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The purpose of this paper is to reflect on the historical narratives of popularization that have the Montoneros guerrilla as an object. The selection includes the books Operación Primicia, by Ceferino Reato (Sudamericana, 2010), Montoneros. Soldados de Peron, ¿Soldados de Massera? by Carlos Manfroni (Sudamericana, 2012), and Peron y la Triple A. Las 20 advertencias a Montoneros, by Sergio Bufano (Sudamericana, 2015). The paper contextualizes the works in the transition from the memory regime of the Kirchnerist governments to a struggle between narratives of the recent past marked by conservative revisionism, which generated the conditions for the irruption of the negationist discourse. Secondly, the text proposes to reconstruct the nuclei of meaning about Argentina in the 1970s, with the aim of reflecting on the production of historical common sense around Montoneros. El propósito de este trabajo es reflexionar sobre las narrativas históricas de divulgación que tienen como objeto a la guerrilla de Montoneros. El recorte incluye los libros Operación Primicia, de Ceferino Reato (Sudamericana, 2010), Montoneros. Soldados de Perón, ¿soldados de Massera?, de Carlos Manfroni (Sudamericana, 2012), y Perón y la Triple A. Las 20 advertencias a Montoneros, de Sergio Bufano (Sudamericana, 2015). La ponencia contextualiza las obras en el tránsito del régimen de memoria de los gobiernos kirchneristas, a una puja entre relatos del pasado reciente signada por el revisionismo conservador, que generó las condiciones para la irrupción del discurso negacionista. En segundo lugar, el texto plantea reconstruir los núcleos de sentido sobre la Argentina de los 70, con el objetivo de reflexionar sobre la producción de sentido común histórico alrededor de Montoneros.

Our country has achieved one of the highest life expectancies in the world, but this increase has not been matched by a similar growth in healthy life years. Maintaining people's functional capacity as they grow older is essential to provide quality of life for the years they have gained, acting on factors that are modifiable and therefore subject to intervention, such as frailty. This is why it was one of the prioritised interventions in the Prevention and Health Promotion Strategy of the Spanish NHS, which began in 2013. In the collective effort to meet the challenge of addressing frailty, the Autonomous Communities and Cities (AACC) have played a key role in implementing actions on the prevention of frailty and falls in the elderly. The 2019 evaluation of the 3 Consensus document on frailty and falls prevention among the elderly showed very positive data, with high or very high implementation in the AACC. The COVID-19 pandemic has also conditioned the approach to frailty. Frailty has been shown to be a risk factor for the development of illness and death, while COVID-19 has been shown to be a frailty generator. To facilitate the care of the elderly and the approach to frailty, the Ministry of Health, within the EPSP Frailty and Falls Working Group, developed the document of Recommendations for the approach to frailty in the health crisis situation generated by the COVID-19. The future of the approach to frailty in the EPSP is set out in the Roadmap for Addressing Frailty, developed in the framework of the EPSP and the ADVANTAGE Joint Action, which aims to contribute to making frailty a public health priority and to promote its approach at population and individual level, including prevention, early population detection and surveillance/monitoring, from an integrated and coordinated model of care, without forgetting the strengthening of training and research. In the current situation of tension in the socio-health system, which has manifested itself since the COVID-19 crisis, it is necessary to articulate how to continue to provide quality care, not only for the acute situation, but also for other situations such as frailty, care for chronic diseases, geriatric syndromes and physical, mental and social needs. A disability-free life expectancy must be based on the promotion of active and healthy ageing to ensure that older people maintain maximum functional capacity. To this end, it is essential to assess and prevent or reverse frailty, avoiding progression to disability and further overburdening of the system, individuals, families and society as a whole.Nuestro país ha alcanzado una de las esperanzas de vida más altas del mundo, pero este incremento no se ha acompañado de un crecimiento similar en años de vida en buena salud. Para dotar de calidad de vida los años ganados, es fundamental mantener la capacidad funcional de las personas a medida que envejecen, actuando en factores que son modificables y, por tanto, sujetos a intervención, como la fragilidad. Por ello, ésta fue una de las intervenciones priorizadas en la Estrategia de Promoción de la Salud y Prevención