Reumatismo
type: channel
description: Official Journal of the Italian Society of Rheumatology. Founded in 1949. Reumatismo is a reference publication for professionals in the field, being the official journal of the Italian Society of Rheumatology (SIR). The journal offers a space for the dissemination of original studies, research and proceedings of Italian conferences, thus contributing to the advancement of scientific knowledge in the field of rheumatology. The articles published cover a wide range of topics, from autoimmune and inflammatory diseases to new therapies and diagnostic approaches, with the aim of providing useful insights for clinical practice and research. With this, ‘Reumatismo’ aims to be not only an important resource for professionals, but also a platform for dialogue and the exchange of ideas within the Italian and international rheumatology community.
publisher: PAGEPress Scientific Publications, Pavia, Italy
language: en
publication name: Reumatismo
issn: 0048-7449
items: Welcome to the 62nd National Congress of the Italian Society of Rheumatology!
items: CO:01:1 | Efficacy and safety of rituximab across the four phenotypes of IgG4-related disease: a European multi-center cohort study of 115 patients
items: CO:01:2 | BAG3 in systemic sclerosis: possible therapeutic target and biomarker for pulmonary fibrosis
items: CO:01:3 | Which PRO reflects remission best? Bridging the gap between patient and physician in systemic lupus erythematosus
items: CO:01:4 | Identify predictors of relapse in idiopathic inflammatory myopathies: insights from an international cohort
items: CO:02:1 | Frequency and predictors of disease progression in contemporary seronegative undifferentiated arthritis in a treated-to-target early arthritis clinic
items: CO:02:2 | Effectiveness of tumor necrosis factor inhibitors in rheumatoid arthritis: real world data from an Italian National Registry
items: CO:02:4 | Whole blood hypercoagulable profiles in patients with rheumatoid arthritis
items: CO:03:1 | Distinct breath metabolomic signature in systemic sclerosis patients with pulmonary arterial hypertension
items: CO:04:1 | Bone properties and biomechanics in patients with psoriatic disease: a cross-sectional study with high-resolution peripheral quantitative computed tomography
items: CO:05:1 | Predicting one-year disease activity in systemic lupus erythematosus using machine learning and explainable AI
items: CO:05:2 | An OMERACT study for the development of an algorithm for automatic identification of calcium pyrophosphate deposition by ultrasound: the Crystal Artificial Intelligence Monitoring Study
items: CO:05:3 | Radiomics and machine learning for differentiating rheumatoid arthritis-associated interstitial lung disease and idiopathic pulmonary fibrosis with usual interstitial pneumonia pattern
items: CO:06:1 | Predictors of damage accrual in a monocentric cohort of patients with Behçet’s syndrome (BS) evaluated with BS overall damage index in real-life clinical practice
items: CO:06:2 | Deep immunophenotyping in patients with juvenile localized scleroderma reveals two distinct immunological endophenotypes
items: CO:06:3 | Clinical and laboratory markers for distinguishing VEXAS from Schnitzler's syndrome in male patients with skin involvement: insights from the International AIDA Network Registries
items: https://www.reumatismo.org/reuma/article/view/2000
items: PO:01:004 | Real-world retention of IL-17 inhibitors in psoriatic arthritis: impact of prior IL-17 exposure across multiple treatment lines in the “BIRRA” multicentre cohort
items: PO:01:005 | Exploring the relationship between alexithymia, pain perception, and disease burden in a cohort of patients with psoriatic arthritis
items: https://www.reumatismo.org/reuma/article/view/2006
items: PO:01:006 | Increased risk of cancer recurrence or mortality associated with DMARDs?
items: PO:01:007 | Modulation of cellular senescence in psoriatic arthritis: exploring the potential impact of b/tsDMARDs treatment on telomere length, mtDNA copy number, and oxidative damage
items: https://www.reumatismo.org/reuma/article/view/2005
items: https://www.reumatismo.org/reuma/article/view/2122
items: PO:01:014 | Differential inflammatory responses of CD14+ and CD14– synoviocytes in psoriatic arthritis: implications for pathogenesis and targeted therapies
items: https://www.reumatismo.org/reuma/article/view/2124
items: PO:02:016 | Real-world evidence of upadacitinib over two years in Italian patients with axial spondyloarthritis
items: PO:02:017 | Difficult-to-treat psoriatic arthritis: clinical and ultrasonographic predictors in a real-life cohort
items: PO:02:018 | After-SECs: clinical predictors of secukinumab retention in psoriatic arthritis patients with inadequate response to anti-tumor necrosis factor therapy
items: PO:02:023 | Monocentric analysis of systemic glucocorticoids in PsA: the art of balancing prescriptive appropriateness and risk factor management
items: PO:02:024 | Development of anti-drug antibodies in patients with peripheral and/or axial spondyloarthritis treated with infliximab or adalimumab: a monocentric cross-sectional study
items: CO:07:3 | Does articular and entheseal structural damage drive pain and patient-driven reported outcomes in difficult-to-treat psoriatic arthrtis patients? Results from a cross-sectional study
items: CO:07:1 | Assessing bone fragility in systemic sclerosis: results of the Sclerobone multicentric study
items: CO:07:6 | Hidden in plain sight: fibromyalgia prevalence and correlates in 3,000 non-clinical Italian subjects
items: CO:08:1 | Aquaporin-4 downregulation in dysphagic idiopathic inflammatory myopathies: association with Type 2 fiber damage and inflammation
items: PO:02:027 | Fast food, slow damage: ultra-processed foods, Western diet and inflammatory arthritis. A systematic scoping review
items: CO:07:2 | Quantitative computed tomography analysis of pulmonary disease in systemic sclerosis: correlation between radiomics and pulmonary function tests
items: PO:03:036 | Psoriatic arthritis: does pre-existing treatment with cs/bDMARDs for psoriasis influence the characteristics and outcomes of joint disease?
items: PO:04:048 | Assessment of chronic and residual pain in axial spondyloarthritis in a single-center cohort of patients treated with anti-tnf agents
items: CO:07:4 | Clinical and psychosocial domains in fibromyalgia: a multidimensional questionnaire approach for personalized management. Results from an Italian monocentric study
items: PO:04:051 | Application of REMS in the assessment of fragility score and bone mineral density in axial spondyloarthritis and psoriatic arthritis with axial involvement
items: CO:07:5 | Enhanced fibroblast signatures in females with early rheumatoid arthritis highlights a potential basis for poorer treatment outcomes
items: PO:04:054 | Clinical efficacy and drug retention rate of upadacitinib in patients with axial spondyloarthritis: results from a single-center observational study
items: PO:04:056 | Willingness of patients with psoriatic arthritis to participate in pharmacological and nutritional clinical trials: a cross-sectional study
items: PO:04:061 | Higher prevalence of baseline comorbidities in patients developing difficult to treat psoriatic arthritis
items: CO:08:2 | Impact of comorbidities on clinical-serological phenotype of primary Sjögren's disease: a retrospective analysis of a multicenter cohort
items: PO:05:066 | Atypical diagnosis and manifestation of spondyloarthritis: a case report
items: PO:05:069 | Risankizumab efficacy in peripheral and axial involvement: monocentric experience
items: CO:08:4 | Paraproteinemias in Sjögren’s disease: cryoglobulinemia and monoclonal component define distinct phenotypes with a synergistic lymphoproliferative risk
items: CO:08:5 | Clinical impact of anti-Ro52 antibodies in idiopathic inflammatory myopathies: insights from a multicenter Italian cohort
items: PO:05:074 | A clinical case of a patient affected by long-standing psoriatic arthritis and multiple comorbidities treated with an anti-IL-23 therapy
items: CO:08:6 | Prevalence, incidence and survival in interstitial lung disease secondary to primary Sjögren’s syndrome. Results from the “EMERGE” longitudinal study
items: PO:06:078 | Is difficult-to-treat rheumatoid arthritis less severe in patients with autoantibody-negative disease? retrospective analysis from a monocentric cohort.
items: CO:09:1 | The impact of sex and gender on fibromyalgia syndrome: data from the Italian Fibromyalgia Registry
items: PO:06:079 | Weighing the burden: how body mass index shapes clinical outcomes in rheumatoid arthritis. Insights from a large Italian cohort
items: CO:09:3 | Effectiveness and safety of nintedanib in autoimmune systemic diseases: real life data from an Italian multicentre study (Island group) of the Italian Society of Rheumatology
items: https://www.reumatismo.org/reuma/article/view/2134
items: CO:09:4 | Erosive hand osteoarthritis: the impact of comorbidities in the context of joint disease
items: PO:06:083 | Clinical characteristics and outcomes of late- and young-onset rheumatoid arthritis in relation to autoantibody status
items: CO:09:6 | Risk of disease flare during pregnancy and postpartum in inflammatory arthritis: association with therapy discontinuation in the prospective P-RHEUM.it study
items: PO:06:084 | Interstitial lung involvement in rheumatoid arthritis patients treated with abatacept: a prospective observational study
items: CO:10:1 | High-grade synovitis and histological pathotype distribution in patients with advanced osteoarthritis undergoing joint replacement: a more inflammatory disease than we thought?
items: PO:06:092 | Early achievement of remission confers better outcomes than low disease activity in both seropositive and seronegative patients with new-onset rheumatoid arthritis
items: https://www.reumatismo.org/reuma/article/view/1991
items: PO:06:093 | Clinical and ultrasound phenotyping comparison between Difficult-To-Treat Rheumatoid Arthritis (D2TRA) and non-D2TRA patients: experience from a monocentric cohort
items: CO:10:3 | Clinical response to JAK inhibitors or non-TNFi-targeted biologicals according to synovial tissue characteristics in patients with difficult-to-treat rheumatoid arthritis
items: PO:06:094 | Exploring the relationship between inflammation and collagen deposition in synovial tissue and clinical outcomes in active arthritis: insights from a monocentric pilot study
items: CO:10:4 | Lung vasculature quantification on computed tomography predicts new onset of interstitial lung disease in systemic sclerosis
items: https://www.reumatismo.org/reuma/article/view/2135
items: CO:10:5 | Beyond major glands: high-resolution ultrasound mapping of labial salivary and lacrimal gland involvement in Sjögren’s disease
items: PO:07:096 | Safety of filgotinib in the treatment of rheumatoid arthritis: results from the multicentre SOFIA study
items: CO:10:6 | Impact of pregnancy on organ damage in systemic lupus erythematosus: a prospective multicenter study
items: PO:07:099 | Survival on therapy of certolizumab pegol in rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis: 8-year data from an Italian multicenter register

