grants/research support from AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer and UCB Pharma. Abstract citation ID: kead104.231 P190 POOR MENTAL HEALTH RISK IS ASSOCIATED WITH HIGH DISEASE ACTIVITY IN AXIAL SPONDYLOARTHRITIS IN THE UK: RESULTS FROM THE INTERNATIONAL MAP OF AXIAL SPONDYLOARTHRITIS (IMAS) Marco Garrido-Cumbrera 1 , Laura Christen 2 , Jose Correa- Fernandez 1 , Jill Hamilton 3 and Helena Marzo-Ortega 4 1 Health & Territory Research (HTR), Universidad de Sevilla, Seville, Spain, 2 Patient Engagement, Novartis Pharma AG, Basel, Switzerland, 3 Head of Policy & Health Services, National Axial Spondyloarthritis Society (NASS), London, United Kingdom, 4 Leeds Teaching Hospitals NHS Trust, NIHR Leeds Biomedical Research Centre, Leeds, United Kingdom Background/Aims Axial spondyloarthritis (axSpA) can have a significant impact on mental health, yet awareness of its impact remains limited among healthcare professionals, policy makers and the general public. The aim of this study was to describe mental health characteristics among UK axSpA patients and factors associated with risk of poor mental health and presence of mental health outcomes. Methods Data from 374 UK unselected patients from the IMAS online survey (2021) were analysed. Socio-demographic characteristics, health habits (physical activity, smoking and alcohol use), diagnostic delay, BASDAI (0-10), functional limitation (0-54), spinal stiffness (3-12), and treatment (ever or current biologics) were compared between patients with and without poor mental health outcomes (risk of poor mental health [GHQ-12 <3], diagnosis of anxiety, depression, and sleep disorders) using independent Chi-square and Mann-Whitney tests. Four binary logistic regression models were used to assess variables associated with presence of specific mental health outcomes. Results Mean age was 56 years and 49.9% were female. 51.6% were at risk of poor mental health, among which 57.3% were female vs 42.7% male (p ¼ 0.002). The odds ratio of being at risk of poor mental health were higher as disease activity increased (OR ¼ 1.362) and among those who had ever used biologics (OR ¼ 2.071). Anxiety was prevalent in 36.0% of patients, who also reported a longer diagnostic delay (13 vs 10.8 years, p ¼ 0.023). Depression was prevalent in 35.4% of patients, and most likely observed among patient organisation members (OR ¼ 1.743), and as disease activity increased (OR ¼ 1.204). Longer diagnostic delay was also reported among patients diagnosed with depression (13.3 vs 10.6, p ¼ 0.010). Lastly, sleep disorders were prevalent in 18.5% of patients and most likely among those with higher disease activity (OR ¼ 1.416). Conclusion The likelihood of being at risk of poor mental health and having a diagnosis of depression and sleep disorders was significantly higher among those with greater disease activity. Interestingly, individuals at risk of depression were more likely to be members of a patient organisation, suggesting a level of awareness or need to seek information and/or support. Mental and physical health go hand in hand in axSpA, and treatment strategies should address both, especially among those with higher disease activity. Whereas patient organisations are ideally placed as gatekeepers, mental health is an area of priority for NHS services aiming to provide cost-effective care provision for long term conditions. Disclosure M. Garrido-Cumbrera: Grants/research support; Research support from Novartis. L. Christen: Corporate appointments; Laura Christen Employee of: Novartis Pharma AG. J. Correa-Fernandez: None. J. Hamilton: None. H. Marzo-Ortega: Consultancies; Consultancy fees from Eli Lilly, Janssen, Moonlake, Novartis, Pfizer, and UCB. Member of speakers’ bureau; Speakers bureau fees from