en el SNS (EPSP), que comenzó en el año 2013. En el esfuerzo colectivo por afrontar el reto del abordaje de la fragilidad, las comunidades y ciudades autónomas (CCAA) han tenido un papel fundamental en la implementación de acciones sobre la prevención de la fragilidad y caídas en la persona mayor. La evaluación de 2019 del Documento de consenso sobre prevención de fragilidad y caídas en la persona mayor, arrojó datos muy positivos, con una implementación alta o muy alta en las CCAA. La pandemia de COVID-19, ha condicionado también el abordaje de la fragilidad. Ésta se ha mostrado como un factor de riesgo para el desarrollo de enfermedad y fallecimiento, a la vez que la COVID-19 se ha manifestado como una enfermedad fragilizante. Para facilitar la atención de las personas mayores y el abordaje de la fragilidad desde el Ministerio de Sanidad, en el seno del Grupo de Trabajo de Fragilidad 2 y Caídas de la EPSP, se desarrolló el documento de Recomendaciones para el abordaje de la fragilidad en situación de crisis sanitaria generada por la COVID-19. El futuro del abordaje de la fragilidad en la EPSP está recogido en la Hoja de Ruta para el abordaje de la Fragilidad, elaborada en el marco de la EPSP y de la Acción Conjunta ADVANTAGE, mediante la que se propone contribuir a convertir la fragilidad en una prioridad de salud pública y a promocionar su abordaje a nivel poblacional e individual, incluyendo su prevención, detección precoz poblacional y vigilancia/monitorización, desde un modelo integrado y coordinado de cuidado, sin olvidar el fortalecimiento de la formación e investigación. En la situación actual de tensión del sistema socio-sanitario, que se ha manifestado a partir de la crisis por la COVID-19, es necesario articular cómo continuar prestando una atención de calidad, no solo a la situación aguda, sino también a otras situaciones como la fragilidad, la atención de las enfermedades crónicas, síndromes geriátricos y a las necesidades físicas, mentales y sociales. Una expectativa de vida libre de discapacidad debe basarse en la promoción de un envejecimiento activo y saludable que garantice que las personas mayores mantengan la máxima capacidad funcional. Para ello es fundamental evaluar y prevenir o revertir la fragilidad, evitando la progresión hacia la discapacidad y la mayor sobrecarga del sistema, las personas, familias y la sociedad en su conjunto.

[Importance] Clinical trials assessing the efficacy of IL-6 antagonists in patients hospitalized for COVID-19 have variously reported benefit, no effect, and harm., [Objective] To estimate the association between administration of IL-6 antagonists compared with usual care or placebo and 28-day all-cause mortality and other outcomes., [Data Sources] Trials were identified through systematic searches of electronic databases between October 2020 and January 2021. Searches were not restricted by trial status or language. Additional trials were identified through contact with experts., [Study Selection] Eligible trials randomly assigned patients hospitalized for COVID-19 to a group in whom IL-6 antagonists were administered and to a group in whom neither IL-6 antagonists nor any other immunomodulators except corticosteroids were administered. Among 72 potentially eligible trials, 27 (37.5%) met study selection criteria., [Data Extraction and Synthesis] In this prospective meta-analysis, risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool. Inconsistency among trial results was assessed using the I2 statistic. The primary analysis was an inverse variance–weighted fixed-effects meta-analysis of odds ratios (ORs) for 28-day all-cause mortality., [Main Outcomes and Measures] The primary outcome measure was all-cause mortality at 28 days after randomization. There were 9 secondary outcomes including progression to invasive mechanical ventilation or death and risk of secondary infection by 28 days., [Results] A total of 10 930 patients (median age, 61 years [range of medians, 52-68 years]; 3560 [33%] were women) participating in 27 trials were included. By 28 days, there were 1407 deaths among 6449 patients randomized to IL-6 antagonists and 1158 deaths among 4481 patients randomized to usual care or placebo (summary OR, 0.86 [95% CI, 0.79-0.95]; P = .003 based on a fixed-effects meta-analysis). This corresponds to an absolute mortality risk of 22% for IL-6 antagonists compared with an assumed mortality risk of 25% for usual care or placebo. The corresponding summary ORs were 0.83 (95% CI, 0.74-0.92; P, [Conclusions and Relevance] In this prospective meta-analysis of clinical trials of patients hospitalized for COVID-19, administration of IL-6 antagonists, compared with usual care or placebo, was associated with lower 28-day all-cause mortality., [Trial Registration] PROSPERO Identifier: CRD42021230155., Funding for administrative and communications support was provided by the World Health Organization.