Welcome to the 62nd National Congress of the Italian Society of Rheumatology!
type: item
description: Dear Colleagues, It is with great pleasure that I welcome you to the 62nd National Congress of the Italian Society of Rheumatology, which is once again being held in the familiar setting of the Rimini Conference Centre, a place that has become symbolic for our scientific community. The Congress is an essential event for all of us, not only for professional development, but also for discussion, collective growth and strengthening the bonds within our society. This year, the Congress has once again been accredited by the ECM (Italian Continuing Medical Education) to allow for even wider participation and to meet the needs of all colleagues. The programme for this edition has been designed to offer a dynamic journey, rich in innovative content, open to interdisciplinary dialogue and future challenges. This year marks the 75th anniversary of the founding of the SIR, and to mark the occasion, we will be organising an opening ceremony that will include a session dedicated to the evolution of rheumatology: from its historical roots to new perspectives linked to artificial intelligence, with two highly knowledgeable speakers capable of conveying passion and enthusiasm. In addition to the plenary sessions and institutional symposia, we are also confirming the formulas that have been so successful over the years: the Hands On courses, the “Meet the Expert” sessions, the “Question Time” sessions and the traditional Review Course on Saturday morning, which will offer participants the opportunity to update themselves on topics of great practical impact. Ample space will also be reserved for oral presentations (including those in English) and poster displays, where we will have the opportunity to take stock of the research activities of national groups. As every year, we will reward the authors of the best presentations. We are also renewing the “Verso EULAR” initiative, which highlights the contribution of our young scientific community. Our colleagues from SIRyoung will once ag…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 1
  topic: category
subject: Posters - Day 1
  topic: category
subject: Oral Communications - Day 2
  topic: category
subject: Posters - Day 2
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Abstract book
  topic: subjects
creator: Andrea Doria
rights: Copyright (c) 2025 the Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2231

