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The temporal relationship between the onset of skin psoriasis (Pso) and psoriatic arthritis (PsA) is a long and well-known feature of psoriatic disease. Psoriatic skin lesions emerge years before the development of musculoskeletal manifestations in nearly 75% of PsA patients. While skin and joint manifestations develop within one year in 15-20% of the patients, joint manifestations precede the skin involvement by a year or more in about 10% of the patients (1).

Background:Although psoriatic arthritis (PsA) may be seen at any decades, juvenil onset PsA is relatively rare. Moreover, there were no more data about clinical features, treatments, and course in juvenile PsA when they reached to adult age.Objectives:The objective of this study was to assess and compare demographic and clinical features for juvenile onset PsA and adult onset PsA.Methods:PsART-ID is a multicenter, international database, investigating the disease characteristic in real life (1). Briefly, demographic data, PsA subtypes, uveitis, enthesitis, dactylitis, Co-morbidities, disease activity scores (TJC, SJC, VAS-pain, VAS patients and physician global assessments, VAS-fatigue, BASDAI), and functional status (HAQ-DI, BASFI) were recorded. Psoriasis and PsA starting age were noted, as well. Patients were classified as juvenile PsA or juvenile PsO (under 18 years old). Results were compared regarding to juvenile versus adult onset age.Results:Overall, 1644 PsA patients were included to study, 301/1644 (18.3%) patients had juvenile onset psoriasis. Of 39/1644 (2.4%) patients had juvenile onset PsA, as well. As expected, juvenile onset PsA patients were younger, however PsA disease duration were longer than adult onset PsA patients. There were no any difference between demographic and clinical data, except BMI and enthesitis were less frequently at the juvenile onset PsA groups. Although, ever csDMARD using were similar between two groups, however, juvenile onset PsA patients were used more frequently bDMARDs.Table.Comparison of demographic and clinical characteristics of juvenile and adult-onset psoriatic arthritisJuvenile onsetAdult onsetpN (%)39 (2.4)1605 (97.6)Female Sex n (%)24 (61.5)1006 (62.7)0.884PsA beginning age mean (SD)13.3 ± 3.8542.3 ± 12.9Current age mean (SD)26.6 ±10.747.3 ±13.07Duration of psoriasis (years)17.10 ± 11.2614.75 ± 11.780.124Duration of psoriatic arthritis (years)13.5 ±115.06 ± 6.7Cigarette smoking (ever) n (%)15/38641/14940.72Education duration/year (mean,SD)10.09 ± 3.679.52 ± 4.810.464BMI (kg/m2) (mean, SD)24.5 ±5.128.3 ± 5.21Family history of PsO/PsA n (%)15 (38.5)559 (34.9)0.642Nail involvement n (%)18 (46.2)762 (47.5)0.864Dactilitis n (%)9 (23.7)367 (24)0.958Entesitis n (%)3 (7.9)384 (25.7)0.013Uveitis n (%)-13 (4.3)0.713Axial involvement (%)15 (38.5)464 (29)0.199Methotrexate36 (92.3)1348 (84)0.162Sulfasalazine17 (43.6)612 (38.1)0.488Leflunomide14 (35.9)379 (23.6)0.076Biologic DMARDs102 (33.9)358 (26.8)0.013Conclusion:Although psoriasis may be seen frequently in the juvenile age, juvenile onset PsA was not so frequent in our PsA cohort. Although, ever csDMARD using were similar between two groups, however, juvenile onset PsA patients were used bDMARDs more frequently.References:[1]Kalyoncu U et al. The Psoriatic Arthritis Registry of Turkey: results of a multicenter registry on 1081 patients. Rheumatology. 2017;56:279-286.Disclosure of Interests:Serpil ERGULU EŞMEN: None declared, Ozun Bayindir: None declared, esen kasapoğlu: None declared, Sibel Bakirci: None declared, Dilek Solmaz: None declared, Gezmiş Kimyon: None declared, Atalay Doğru: None declared, Ediz Dalkiliç: None declared, Cem Özişler: None declared, Meryem Can: None declared, Servet Akar: None declared, Emine Figen Tarhan: None declared, Sule Yavuz: None declared, Levent Kiliç: None declared, Orhan Küçükşahin: None declared, Ahmet Omma: None declared, Emel Gönüllü: None declared, Fatih Yildiz: None declared, Duygu Ersözlü: None declared, abdurrahman tufan: None declared, Muhammet Çinar: None declared, Abdulsamet Erden: None declared, Sema Yilmaz: None declared, Seval Pehlevan: None declared, Mehmet Tuncay Duruöz: None declared, Sibel Aydin: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB

Background Psoriatic arthritis (PsA) has a genetic background, approximately 40% of patients having a family history of psoriasis or PsA in first-degree relatives, which may impact the disease features. Objectives The aim of this study was to evaluate the effects of family history of psoriasis or PsA on the disease phenotypes. Methods The demographic and clinical data were retrieved from the longitudinal, multicenter PsArt-ID (Psoriatic Arthritis-International Database). Family history of psoriasis and PsA were investigated for 1st and 2nd degree relatives separately. The effect of the family history of psoriasis and/or PsA on disease phenotypes and severity were analysed, calculating the relative risks (RR). Results 1393 patients had the data for family history, 444 (31.9%) of whom was positive for psoriasis and/or PsA. The majority of the family history was only psoriasis (333/444; 75%) and 58.5% (260/444) of the patients had first-degree relatives affected. There was no differences in maternal or parental transmission rates however women had more psoriasis and/or PsA in their family (67.3% vs 32.7% p: 0.028). Patients with a family history had an earlier onset of age for psoriasis (29±14.8 vs 31±14.9 p: 0.007), more frequent nail involvement (50.7% vs 29.6% p: 0.032), more frequent enthesitis (28.2% vs 17.7% p Conclusions The family history of psoriasis and PsA has impacts on skin phenotypes, musculoskeletal features and the disease severity. The differences between family history of psoriasis and PsA and pustular vs plaque phenotypes may point out to a different genetic background and pathogenic mechanisms in these subsets. Disclosure of Interest None declared

Background The environmental and genetic factors play a crucial role in the pathogenesis of psoriatic arthritis (PsA) which may cause a difference in disease characteristics for patients from different geographical regions. Objectives The aim of the study was to explore the disease characteristics, treatment choices and comorbidities in patients with PsA in different countries to see the impact of geographic factors. Methods PsArt-ID (Psoriatic Arthritis- International Database) is a prospective, multicentre registry in PsA, which was initially developed in Turkey in 2014, with participation of Canada since 2015 and Italy since 2017. Patients with PsA are consecutively registered to this registry with the aim of investigating the real-life data. Patient characteristics across Turkey (n=1283) and Canada (n=119) are compared for this analysis. Results Canadian patients were older at the time of recruitment (Table). They also were more frequently smokers, had higher duration of education and higher BMI than patients in Turkey. Patients in Canada had more frequent polyarthritis (66.7% vs 39.6%, p Conclusions Geographical differences have impacts on the disease features in PsA, which may be due to genetic, environmental and cultural differences. The treatments are comparable suggesting a similar approach by the physicians. Disclosure of Interest None declared

Background Comorbidities are frequent in Psoriatic arthritis (PsA) and can have an impact on morbidity and mortality. Objectives We aimed to investigate the frequency of different comorbidities in PsA, how comorbidities have an impact on PsA features and which factors were associated with the occurrence of comorbidities in a large number of patients, using PsART (Psoriatic Arthritis Registry of Turkey)registry. Methods PsART is a national, web-based registry where consecutive patients with PsA are recruited and demographic, clinical and therapeutic information are collected as well as comorbidities. The following comorbidities are questioned: Hypertension (HT), hyperlipidemia, depression, diabetes mellitus (DM), hyperuricemia, coronary arterial disease, liver disease, cerebrovascular accident, cancer, and depression. BMI more than 30 is recorded as obesity. Patients with or without comorbidities were compared for their demographic features and outcome tools. Results One thousand and sixty-nine patients whom comorbidity data were available were analyzed. Within these 693 (64.8%) were women. Mean (SD) age was 46.9 (12.8), with a median (range) PsA duration 45 (0–545) months. The number of patients with 1, 2 and 3 comorbidities were 642 (60.1%), 345 (32.3%), and was 191 (17.9%), respectively. Frequency of comorbidities was obesity in 327 (30.6%), HT in 256 (23.9%), hyperlipidemia in 199 (18.6%), depression in 188 (17.6%), DM in 161 (15.1%), hyperuricemia in 74 (6.9%), coronary artery disease in 39 (3.6%), liver disease 38 (3.6%), cerebrovascular event in 19 (1.8%), and cancer history 16 (1.5%). Patients with at least one comorbidity were older (51.1 (11.8) vs 40.9 (11.7), p Conclusions Our registry supported that comorbidities are frequent in PsA increasing the complexity of the disease and have an impact on the disease severity. Patients with comorbidities are less educated showing that education and awareness are important to improve patient outcomes in PsA in long term. Disclosure of Interest None declared

Background PsART (PsA registry of Turkey) is a multicenter web-based registry. Objectives The objective of this registry is to assess characteristics of PsA and compare the differences among genders in our population. Methods PsART was established in 2014 including 32 rheumatology centers. Detailed data regarding demographics for the skin and joint disease, disease activity assessments and treatment choices were collected. Results One thousand and eighty-one patients (64.7% women) with a median (range) PsA duration for 3.7 (0–45) years were enrolled. Median psoriasis duration was 13 (0–59) years. The most frequent type of PsA was polyarticular 437 (40.5%) followed by oligoarticular 407 (37.7%) and axial disease 372 (34.4%). Patients with a combination of axial and peripheral disease had a longer disease duration than patients with one type of joint disease (52 (0–545) vs 42 (0–486) months, p=0.008). Mean (SD) swollen and tender joint counts were 1.7 (3) and 3.6 (4.8). 38.6% of patients were on csDMARD monotherapy, 7.1% were anti-TNF monotherapy and 22.5% were using anti-TNF plus csDMARD combinations. Within items included in the minimal disease activity, only 17.6%>67% of patients had inactive disease state. The major differences among genders were women being older (48.3 (12.8) VS 44.4 (12.5), P Conclusions PsART had similarities with the previously published registries, supporting its external validity. Women having more fatigue and worse functioning and as well as the high percentage of active disease state point out to the unmet need in treatment of PsA. Disclosure of Interest None declared