BackgroundAnti-transcriptional intermediary factor 1γ (anti-TIF 1γ) antibody is robustly linked with cancer-associated dermatomyositis (DM) in adults, but its specificity varies widely between series. TIF 1γ can act either as a tumor promoter or suppressor and may behave as an autoantigen.ObjectivesInvestigate the association between anti-TIF 1γ antibody positivity and development of neoplasia.MethodsA retrospective chart review was conducted among patients with positive anti-TIF 1γ antibodies detected by immunoblot from March 2019 to December 2021 in three tertiary hospitals. Demographic variables, creatine kinase (CK) values, other autoantibodies, associated autoimmune diseases (AIDs) and existence or not of a cancer diagnosis were analyzed. To rule out malignancy, patients had to present a PET-CT scan without pathological findings or a chest CT scan, a gynecological study and a digestive study without alterations. A descriptive statistical analysis was performed.Results29 patients with anti-TIF 1γ antibodies were analyzed, 82.7% women, with a mean age of 61 years (31-96 years).The reason for requesting this antibody was: clinical features suggestive of DM in 10 patients (34.5%), muscle weakness in 9 (31%), interstitial lung disease (ILD) in 5 (17.2%), persistent CK elevation in 3 (10.3%), constitutional syndrome in 1 (3.5%) and antiphospholipid syndrome in 1 patient (3.5%). The mean time from symptoms onset to the detection of anti-TIF 1γ was 14 months (0-60 months).10 patients (34.5%) had a diagnosis of DM; 4 patients (13.8%) systemic lupus erythematosus (SLE); one (3.5%) had a SLE/DM overlap syndrome; one patient (3.5%) subacute cutaneous lupus; one (3.5%) was diagnosed with diffuse systemic sclerosis; one patient (3.5%) limited systemic sclerosis; one patient (3.5%) antiphospholipid syndrome; one patient (3.5%) HLA-B27+ spondyloarthritis and 9 patients (31%) had no associated AIS.5 patients (17.2%) showed ILD with different patterns: UIP (n=2), NSIP (n=2) and COP (n=1). Only 9 patients (31%) had elevated CK levels at the time of antibody determination.10 patients (34.5%) were diagnosed with cancer: lung adenocarcinoma (n=2), small cell lung carcinoma (n=2), breast carcinoma (n=2), hepatocarcinoma (n=1), cervical cancer (n=1), ovarian carcinoma (n=1) and gallbladder adenocarcinoma (n=1). Of those, 7 patients (70%) had elevated CK levels and 6 (60%) had a diagnosis of DM. None of the patients diagnosed with cancer had ILD.In 4 patients (40%), the diagnosis of cancer was simultaneous with the diagnosis of anti-TIF 1γ antibodies; in 4 (40%), the diagnosis of the tumor preceded the finding of the antibodies; in the other 2 (20%), the finding of the antibodies preceded that of the tumor. 30-month survival after cancer diagnosis was 10%.In 17 patients (58.6%) no malignancy has been found so far in the annual cancer screening. In two patients (6.9%) no cancer screening was performed.ConclusionIn our study, 60% of patients with DM and anti-TIF 1γ presented neoplasia, a prevalence similar to that established in other series (60-80%). Furthermore, 21% of patients with antibodies and without DM were diagnosed with cancer, suggesting that anti-TIF 1γ antibodies could also be associated with neoplasia in patients without DM. Patients with ILD did not present cancer, supporting the observation of previous studies in which the presence of ILD is a marker of low risk for neoplasia in patients with DM. HyperCKemia might predict the association with neoplasia in patients with anti-TIF 1γ antibodies.References[1]De Vooght J, Vulsteke JB, De Haes P, Bossuyt X, Lories R, De Langhe E. Anti-TIF1-γ autoantibodies: warning lights of a tumour autoantigen. Rheumatology. 2020 Mar 1;59(3):469-477[2]Shimizu K, Kobayashi T, Kano M, Hamaguchi Y, Takehara K, Matsushita T. Anti-transcriptional intermediary factor 1-γ antibody as a biomarker in patients with dermatomyositis. J Dermatol. 2020 Jan;47(1):64-68[3]Masiak A, Kulczycka J, Czuszyńska Z, Zdrojewski Z. Clinical characteristics of patients with anti-TIF1-γ antibodies. Reumatologia. 2016;54(1):14-8Disclosure of InterestsNone declared