CO:01:1 | Efficacy and safety of rituximab across the four phenotypes of IgG4-related disease: a European multi-center cohort study of 115 patients
type: item
description: Background. IgG4-related disease (IgG4-RD) is a rare, immune-mediated fibroinflammatory disorder that affects various organs. Four distinct clinical phenotypes have been described based on organ involvement, yet it is unknown whether treatment response to B-cell depletion varies across them. This study aimed to evaluate the efficacy and safety of rituximab (RTX) across the four IgG4-RD phenotypes in a large real-world European cohort. Materials and Methods We retrospectively analyzed prospectively collected data from adult patients with IgG4-RD treated with RTX at three tertiary centers in Europe—Oslo University Hospital (Norway), San Raffaele Scientific Institute (Milan, Italy), and LMU University Hospital (Munich, Germany). Patients were categorized into four phenotypes: pancreato-hepato-biliary, retroperitoneum and aorta, head and neck-limited, and Mikulicz’ and systemic disease. The primary endpoint at 6 months was a composite of treatment response (gretaer than 2-points decrease in responder index [RI]), absence of flare, and low-dose or no glucocorticoid (lower than 7.5 mg). Secondary endpoints included flare, remission, GC discontinuation, and safety events at 6 and 12 months. Results. We included 115 patients: 33 (28.7%) had pancreato-hepato-biliary disease, 22 (19.1%) retroperitoneal and aortic disease, 19 (16.5%) head and neck-limited disease, and 41 (35.7%) Mikulicz’ and systemic disease. All phenotypes showed comparable response to RTX, with 80 patients (70%) achieving the primary endpoint. However, the retroperitoneum and aorta phenotype had the lowest remission rate at 6 months (4.5% vs 18.2–36.6%, p=0.025), and the head and neck-limited phenotype had the highest flare rate at 12 months (38.9% vs 4.8–25.0%, p=0.006) (Figure 1). Fulfillment of the 2019 ACR/EULAR classification criteria was lower in these two phenotypes. Higher baseline RI score and criteria fulfillment predicted treatment response. Safety profiles were similar across phenotypes. Infusio…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 1
  topic: category
subject: IgG4-RD
  topic: keywords
subject: Rituximab
  topic: keywords
subject: Phenotypes
  topic: keywords
subject: Marco Lanzillotta
  topic: disciplines
subject: Jens Vikse
  topic: disciplines
subject: Elisabetta Goni
  topic: disciplines
subject: Veronica Batani
  topic: disciplines
subject: Jasmin Mahajne
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
subject: Emanuel Della Torre
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1961

CO:01:2 | BAG3 in systemic sclerosis: possible therapeutic target and biomarker for pulmonary fibrosis
type: item
description: Background: BAG3 (Bcl2-associated athanogene 3) regulates apoptosis and autophagy while inducing fibroblast-to-myofibroblast transformation. In systemic sclerosis (SSc), myofibroblasts drive skin and organ fibrosis, with interstitial lung disease (ILD) affecting ~50% of patients as the leading mortality cause. BAG3 serum levels correlate with diffuse cutaneous SSc and nintedanib treatment response. This study investigated BAG3's role in SSc pathophysiology using complementary experimental approaches. Methods: Immunohistochemistry assessed BAG3 expression in lung tissue from SSc patients (N=3) and healthy controls (N=5). For in vivo studies, bleomycin-induced pulmonary fibrosis was established in mice (N=23), followed by vehicle (N=11) or anti-BAG3 mAb treatment (20 mg/kg twice weekly, N=12) from day 7-28. Label-free shotgun proteomics using SP3 protocol analyzed lung samples, with Proteome Discoverer 2.4 software processing protein expression data. Results: BAG3 dysregulation was demonstrated across multiple experimental platforms. Immunohistochemistry analysis (Figure 1A) showed significant BAG3 overexpression in SSc lung specimens versus controls, with quantitative analysis confirming elevated BAG3 mean intensity (p=0.0002) (Figure 1B). In the bleomycin-induced pulmonary fibrosis model (Figure 1C), anti-BAG3 mAb treatment markedly reduced fibrotic areas compared to PBS controls (Figure 1D, p=0.02). Comprehensive nanoLC-Orbitrap-MS/MS proteomic analysis revealed distinct molecular signatures between groups. Heat map clustering (Figure 1E) and principal component analysis (Figure 1F-G) demonstrated separation of experimental groups, with anti-BAG3 treated animals displaying proteomic profiles distinct from bleomycin-induced pathology. Functional pathway analysis (Figure 1H) revealed BAG3 inhibition significantly modulated key biological processes, downregulating harmful pathways including apoptosis (-8.095), fibrosis (-9.756), necrosis (-9.101), and respiratory infl…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 1
  topic: category
subject: Fibrosis
  topic: keywords
subject: Pathogenesis
  topic: keywords
subject: Biomarker
  topic: keywords
subject: Claudia Iannone
  topic: disciplines
subject: Margot De Marco
  topic: disciplines
subject: Antonina Minniti
  topic: disciplines
subject: Paola Manzo
  topic: disciplines
subject: Angela D'Ardia
  topic: disciplines
subject: Antonia Falco
  topic: disciplines
subject: Liberato Marzullo
  topic: disciplines
subject: Angela Rosato
  topic: disciplines
subject: Maria Caterina Turco
  topic: disciplines
subject: Roberto Caporali
  topic: disciplines
subject: Nicoletta Del Papa
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1962

CO:01:3 | Which PRO reflects remission best? Bridging the gap between patient and physician in systemic lupus erythematosus
type: item
description: Objective. Systemic lupus erythematosus (SLE) exerts a substantial burden on patients’ quality of life (QoL). Even if in SLE the goal is represented by the achievement of remission, in order to minimize damage accrual, many patients still report a reduced QoL. Currently the definition of remission does not include patient’s perspective. This study aims to identify which patient reported outcomes (PROs) may be the most suitable to be integrated into the definition of remission, in order to reflect the patient's viewpoint. Materials and Methods. A 10-year retrospective analysis of SLE patients was conducted. Demographics, clinical (disease duration, fibromyalgia, anxiety and depression, death), clinimetrics (SLEDAI-2k, SLICC/Damage Index (SDI), and therapeutic data were collected. The following PROs: Short Form Health Survey (SF)-36, Health Assessment Questionnaire (HAQ), The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Visual Analogue scale (VAS)-pain scale and VAS- global health (GH) were recorded. A heatmap based on a correlation matrix (R >=|0.6| moderate, >0.4-<0.6 acceptable) between PROs and clinimetric indices and between different PROs was built. Then we analyzed correlation between PROs and patients in remission (REM), in lupus low disease activity (LLDAS) and with active disease, also integrating PROs in the definition of clinical status of REM and LLDAS. Results. Out of 111 patients (mean age 47.3±13.7 years; disease duration 15.1±7.4 years), 6 (5.4%) were male (see Table1). FACIT-F , found <34 in 55 patients (49.5%), showed weak correlation with SLEDAI (R=-0.25; p=0.01) and SDI (R=-0.25 p=0.01);VAS-pain >=4 was found in 54 patients (48.6%) and weakly correlated with SLEDAI (R=0.21; p=0.02) (Fig. A). HAQ , altered (>=0.5) in 46 patients (41.4%), weakly correlated with SLEDAI (R=0.19; p=0.04) while VAS-GH and SF-36 did not correlate significantly with SLEDAI. FACIT-F demonstrated a moderate inverse correlation with HAQ (R=-0.60; p<0.0…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 1
  topic: category
subject: Remission
  topic: keywords
subject: Patient-reported outcomes
  topic: keywords
subject: Fatigue
  topic: keywords
subject: Elena Ragusa
  topic: disciplines
subject: Elisabetta Chessa
  topic: disciplines
subject: Marta Paola Pireddu
  topic: disciplines
subject: Fabio Congiu
  topic: disciplines
subject: Giulia Rizzo
  topic: disciplines
subject: Marianna Salis
  topic: disciplines
subject: Alessandra Oliva
  topic: disciplines
subject: Mattia Congia
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1963

