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Background Cytokine genotypes have previously been studied in patients undergoing solid organ transplantation; certain polymorphisms have been implicated in the development of acute rejection (AR) and graft dysfunction (GD). Allograft outcomes determined, in part, by alloimmune responses is mainly mediated by T-cell responses, activated and driven by cytokines. Interleukin-4 (IL-4) is one such cytokine, which exerts its biological effects through binding to the IL-4 receptor (IL-4R) complex on target cells. In the present study, we investigated whether polymorphisms of the IL-4 and/or IL-4R gene were associated with susceptibility to acute AR and GD after kidney transplantation. Methods We analyzed 2 single nucleotide polymorphism (SNPs) of IL-4 (rs2243250 and rs2070874) and 3 SNPs of IL-4R (rs1801275, rs2107356, and rs1805010) in 344 kidney transplant recipients. These patients included 62 of whom had developed AR and 215 of whom had GD in 1 year after kidney transplantation. Results The AR group included 62 patients (45 men and 17 women). There was a statistically significant difference in the male-to-female ratio and the use of tacrolimus in the AR group. The GD group included 215 patients. Patients who developed GD were more likely to be older and have an underlying cause of end-stage renal disease that was unknown compared with patients who did not have GD, the cause of which was typically known. Among the SNPs examined, 1 of the SNPs in the IL-4R gene (ie, rs1801275) showed a statistical association with AR (co-dominant model, P = .061; dominant model, P = .019; and log-addictive model, P = .029). In addition, 1 of the IL-4R SNPs (ie, rs2107356) was statistically associated with GD (dominant model, P = .034). No significant difference in the IL-4 genotype was observed between the AR/GD and non-AR/non-GD subjects. Conclusions One IL-4R gene polymorphism (rs1801275) was associated with AR. In addition, a separate IL-4R SNP (rs2107356) was statistically associated with GD after kidney transplantation.

Bone morphogenetic proteins (BMP) belong to the transforming growth factor beta superfamily of proteins. This study was performed to evaluate the association of BMP gene polymorphisms with acute renal allograft rejection (AR) and graft dysfunction (GD) in Koreans.Three hundred thirty-one patients who had kidney transplantation procedures were recruited. Transplantation outcomes were determined in terms of AR and GD criteria. We selected six single nucleotide polymorphisms (SNPs): rs1979855 (5' near gene), rs1049007 (Ser87Ser), rs235767 (intron), rs1005464 (intron), rs235768 (Arg190Ser), and rs3178250 (3; untranslated region).Among the six SNPs tested, the rs235767, rs1005464, and rs3178250 SNPs were significantly associated with AR (P .05). The rs1049007 and rs235768 SNPs also showed an association with GD (P .05).In conclusion, these results suggest that the BMP2 gene polymorphism may be related to the development of AR and GD in kidney transplant recipients.

Background Acute rejection (AR) after kidney transplantation resulting from alloimmune responses has a negative effect on graft survival. AR is mainly caused by T-cell immune responses activated by cytokines, including interleukin (IL)-2, -4, and -7. Many reports have shown that single nucleotide polymorphisms (SNPs) of these cytokines can affect the occurrence of AR. IL-3, which is secreted by activated T cells, can mediate AR. Our study sought to investigate the association between SNPs of the IL3 gene and the occurrence of an AR episode (ARE). Methods We analyzed 3 SNPs of IL3 (rs181781, rs2073506, and rs40401) among 330 renal recipients, 60 of whom had developed an ARE. SNPs of the IL3 gene, including 1 exonic SNP (rs40401) and 2 regulatory thought to be promoter SNPs (rs181781 and rs2073506). Results The genotypes of 60 ARE subjects and the 270 patients without AR demonstrated a significant relationship between genotype frequencies and the SNPs. The occurrence of an ARE was associated with rs181781 (P = .041, dominant model), rs2073506 (P = .009, codominant 1 model; P = .003, dominant model), and rs40401 (P = .014, recessive model). Among haplotypes, AAT showed a significant association with ARE. (P = .0033). Conclusion Our results suggest that IL3 gene polymorphisms were associated with this event.