BackgroundThe EPISER study is the first Spanish epidemiological study that has confirmed the great burden of rheumatic diseases in the general population: they consume a large quantity of health resources (doctor visits, medical products) and imply a high social impact in terms of work absenteeism. Rheumatic diseases represent almost 30% of Primary Care medical consultations in Spain1,2. Electronic consultation could be an alternative response to the increase of this demand, both to make an early diagnosis and derivation and to improve communication with Primary Care physicians3,4.ObjectivesTo analyze the demand of Primary Care and its resolution through the electronic consultation system of the Rheumatology Department of a tertiary hospital.MethodsRetrospective descriptive study of the data collected in the request and information system (Sistema de Peticiones Electrónicas, SIPE) that supports electronic consultation between primary care physicians of the health area and the Rheumatology Department of a tertiary hospital, between July 2020 and May 2021.The following variables were collected: age, sex, reason for consultation, response time in days and destination (primary care/outpatient follow-up). Descriptive statistics were used to present the results.ResultsThe last 500 consecutive electronic consultations registered in the system, referring to 496 patients, were collected. Mean age was 59.5±17.7 years; 74.2% women. Mean response time was 2 days, median response time 1 day and range 0-45. The reasons for consultation (see Graph 1) were: osteoporosis assessment 55 (11%), treatment adjustment 50 (10%), appointment request 49 (9.8%), loss to follow-up 43 (8.6%), local-regional pathology assessment 39 (7.8%), infiltration request 28 (5, 6%), suspected rheumatoid arthritis 19 (3.8%), flare 18 (3.6%), suspected polymyalgia rheumatica or giant cell arteritis 16 (3.2%), COVID vaccine consultation 14 (2.8%), Raynaud’s phenomenon 13 (2.6%), monoarthritis assessment 12 (2.4%), assessment of polyarthritis 11 (2.2%), adverse effects of treatment 11 (2.2%), suspected spondyloarthritis 11 (2.2%), suspected psoriatic arthritis 8 (1, 6%), generalized pain 7 (1.4%), suspected Sjögren’s syndrome 5 (1%), suspected systemic lupus erythematosus 1 (0.2%), suspected other systemic autoimmune diseases 9 (1.8%), others 81 (16.2%). Fifty-seven and four % (287) of the patients required an appointment at the Rheumatology outpatient clinic and in 42.6% of the patients (213) the electronic consultation was successful, so it was not necessary to refer the patient to the hospital.ConclusionForty-two and six percent of the queries were resolved thanks to the electronic consultation system in an average of two days, otherwise that patients would have been referred to specialized care. The main reasons for consultation were osteoporosis assessment and clarification of doubts about the treatment of patients who were already being followed up by the Rheumatology Department.References[1]Carmona L, Ballina J, Gabriel R, Laffon A. The burden of musculoskeletal diseases in the general population of Spain: results from a national survey. Ann Rheum Dis 2001 -11;60(11):1040-1045.[2]Seoane-Mato D, Martínez Dubois C, Moreno Martínez MJ, Sánchez-Piedra C, Bustabad-Reyes S. Frequency of medical visits due to osteoarticular problems of the adult general population in Spain. EPISER2016 Study. Gac Sanit 2020 Sep - Oct;34(5):514-517.[3]Tejera Segura B, Bustabad S. A New Form of Communication Between Rheumatology and Primary Care: The Virtual Consultation. Reumatol Clin 2016 /01/01;12(1):11-14.[4]Pego-Reigosa JM, Peña-Gil C, Rodríguez-Lorenzo D, Altabás-González I, Pérez-Gómez N, Guzmán-Castro JH, et al. Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology. BMC Health Serv Res 2022 -01-12;22(1):60.Disclosure of InterestsNone declared