CO:01:4 | Identify predictors of relapse in idiopathic inflammatory myopathies: insights from an international cohort
type: item
description: Background. Idiopathic inflammatory myopathies (IIM) are a group of rare and heterogeneous diseases. One of the greatest challenges in IIM management is defining and predicting disease flares, which are inconsistently characterized across studies. The aim of the study was to identify predictors of relapse in a retro-prospective, multi-centric IIM cohort during the first two years of disease. Methods. Patients with IIM subsets—dermatomyositis (DM), polymyositis (PM), anti-synthetase syndrome (ASyS), connective tissue disease-associated IIM (CTD-IIM), or immune-mediated necrotizing myopathy (IMNM)—were included if >=18 yrs and with >= 2 years of follow-up. Relapse was defined as a change in disease activity requiring escalation of immunosuppressive therapy and/or steroids. Patients were classified as monocyclic (no relapse in the first 2 years), polycyclic (>=1 relapse in the first 2 years), or chronic continuous. Clinical characteristics across subgroups were compared using chi-square, Mann–Whitney U, or Student’s t-test. Predictors were identified through multivariable logistic regression. Results. Of 297 screened patients, 91 were excluded due to missing data. A total of 206 patients were included (155 female; median age at diagnosis 46.9 years). 82 (39.8%) were DM, 56 (27.2%) ASyS, 40 (19.4%) CTD-IIM, 14 (6.8%) PM, and 14 (6.8%) IMNM. During the first 2 years of disease, 84 patients (40.8%) had monocyclic course, 67 (32.5%) polycyclic course, and 55 (26.7%) chronic continuous course. No significant differences in disease course distribution were observed across IIM subsets, although PM and IMNM were more frequently associated with chronic or relapsing patterns (64.2% vs. 35.8%). Myositis autoantibodies were not significantly linked to any disease course. Relapses occurred despite stable treatment for over one year in approximately one-third of cases. Most relapses involved muscle (61.9%), particularly in PM/IMNM (89%), whereas the frequency was notably lower in AS…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 1
  topic: category
subject: myositis
  topic: keywords
subject: Relapse
  topic: keywords
subject: Flare
  topic: keywords
subject: Cristina Bochicchio
  topic: disciplines
subject: Maria Rosa Pellico
  topic: disciplines
subject: Claudia Iannone
  topic: disciplines
subject: Lekshmi Minikumari Rahulan
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
subject: Edoardo Conticini
  topic: disciplines
subject: Musataka Musataka
  topic: disciplines
subject: Akira Yoshida
  topic: disciplines
subject: Silvia Cavalli
  topic: disciplines
subject: Silvia Grazzini
  topic: disciplines
subject: Giulio Fraticelli
  topic: disciplines
subject: Alessia Gatti
  topic: disciplines
subject: Giulio Lopinto
  topic: disciplines
subject: Paolo Semeraro
  topic: disciplines
subject: Veronica Batani
  topic: disciplines
subject: Thomas Patric Sheeran
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Giacomo De Luca
  topic: disciplines
subject: Roberto Caporali
  topic: disciplines
subject: Latika Gupta
  topic: disciplines
subject: Nicoletta Del Papa
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1964

CO:02:1 | Frequency and predictors of disease progression in contemporary seronegative undifferentiated arthritis in a treated-to-target early arthritis clinic
type: item
description: Background. With the introduction of the 2010 classification criteria for rheumatoid arthritis (RA), the characteristics of undifferentiated arthritis (UA) have shifted towards mostly seronegative, less inflammatory and persistent forms. However, as many as 10-30% of UA patients may still progress to RA or chronic RA-like arthritis. Predictors of disease progression in contemporary UA are at present unexplored. Aim of this study was to analyze the clinical characteristics and outcomes of patients presenting with UA after the introduction of the 2010 criteria. Methods: The study population was selected from a monocentric inception cohort of patients with new-onset inflammatory arthritis (symptom duration < 12 months; at least 3 swollen joints or, in case of <3 joints, a positive squeeze test or morning stiffness >30 min). After careful exclusion of differential diagnoses, patients classified as UA were followed at 3-month intervals. Treatment with conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs; methotrexate -MTX- if not contraindicated) was started in case of persistent disease activity (DAS28 >3.2) and positive judgement of the treating rheumatologist. Outcomes of interest were RA development and/or escalation to a csDMARD within the first 24 months. Results: Of a total population of 1528 patients enrolled in the years 2011-2019, 431 (28.2%) were diagnosed with UA. Patients were seronegative in 95% of the cases. The vast majority (71.9%) had exclusive involvement of hand joints (wrists and/or small joints, 30% monoarticular), 20.9% had combined involvement of hand and large joints, and the remaining 7.2% had exclusive involvement of large joints (70% monoarticular). During the 24-month observation period, 45 (13.1%) of the 344 patients with complete data for at least 6 months developed RA criteria, and 84/291 additional patients among those remaining UA (28.9%) required escalation to csDMARDs (MTX in 87%). At multivariable analysis, independ…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 1
  topic: category
subject: undifferentiated arthritis
  topic: keywords
subject: remission of early arthritis
  topic: keywords
subject: Joint involvement
  topic: keywords
subject: Elena Manna
  topic: disciplines
subject: Ludovico De Stefano
  topic: disciplines
subject: Domenico Sorace
  topic: disciplines
subject: Jacopo Pelizza
  topic: disciplines
subject: Blerina Xoxi
  topic: disciplines
subject: Antonio Manzo
  topic: disciplines
subject: Carlomaurizio Montecucco
  topic: disciplines
subject: Serena Bugatti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1965