This study was conducted to examine the effect of Hwangto, Illite, and any other disease resistant materials as dietary supplements on the growth performance and immunity for growing period with 30 Hanwoo male calves weaned 75days in age. Feeding trial was conducted with 6 treatments(five heads/treatment), which were T1(Control), T2(Control + 2% Hwangto), T3(Control + 2% Illite), T4(Control + 0.04% Oligosacharides), T5(Control + 2% Charcoal powder) and T6(Control + 0.1% Chromium picolinate) for 120 days from three to seven months in age. The results obtained are summarized as follows; During the experimental period, average daily gains were 0.82 to 0.92kg, and were high in the order of T3, T6, T4, T5, T2 and T1. Especially the growth rate of calves for growing period was higher in Illite, chromium-picolinate and oligo- sacharides feeding groups than in any other groups. Average daily intakes and intake ratio to body weight of concentrates for 120days were 3.91 to 4.15kg(average 4.03kg) and 3.10 to 3.31% (average 3.21%), respectively. TDN intakes per kilogram gains were 3.20 to 3.57kg(average 3.35kg) and were smaller in the order of T5, T3, T6, T4, T2 and T1, respectively. Density of IgG in serum of calves measured by the IgG SDID Kit was 10.2 to 11.6mg/, and especially increase rate of IgG for experimental period was high in T3 and T5 by 6.9 and 2.8%, respectively. But incidence of disease was not found to be different by treatments. According to the above results it may be concluded that Illite is a sort of clay minerals increased the growth rate, feed efficiency and immunity of early weaned calves for growing period, but was not in unprocessed Hwangto.

Background The cold-inducible RNA-binding protein (CIRP) is 18 kDa protein of the glycine-rich RNA binding protein (GRP) family, and these proteins function as RNA chaperones to facilitate translation. Extracellular CIRP is a recently identified endogenous proinflammatory mediator and damage-associated molecular pattern molecules (DAMP) that triggers inflammatory responses in sepsis and inflammatory bowel disease. Objectives This study was planned to investigate the relationship between CIRP and rheumatoid arthritis. Methods Peripheral blood and synovial fluid were collected from 15 patients with rheumatoid arthritis (RA) and 16 patients with osteoarthritis (OA). The concentration of CIRP was measured by sandwich Enzyme-Linked Immunosorbent Assay (ELISA). Results The concentration of serum CIRP was significantly elevated in RA patients group (RA patients=26.39±10.48 pg/ml, OA patients=17.14±7.24 pg/ml, p=0.009). Furthermore, the RA patients group showed significantly higher CIRP concentration than the OA patients group in synovial fluid (153.56±108.93 pg/ml vs. 23.63±16.18 pg/ml, p The mean concentration of synovial fluid CIRP was significantly higher than that of serum in RA patients group (Serum concentration=26.39±10.48 pg/ml, Synovial fluid=153.56±108.93 pg/ml, p DAS28-ESR and DAS28-CRP were positively correlated with synovial fluid concentration of CIRP (DAS28-ESR: r=0.582, p=0.023, DAS28-CRP: r=0.541, p=0.037, by correlation analysis). Conclusions The serum and synovial concentration of CIRP in RA patients was increased compared to OA patients. Also synovial concentration of CIRP in RA patients correlated well with the disease activity, i.e. the DAS28-ESR/CRP. Based on these results, the CIRP mediates the inflammation and is potential marker for synovial inflammation. References Qiang X, Yang WL, Wu R, Zhou M, Jacob A, Dong W, Kuncewitch M, Ji Y, Yang H, Wang H, Fujita J, Nicastro J, Coppa GF, Tracey KJ, Wang P (2013) Cold-inducible RNA-binding protein (CIRP) triggers inflammatory responses in hemorrhagic shock and sepsis. Nat Med 19:1489–95. Nishiyama H, Higashitsuji H, Yokoi H, Itoh K, Danno S, Matsuda T, Fujita J (1997) Cloning and characterization of human CIRP (cold-inducible RNA-binding protein) cDNA and chromosomal assignment of the gene. Gene 204:115–20. Nishiyama H, Danno S, Kaneko Y, Itoh K, Yokoi H, Fukumoto M, Okuno H, Millan JL, Matsuda T, Yoshida O, Fujita J (1998) Decreased expression of cold-inducible RNA-binding protein (CIRP) in male germ cells at elevated temperature. Am. J. Pathol 152:289–96. Nishiyama H, Xue JH, Sato T, Fukuyama H, Mizuno N, Houtani T, Sugimoto T, Fujita J (1998) Diurnal change of the cold-inducible RNA-binding protein (Cirp) expression in mouse brain. Biochem. Biophys. Res. Commun 245:534–8. Disclosure of Interest None declared

