status, alcohol consumption, current physical activity and dietary calcium intake. No such relationships were apparent in men, before or after adjustment. No relationships were observed between past PA and grip strength in this sample. Conclusion: Regular weight bearing activity around the time of peak bone mass acquisition was less common in women than men in this historical cohort. However, we observe higher hip BMD in those women participating in regular PA throughout the life-course, high- lighting the need to promote exercise among young women. Disclosures: J. Zhang: None. M. Clynes: None. K. Jameson: None. C. Cooper: None. E. Dennison: None. 168 USING GP PRACTICE LIST TO IDENTIFY PEOPLE TREATED APPROPRIATELY FOR OSTEOPOROSIS Sindhuja Jothimurugan 1 , Deepali Sanganee 2 , Sharmistha Williams 3 , Subramanian Jothimurugan 2 and Thushani S. Wickramaratne 3 1 Medicine, Barts and The London School of Medicine and Dentistry, London, UNITED KINGDOM, 2 General Practice, Maylands Healthcare 300 Upper Rainham Road Hornchurch Essex RM12 4EQ, Hornchurch, UNITED KINGDOM, and 3 Rheumatology, Queens Hospital, Barking,Havering & Redbridge NHS Trust, Romford,, UNITED KINGDOM Background: There is no national algorithm for treatment of osteoporosis for primary care. In secondary care, we developed a treatment pathway for patients in the community as a guideline for treatment of fragility fractures. As a pilot project, a GP practice with a population of 14,000 was selected to identify the patients for audit if appropriately identified, coded as osteoporosis, treated and followed the recommended treatment. Methods: A search of the practice clinical system was undertaken in July 2017 for three groups of patients coded as the following: patients currently on the existing practice osteoporosis register, patients with a code of ’osteoporosis’ or ‘fragility fracture’ but not prescribed an osteoporosis treatment, and patients currently prescribed an osteo- porosis treatment with no coding for ‘osteoporosis’ or ‘fragility fracture’. Methods used on the GP practice list used the words ’osteoporosis’, ’fragility fractures’, ’QOF’ and all individual drug names as search engine. Data was collected retrospectively from July to December 2017 then analysed and compared against the local osteoporosis guidelines. A medical student helped to collect and analyse the data. Results: Total number of patients identified in the practice from the 14,000 patient population using above criteria was 173 i.e 1.23 % of the total practice list. 22 (0.16%) was excluded due to incorrect coding. The remaining patient number was 151 (1.07%). 100% of these patients were over 50 years of age. 55 (36%) were males and 96 (64%) were females. 101 (67%) had sustained a fragility fracture. 128 (85%) had a DXA scan to assess suitability consisting of 35 males (27%) and 93 (73%) females. 21(14%) had no DXA scan despite a record of fragility fracture. 139 (92%) were appropriately treated but 12 (8%) were not receiving the designated therapy. 113 (75%) were treated following the local guidelines pathway, with 34 (22.4%) not following the local guidelines pathway and 4 (2.6%) had unclear notes. Conclusion: This a large GP practice group within a multi-cultural multi- ethnic community. We initiated this project as a pilot project to assess the ability to identify patients who are at risk of osteoporosis and review their treatment pathway. As patients were in three different codes, the identification of patients was exhaustive and time-consuming. In future, it may be more feasible if patients were categorised into one coding of osteoporosis and fragility fracture. However, the results are promising in that the analysed data indicate that the GP practice list can be used to identify and treat high-risk patients for osteoporosis, and assess the adherence to local guidelines pathway. We aim to discuss these findings by engaging stakeholders from the CCG, along with primary and secondary care providers, thus rolling this project into other practices in the local area to ensure safe, cost effective and appropriate treatment is provided to the high-risk patients. Disclosures: S. Jothimurugan: None. D. Sanganee: None. S. Williams: None. S. Jothimurugan: None. T.S. Wickramaratne: None. 169 PATIENT PRIORITIES IN OSTEOPOROSIS RESEARCH: GENERATING MEANINGFUL RESEARCH QUESTIONS Ashley Hawarden 1 , Clare Jinks 1 , Waheed Mahmood 1 , Stephen Gwilym 2 and Zoe Paskins 1,3 1 Arthritis Research UK Primary Care Centre, Research Institute for Primary Care Sciences, Keele University, Stoke on Trent, UNITED KINGDOM, 2 Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UNITED KINGDOM, and 3 Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke on Trent, UNITED KINGDOM Background: We have previously conducted a national e-survey to identify patient and public research priorities in osteoporosis. The e- survey identified broad topics as research priorities rather than research questions. Translating research priority topics into research questions that can be used by researchers and funders is required. We aimed to use free text responses from the e-survey to generate specific research questions within broad priority topics, and identify any new themes not covered by the survey questions. Methods: The e-survey, emailed to approximately 16,000 National Osteoporosis Society supporters, included a free-text question ‘Is there anything else you would like to tell us about what is important for research in osteoporosis?’. Using a combined inductive and deductive approach, free text entries were coded, using thematic analysis and informed by the existing survey topics by two researchers. Research questions were identified from the free text within the three highest ranking topics identified in the e-survey. Results: 575 of the 1,088 survey respondents entered free text comments which were analysed. Comments were coded to 33 of the 40 survey topics and one additional theme was identified. Research questions relating to ‘drug treatment’ were: how safe are bispho- sphonates? (including what is the risk of osteonecrosis of the jaw/ atypical fractures and what drug interactions exist); how effective are bisphosphonates, HRT or progesterone cream? what is the com- parative effectiveness of HRT vs bisphosphonates, oral vs intrave- nous bisphosphonates and bisphosphonates vs non- pharmacological treatment? what is the optimal duration of bispho- sphonates? and what are predictors of response to treatment? Research questions relating to ‘early identification and screening’ were: what is the utility of routine DXA? which specific risk factors should be targeted for screening? what alternative methods of screening exist for impaired bone health? (including questionnaires, blood tests, height measurements); and how can vertebral fractures be identified early? Research questions relating to improving ‘advice and information from health professionals’ were: how can explana- tions be optimised? (specifically relating to DXA results, prognosis, non-pharmacological management and moving safely); what is the best support and information for younger people with osteoporosis, men with osteoporosis, and people with spinal fractures? how can awareness and knowledge of osteoporosis be optimised among primary care clinicians and care home staff? Additionally, one new theme emerged from the analysis: implementing evidence-based care. Respondents voiced concern about the dissemination of best available evidence to non-specialist medical practitioners and inconsistencies in standard care across the UK. Conclusion: This study adds to the existing published work by expanding broad research themes and identifying patient driven research questions. In order to inform research strategies further work is needed to review existing literature and determine if these research questions are true uncertainties. Disclosures: A. Hawarden: None. C. Jinks: None. W. Mahmood: None. S. Gwilym: None. Z. Paskins: None. PAEDIATRIC AND ADOLESCENT RHEUMATOLOGY 170 SAFETY AND EFFICACY OF SUBCUTANEOUS TOCILIZUMAB IN PATIENTS WITH SYSTEMIC AND POLYARTICULAR JUVENILE IDIOPATHIC ARTHRITIS Athimalaipet V. Ramanan 1 , Hermine I. Brunner 2 , Nicola Ruperto 3 , Alberto Martini 3 , Rube ´ n J. Cuttica 4 , Jennifer E. Weiss 5 , Michael Henrickson 2 , Heinrike Schmeling 6 , Jordi Anto ´n 7 , Kirsten Minden 8 , Gerd Horneff 9 , Marı ´a Luz Ga ´ mir-Ga ´ mir 10 , Markus Hufnagel 11 , Wendy Douglass 12 , Chris Wells 12 , Sunethra Wimalasundera 12 , Navita L. Mallalieu 13 , Daniel J. Lovell 2 and Fabrizio De Benedetti 14 1 Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UNITED KINGDOM, 2 Pediatric Rheumatology Collaborative Study Group (PRCSG), Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 3 n/a, Pediatric Rheumatology International Trial Organization (PRINTO) Coordinating Centre, Genoa, ITALY, 4 n/ a, Hospital Gral de Nin ˜ os Pedro Elizalde, Buenos Aires, ARGENTINA, 5 n/a, Hackensack University Medical Center, Hackensack, NJ, iii110 Wednesday 1 May 2019 INVITED SPEAKERS ABSTRACTS Downloaded from https://academic.oup.com/rheumatology/article-abstract/58/Supplement_3/kez108.078/5444270 by guest on 26 May 2020