BackgroundSjögren syndrome (SS) is a chronic systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, which alters their function producing dryness of the mouth, eyes and other mucous membranes. The method used to quantify glandular hypofunction is by whole saliva flow stimulated and unstimulated (UWSF) [1], which takes between 5 and 15 minutes (min). The Saxon test [2], is another tool with the same objective but requires less time: 2 minutes. In the literature, we only have found one study that compares the Saxon test with other diagnostic methods although it is developed in patients without SS [3].ObjectivesTo compare the Saxon test and UWSF in a cohort of patients with suspected SS.MethodsIn a consecutive cohort of patients who attended the rheumatology department for suspected SS, UWSF was measured (mL/5 min) and the Saxon test (gr/2 min) was performed. The Index Reported by Patients with Sjögren’s Syndrome of the EULAR (ESSPRI) was collected too. This is a patient-reported index designed to assess the severity of patients’ symptoms (dryness, pain, somatic and mental fatigue) in SS through an average of single 0–10 numerical scale for each domain. To measure the UWSF, patients were asked to swallow their saliva before the start of the test and then to spit into a container for 5 min. The Saxon test was performed by calculating the difference in the weight of two pieces of sterile gauze that the patient chews for two minutes. An UWSF >0.25 mL/min, a Saxon test >2.75 g/2min and an ESSPRIs) was used to determine the correlation between both quantitative variables. The Chi-square test and the Gamma test were used in the comparisons between the groups (altered and normal) and the Mann-Whitney U in the comparisons of the quantitative variables based on the groups (altered and normal) previously defined. P values ResultsWe enrolled 70 patients (63 women/7 men), with a mean age ± standard deviation of 54±13 years. The medians (Me) and interquartile ranges (IQR) obtained were 1.500 (0.6750 – 2.5000) mL/5min for the UWSF, 2.405 (1.6775-3.4925) g/2min for the Saxon test, 6.67 (3.67-7.67) for ESSPRI and 7.00 (4.00-8.00) for ESSPRI-dryness score.A direct and significant correlation between the Saxon test and the UWSF (rs=0.325; P=0.006) was observed. Twenty-four patients (34.3%) presented an altered UWSF and forty-two patients (60%) had an altered Saxon test. When we analysed the intensity of the association between the different groups (altered/normal) of both variables, we observed a direct and significant association (Gamma value=0.583, P=0.010) between both tools.We also detected differences in the Saxon test between patients with altered UWSF (Me: 1.89 gr/2min.; IQR: 1.47-2.68) and those with normal UWSF (Me: 2.78 gr/2 min.; IQR: 1.77-3, 75) (P=0.029). Similarly, we observed significant differences in UWSF values between patients with altered Saxon test (Me: 1.30 mL/5min IQR: 0.50-2.13) and those with a normal Saxon test (Me: 2.00 mL/5min IQR: 1.5-2.88) (P=0.008).Regarding the ESSPRI, 42 (62,7%) patients presented an altered ESSPRI and 49 (73,1%) had an altered ESSPRI-dryness score. The group patients with ESSPRI-dryness score≥5 obtained significantly worse scores on the Saxon test (Me: 2.10 g/2min IQR: 1.58-3.07) and on the ESSPRI (Me:7.33 IQR:5.83-8.00) than the normal ESSPRI-dryness score group: Me:3.02 g/2min, IQR:2.20-3.84, on Saxon test (P=0.026); Me: 2.66 IQR:1, 00-4.08, on the ESSPRI (P=0.000).ConclusionIn patients with suspected SS, there is a direct and significant correlation between the Saxon test and the UWSF. Therefore, the Saxon test could be useful in the initial assessment of oral gland dysfunction, to save time and/or to select patients who require performing the UWSF.References[1]Martínez Ceballos MA et al. Rev. Colomb Reumatol.2020; 27 (S2):90-101.[2]Kohler PF & Winter ME. Arthr & Rheum. 1985;28(10):1128-32.[3]Minagi HO et al. J Oral Rehabil.2020;47:1550-6.Disclosure of InterestsNone declared