Background Tacrolimus (TAC) is used as a disease modifying antirheumatic drug (DMARD) in rheumatoid arthritis (RA). Combination of TAC with methotrexate (MTX) has been shown to be effective and safe in RA, yet comparative clinical studies are insufficient to date. Objectives To investigate the efficacy and safety of TAC versus leflunomide (LEF) when combined with MTX in RA patients Methods The PLATINUM-X study is a 24-week multi-center, double-blinded randomized non-inferior (phase 4) study targeting RA patients with moderate to active disease activity (DAS28(ESR) >3.2) that had a inadequate clinical response to MTX. Patients were randomized into the TAC or LEF (add-on) group. The initial daily dose of TAC and LEF were 1.5 mg and 10 mg, respectively for 4 weeks, then increased to 3 mg, 20 mg until the end of the study. Clinical (DAS28, Korean (K-) HAQ) and laboratory data were obtained at 4, 8, 16, and 24 weeks. The primary endpoint was to compare DAS28 in both groups at 24 weeks. Non-Inferiorly was established if the upper limit of the 95% confidence interval (CI) for DAS28 difference was less than 0.7. Secondary endpoint variables included DAS28, K-HAQ as well as swollen/tender joint counts at each visit. Safety profiles were assessed at each patient9s visit. The per protocol set was used for statistical analysis. Results Eighty seven patients were screened in 9 centers, and 75 patents were randomized into 2 groups. Baseline demographics of patients were comparable with baseline DAS28 being 4.54 ± 0.61 and 4.91 ± 1.01 in the TAC and LEF group, respectively. TAC was non-inferior to LEF in terms of reduction of DAS28 at 24 weeks (mean difference -0.0565, CI -0.6513, 0.5384). Improvement of DAS28, K-HAQ throughout each visit was not statistically different between the 2 groups. Yet, reduction in tender joint count was significant in the TAC group compared with LEF (-5.97 ± 4.89 versus -3.08 ± 5.55 at 24 weeks, p =0.0145). There was more numbers of adverse events (AE) or adverse drug reactions in the LEF group (89 in LEF and 64 in TAC); 6 patients presented transaminitis in the LEF group compared with 2 in TAC. Conclusions The efficacy of TAC plus MTX is non-inferior to LEF combined the MTX, with reasonable safety profile in RA patients with moderate to active disease activity (cris.nih.go.kr KCT0000781). References Tacrolimus in RA patients receiving concomitant MTX. Kremer et al. Arthritis Rheum 2003 Efficacy and safety of tacrolimus in patients with RA. Youcum et al. Arthritis Rheum 2003 Disclosure of Interest None declared

