Serum progranulin levels in axial spondyloarthropathy and relationship with clinical features

Objectives: In this study, we aimed to investigate the serum progranulin (PGRN) levels in patients with axial spondyloarthropathy (AxSpA) and to identify the correlation between disease activity, symptom severity, acute phase reactant (APR), and serum PGNR levels in patients with AxSpA. Patients and methods: This prospective, cross-sectional study included a total of 152 patients (105 males, 47 females; mean age: 41.8±10.3; range 20 to 65 years) with AxSpA according to the 2009 Assessment of SpondyloArthritis Society (ASAS) criteria who received treatment and 100 healthy individuals (61 males, 39 females; mean age 43.4±14.2; range 20 to 65 years) between February 2018 and February 2019. Serum PGRN levels from the venous blood were analyzed in both groups. The clinical AxSpA assessment scales were used in the patient group. Erythrocyte sedimentation rate and C-reactive protein levels were examined. Results: The mean serum PGRN level was 6.9±5.4 ng/mL in the patient group and 11.2±6.0 ng/mL in the control group. Serum PGRN level was significantly higher in the control group (p<0.001). No significant correlation was found between the PGRN levels and disease activity, symptom severity, duration of disease, and age of the patient (p>0.05). Serum PGRN levels were significantly higher in female patients in the patient group (p<0.01). In the control group, the serum PGRN levels of individuals with a high body mass index were significantly higher (p=0.001). Conclusion: Serum PGRN levels of patients with AxSpA who are under treatment and follow-up are significantly lower than healthy individuals. Serum PGRN levels in female patients with AxSpA are also significantly higher than male patients. Serum PGRN levels do not seem to be related to disease activity.

POS0999 HIGH CORRELATIONS BETWEEN QUESTION 1 & 2 OF THE BASFI: AN OPPORTUNITY TO STREAMLINE THE BASFI

Background:The Bath Ankylosing Spondylitis Functional Index (BASFI) is a useful tool to quantitatively characterise functional ability in a patient with axial spondyloarthropathy (axSpA). Whether first presentation, decompensated, or routine follow-up, BASFI can help establish a more accurate understanding of disease progression, or response. As with any questionnaire, relevance and absence of redundancy is required. This analysis questions the redundancy of the first two questions of the BASFI:1) How difficult is it to put socks on your feet?2) How difficult is it to pick a pen up off the floor?Objectives:To compare variation in reporting of questions one and two of the BASFI, to establish redundancy or exclusivity of these questions.Methods:IBM SPSS version 26 was used for data analysis. Data from axSpA patients who attended the Rheumatology department during the study period were included in the analysis where BASFI scores were available. Both variables (pen scores and sock scores) were assessed with a Shapiro-Wilk’s test for normal distribution. The variables were also assessed for the presence of a monotonic relationship by visual inspection of a scatterplot of the variables. Once a monotonic relationship was established a Spearman’s rank order correlation between the sock score and pen scores for each participant was analysed.Results:In total data from 82 axSpA patients were included in this analysis. Population was made up of 28% (23) females, 72% (59) males with mean BASDAI score 4.33 and mean BASFI score 3.88(Table 1). Both variables were not normally distributed as assessed by Shapiro-Wilk’s test (p <0.05) necessitating a Spearman’s rank-order correlation for analysis. Preliminary analysis variables demonstrated the relationship between the variables to be monotonic as determined by visual inspection of the scatterplot (graph 1) with no outliers detected. There was a statistically significant, strong positive correlation between sock scores and pen scores in this axSpA population, rpartial(80) =0.809 significant at the p < 0.01 level.Table 1.Descriptive output of data% (n)n82Females28% (23)Males72% (59)Age45.03BASDAI4.33BASFI3.88Pen score3.93Sock score2.88Sock score greater7.3% (6)Pen score greater50% (41)Same scores42.7% (35)Conclusion:There is a strong positive correlation between sock (question 1) and pen scores (question 2) as captured by the BASFI. It appears that both questions are capturing a similar functional limitation in patients with axSpA. In order to minimise redundancy and improve the relevance of the BASFI our results support the removal of one of these questions to simplify the BASFI. From a practical perspective, putting on socks (question 1) would be a more commonly encountered daily activity than picking up apen from the floor(question 2). As such, we would suggest removal of question 2 from the BASFI.Table 1 & Figure 1Graph 1.Spread of Data points demonstrating a monotonic relationship with no outliersDisclosure of Interests:Michael MacLean: None declared, Sinead Maguire Grant/research support from: Recipient of the Gilead Inflammation Fellowship, Finbar Barry O’Shea: None declared.

P180 Undiagnosed depression in axial spondyloarthropathy negatively affects disease activity and quality of life

Background/Aims Previous research in axial spondyloarthropathy (axSpA) has shown this population to have a high prevalence of depression. This co-morbidity has been previously shown to impact disease activity in patients with rheumatic disease. The purpose of this study was to screen for signs of depression using two validated tools, the Patient Health Questionaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale for depression (HADs-D) in axSpA patients. Methods AxSpA patients attending the rheumatology department in St James’ Hospital between February and October 2020 were invited to take a self-administered survey which included the PHQ-9 and the HADs-D. Scores from the HADs-D yielded a numerical result which was then categorised as normal, borderline or abnormal. PHQ-9 numerical results were categorised as normal, mild, moderate, moderate/severe or severe. Patients with a known diagnosis of depression were excluded. In addition to baseline demographics, patient reported outcomes were also recorded. Data analysis was performed using IBM SPSS version 26. Continuous variables were recorded as means, categorical variables as frequencies with percentages. A one-way analysis of variance analysis (ANOVA) determined significance of variation in outcomes between patient outcomes as determined by the HADs-D and PHQ-9. A p-value of &lt; 0.05 was deemed significant. Consent was obtained prior to participation. Approval was received from the St James’/Tallaght Hospital Joint Ethics Committee. Results In total 71 axSpA patients took part in the survey. The population was 70.4% (50) males and 29.5% (21) female, with an average age 47.9 years and mean disease duration 19.7 years (mean outcomes: BASDAI 4.08, BASFI 3.62, BASMI 3.54, ASQoL 6.79). Overall, 7 (9.9%) participants recorded abnormal HADs D scores, while 17 (23.9%) recorded moderate to severe PHQ-9 scores indicative of underlying depression. AxSpA females had higher mean HADs-D scores (7.5 vs 4.8, p = 0.01) than males, with abnormal scores in 19% (4) of females and 6% (3) of males. No significant differences were found in PHQ-9 scores between genders. Analysis revealed significantly worse BASDAI (6.27 vs 3.42, p &lt; 0.01) and AQoL scores (12.57 vs 5.26, p &lt; 0.01) in axSpA patients with abnormal compared to normal HADs D scores. No significant differences were noted in BASFI, BASMI or baseline demographics. A similar pattern was noted on analysis of PHQ-9 scores, with significantly worse BASDAI (7.9 vs 2.55, p &lt; 0.01), BASFI (8.05 vs 2.33, p &lt; 0.01) and ASQoL (19.5 vs 2.62, p &lt; 0.01) noted in those scoring as severe compared to normal. No significant differences were detected in BASMI scores or baseline demographics. Conclusion A high percentage of axSpA patients recorded high HADs D and PHQ-9 scores for undiagnosed depression. These patients had significantly worse disease activity and quality of life as compared to patients with normal scores. Clinicians treating axSpA should consider screening for depression in this population. Disclosure S. Maguire: None. F. O'Shea: None.