BackgroundNon-alcoholic fatty liver disease (NAFLD), the most common cause of liver disease, has a prevalence of about 25% in the general population. It increases mortality and comorbidity in patients with immune-mediated inflammatory diseases.ObjectivesThe main objective is to estimate the prevalence of NAFLD in three of the most common rheumatologic pathologies: rheumatoid arthritis (RA), axial spondyloarthritis (SpA-ax) and psoriatic arthritis (PsA). As a secondary objective, the possibility of finding associated risk factors in this group of subjects that may imply a higher risk of developing NAFLD is proposed.MethodsWe conducted a prospective single center observational study which included patients diagnosed with RA, EspA-ax, and PsA attended in the Rheumatology department of a tertiary hospital from January to April 2021. Anthropometric parameters, history related to cardiovascular risk factors and disease activity at the time of the visit were collected. Additionally, blood tests and transitional elastography were performed in all patients and the presence of NAFLD was assessed by the fatty liver index (FLI) scale. Different variables were considered to study their association with NAFLD.Results90 patients were included: 28 diagnosed with RA, 36 with EspA-ax and 26 with PAs. 41.1% were male (age range: 27-79 years). Patients with previous liver disease were excluded from the study. 22 (27.2%) patients had NAFLD measured by FLI ≥ 60. No significant differences in prevalence of hepatic steatosis were found between the 3 groups, although values were higher in patients with PsA.The variables that were significantly associated with the development of NAFLD in our cohort were: body mass index (BMI), abdominal perimeter, blood glucose level, HOMA-IR (Homeostatic Model Assessment for Insulin Resistance), HDL, TG, GGT, ferritin and uric acid levels. The rest of the variables studied did not show statistically significant differences (Table 1).Table 1.NO STEATOSIS (FLISTEATOSIS (FLI>60)n=22MeanStandard deviationMeanStandard deviationpBMI24,523,0030,292,77< 0,001Abdominal perimeter86,3410,01106,828,55< 0,001Age52,9312,8757,598,240,1185Glucose78,648,3790,6419,690,0002Insulin8,8310,1212,406,660,1302HOMA1,752,022,761,700,0500HbA1c5,350,455,690,640,0096Total cholesterol190,9829,46201,4138,530,1977HDL64,8817,6655,5911,550,0249LDL110,4428,45120,0036,210,2163TG81,1232,42128,5055,52< 0,001GPT25,8330,7337,1819,820,1116GOT27,2023,4926,8210,690,9413GGT20,8017,6649,9538,46< 0,001Creatinin0,750,190,840,180,0583Uric acid4,781,305,911,140,0007Ferritina121,75111,30208,00140,170,0050PCR2,894,552,672,330,8307ConclusionHepatic steatosis was present in 27.2% of patients vs 25% estimated prevalence in the general population. Identification of risk factors involved would allow better control of the comorbidities associated with NAFLD.The fact that the prevalence found in our sample population is so close to that of the general population, may be related to a good inflammatory control of the underlying disease.Further prospective studies with larger sample sizes are needed to find additional predictive factors for the development of NAFLD in this group of diseases.References[1]Bedogni, G., Bellentani, S., Miglioli, L., Masutti, F., Passalacqua, M., Castiglione, A. y Tiribelli, C. (2006). The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterology, 6: 33.[2]Brenner, C., Galluzzi, L., Kepp, O. y Kroemer, G. (2013). Decoding cell death signals in liver inflammation. Journal of Hepatology, 59(3): 583-594.[3]Byrne, C.D. y Targher, G. (2015). NAFLD: a multisystem disease. Journal of Hepatology, 62(1 Suppl): 47[4]Miele, L., Vallone, S., Cefalo, C., La Torre, G., Di Stasi, C., Vecchio, F.M., et al. (2009). Prevalence, characteristics and severity of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis. Journal of Hepatology, 51(4): 778-786.Disclosure of InterestsNone declared