Background Behcet9s disease (BD) is a multisystemic vasculitis of unknown etiology. Cardiovascular (CV) involvement has been reported in 1–6% of BD patients. In case of CV involvement, prognosis is poor. The incidence of the CV involvement in Korean patients with BD is not clearly documented. Objectives The aim of this study is to evaluate the CV findings in Korean patients with BD and to prevent or lower mortality and morbidity through early diagnosis and early treatment. Methods We performed Ankle Brachial Index (ABI), Pulse wave velocity (PWV) and Echocardiographic screening in 81 patients with BD who fulfilled the International Study Group criteria. PWV was calculated as the brachial-ankle path length divided by the brachial-ankle transit time (baPWV). We compared the result between two groups of patients with BD. Two groups are patients who have been treated with immunosuppressant agent and without immunosuppressant agent. The patients of former group are patients who have been suffered from severe complication or refractory disease. Results Fifty-nine (72.8%) patients were female. Mean age was 50.6 ± 2.5 years old. Mean age at diagnosis was 40.5 ± 2.3 years old and disease duration was 10.2 ± 1.5 years. Mean ABI was 1.10 ± 0.03. There was no significant difference between with and without immunosuppressant agent treated group. (1.11 ± 0.03 vs. 1.09 ± 0.03, P=0.167). The number of patients with abnormal ABI was 7 (17.5%) vs. 6 (14.6%), P=0.781. Mean PWV (m/sec) was 14.0 ± 0.67. There was no significant difference between two groups (13.8 ± 1.09 vs. 14.2 ± 0.83, P=0.144). But the immunosuppressant treated group had more patients with elevated levels of PWV (>12.0 m/sec) compared to non-immunosuppressant treated group [n =34 (82.9%) vs. n=25 (62.5%), P=0.024]. Echocardiography was done. Left ventricular ejection fraction (%) (64.9 ± 1.5 vs. 63.7 ± 1.7, P=0.254), Left ventricular mass index (g/m 2 ) (74.9 ± 5.0 vs 74.1 ± 5.7, P=0.970), E/E9 ratio (8.35 ± 0.9 vs 9.17 ± 1.0, P=0.228), Tricuspid regurgitating velocity (TRV) max (m/sec) (2.35 ± 0.09 vs 2.39 ± 0.11, P=0.572) were similar in both groups. We detected 39 minimal mitral, aortic and tricuspid valve insufficiencies. One patient showed suspiciously resting pulmonary hypertension (TRVmax – 3.3m/sec). In two patients, dilatation of ascending aorta was showed. There was aortic arch mass in one patient. Conclusions The CV involvement in BD can be a cause of death. In this screening study, asymptomatic patients showed many CV manifestations. And in 59 (72.8%) patients, PWV was elevated. Arterial stiffness can be a surrogate marker of CV disease. Larger study about CV manifestations in BD must be planned. And during treatment of patients with BD, CV screening study needs to be considered. References H L Chang, S K Kim, S S Lee, M Y Rhee. Arterial stiffness in Behcet9s disease: increased regional pulse wave velocity values. Ann Rheum Dis. 2006 Mar; 65(3): 415–416. Geri G, Wechsler B, Huong DLT, et al. Spectrum of cardiac lesions in Behcet disease: a series of 52 patients and review of literature. Medicine (Baltimore). 2012 Jan;91(1):25–34. C.A. Caldas, E.F. Borba, L.A. Bortolotto, D.M. Medeiros, E. Bonfa and C.R. Goncalves. Increased arterial stiffness assessed by pulse wave velocity in Behcet9s disease and its association with the lipid profile. J Eur Acad Dermatol Venereol. 2013 Apr;27(4):454–9 Disclosure of Interest None declared

