Scientific Abstracts Saturday, 13 June 2015 861 cyclooxygenase inhibitors and aspirin can be safely used during the first and second trimester but should be withdrawn after gestational week 20 for the risk of ductus constriction. When corticosteroids are needed they are safe when used at low dosages.The effects of colchicine during pregnancy are only studied in patients with familial Mediterranean fever condition in which it appeared to be safe. Nowadays the general outcomes of pregnancies in patients with pericarditis can be similar to the general population, especially when carefully followed by multidisciplinary teams. A rheumatological approach to these pregnancies was safe and effective. References: [1] Imazio M, Brucato A, Belli R, Forno D, Ferro S, Trinchero R, Adler Y. Colchicine for the prevention of pericarditis: what we know and what we do not know in 2014 - systematic review and meta-analysis. J Cardiovasc Med (Hagerstown). 2014 Dec;15(12):840-6.1) [2] Imazio M, Belli R, Brucato A, Cemin R, Ferrua S, Beqaraj F, Demarie D, Ferro S, Forno D, Maestroni S, Cumetti D, Varbella F, Trinchero R, Spodick DH, Adler Y. Efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis (CORP-2): a multicentre, double-blind, placebo-controlled, randomised trial. Lancet. 2014 Jun 28;383(9936):2232-7. [3] Imazio M, Brucato A, Adler Y. A randomized trial of colchicine for acute pericarditis. N Engl J Med. 2014 Feb 20;370(8):781. [4] Imazio M, Spodick D.H., Brucato A., Trinchero R., Adler Y. Controversial issue in the management of pericardial disease. Circulation. 2010; 121: 916-928. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2015-eular.6342 SAT0555 ERYTHEMA NODOSUM IN RHEUMATOLOGY CLINIC: A STUDY OF 130 CASES Y. Karpova , B. Belov, O. Egorova. V. A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation Background: Erythema nodosum (EN) is a type of septal panniculitis that occurs predominantly without vasculitis. EN can be caused by a wide range of etiological factors (infection, sarcoidosis, rheumatic diseases, medications, and other). Objectives: To examine the incidence and clinical features of EN in modern rheumatology practice. Methods: The study included 130 patients (19 men and 111 women, median age 39±13 years) who applied with EN as referral diagnosis to rheumatology clinic during 3-year period. Examination of patients was performed according to the developed algorithm, necessitating collection of thorough medical history, physical examination, clinical, biochemical and immunological blood tests (including CRP, ASLO, RF, anti-DNA), as well as HBs, HCV and RW/VDRL. All patients also underwent chest CT. Results: 7 (5%) patients were diagnosed with primary (idiopathic) EN (PEN), 123 - secondary EN (SEN). Association of EN with infectious process (streptococ- cal infection-16, mycoplasmal pneumonia-3, upper respiratory tract infection-14, yersiniosis -5 hepatitis C- 5, HIV with HCV-1, infectious mononucleosis-1) was established in 45 (35%) patients, Löfgren’s syndrome was diagnosed in 45 (35%) patients, rheumatic diseases - in 20 (15%) patients (7-systemic lupus erythematosus, 5-Behcet’s disease, 3-reactive arthritis, 3-primary Sjögren’s syn- drome, 2-rheumatoid arthritis). In 13 (10%) SEN cases other causes were found: cancer-3, allergic reactions, 3-contraception-2, endometriosis-2, vaccination-1, autoimmune thyroiditis -1, ulcerative colitis-1. In general, EN onset more often occurred during the spring-summer period (60%). PEN patients presented with small number of nodes (to 5.66±4,89), localized exclusively in the sural area. In patients with Löfgren’s syndrome skin lesions typically occurred on the ankles (84%) and persisted for the shortest period of time (1,69±2,29 weeks.). In patients with rheumatic diseases EN occurred more frequently in summer time (50%), was prone to chronicity (60%), longer duration (5,51±7,58 weeks.) and wider distri- bution on the skin involving legs, hips, shoulders and trunk, showing tenderness to palpation while assessing pain intensity by the visual analogue scale (60±23 mm). Wrist joints and small joints of the hands and feet were significantly more often affected in this group (24% and 38%, respectively, p<0.01). Conclusions: Routine use of expanded diagnostic algorithm allowed to verify EN cause in 95% of cases, which is significantly higher as compared to other authors [1,2]. Infections and sarcoidosis were the most common causes of EN in our group of patients, which is probably related to the population characteristics of the sample. Clinical variants of EN allow to suspect the likely cause of the disease and provide a targeted diagnostic screening. References: [1] Cribier B, et al. Erythema nodosum and associated diseases. A study of 129 cases. Int J Dermatol. 1998 Sep;37(9):667-72. [2] Mert A, et al. Erythema nodosum: an evaluation of 100 cases. Clin Exp Rheumatol. 2007 Jul-Aug;25(4):563-70. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2015-eular.2352 SATURDAY, 13 JUNE 2015 Psoriatic arthritis SAT0556 METHOTREXATE EFFICACY IN EARLY PSORIATIC ARTHRITIS – OPEN LABEL DATA FROM THE TICOPA STUDY L.C. Coates , P.S. Helliwell. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom Background: Methotrexate (MTX) is a common first line DMARD in psoriatic arthritis (PsA) but until recently no RCTs evaluating its efficacy in PsA were available. The MIPA trial found no significant difference in arthritis outcomes at 6 months but was criticised as the target dose was only 15mg. Objectives: The aim of this analysis was to investigate clinical outcomes in patients with early PsA treated with MTX in the TICOPA study. Methods: Within the Tight Control of Psoriatic Arthritis, patients (in either arm) could be treated with methotrexate. All patients in the tight control arm received MTX as first line monotherapy for the first 12 weeks while patients in the standard care arm the majority of the patients in the standard care arm also received MTX. Clinical outcomes were recorded at the 12 week visit including joint counts, PASI, NAPSI, enthesitis and dactylitis measures. Results: Of the 206 patients enrolled in TICOPA, 188 received oral methotrexate in the first 12 weeks of the trial. Of these, 175 patients reached a dose of at least 15mg by 12 weeks, with 122 reaching a dose of at least 20mg and 86 reaching the top dose of 25mg. The proportions of patients achieving the ACR outcomes at 12 weeks were ACR20 40.8%, ACR50 18.8% and ACR70 8.6% with 22.4% achieving minimal disease activity (MDA). Improvements were also seen in PASI scores with 27.2% reaching a PASI75. For those with enthesitis at baseline (n=148) the median change in enthesitis score was 0 (IQ range -1, 0 for LEI and IMPACT, -2, 1 for MASES). For those with baseline dactylitis (n=59), there was a median change in LDI scores of -59.7 (-157.4, -26.4). 117 patients had nail involvement and these patients showed a median change in mNAPSI score of -2 (IQ range -8, 0) with changes more commonly in the nail bed due to the short follow up time. Slightly higher proportions of patients receiving 180mg MTX or more over the 12 week period (equivalent to an average of 15mg per week) achieved ACR20, 50 and PASI 75 but the numbers were small so this did not reach significance. Conclusions: Despite this data being open-label, it does show improvements in multiple clinical outcomes associated with MTX use in PsA. The proportion reaching ACR20 is slightly higher than that in MIPA (41 vs 34%) but no comparative data are available for the other outcomes. There is a suggestion of better responses with doses above 15mg per week but the dose-response is harder to assess in such a study where confounding exists as patients doing well may be left on lower doses. Disclosure of Interest: L. Coates: None declared, P. Helliwell Grant/research support from: Pfizer, Consultant for: Pfizer DOI: 10.1136/annrheumdis-2015-eular.5196 SAT0557 PREDICTORS OF RESPONSE IN PATIENTS WITH PSORIATIC ARTHRITIS TREATED WITH ANTI-TNF IN A REAL-WORLD SETTING D. Sholter 1 , J. Kelsall 2 , R. Arendse 3 , A. Avina-Zubieta 4 , W. Bensen 5 , M. Zummer 6 , R. Faraawi 7 , S. Dixit 5 , M. Khraishi 8 , I. Fortin 9 , J. Sampalis 10 , E. Psaradellis 10 , F. Nantel 11 , C. Tkaczyk 11 , A.J. Lehman 11 . 1 University of Alberta, Edmonton; 2 Mary Pack Arthritis Centre, Vancouver; 3 University of Saskatchewan, Saskatoon; 4 Arthritis Research Canada, Richmond; 5 McMaster University, Hamilton; 6 Université de Montréal, Montreal; 7 McMaster University, Kitchener-Waterloo; 8 Nexus Clinical Research, St. John’s; 9 CH Rimouski, Rimouski; 10 JSS Medical Research Inc, Montreal; 11 Janssen Inc Canada, Toronto, Canada Background: Recent studies have suggested that early and aggressive treatment of spondyloarthritis, including ankylosing spondylitis (AS) and psoriatic arthritis (PsA), may be associated with favorable patient outcomes, reducing synovial inflammation, delaying joint damage, and maintaining functional status. Objectives: The objective of this analysis was to determine the predictive factors of early DAS28 improvement in PsA patients treated with infliximab (IFX) or golimumab (GLM) in a Canadian routine clinical care setting. Methods: BioTRAC is an ongoing, prospective registry of patients initiating treatment for RA, AS, or PsA with IFX or GLM. The analysis was based on PsA patients treated with IFX or GLM between 2005 and 2014. Variables associated with improved response were examined using general linear models and those showing a statistical trend (P<0.150) were considered in multivariate analysis to identify independent predictors. Results: A total of 176 patients were included in the analysis with a mean (SD) age of 49.4 (11.4) years and a disease duration of 5.2 (7.2) years. The majority of patients were male (54.1%). Upon 6 months of treatment statistically significant and clinically meaningful improvements were observed in DAS28 (4.1 vs. 2.9; P<0.001), HAQ (1.05 vs. 0.78; P<0.001), TJC (5.0 vs. 2.6; P<0.001), SJC (3.7 vs. 1.6; P<0.001), pain (46.8 vs. 30.7 mm; P<0.001), PtGA (48.6 vs. 29.7 mm; P<0.001), MDGA (5.3 vs. 2.3 cm; P<0.001), and morning stiffness (65.8 vs. 45.0 min; P<0.001).