AB0386 Relationship between extra-articular manifestations and joint surgery in rheumatoid arthritis

Background Extra-articular organ involvement is a serious condition in rheumatoid arthritis (RA) associated with increased mortality. These manifestations may affect the course of the disease, but could they accelerate the joint destruction and shorten the pre- joint surgical period? Objectives Our objective was to study the impact of extra-articular manifestations (EAM) on joint surgery during RA management. Methods It is a retrospective comparative study involving 500 RA patients (according to 1987 ACR or 2010 ACR/EULAR criteria) in rheumatology department between 2000 and 2014. The assessment of EAM was systematically done in RA diagnosis and during management. We compared 2 groups of RA patients according to the presence or not of EAM. Results We enrolled 422 women and 78 men with mean age of 53.3 years (21–83) and mean disease duration of 12 years [2–40]. RA was Rheumatoid Factor positive and erosive in 71.4% and 90% cases respectively. A surgical procedure was considered necessary in 59 cases (11.8%). An EAM was diagnosed in more than a half of patients (62.4%) with a predominance of ocular and bone manifestation, mainly xerophthalmia (173 cases, 34.6%) and osteoporosis (120 cases, 24%). Secondary Sjogren’s syndrome was confirmed in 70 cases. Pulmonary manifestations related to RA were noted in 70 patients (14%), especially diffuse interstitial pulmonary in 48 cases (9.6%). Renal involvement was present in 45 patients, of which interstitial renal disease was the most common manifestation (29 patients, 64.4%). Rheumatoid nodules (4.6%) and small vessel vasculitis (0.6%) were the most frequent skin manifestations. A significantly higher incidence of joint surgery was noted in osteoporotic RA patients (OR=1.91; p=0.029). There was no significant correlation between joint surgery resort and other EAM (table 1). Conclusions Our study concluded to a higher incidence of EAM during RA management. Osteoporosis was the only EAM associated to greater frequency of joint surgery. Disclosure of Interest None declared