Background Myositis-specific antibodies in patients with inflammatory myopathies are known to be associated with various clinical manifestations, classifications and diagnosis. Among them, recently found anti-transcriptional intermediary factor 1 (TIF1) α, β, or γ antibodies, has been reported to be associated with dermatomyositis (DM) accompanied by cancer. Objectives Although previous studies have evaluated the association of the antibodies in serum and clinical subtypes, the information about the target antigen is insufficient. The purpose of this study was to confirm the overexpression of TIF1s in the muscle and skin tissues of patients with inflammatory myopathies. Methods From February 2004 to November 2014, skin and muscle biopsies were performed on 45 patients diagnosed with dermatomyositis and polymyositis. We stained skin and muscle tissue by immunohistochemistry using anti-TIF1α, β, or γ and compared with the results of healthy control. We analyzed the association between the clinical manifestations and protein expression in each tissue. Results When compared with the control group, any antigens showed no significant overexpression in the muscle. However, TIF1α showed higher positive rate in the skin of DM (12/15 [80%]) than in the skin of healthy control (0/7 [0%]) (p=0.001). TIF1γ expression was higher in the muscle of patients with DM while there was no expression in the muscle of healthy controls (DM, 8/19 [80%] vs. healthy control 0/7 [0%], p=0.039). In the tissues of inflammatory myopathies, TIF1α and TIF1γ demonstrated higher positive rates in the skin than in the muscle (TIF1α, muscle, 4/35 [11%] vs. skin, 12/15 [80%], p Analyzing the association with TIF1s expression and cancer, there was no significant difference in the positive rate of TIF1α or γ in the muscle or skin between the myositis patient with or without cancer. Conclusions TIF1α was expressed more in the skin of DM patients than that in that of control group and TIF1γ in the muscle of DM patients than in that of control. The expression of TIF1α in the skin and TIF1γ in the muscle of cancer associated DM was not higher than those of DM without cancer. Thus the expression levels of TIF1α in the skin and TIF1γ in the muscle may be associated with myositis rather than with cancer. References Hoshino K, et al. Anti-MDA5 and anti-TIF1-gamma antibodies have clinical significance for patients with dermatomyositis. Rheumatology (Oxford) 2010;49(9):1726–1733. Fiorentino D. Casciola-Rosen L, Autoantibodies to transcription intermediary factor 1 in dermatomyositis shed insight into the cancer-myositis connection. Arthritis Rheum 2012;64(2):346–349. Disclosure of Interest None declared

Background Long-term use of glucocorticoids (GC) is problematic for patients with increased risk for vertebral fractures, especially those with rheumatoid arthritis (RA). Thus, prevention of GC-induced osteoporosis (GIOP) with bisphosphonates has now become an important strategy for reducing morbidity in RA patients. Ibandronate is indicated for the treatment and prevention of osteoporosis in postmenopausal women. However, evidence for ibandronate in GIOP prevention has been insufficient to date. Objectives To investigate efficacy of monthly ibandronate in RA women with reduced bone mineral density receiving long-term GCs Methods Female RA patients meeting the 1987 ACR classification criteria were enrolled in this 48-week double-blinded randomized placebo-controlled trial (clinicaltrials.gov NCT01287533). Patients that had taken GC (prednisolone-equivalent dose of ≥5 mg) for 3 or more consecutive months and fulfilling L1-4 T-score of Results Two hundred eleven patients from 13 centers nationwide participated in this study. One hundred sixty seven patients were randomized. The mean age of patients in the ibandronate and placebo group were 54.5 and 55.1 years, respectively. Baseline characteristics were not dissimilar between the 2 groups. The result of the primary endpoint is shown below (table). Serum C-terminal telopeptide was significantly reduced at 48 weeks in the ibandronate group. There was no incident of fracture in both groups during the study period. Safety profiles including adverse events were comparable between the 2 groups. Conclusions Monthly ibandronate for 48 weeks is effective in reducing bone loss in RA women on long-term glucocorticoids. Longer follow-up studies would be needed to investigate the effect on fracture prevention. Acknowledgements We would like to thank CTC bio for manufacturing the placebo, and Mr. Je-suk Kim for aiding statistical analyses. Disclosure of Interest None declared

