYC) or Assessment of SpondyloArthritis international Society (ASAS) criteria. Results A total of 1018 patients with PsA were included in this study. Of the 373 patients with axial involvement, 150 were male (40.2%) and 223 (59.8%) were female. Spondylitis was detected in 14,7% of men and 21,9% of women in all patients. Pain score (VAS) (p < .002), fatigue (p < .001), ESR (p < .001), DAS28 (p < .001), BASDAI score (p < .001), PsAQoL (p < .001), HAQ score (p < ,01), HAQ-S score (p < .001), anxiety (p < .001), depression (p < .024), FACIT (p < .001) and FiRST (p < .001) scores were statistically significantly worse in women than males with axial PsA. However, quality of life was better (p < .001) and PASI score (p < .005) were statistically worse in male patients than in female patients with axial involvement. Conclusion This study has shown that the burden of disease in axial PsA has significant difference between genders. Disease activity, physical disability, functional limitation, depression and anxiety scores were higher in female patients, while quality of life were better and PASI score were higher in male patients. Therefore, we suggest that new strategies should be developed for more effective treatment of axial PsA in female patients.

Background: Gout is the most common form of crystal arthropathy. Monoarthritis affecting the first metatarsophalangeal joint is the common initial presentation. Bilateral olecranon bursitis is a rare presentation of gout. Aim of the work: To describe the clinical features of bilateral olecranon bursitis as an initial presentation of gout. Case report: A 62-year old male patient presented to the rheumatology clinic , Adnan Menderes University with sudden bilateral elbow pain and swelling for three months . Swellings gradually increased to the size of a golf ball with minimal restriction in the elbow extension (170°). He didn’t have arthritis in the elbows. The patient had medical history of heart failure and chronic obstructive pulmonary disease and medications received included acetylsalicylic acid and diuretics. Blood tests revealed elevated serum uric acid (12.6 mg/dL), with normal renal function tests, erythrocyte sedimentation rate (ESR) 43 mm/h and C-reactive protein (CRP) 8.8 mg/L. Rheumatoid factor and hepatitis markers were negative. Diagnostic bursal aspiration excluded septic bursitis and under polarized microscopy monosodium urate (MSU) crystals were identified with typical negative birefringence. A diagnosis of gout was established. ESR and CRP were normalized after diclofenac potassium (100 mg) and colchicine (1.5 mg). Allopurinol 300 mg was added when his joint pain was relieved. Conclusion: This is the first gout case initially presenting with bilateral olecranon bursitis. Bursal fluid analysis is important in such atypical presentation to look for MSU crystals and establish a diagnosis. Keywords: Olecranon bursitis, Gout, Crystal arthropathy, Monosodium urate

Background: Psoriatic arthritis (PsA), a chronic rheumatic disease associated with reduced quality of life. Obesity is an important clinical problem which may interfere with loss of functioning and quality of life. Obesity is usually an overlooked entity in patients with PsA. Several studies were invastigated prevalence and the impact of obesity on disease activity in patients with PsA, however relationship between psychological status and quality of life have not been evaluated comparatively. Objectives: To assess the impact of obesity on quality of life, psychological status and clinical parameters in patients with PsA. Methods: Patients with PsA were recruited who met CASPAR classification criteria enrolled by Turkish League Against Rheumatism-NETWORK (TLAR-NETWORK) derived from 24 different centers of our country.Patients with BMI ≥30 kg/m2 were considered obese. Differences among patients with or without obesity were assessed.VAS fatigue, psychological status and health related quality of life measures [SF-36; HAQ; Psoriatic arthritis quality of life (PsAQoL); Hospital Anxiety and Depresson Scale], FACIT-Fatigue, DAS28, BASDAI, BASFI, BASMI, Maastrich Ankylosing Spondylitis Enthesitis Score (MASES) and Psoriasis area severity index (PASI) scores were compered between this groups. Results: A total 1130 patients with PsA (36.0% male, 64.0% female) included in this study. In this cohort 37.6% obese and 62.4% non-obese. The presence of peripheral arthritis, enthesitis, dactylitis, uveitis and spine involvement, PASI scores as well as MASES scores were quite similar between patients with and without obesity. Obese patients had significantly higher scores in VAS fatigue and disease activity, poorer QoL and physical functions compared to non-obese patients (p Conclusion: Obesity associated with the risk of depression and anxiety, fatigue, poorer QoL and higher disease activity.These findings suggest that obesity should be considered while assessing patients with PsA. References [1] Li W,Han J,Qureshi AA.Obesity and risk of incident psoriatic arthritis in US women.Ann Rheum Dis.2012Aug;71(8):1267-72. [2] Klingberg E,Bilberg A,Bjorkman S, et al.Weight loss improves disease activity in patients with psoriatic arthritis and obesity:an interventional study.Arthritis Res Ther.2019Jan11;21(1):17 Disclosure of Interests: Kevser Gok: None declared, Kemal Nas: None declared, Erkan Kilic: None declared, Betul Sargin: None declared, Sevtap Acer Kasman: None declared, Hakan Alkan: None declared, Nilay Sahin: None declared, Gizem Cengiz: None declared, Nihan Cuzdan: None declared, Ilknur Albayrak Gezer: None declared, Dilek Keskin: None declared, Cevriye Mulkoglu: None declared, Hatice Resorku: None declared, Ismihan Sunar: None declared, Ajda Bal Hasturk: None declared, Mehmet Tuncay Duruoz Grant/research support from: Abvie, Speakers bureau: Novartis, AMGEN, Abdi Ibrahim, Ilko, Okan Kucukakkas: None declared, Ozan Volkan Yurdakul: None declared, Meltem Alkan Melikoglu: None declared, Yildiray Aydin: None declared, Figen Ayhan: None declared, Hatice Bodur: None declared, Mustafa Calis: None declared, Erhan Capkin: None declared, Gul Devrimsel: None declared, SAMI HIZMETLI: None declared, Ayhan Kamanli: None declared, Yasar Keskin: None declared, Hilal Kocabas: None declared, Oznur Kutluk: None declared, Nesrin Sen: None declared, Omer Faruk Sendur: None declared, ibrahim tekeoglu: None declared, Murat Toprak: None declared, Sena Tolu: None declared, Tiraje Tuncer: None declared

