Entheseal morphologic abnormalities, PD signal, and bursitis were US abnormalities that were responsive to anti-TNF therapy in SpA. PDUS can be a reproducible method for multicenter monitoring of therapeutic response in enthesitis of SpA.

To develop recommendations on the transition from pediatric care to adult care in patients with chronic inflammatory rheumatic diseases with childhood onset based. Recommendations were generated following nominal group methodology and Delphi technique. A panel of 16 experts was established. A systematic literature review (on transitional care) and a narrative review were performed and presented to the panel in the first panel meeting to be discussed. A first draft of recommendations was generated and circulated. Focal groups with adolescents, young adults and parents were organized. In a second meeting, the focus group results along with the input from invited psychologist were used to establish definitive recommendations. Then, a Delphi process (two rounds) was carried out. A group of 72 pediatric and adult rheumatologists took part. Recommendations were voted from 1 (total disagreement) to 10 (total agreement). We defined agreement if at least 70 % voted ≥7. The level of evidence and grade or recommendation was assessed using the Oxford center for evidence-based medicine levels of evidence. Transition care was defined as a purposeful, planned process that addresses the medical, psychosocial and educational/vocational needs of adolescents and young adults with chronic inflammatory rheumatic diseases with childhood onset as they move from child-centered to adult-oriented healthcare systems. The consensus covers: transition needs, barriers and facilitators, transitional issues (objectives, participants, content, phases, timing, plans, documentation and responsibilities), physicians' and other health professionals' knowledge and skill requirements, models/programs, and strategies and guideline for implementation. Preliminary recommendations and agreement grade are shown in the Table (first Delphi round). These recommendations are intended to provide health professionals, patients, families and other stakeholders with a consensus on the transition process from pediatric to adult care.

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Aim: The aim of this study was to evaluate the association between periodontal parameters related with the periodontal disease severity and the presence and levels of anti-citrullinated protein antibodies (ACPAs) in rheumatoid arthritis (RA) patients. Materials and methods: This cross-sectional study included 164 RA patients. Socio-demographics and RA disease characteristics, including ELISA-detected ACPA (anti-CCP-2), were recorded. Exposure was assessed by periodontal parameters: plaque index (PI), bleeding on probing (BoP), probing pocket depth, and clinical attachment levels (CAL). Presence and levels of ACPAs (outcome) and exposure variables were compared by both parametric and non-parametric tests and associations were evaluated by adjusted odds ratio (OR). Results: A significant association was observed between the presence of anti-CCP antibodies and severity of periodontal outcomes such as the mean CAL (OR 1.483, p = 0.036), mean PI (OR 1.029, p = 0.012), and the number of pockets ≥ 5 mm (OR 1.021, p = 0.08). High anti-CCP antibodies levels were associated with mean CAL, mean PI, and number of pockets ≥ 5 mm with an OR of 1.593 (p = 0.043), 1.060 (p < 0.001), and 1.031 (p = 0.031), respectively. Furthermore, a significant increase of 4.45 U/mL in anti-CCP antibodies levels (p = 0.002) in RA patients was found for each pocket ≥ 5 mm after adjusting for age, gender, smoking, time of disease evolution, and RA activity. Conclusions: In RA patients, the severity of periodontal conditions such as mean CAL, mean PI, and the number of pockets ≥ 5 mm were linearly associated with both the presence and levels of anti-CCP antibodies.

To estimate the prevalence of Sjögren’s syndrome (SS) in the adult Spanish population we performed a population-based multicenter cross-sectional study. Cases were defined by the American-European Consensus Group criteria proposed in 2002. A total of 4,916 subjects aged 20 years or over were included. The estimated prevalence of SS (including primary and secondary forms) in the adult population in Spain was 0.33% (95% CI 0.21–0.53). Extrapolating to the total population of the country aged ≥ 20 years (around 37.7 million persons), there would be around 125,000 cases of SS in Spain. Considering only primary SS, the estimated prevalence was 0.25% (95% CI 0.15–0.43) or 1 person in 400. The prevalence of primary SS in Spain is comparable to that reported in other European studies with a similar design and diagnostic criteria. Based on these results, primary SS could not be considered a rare (orphan) disease. Only 50% of cases had already been diagnosed with SS prior EPISER 2016 study, confirming the existence of a non-negligible proportion of undiagnosed cases in the general population.

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BackgroundPrevalence of rheumatic diseases was first studied in Spain in 2000 EPISER 2000 study1). Sociodemographic and lifestyle changes during the last 16 years and their possible influence in prevalence figures justify a new study.ObjectivesTo estimate the prevalence of rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), Sjögren syndrome, symptomatic osteoarthritis (knee, hip, hands, cervical and lumbar spine), fibromyalgia, gout and symptomatic osteoporotic fracture in adult population in Spain.DiseasePrevalence95% CI Cervical osteoarthritis10.1%9.1–11.2Lumbar osteoarthritis15.5%14.3–16.8Hand osteoarthritis7.9%7.0–8.9Hip osteoarthritis5.2%4.4–6.0Knee osteoarthritis13.9%12.7–15.1RA0.9%0.7–1.3PsA0.6%0.4–0.8AS0.4%0.3–0.7Gout2.5%2.0–3.1SLE0.2%0.1–0.4Sjögren syndrome0.3%0.2–0.5Fibromyalgia2.4%2.1–2.9Symptomatic osteoporotic fracture1.8%1.4–2.4MethodsPopulation-based multicenter cross-sectional study, with the participation of 78 municipalities in the 17 Spanish autonomous communities. The reference population are adults aged 20 and above residing in Spain. All participants gave their informed consent. CATI system (Computer Assisted Telephone Interview) was used for initial data collection and screening questionnaire. Diagnostic suspicions and diagnosis referred by the participants were studied by rheumatologists in the referral hospital for the selected municipalities. Statistical analysis: the prevalence of the rheumatic diseases were calculated using estimators and their 95% confidence intervals. Weights were calculated in each of the sampling stages in accordance with the probability of selection. The distribution of population in Spain obtained from the National Statistics Institute was taken into account.Results4916 subjects were included in the study. 4753 completed their participation. Prevalence of rheumatic diseases were the following: The negative predictive value (NPV) of the initial screening questionnaire was 93.8%. The lower NPV corresponded to knee osteoarthritis (95.1%).ConclusionsPrevalence of RA, PsA, AS, gout and SLE seems to be higher than previously published in other European countries.Reference[1] Carmona L, Ballina J, Gabriel R, Laffon A. The burden of musculoskeletal diseases in the general population of Spain: results from a national survey. Ann Rheum Dis2001;60(11):1040–5.AcknowledgementsThis study was funded by Celgene, Gebro Pharma, MSD, Novartis, Hopira/Pfizer and Sanofi Genzyme.Disclosure of InterestNone declared

RA patients treated with TCZ show lower plasma concentrations of Lp(a) compared with patients without BT.