Background B7-H3 (B7-H3), newly identified B7 family member, has functional duality as a T-cell costimulator or coinhibitor for fine-tuning T-cell mediated immune responses. Given that B7-H3 expression is enhanced in human monocyte and dendritic cells by inflammatory cytokines, it has been suggested their potential inmmunoregulatory function at sites of inflammation. Monocytes play a crucial role in the pathophysiology of various inflammatory disorders including autoimmune diseases. However, the immunological role of B7-H3 in rheumatoid arthritis (RA) has not been defined. Objectives We aimed to investigate the possible roles of B7-H3 on monocyte in pathogenesis of RA. Methods Synovial fluid and peripheral blood from 33 RA patients and peripheral blood from 19 healthy controls (HCs) were obtained. The expression of B7-H3 on monocytes in RA patients and HCs were analyzed using flow cytometic analysis and quantitative RT-PCR. Purified synovial and peripheral monocytes were used for immunoblotting and intracellular flow cytometic analysis to investigate the distinct expression and localization of two isoforms of B7-H3. B7-H3-expressing THP-1 cells were transfected with B7-H3-specific siRNA and subjected to coculture assay with CD4 T cells. Proliferation and cytokine production of the cocultured T cells were assessed by CFSE dilution and ELISA, respectively. Clinical relevance of enhanced B7-H3 expression in RA was tested by comparison with clinical parameters and disease severity in the patients and with synovial cytokine levels measured by multiplex cytokine assay. Results Synovial monocytes but not peripheral monocytes in RA patients predominantly induce surface B7-H3 expression. The induced B7-H3 is exclusively 4Ig isoform, whereas 2Ig B7-H3 isoform constitutively express the intracytoplasmic region both peripheral and synovial monocytes. The B7-H3 knockdown experiments provided the evidence that 4Ig B7-H3 isoform has an inhibitory effect on interferon-gamma (IFN-γ) production of CD4 memory cells. Moreover, the expression level of 4Ig B7-H3 on synovial monocytes was inversely correlated with clinical parameters such as C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and Disease Activity Score in 28 joints (DAS28). Conclusions Our findings demonstrate that activation-induced B7-H3 expression on synovial monocytes has the potential to inhibit Th1-mediated immune response and immunomodulatory role affecting pathogenesis of RA. Disclosure of Interest None declared

Toll-like receptors are a recently identified group of receptors that are an important component of the immune system. Thus far, ten different receptors have been identified and have unique tissue distribution, ligand binding properties, cellular signaling pathways, and cytokine production profiles. Importantly, ligand binding has been shown to regulate both the adaptive and host immune response; thus, defects in this pathway have the potential to lead to increased susceptibility to infection and inflammatory dysregulation. In this article, the burgeoning literature pertinent to the discovery and signaling mechanisms are reviewed in addition to the discussion of the important role Toll-like receptors may play in the pathogenesis of numerous skin diseases. Learning objective At the completion of this learning activity, participants should be familiar with the role of Toll-like receptors in host defenses and their relevance to dermatologic diseases.

Background Non-synonymous ERAP1 single nucleotide polymorphisms (SNPs), rs10050860 and rs17482078, were found to be associated with Behcet9s disease (BD) by a recessive model in Turkish patients [1]. Objectives To investigate the association between ERAP1 SNPs and BD in Korean patients. Methods DNA samples were obtained from 391 patients who met the International Study Group criteria for BD and from 800 age- and sex-matched healthy controls. Nineteen tag-SNPs (rs27980, rs27582, rs27038, rs149481, rs149173, rs27039, rs27043, rs42398, rs10050860, rs151928, rs13170045, rs27710, rs27529, rs25866, rs26652, rs26498, rs27045, rs10062964, rs28050) in and within 1kb from ERAP1 were selected for genotyping. Results Allele-based analysis failed to detect any significant associations between 19 SNPs and BD after correction for multiple testing. In genotype-based analysis, only an intronic variant rs27043 was associated with BD by a dominant model (for AG+GG genotypes, 85.8% in patients vs. 72.4% in controls; OR [95% CI] =2.29 [1.65-3.20], p=6.2x10 –7 , corrected p=1.18x10 -5 ). This association was significant in patients with uveitis (84.4% vs. 72.4%; OR [95% CI] =2.06 [1.28-3.29], p=0.002, corrected p=0.038) as well as in patients without uveitis (85.4% vs. 72.4%, OR [95% CI] =2.23 [1.46-3.41], p=0.0001, corrected p=0.0019) compared to controls. The non-synonymous rs10050860 found to be associated with BD in a Turkish GWAS did not show any statistical significance (minor allele frequencies of 4.7% in patients and 4.9% in controls). Conclusions An intronic variant rs27043 was associated with BD notably by a dominant model in a Korean population. Efforts to impute genotypes using a reference panel from Korean/Asian HapMap data are underway to fully examine non-synonymous SNPs in strong linkage disequilibrium with rs27043 and their haplotype effects. References Kirino Y, Bertsias G, Ishigatsubo Y, et al. Genome-wide association analysis identifies new susceptibility loci for Behcet9s disease and epistasis between HLA-B*51 and ERAP1. Nat Genet 2013; 45: 202-7. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.3438