Background: Psoriatic arthritis (PsA) can lead to significant mental burden affecting several aspects of life in majority of patients. Mental health problems, such as depression and anxiety may result in poor treatment adherence and difficulty in coping with disease burden. Objectives: The aim of this study is to determine the risk factors associated with clinically significant depression and anxiety in patients with PsA. Methods: The data from 1128 patients with PsA who met CASPAR classification criteria enrolled by Turkish League Against Rheumatism (TLAR)-Network derived from 25 investigating centers. All of the patients underwent clinical, radiological and also laboratory assessment by using standardized protocol. The associations between psychological variables and clinical parameters were assessed by univariate and multivariate analyses. Results: Of the 1128 patients with PsA (the mean age 46.9 ±12.2,%64 F), 574 (%50.9) had high risk for depression (HADS-D score ≥7) and 270 (%23.9) for anxiety (HADS-A score ≥10). By univariate analysis, the highest odds ratio (OR) associated with both depression and anxiety were SF36-MCS Conclusion: This large nationwide database indicated that higher disease activity, functional disability, fibromyalgia (FMS), poor health related quality of life as well as structural damage were estimated as the important risk factors for mental disorders in PsA. Disclosure of Interests: Gamze Kilic: None declared, Kemal Nas: None declared, Erkan Kilic: None declared, ibrahim tekeoglu: None declared, Betul Sargin: None declared, Sevtap Acer Kasman: None declared, Hakan Alkan: None declared, Nilay Sahin: None declared, Gizem Cengiz: None declared, Nihan Cuzdan: None declared, Ilknur Albayrak Gezer: None declared, Dilek Keskin: None declared, Cevriye Mulkoglu: None declared, Hatice Resorlu: None declared, Sebnem Ataman: None declared, Ajda Bal: None declared, Mehmet Tuncay Duruoz Grant/research support from: Abvie, Speakers bureau: Novartis, AMGEN, Abdi Ibrahim, Ilko, Okan Kucukakkas: None declared, Ozan Volkan Yurdakul: None declared, Meltem Alkan Melikoglu: None declared, Yildiray Aydin: None declared, Figen Ayhan: None declared, Hatice Bodur: None declared, Mustafa Calis: None declared, Erhan Capkin: None declared, Gul Devrimsel: None declared, SAMI HIZMETLI: None declared, Ayhan Kamanli: None declared, Kevser Gok: None declared, Yasar Keskin: None declared, Hilal Kocabas: None declared, Oznur Kutluk: None declared, Nesrin Sen: None declared, Omer Faruk Sendur: None declared, Murat Toprak: None declared, Sena Tolu: None declared, Tiraje Tuncer: None declared

Annual European Congress of Rheumatology (EULAR) -- JUN 12-15, 2019 -- Madrid, SPAIN, WOS: 000472207102501, Background PsA is a chronic musculoskeletal disease. The prevalence of axial involvement in PsA varies according to the duration of the disease. In early stage the incidence varies between 5% and 28%, but it increases up to 25-70% in later stages of the disease. In the literature, there is limited data on the differences in disease activity, functional status and quality of life of men and women with axial PsA., European League Against Rheumatism

Aims Previous studies have shown that C-reactive protein (CRP) gene polymorphism can be related to inflammatory changes. The present study aimed to examine the association between CRP gene polymorphism and clinical and laboratory findings in ankylosing spondylitis (AS) patients. Materials and methods A total of 80 patients, 40 with AS and 40 controls, were included in the study. Diagnosis of AS was made according to Assessment in AS International Working Group criteria. Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index and Bath Ankylosing Spondylitis Radiology Index scores were evaluated. CRP gene C, A and T alleles were evaluated and were determined using the analysis of melting curves after real time polymerase chain reaction. The odds ratios were calculated for all alleles and haploids of the CRP gene. We investigated the relationship between the CRP polymorphism and clinical and laboratory findings. Results A, C, T allele frequencies in the control group were 15%, 57.5% and 27.5%. The allele frequencies in the AS group were 38%, 68.8% and 26.2%. While C and T allele frequencies were shown to be similar in the two groups, A allele frequency was higher in the AS group compared to the control group. The CC wild allele was 42.5% in the control group and 47.5% in the AS group (P = 1.0). Odds ratios for the C allele were 1.6, for the CC haploid 1.2 and for the CT haploid 3.7. Chest expansion and finger-to-ground distance was better in the CRP gene polymorphism group compared to the no polymorphism group. Conclusion The presence of the CRP gene CC wild haploid and C allele in patients may indicate an increased risk for AS.