CO:02:2 | Effectiveness of tumor necrosis factor inhibitors in rheumatoid arthritis: real world data from an Italian National Registry
type: item
description: Tumor necrosis factor inhibitors (TNFi) remain a cornerstone in the management of rheumatoid arthritis (RA), representing the first-line biologic therapy for most patients. This study aimed to assess the real-world effectiveness of TNFi in RA patients. To this purpose, we retrospectively analysed data from RA patients treated with TNFi and enrolled in an Italian national registry. Baseline demographic and clinical characteristics included age, sex, body mass index (BMI), tobacco use, comorbidities, rheumatoid factor and ACPA positivity, line of biologic therapy, VAS pain, patient and physician global assessment, DAS28, CDAI, SDAI, HAQ-DI, use of concomitant glucocorticoids (including dose), and csDMARD co-therapy. Changes in disease activity, quality of life, and steroid use were assessed at 12 months. Remission rates were evaluated at 3, 6, 12, 24, and 60 months. Drug survival was analyzed at 6, 12, 24, and 60 months. Discontinuations and reasons for treatment withdrawal were also recorded. Baseline demographic and clinical characteristics are summarized in Table 1. A significant reduction in disease activity (measured as DAS28, CDAI and SDAI), quality of life and proportion of patients in steroid therapy was observed at 12 months, with DAS28 remission rates of 36% at 3 months, 45%% at 6 months, 44%% at 12 months, 59% at 24 months, and 50% at 60 months. TNFi survival rates were 87.5% at 6 months, 76.8% at 12 months, 63.8% at 24 months, and 44.3% at 60 months. The overall drug survival is depicted in Figure 1A. A significant reduction in treatment survival was observed when TNFi were prescribed at third or further therapeutic line (Figure 1B), while co-therapy with csDMARDs had no influence on survival on treatment (Figure 1C). A total of 942 treatment discontinuations were recorded during follow-up. The main reason for treatment discontinuation was represented by loss of efficacy (30.5% of patients), while adverse events led to suspension in 11.6% of cases. In summ…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 1
  topic: category
subject: Rheumatoid arthritis
  topic: keywords
subject: TNF inhibitors
  topic: keywords
subject: Efficacy
  topic: keywords
subject: Valerio Fiorilli
  topic: disciplines
subject: Francesca Romana Spinelli
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Chiara Bazzani
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
subject: Rosario Foti
  topic: disciplines
subject: Marcello Govoni
  topic: disciplines
subject: Francesco Paolo Cantatore
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
subject: Roberto Caporali
  topic: disciplines
subject: Marco Sebastiani
  topic: disciplines
subject: Roberta Ramonda
  topic: disciplines
subject: Serena Bugatti
  topic: disciplines
subject: Elisa Gremese
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
subject: Bruno Frediani
  topic: disciplines
subject: Maurizio Rossini
  topic: disciplines
subject: Angelo Semeraro
  topic: disciplines
subject: Leonardo Santo
  topic: disciplines
subject: Gianfranco Ferraccioli
  topic: disciplines
subject: Giovanni Lapadula
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1966

CO:02:4 | Whole blood hypercoagulable profiles in patients with rheumatoid arthritis
type: item
description: Background: Rheumatoid arthritis (RA)-associated disease activity is accompanied by abnormalities in the coagulation-fibrinolysis system, potentially increasing the risk of venous and arterial thromboembolism. The aim of this case-control study was to evaluate the hemostatic system functions in a group of RA patients by whole blood rotation thromboelastometry and impedance aggregometry. Methods: Whole blood rotation thromboelastometry and impedance aggregometry were performed in RA patients (cases) treated with biological and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) and compared 1:1 with age (± 3 yrs) and sex-matched healthy individuals (controls). In each enrolled participant, global coagulation monitoring was assessed by whole blood rotational thromboelastometry (ROTEM®, Instrumentation Laboratory-Werfen) and whole blood impedance aggregometry (Multiplate® Analyser, Roche Diagnostics) tests. Variables assessing disease activity, demographics and cardiovascular risk were assessed. Univariate analyses (independent T-test, Pearson correlation) were performed. Results: The study population included 30 RA patients on b/tsDMARDs and 30 controls. The cases (mean age 56.2±11.6 years, 90% female) had a mean disease duration of 17.8±9.1 years; most received methotrexate (60%) and low-dose prednisone (1.2±2.1 mg/day); NSAIDs were used by 47%. No participants were taking antiplatelet or anticoagulant medications. Disease activity and inflammatory markers were generally low (SDAI: 10.1±8, CRP 3.5±4.3 mg/L, ESR 23±18.5 mm/h). A history of VTE was reported in 7% of patients, while no previous MACE events were documented. Regarding cardiovascular risk factors: 10% were current smokers, 53% had hypercholesterolaemia, 27% had hypertension and only one patient had diabetes mellitus. Thromboelastometry and aggregometry showed excellent internal validity, as several measurements significantly and strongly correlated with inflammatory markers, disease acti…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 1
  topic: category
subject: Rheumatoid Arthritis
  topic: keywords
subject: Thromboelastography
  topic: keywords
subject: Aggregometry
  topic: keywords
subject: Lorenzo Di Luozzo
  topic: disciplines
subject: Alessandro Giollo
  topic: disciplines
subject: Mariangela Salvato
  topic: disciplines
subject: Francesca Frizzera
  topic: disciplines
subject: Kiren Khalid
  topic: disciplines
subject: Luca Spiezia
  topic: disciplines
subject: Andrea Benetti
  topic: disciplines
subject: Chiara Samà
  topic: disciplines
subject: Paolo Simioni
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1967

CO:03:1 | Distinct breath metabolomic signature in systemic sclerosis patients with pulmonary arterial hypertension
type: item
description: Background/Purpose: Pulmonary arterial hypertension (PAH) is a severe complication of systemic sclerosis (SSc), associated with high morbidity and mortality. Accurate and early diagnosis of SSc-PAH is essential to initiate targeted therapies that may improve outcomes by counteracting key pathophysiological mechanisms. Breathomics, the analysis of volatile organic compounds (VOCs) in exhaled breath, has emerged as a promising non-invasive tool, as VOCs reflect underlying metabolic and pathological processes. This study investigates the potential of breathomics in SSc-PAH, both for disease understanding and diagnosis. Methods: 14 SSc patients with a diagnosis of PAH confirmed by right heart catheterization, 28 age- and sex-matched SSc patients without PAH, and 36 matched healthy controls (HCs) were enrolled in a single-center, case-control observational study. Exhaled breath VOCs were collected using the ReCIVA® breath sampler connected to a clean air supply (CASPER®). Samples were trapped on sorbent tubes and analyzed by thermal desorption gas chromatography–mass spectrometry (TD-GC-MS) at Owlstone Medical. VOCs were chemically identified according to Metabolomics Standards Initiative (MSI) criteria, and blank air samples were analyzed to distinguish true breath compounds from environmental contaminants. Data were analyzed using linear regression, adjusting for relevant covariates and excluding outliers. Results: all SSc participants were female and predominantly affected by lcSSc (n = 23, 63.4%) and mostly tested positive for ACA (n = 40, 85%). The mean age was 68 ± 9 years, with no differences between the SSc-PAH and SSc-noPAH groups. A total of 1.382 VOCs were analyzed; of these, 186 were confirmed to be genuinely present “on breath” and annotated with high confidence (MSI tier 1 or 2). Among these, 55 VOCs significantly differentiated SSc-PAH from SSc-noPAH, and 40 differentiated SSc-PAH from healthy controls. Notably, 32 VOCs distinguished SSc-PAH from both comp…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 1
  topic: category
subject: Breathomics
  topic: keywords
subject: Systemic sclerosis
  topic: keywords
subject: Pulmonary hypertension
  topic: keywords
subject: Martina Iacubino
  topic: disciplines
subject: Lorenzo Rocco
  topic: disciplines
subject: Marco Vicenzi
  topic: disciplines
subject: Chiara Bellocchi
  topic: disciplines
subject: Marta Mozzo
  topic: disciplines
subject: Adriana Severino
  topic: disciplines
subject: Monica Caronni
  topic: disciplines
subject: Alessandro Santaniello
  topic: disciplines
subject: Gaia Montanelli
  topic: disciplines
subject: Barbara Vigone
  topic: disciplines
subject: Liam Grimmett
  topic: disciplines
subject: Matthew Kerr
  topic: disciplines
subject: Lorenzo Beretta
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1968