AbbVie, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Takeda and UCB. Grants/research support; Grant/research support from Janssen, Novartis and UCB. Abstract citation ID: kead104.232 P191 EFFICACY AND IMPROVEMENT IN PATIENT- REPORTED OUTCOMES AT WEEKS 16 AND 52 IN IXEKIZUMAB TREATED BIOLOGICAL NAI ¨ VE PATIENTS WITH RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS ACHIEVING CLINICALLY IMPORTANT PAIN AT NIGHT REDUCTION AT WEEK 16: RESULTS FROM COAST-V TRIAL Sofia Ramiro 1 , Ce ´ dric Lukas 2 , Michael Nissen 3 , Yves Schymura 4 , Khai Jing Ng 4 , Andrew Bradley 4 , Gabriel Doridot 4 , Soyi Liu-Leage 4 , Antoni Chan 5 and Cheng-Chung Wei 6 1 Rheumatology, Leiden University Medical Centre (LUMC, Leiden, Netherlands, 2 Rheumatology, University Hospital Centre Montpellier, University of Montpellier, Montpellier, France, 3 Rheumatology, Geneva University Hospital, Geneva, Switzerland, 4 Rheumatology, Eli Lilly and Company, Indianapolis, IN, 5 Rheumatology, Royal Berkshire Hospital, Reading, United Kingdom, 6 Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan Background/Aims Ixekizumab (IXE), a monoclonal antibody that selectively targets interleukin IL-17A, has shown efficacy in patients with radiographic axial spondyloarthritis (r-axSpA). Spinal pain, in particular spinal pain at night (SP-N), is a major contributor to the patient burden of r- axSpA.To assess SP-N improvement in patients up to week (W) 52 and to determine the association of SP-N improvement in patients treated with IXE with other patient-reported outcomes (PROs) at W16 and with reaching ASDAS LDA at W52. Methods The Phase III COAST-V (NCT02696785) trial investigated the efficacy of IXE in 341 patients with r-axSpA and were biological disease- modifying anti-rheumatic drug (bDMARD)-naı¨ve. Patients were rando- mised to IXE every 2W (IXEQ2W), IXE every 4W (IXEQ4W), adalimumab (ADA) or placebo (PBO) up to W16. Only approved dose IXEQ4W data are presented here. SP-N was measured at each visit using a numeric rating scale (NRS) (0-10). A clinically relevant improvement in SP-N was defined as > 2 point improvement from baseline. Differences in baseline variables between those achieving versus not achieving >2 improvement in SP-N were tested using Fisher’s exact test (binary variables) and analysis of variance (ANOVA; continuous variables). Associations of SP-N improvement with PROs (BASFI, Fatigue Severity NRS, Jenkins Sleep Evaluation Questionnaire (JSEQ), SF-36 PCS) at W16, and ASDAS LDA at W52 were tested using analysis of covariance (ANCOVA; continuous variables) and logistic regression (binary variables). Missing values were imputed using non-responder imputation (NRI), and modified baseline observation carried forward. Results A greater proportion of patients achieved >2 improvement in SP-N with IXE treatment compared to PBO at W16 (63.0% vs. 32.2%, p < 0.001) and improvement was sustained up to W52. Of the 81 patients originally randomised to IXE, those achieving >2 improvement in SP-N (63%) at W16 were younger, more frequently positive for HLA- B27 and had higher disease activity at baseline compared to those that did not achieve >2 improvement. Achieving >2 improvement in SP-N was associated with improvement in PROs including BASFI, Fatigue Severity, JSEQ and SF-36 PCS at W16 and with achieving ASDAS<2.1 at W52 compared to those not achieving >2 improvement in SP-N. Conclusion IXE improved SP-N for patients with r-axSpA not previously treated with bDMARDs. Improvements in SP-N were associated with improvements in disease activity, function, fatigue, and quality of life. Disclosure S. Ramiro: Consultancies; S. Ramiro has served as a speaker and/or consultant for: AbbVie, Eli Lilly and Company, Merck Sharp & Dohme, Novartis, Pfizer, Sanofi, and UCB Pharma. 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