BackgroundThe therapeutic management of Sjögren’s Syndrome remains challenging in clinical practice. Randomized clinical trials with rituximab (RTX) fail to submit primary outcomes; nevertheless, some case series show improvement with this treatment.ObjectivesTo evaluate the effectiveness of therapy with RTX in patients with primary Sjögren’s Syndrome (pSS).MethodsA retrospective chart review was conducted among patients with pSS who fulfilled 2002 AECG and 2016 ACR/EULAR criteria and had received RTX in the last 6 years. Patients with Sjögren’s Syndrome associated with other autoimmune diseases were not included. Clinical, serological and radiological variables were analyzed (prior and 6 months after RTX therapy). A descriptive statistical analysis was performed.Results18 patients were analyzed, 72.2% women, with a mean age of 60.9 years (36-83) and a mean duration of disease of 9.7 years (2-28).Reasons for treatment initiation were pulmonary involvement (n=5), renal involvement (n=4), arthritis (n=3), severe ocular/oral dryness (n=3), recurrent mumps (n=2) and autoimmune hepatitis with lymphadenopathy (n=1).Initial regimen was 2 doses of 1 g each administered 15 days apart. In 8 patients the dose was reduced in subsequent cycles to a single dose of 1 g or 500 mg. The mean number of cycles received was 3.2 (1 - 12).In 7 patients its administration persists as maintenance treatment every 6 months. In 5 patients, treatment was suspended because of clinical improvement/stability; in 2 it was stopped due to adverse effects (one for psychosis and the other for infusion reaction).; in 1 patient it was discontinued due to lack of efficacy in dryness; in 1 patient with pulmonary involvement, it was replaced by mycophenolate due to COVID-19 pandemic and clinical stability; in 1 patient it was suspended due to initiation of radiotherapy for epidermoid carcinoma of the scalp and 1 died of large cell neuroendocrine carcinoma.RTX was effective in 5 (100%) patients with pulmonary involvement (clinical, radiological and functional stability and/or improvement); in 4 (100%) patients with renal involvement (clinical and analytical improvement); in 3 (100%) patients with arthritis complete improvement was obtained; in 2 (100%) patients with recurrent mumps relapse was avoided; in 1 (100%) patient with autoimmune hepatitis and lymphadenopathy clinical and radiological improvement was obtained. Of the three patients with dryness: 1 experienced subjective clinical improvement, 1 reported improvement coinciding with the use of therapeutic contact lenses and 1 improved only at the beginning.Subjective improvement in asthenia was observed in 4 patients.Complement levels normalized in 4 of 5 patients with hypocomplementemia as well as in 4 of 4 with increased B2-microglobulin; 3 of 6 patients with hypergammaglobulinemia normalized IgG value. No changes were observed in the four patients who were rheumatoid factor positive.6 of 6 patients receiving corticosteroid treatment, reduced the dose by half and 1 achieved corticoid withdrawal.ConclusionThe observed data suggest that RTX may be useful in selected patients with pSS. Further research is needed to determine its efficacy.References[1]Chen YH, Wang XY, Jin X, Yang Z, Xu J. Rituximab Therapy for Primary Sjögren’s Syndrome. Front Pharmacol. 2021 Sep 2;12:731122[2]Ramos-Casals M, Brito-Zerón P, Bombardieri S, Bootsma H, De Vita S, Dörner T, et al. EULAR recommendations for the management of Sjögren’s syndrome with topical and systemic therapies. Ann Rheum Dis. 2020 Jan;79(1):3-18[3]Mavragani CP, Moutsopoulos HM. Sjögren’s syndrome: Old and new therapeutic targets. J Autoimmun. 2020 Jun;110:102364[4]Mariette X, Criswell LA. Primary Sjögren’s Syndrome. N Engl J Med. 2018 Mar 8;378(10):931-939Disclosure of InterestsNone declared