CO:04:1 | Bone properties and biomechanics in patients with psoriatic disease: a cross-sectional study with high-resolution peripheral quantitative computed tomography
type: item
description: Background. Psoriatic disease has a complex effect on bone metabolism, resulting in both pathological bone formation and bone resorption. However, microstructural changes in cortical and trabecular compartment remain poorly understood. The aim of this study was to investigate the prevalence and determinants of bone microarchitectural damage in patients with psoriatic disease. Methods. We performed a cross-sectional study on patients with Psoriasis (PsO), Psoriatic arthritis (PsA) and age-matched healthy controls (HC) recruited into the department of Dermatology and Rheumatology of AOUI of Verona center. We conducted High-Resolution peripheral Quantitative Computed Tomography (HRpQCT) of the radius and finger joints of the non-dominant hand data. Bone microstructure parameters and Finite Element Analysis (FEA) were calculated. Results. Fifty-one patients with PsO and thirty-nine patients with PsA were consecutively enrolled in the study. Twenty-four age-matched HC were enrolled as well. Distal radius Bone Mineral Density (BMD) levels were lower in patients with PsA e PsO compared with HC. On distal radius FEA analysis we found a significant reduction of stiffness in PsA compared to both HC and PsO patients. Proximal and distal region of distal interphalangeal (DIP) BMD were lower in PsO compared to PsA. In contrast, PsA patients had lower stiffness and cortical thickness compared to PsO. Nail involvement in psoriatic disease was negatively associated with bone stiffness at the proximal and distal region of DIP. Conclusions. Psoriatic disease negatively impacts bone integrity, particularly in PsA patients. Patients with psoriatic disease seemed to have lower bone density and more microarchitectural alteration. Nail involvement was associated with decreased bone stiffness in psoriatic disease.
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 2
  topic: category
subject: Psoriatic arthritis
  topic: keywords
subject: Bone mineral density
  topic: keywords
subject: HRpQCT
  topic: keywords
subject: Anna Piccinelli
  topic: disciplines
subject: Francesco Bellinato
  topic: disciplines
subject: Francesco Pollastri
  topic: disciplines
subject: Francesco Giorgio
  topic: disciplines
subject: Martina Teoni
  topic: disciplines
subject: Angelo Fassio
  topic: disciplines
subject: Camilla Benini
  topic: disciplines
subject: Carmela Dartizio
  topic: disciplines
subject: Mattia Tugnolli
  topic: disciplines
subject: Davide Gatti
  topic: disciplines
subject: Maurizio Rossini
  topic: disciplines
subject: Ombretta Viapiana
  topic: disciplines
subject: Paolo Gisondi
  topic: disciplines
subject: Giovanni Adami
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1969

CO:05:1 | Predicting one-year disease activity in systemic lupus erythematosus using machine learning and explainable AI
type: item
description: Background: Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease characterized by marked heterogeneity in clinical presentation, disease course, and response to therapy. This variability makes it particularly challenging to predict disease flare-ups in clinical practice, despite their profound implications on prognosis and quality of life. Objectives: This study aimed to develop a machine learning model to predict the risk of disease activity events in SLE patients within a 12-month time frame, based on clinical status, recent history, and long-term disease trajectory. Methods: We built a structured dataset (SLE Data Mart) from electronic health records using data mining and NLP techniques. It includes demographic, therapeutic, clinical, and laboratory information from SLE patients seen at our University Hospital. Patients had at least one outpatient visit and one hospitalization coded as ICD9 710.0 or 695.4. The outcome—an activity event within 12 months—was defined as any of the following: neurological, renal, or vascular symptoms; new organ domain involvement; or hospitalization for SLE. Input features described current contact, past 12 months, and prior clinical history, expressed as binary or continuous variables. Univariable selection (Chi-Square, Mann-Whitney U tests) identified features significantly associated with the outcome (p < 0.05). Selected variables were used to train multiple models (Logistic Regression, SVC, Decision Tree, Random Forest, XGBoost), evaluated by 5-fold cross-validation. The model with the highest AUC was selected and interpreted using SHAP to identify key predictors. Results: The dataset included 262 SLE patients and 5,952 contacts between 2012–2020. Most patients were female (88%), with a median age of 43 years and median follow-up of 6 years. Patients had a median of 16 contacts each. The cohort was split into training (70%) and testing (30%) sets. Overall, 48% of contacts were associated with an activit…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 2
  topic: category
subject: Lupus
  topic: keywords
subject: Machine learning
  topic: keywords
subject: Artificial intelligence
  topic: keywords
subject: Pier Giacomo Cerasuolo
  topic: disciplines
subject: Augusta Ortolan
  topic: disciplines
subject: Livia Lilli
  topic: disciplines
subject: Laura Antenucci
  topic: disciplines
subject: Carlotta Maschiocchi
  topic: disciplines
subject: Jacopo Lenkowicz
  topic: disciplines
subject: Lucia Lanzo
  topic: disciplines
subject: Luca Petricca
  topic: disciplines
subject: Maria Rita Gigante
  topic: disciplines
subject: Vivianaantonella Pacucci
  topic: disciplines
subject: Pierluigi Rizzuti
  topic: disciplines
subject: Rebecca Ventura
  topic: disciplines
subject: Silvia Piunno
  topic: disciplines
subject: Cesare Gavotti
  topic: disciplines
subject: Marco Gorini
  topic: disciplines
subject: Gabriella Castellino
  topic: disciplines
subject: Alfredo Cesario
  topic: disciplines
subject: Stefano Patarnello
  topic: disciplines
subject: Silvia Laura Bosello
  topic: disciplines
subject: Maria Antonietta D'Agostino
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1970