Background Interleukin-7 (IL-7), a member of the common gamma-chain cytokine family, plays a crucial role in T cell development, which induces T cell survival, proliferation, differentiation in mature naive and memory T cells. IL-7 is expressed by stromal cells, epithelial cells, and fibroblasts. IL-7 is highly expressed in synovial tissue (ST) of patients with rheumatoid arthritis (RA) and its expression level correlates with the disease activity. Although IL-7Rα is mainly expressed in T cells, IL-7 receptor α (IL-7Rα) is able to be expressed in CD19-positive B cells and monocytes of synovial fluid mononuclear cells (SFMC) in RA patients. IL-7 promotes the secretion of osteoclastogenic factors, such as M-CSF and RANKL, in T cells, and eventually induces osteoclastogenesis. In contrast, It has been shown that IL-7α-deficient mice promote osteoclastogenesis and IL-7 treatment inhibits the osteoclastogenesis in vitro. Thus, the role of IL-7 involved in osteoclastogenesis is still unclear. Objectives In order to resolve this discrepancy, we investigated the effect of IL-7 on the differentiation of monocytes into osteoclasts. Methods First, we examined the expression level of IL-7Rα in several subsets from PBMC and SFMC of RA patients as well as healthy subjects. Second, we determined the direct role of IL-7 in osteoclast differentiation of monocytes expressing IL-7Rα in vitro. Results As results, we found that IL-7Rα was highly expressed in monocytes from RA SFMC compared to health PBMC, and its expression was confined to specific monocyte-subsets, intermediate monocyte (CD14+CD16+) and inflammatory monocyte (CD14-CD16++). Furthermore, IL-7 induced osteoclastogenesis from RA monocytes in the presence or absence of M-CSF and RANKL, and also promoted the osteoclastogenesis in earlier than done by M-CSF and RANKL. Conclusions These finding suggest that IL-7 may directly affect monocyte differentiation in osteoclast cells in inflammatory condition, such as synovial fluid of RA, and blocking IL-7 or IL-7Rα as therapy may give a new pathway to treatment of bone erosion in patient with RA. Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.1500

Background CT-P13 is a biosimilar product of infliximab (INX). Data up to week 30 has been reported at EULAR 2012. 1 Objectives To assess the PK, efficacy and safety of CT-P13 in patients with active AS up to week 54 and to compare this with INX, also in relation to the formation of anti-drug antibodies (ADAs). Methods Patients with active AS (1984 modified NY criteria) were randomised (1:1) to receive either CT-P13 (5mg/kg) or INX (5mg/kg) at weeks 0, 2, 6 and then every 8 weeks up to week 54. Results Of 250 patients randomised at baseline, 213 patients were treated up to week 54. C max of CT-P13 and INX were shown to be equivalent, since 90% CIs for the ratio of geometric means were within 80–125% at all doses (CT-P13, 128.1µg/mL–172.2µg/mL; INX, 123.0µg/mL–176.7µg/mL). At week 54, the proportion of patients testing positive for ADAs was comparable between CT-P13 and INX (22.9% [25/109] vs 26.7% [28/105]). ADAs had similar effects on PKs in both groups. Patients with negative ADA results had higher C max values (CT-P13, 134.5µg/mL–177.2µg/mL; INX, 131.9µg/mL–177.4µg/mL) compared with patients with positive results (CT-P13, 101.8µg/mL–160.4µg/mL; INX, 104.0µg/mL–175.2µg/mL). At week 54, ASAS40 and ASAS partial remission were comparable between groups (CT-P13, 54.7% and 19.8%; INX, 49.1% and 17.6%, respectively). More patients with negative ADA results achieved ASAS40 responses (CT-P13, 61.0%; IFX, 54.7%) compared with patients with positive results (CT-P13, 37.9%; IFX, 36.4%). The safety profiles of CT-P13 and INX were also comparable (table). Active tuberculosis (TB) was reported in 3 patients (CT-P13, 2; INX, 1) and there were no malignancies. Conclusions CT-P13 has similar PK values and a clinical efficacy comparable to INX up to week 54. CT-P13 was well tolerated with a safety profile comparable to that of INX up to 54 weeks. ADAs seem to diminish the clinical response to both agents in some patients. References Park W et al. A randomised, double-blind, phase 1 study demonstrates equivalence in pharmacokinetics, safety and efficacy of CT-P13 and infliximab in patients with ankylosing spondylitis. Ann Rheum Dis 2012;71(Suppl 3):111. Disclosure of Interest W. Park Consultant for: CELLTRION Inc., J. Jaworski Grant/research support from: CELLTRION Inc., J. Brzezicki Grant/research support from: CELLTRION Inc., A. Gnylorybov Grant/research support from: CELLTRION Inc., V. Kadinov Grant/research support from: CELLTRION Inc., I. Goecke Sariego Grant/research support from: CELLTRION Inc., C. Abud-Mendoza Grant/research support from: CELLTRION Inc., W. J. Otero Escalante Grant/research support from: CELLTRION Inc., S. W. Kang Grant/research support from: CELLTRION Inc., D. Andersone Grant/research support from: CELLTRION Inc., F. Blanco Grant/research support from: CELLTRION Inc., D. H. Yoo Consultant for: CELLTRION Inc., C. Ahn Consultant for: CELLTRION Inc., Speakers bureau: CELLTRION Inc., H. U. Kim Employee of: CELLTRION Inc., J. Braun Consultant for: CELLTRION Inc., Speakers bureau: CELLTRION Inc.