Objective: This study aims to investigate the relationship between serum lipids and bone mineral density in ankylosing spondylitis patients. Methods: A total of 94 ankylosing spondylitis patients fulfilling the 1984 Modified New York Criteria who had serum lipid levels and bone mineral density scores in medical records were included in this study. These patients treated with nonsteroid antiinflammatory drugs. Their files were examined in detail. Later demographic and laboratory features were recorded to the research form. Dual-energy X-ray absorptiometry was used to assess bone mineral density in two bone sites of femur (neck, intertrochanteric zone and trochanter) and spinal lumbar vertebras (Lumbar 1-Lumbar 4). Results: Significant and positive correlation was found between high density lipoprotein and femoral neck bone mineral density (r = 0.356, p = 0.021) in osteopenic group and in osteoporotic group (r = 0.005, p = 0.040). Conclusion: According to our study significant and positive correlations are found between high density lipoprotein and femoral neck bone mineral density in osteopenic and osteoporotic group. However, we believe that more studies are needed about this research.

Objectives. We aimed to evaluate the frequency of toll-like receptor 4 ( TLR4) gene polymorphism and its relationship between disease activity in patients with ankylosing spondylitis (AS). Methods. Forty-one AS patients (25 male/16 female) fullfilling the 1984 Modified New York Criteria and 41 healthy controls ( 25 male/16 female) were included in this study. Disease activity of the AS patients was assesed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The TLR4 gene polymorphism of AS patients and healthy controls were analyzed by Real-Time Polymerase Chain Reaction (PCR) System. Results. Three (7.3%) patients with AS had TLR4 gene polymorphism compared with healthy controls (0/41; 0%). Two of these patients had heterozygous mutation and one had homozygous mutation. Significant correlation was not found between TLR4 gene polymorphism and BASDAI score ( p > 0.05). Conclusions. In our study, TLR4 gene polymorphism was higher in patients with AS compared with control group. But, this polymorphism was not associated with disease activity, erythrocyte sedimentation rate and C-reactive protein levels.

Scleroderma is a chronic autoimmune multisystem disorder which is characterized by progressive fibrosis of the skin and internal organs. Ovary cancers with scleroderma have been reported in the literature. But recurrent ovary cancer with scleroderma has not been reported before. Here, we report a 65 -year old female patient presenting with recurrent ovary cancer and subsequently diagnosed with scleroderma. Due to literature sources, this is the first case of presenting with recurrent ovary cancer and scleroderma

Introduction: Ankylosing spondylitis (AS) is a chronic inflammatory disease. Thyroid dysfunctions are more frequent in patients with inflammatory diseases. In this study, we aimed to evaluate thyroid functions and thyroid autoantibodies in ankylosing spondylitis patients, to determine the effect of anti-tumor necrosis factor treatment in AS patients and the relationship between thyroid function and autoantibody levels, inflammatory markers and disease activity in ankylosing spondylitis patients. Materials and Methods: 74 ankylosing spondylitis patients diagnosed according to 1984 Modified New York criteria and Assessment in Spondylarthritis International Society classification criteria were included. 41 of them were receiving anti-tumor necrosis factor treatment and 33 of them were receiving nonsteroid anti-inflammatory drugs. We recorded patients' age, gender, erythrocyte sedimentation rates, C-reactive protein values, blood count, biochemical analysis, thyroid function tests, autoantibody levels, Bath Ankylosing Spondylitis Disease Activity Index. Results: Mean anti-thyroid peroxidase levels were significant at a high level in ankylosing spondylitis patients receiving anti-tumour necrosis factor compared to patients receiving nonsteroid anti-inflammatory drugs (p= 0.009).Negative correlation was found between thyrotropin-stimulating hormone and C-reactive protein(r=-0,264, p=0,023).A positive correlation was found between free thyroxine and C-reactive protein (r=0,436,p=0,009), anti-thyroid peroxidase positivity and erythrocyte sedimentation rate (r=0,384,p=0,001),anti-thyroglobulin positivity and erythrocyte sedimentation rates and C-reactive protein(r=0,329,r=0,265,p=0,004,p=0,022). Conclusion: The frequency of thyroid disorder in patients with AS receiving anti-TNF α was lower compared to patients receiving nonsteroid anti-inflammatory drugs. We can consider that anti-TNF α treatment could reduce autoimmune thyroid diseases and had a positive effect on thyroid functions.