BackgroundThe classification system for Sjögren’s syndrome (SS) proposed by the American-European Consensus Group (AECG) and the revised diagrams proposed by the American College of Rheumatology (ACR) include an altered minor salivary gland biopsy (MSGB) or positive antiRo, among other findings. Thus, an altered MSGB is a particularly important finding in patients with autoantibody-negative. A retrospective cohort study showed that a positive biopsy result led to a definitive diagnosis in 80% of patients1.ObjectivesTo assess the usefulness of MSGB in the diagnosis of SS in anti-SSA/SSB (Ro/La) negative patients.MethodsRetrospective descriptive study in patients with suspected SS in which MSGB were collected according to standard clinical practice over a consecutive period (from September 2020 to May 2021) in the Rheumatology Department of a tertiary hospital.Patients were grouped according to the reason for requesting the biopsy: 1) Dry eye/oral syndrome (DEOS), 2) DEOS + altered Saxon/Schirmer, 3) DEOS + positive antinuclear antibodies (ANA+), 4) DEOS + (ANA+) + other serological alterations (hypergammaglobulinaemia, rheumatoid factor (RF), hypocomplementemia), 5) DEOS + extraglandular manifestations (EG) + (ANA+) +/- other serological alterations. The following variables were collected: age, sex, dry eye/oral syndrome, Raynaud’s phenomenon, EG manifestations (arthritis, autoimmune hepatitis, primary biliary cirrhosis, interstitial lung disease, pleuropericarditis, autoimmune chronic nephropathy suspected or tubulointerstitial nephritis and/or neurological manifestations), ANA, hypergammaglobulinaemia, RF, hypocomplementemia, Saxon and Schirmer tests and histological result of MSGB according to its Focus Score (FS); MSGB was considered altered when FS was ≥1. Descriptive analysis was performed (means and frequencies); Chi-square test was used to compare the reasons for requesting MSGB between patients with altered and unaltered results and to compare whether any of the groups (Groups 2-5) were more frequently associated with an altered MSGB compared to patients presenting only with dry syndrome (Group 1).ResultsSeventy-eight MSGB were collected. Mean age of patients was 55 years; 90% were women. ANA were present in 17% of patients with altered MSGB. DEOS was the suspected manifestation in 83% of patients, 13% had Raynaud’s phenomenon and 47% had some EG manifestation. MSGB was compatible with a diagnosis of SS (according to 2002/2016 classification criteria) in 28% of anti-SSA/SSB negative patients. Patients with dry syndrome and positive ANA (Group 3) were significantly associated with MSGB altered (Table 1).Table 1. Comparative table of patterns inidicated in the reasons for requesting a MSGB. *Not significant (NS).Reason for request (%)MSGB alteredMSGB unalteredpp vs drynessDEOS (50)19460.65DEOS + Saxon/Schirmer (38)15340.47NSDEOS + ANA (30)11270.67NSDEOS + ANA + others (8)640.410.05DEOS + EG + ANA (14)9150.69NSConclusionMSGB was compatible with a diagnosis of SS in 28% of anti-SSA/SSB negative patients. The data suggest that patients presenting with objectified dryness with Saxon and/or Schirmer test, as well as those with extraglandular manifestations and ANA+ and/or other serological alterations, are more likely to have a compatible with SS result on MSGB. Studies with larger numbers of patients are needed.References[1]Wicheta S, Van der Groen T, Faquin WC, August M. Minor Salivary Gland Biopsy-An Important Contributor to the Diagnosis of Sjögren Syndrome. J Oral Maxillofac Surg 2017 -12;75(12):2573-2578.Disclosure of InterestsNone declared