Background Rheumatoid arthritis (RA) is a chronic inflammatory disease that results in localized and generalized bone loss. Osteoporosis and anemia are one of the most common complications seen in patients with RA. Objectives The aim of this study was to identify the relationship between inflammation, hemoglobin, BMD loss and fibroblast growth factor (FGF)-23 that is a phosphaturic hormone. Methods This study included 42 patients with rheumatoid arthritis fulfilling the new American college of Rheumatology/European League Against Rheumatism diagnostic criteria for rheumatoid arthritis and 26 healthy volunteers as controls. All were subjected to a complete blood count, rheumatoid factor and/or anti-cyclic citru-llinated peptide antibody. The concentration of FGF-23 was measured by ELISA (Immuntopics Inc., CA USA). Dual-energy x-ray absorptiometry was used to measure bone mineral density (BMD) of the lumbar spine (L1-L4) at the time of recruitment. Results In comparison with control group, RA patients had elevated FGF-23 (p=0.041) and ESR (p Conclusions In this study, Hemoglobin rather than inflammation is a negative predictor of plasma FGF-23 that is a potent regulator of the vitamin D and phosphate metabolism. Therefore, the association between ESR, anemia, FGF-23, and BMD loss in RA suggests a pathway between disease activity and BMD loss. Disclosure of Interest None Declared

It is sometimes difficult to distinguish infection from disease flare in febrile patients with systemic lupus erythematosus (SLE). Chill, leucocytosis, and increased C reactive protein (CRP) are known to be markers favouring infection.1 Procalcitonin (PCT) is the precursor of calcitonin and is synthesised in the parafollicular C cells of the thyroid. Serum PCT increases in severe bacterial or fungal infection but does not increase, or increases only slightly, in viral infections.2 3 The purpose of this study was to evaluate the usefulness of serum PCT in febrile episodes of patients with SLE to distinguish infection from disease flare. We prospectively enrolled 19 patients with SLE with fever who were admitted to Seoul National University Hospital between October 1998 and April 1999. Fever was defined as an axillary temperature over 38°C. Eleven patients with inactive SLE were enrolled as controls. Blood of the febrile lupus patients was withdrawn three times: on the day of the hospital visit, and after 24 hours and 48 hours. Another sample was withdrawn two weeks after defervescence to control infection or because of a decrease in lupus activity. At the detection of fever, blood cultures and other necessary cultures were performed with complete blood count, Westergren erythrocyte sedimentation rate (ESR), CRP, serum anti-dsDNA, complements …