CO:05:2 | An OMERACT study for the development of an algorithm for automatic identification of calcium pyrophosphate deposition by ultrasound: the Crystal Artificial Intelligence Monitoring Study
type: item
description: Background. Calcium pyrophosphate deposition (CPPD) is one of the most frequent causes of chronic arthropathy in individuals over 60. Ultrasound (US) has recently become central in the diagnostic process, with the OMERACT group defining elementary US lesions and a standardized scoring system. Despite its increasing use, US remains operator-dependent and requires specialized expertise to reduce diagnostic variability. This study aims to develop an Artificial Intelligence (AI) tool capable of automatically identifying and grading CPPD in knee menisci using US images. Materials and Methods. This project is part of an international initiative to develop AI algorithms for detecting and scoring elementary US lesions in CPPD and gout. Nineteen rheumatologists from ten countries contributed a total of 446 high-quality US images of CPPD in the knee menisci, previously classified by expert consensus into four grades (0 to 3). Each image was manually annotated to isolate the meniscal region using 3DSlicer software. A deep learning approach based on transfer learning was employed, utilizing convolutional neural networks (CNNs) pretrained on the ImageNet dataset. The models were fine-tuned on the collected dataset and trained using standard techniques including early stopping, data augmentation (rotation, shift, zoom, flipping), and class weighting to handle data imbalance. The dataset was split into training (80%) and validation (20%) subsets while preserving grade distribution. Model performance was evaluated using standard classification metrics: accuracy, precision, recall, and F1-score. All processes were implemented using Python, OpenCV, and TensorFlow-Keras frameworks. Results. The image dataset showed an unbalanced distribution: 9% grade 0, 18% grade 1, 48% grade 2, and 25% grade 3. The highest accuracy obtained for binary classification (CPPD presence vs. absence) was 0.69. The model showed acceptable performance in identifying grades 0, 2, and 3, while classification o…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 2
  topic: category
subject: Artificial intelligence
  topic: keywords
subject: CPPD
  topic: keywords
subject: Gout
  topic: keywords
subject: Daniele Cirillo
  topic: disciplines
subject: Tito Bassani
  topic: disciplines
subject: Silvia Sirotti
  topic: disciplines
subject: Greta Pellegrino
  topic: disciplines
subject: Alessandro Lucia
  topic: disciplines
subject: Rodolfo Fabbri
  topic: disciplines
subject: Laura Pezzoni
  topic: disciplines
subject: Piercarlo Sarzi Puttini
  topic: disciplines
subject: Georgios Filippou
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1971

CO:05:3 | Radiomics and machine learning for differentiating rheumatoid arthritis-associated interstitial lung disease and idiopathic pulmonary fibrosis with usual interstitial pneumonia pattern
type: item
description: Background. While Idiopathic Pulmonary Fibrosis (IPF) and Rheumatoid Arthritis-associated Interstitial Lung Disease (RA-ILD) can manifest identical Usual Interstitial Pneumonia (UIP) patterns on HRCT, their underlying histopathology reveals fundamentally different disease processes—IPF driven by aberrant fibroblast proliferation and excessive collagen deposition versus RA-ILD's autoimmune-mediated inflammation. This pathological divergence translates to dramatically different prognoses and treatment responses, yet current imaging interpretation cannot reliably capture these microscopic differences. Radiomics offers a revolutionary approach: extracting hundreds of quantitative features that may encode histopathological signatures within standard HRCT images. Combined with machine learning, this technology might unveil tissue-level distinctions invisible to visual analysis, potentially transforming a diagnostic challenge into a data-driven classification. Our aim was to develop a radiomic-based framework for distinguishing IPF from RA-ILD in UIP-pattern patients. Methods. We conducted a retrospective analysis of patients with confirmed UIP pattern diagnosed in tertiary centres. Whole-lung volumes were semi-automatically segmented using 3DSlicer (v5.4.0, https://tinyurl.com/mr339kmm). 120 radiomic features were extracted via PyRadiomics (v3.0.1). Features underwent z-score standardization and multicollinearity assessment Two distinct XGBoost models were developed to address different clinical scenarios: Standard Model: Leveraged all radiomic features to maximize discriminative performance. - Extent-Aware Model: Excluded volume-related features and incorporated mesh volume as a covariate to control for disease severity, ensuring classification based on intrinsic tissue characteristics rather than disease burden. Model performance was evaluated using 5-fold cross-validation with area under the receiver operating characteristic curve (AUC) as the primary metric. Results. …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 2
  topic: category
subject: Interstitial Lung Disease
  topic: keywords
subject: Rheumatoid arthritis
  topic: keywords
subject: Radiomics
  topic: keywords
subject: Vincenzo Venerito
  topic: disciplines
subject: Chiara Nani
  topic: disciplines
subject: Andreina Manfredi
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Cecilia Burattini
  topic: disciplines
subject: Marco Sebastiani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1972

CO:06:1 | Predictors of damage accrual in a monocentric cohort of patients with Behçet’s syndrome (BS) evaluated with BS overall damage index in real-life clinical practice
type: item
description: Objectives. Behçet’s syndrome (BS) is a rare chronic multisystemic inflammatory disease associated with increased risk of morbidity, disability and mortality. Consistent assessment of damage and prevention of damage accrual is therefore crucial in daily clinical practice. This study aims to assess damage progression in our cohort of patients with BS using Behçet’s Syndrome Overall Damage Index (BODI), to evaluate BODI across time and the associations of BODI score with demographic and clinical features to identify potential independent predictors of damage accrual. Methods. We conducted a retrospective observational monocentric study including patients with BS. BODI scores (range: 0-46; higher scores indicate greater damage) were calculated at T0 (diagnosis/first visit) and T1(last follow-up). Demographic, clinical features and treatments were retrieved. Patients were stratified according to BODI scores and comparisons were made using Mann-Whitney test or Chi-square test. Logistic regression models were used to identify potential independent predictors of damage accrual (BODI>=1) at T0 and T1, including BODI score variations (deltaBODI) between T0 and T1. Results. We included 155 patients (56.8% females), median age at diagnosis 36 years [IQR 26-44], median disease duration at last follow-up 9 years [IQR 5-13], and median diagnostic delay 2 years [IQR 0-6]. Most were Italians (80%) and 63.8% (81/127) had HLA-B*51. Among clinical cumulative manifestations the most frequent were oral ulcers (96.8%), skin lesions (66.5%), musculoskeletal manifestations (55.5%) and genital ulcers (54.8%), while ocular, neurological, vascular, gastrointestinal and cardiopulmonary involvement occurred in 40%, 21.9%, 21.9%, 17.4%, and 11% respectively. Median BODI at T0, T1 and deltaBODI were 0 [IQR 0-1; min 0, max 7], 0 [IQR 0-2; min 0, max 17], 0 [IQR 0-1; min 0, max 17] respectively; 27.6% (42/152) of patients had deltaBODI>=1. Patients with BODI>=1 at T0 or T1 as compared to those with…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 2
  topic: category
subject: Predictors of damage accrual
  topic: keywords
subject: Behçet's syndrome
  topic: keywords
subject: BODI
  topic: keywords
subject: Giulia Voltarel
  topic: disciplines
subject: Francesca Crisafulli
  topic: disciplines
subject: Alba Chiara Pozzi
  topic: disciplines
subject: Anita Melzani
  topic: disciplines
subject: Micol Frassi
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
subject: Paolo Airò
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1973

CO:06:2 | Deep immunophenotyping in patients with juvenile localized scleroderma reveals two distinct immunological endophenotypes
type: item
description: Background. The aim of this project is to perform immunophenotyping of patients with JLS and healthy controls to assess dysregulated immunological pathways in JLS, and to identify biomarkers able to predict clinical features. Methods. We included in this study pediatric patients diagnosed with linear and mixed JLS. Peripheral blood mononuclear cells (PBMCs) and plasma samples at diagnosis or treatment escalation were identified retrospectively and retrieved from our biobank. We included only patients whose first available blood sample was obtained at time of diagnosis and before the initiation of any treatment. Levels of 50 cytokines were measured in the plasma by protein array (RayBiotech). Lymphocyte and monocyte subsets were analysed with a 26-colour flow cytometry panel and acquired on a FACSymphony (BD). Results. We identified samples at baseline from 11 patients with JLS and 10 controls. Cytokine array identified 15 cytokines that were significantly elevated in JLS patients compared to controls. Using Principal Component Analysis (PCA), we observed a distinct distribution between patients and controls, with approximately 50% of patients clustering away from controls, and the remaining 50% aligning closely with them (Figure 1A). Patients clustering near controls exhibited the lowest cytokine levels and were designated as non-inflammatory JLS (no_inf JLS), whereas those clustering away had the highest cytokine levels and were classified as inflammatory JLS (inf_JLS) (Figure 1A). We then validated the results of the cytokine array in ELISA: CXCL9, CXCL10, and CXCL13 were consistently elevated in all patients with inf_JLS, at baseline and during longitudinal follow-up, while cytokine levels in patients with no_inf JLS remained within normal ranges (Figure 1B). We then performed a 26-parameter staining of PBMCs, allowing comprehensive evaluation of major lymphocytes and monocytes subsets by flow cytometry. Our analysis identified 81 subpopulations of interest; a PC…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 2
  topic: category
subject: juvenile localised scleroderma
  topic: keywords
subject: T cells
  topic: keywords
subject: Cytokines
  topic: keywords
subject: Emiliano Marasco
  topic: disciplines
subject: Angela Aquilani
  topic: disciplines
subject: Rebecca Nicolai
  topic: disciplines
subject: Ivan Caiello
  topic: disciplines
subject: Fabrizio De Benedetti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1974

CO:06:3 | Clinical and laboratory markers for distinguishing VEXAS from Schnitzler's syndrome in male patients with skin involvement: insights from the International AIDA Network Registries
type: item
description: Background: VEXAS syndrome and Schnitzler’s disease are rare adult-onset autoinflammatory conditions that often present with overlapping clinical and laboratory features, particularly in the early stages. Both disorders are characterized by systemic inflammation, recurrent fever, cutaneous involvement, and elevated inflammatory markers. A common hallmark is the presence of urticarial rash, frequently associated with monoclonal gammopathy of undetermined significance (MGUS). Given these similarities—especially in older male patients—differential diagnosis may be particularly challenging, underscoring the need for specific clinical and laboratory markers to guide classification and management. As prognosis differs between the two entities, the present study was undertaken to identify the clinical and laboratory parameters that should raise suspicion for VEXAS syndrome among patients under evaluation for Schnitzler’s disease. Methods: Data from patients with Schnitzler’s syndrome and VEXAS syndrome were obtained from the respective international AutoInflammatory Disease Alliance (AIDA) Network registries. Inclusion criteria for patients affected by VEXAS syndrome required the presence of a pathogenic or likely pathogenic mutation in the UBA1 gene. For patients with Schnitzler’s syndrome, the inclusion criteria required the fulfillment of Strasbourg diagnostic criteria. Male patients diagnosed with Schnitzler’s syndrome were compared to VEXAS patients who presented with urticarial skin manifestations. Clinical and laboratory features were analyzed using univariate and multivariable logistic regression models to identify variables associated with VEXAS syndrome. Results. A total of 19 VEXAS patients and 18 patients with Schnitzler’s syndrome were enrolled. At univariate binary logistic regression, the diagnosis of VEXAS syndrome was associated with the age at disease onset (OR=1.08, 95% CI. 1.01-1.16, p=0.02), haemoglobin levels (OR=0.44, 95% CI. 0.26-0.77, p=0.003), the…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 2
  topic: category
subject: UBA1 mutation
  topic: keywords
subject: Skin manifestations
  topic: keywords
subject: Differential diagnosis
  topic: keywords
subject: Valeria Caggiano
  topic: disciplines
subject: Jessica Sbalchiero
  topic: disciplines
subject: Micol Frassi
  topic: disciplines
subject: Andrea Hinojosa-Azaola
  topic: disciplines
subject: Francesca Crisafulli
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
subject: Paolo Sfriso
  topic: disciplines
subject: Sara Bindoli
  topic: disciplines
subject: José Hernández-Rodríguez
  topic: disciplines
subject: Henrique A. Mayrink Giardini
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Ombretta Viapiana
  topic: disciplines
subject: Amato De Paulis
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
subject: Antonio Gidaro
  topic: disciplines
subject: Serena Bugatti
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Rosetta Vitetta
  topic: disciplines
subject: Cecilia Chighizola
  topic: disciplines
subject: Marcello Govoni
  topic: disciplines
subject: Giacomo Emmi
  topic: disciplines
subject: Paola Triggianese
  topic: disciplines
subject: Carmelo Gurnari
  topic: disciplines
subject: Bruno Frediani
  topic: disciplines
subject: Claudia Fabiani
  topic: disciplines
subject: Luca Cantarini
  topic: disciplines
subject: Antonio Vitale
  topic: disciplines
subject: for the AIDA Network
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1975

https://www.reumatismo.org/reuma/article/view/2000
type: item
title: PO:01:003 | Sex-based differences in 2 years treatment outcomes with b/ts-DMARDs in psoriatic arthritis: from real-world evidence to predictive modeling from the Gruppo Italiano Studio Early Arthritis (GISEA) prospective registry
description: Background. Psoriatic arthritis (PsA) presents several evidence of sex-related disparities, highlighting critical gaps in our understanding and management of PsA. This study aimed to evaluate b/ts-DMARDs effectiveness, drug survival and clinical response predictors in PsA patients, related to biological sex. Patients and Methods. PsA patients starting a b-/ts-DMARDs between January 2016 and December 2023 were included in this multicentre real-world observational study based on the Italian GISEA prospective registry. Demographic, laboratory and clinical data were collected at baseline and at four-months interval thereafter.Logistic regression was used to investigate the association between selected variables and MDA achievement at T4, reporting as adjusted odds ratio (adjOR) with 95% confidence interval (CI), adjusting for age, BMI, csDMARDs and steroid user and baseline DAPSA score. Results. A total of 4197 PsA patients were enrolled, comprising 1714 males (mPsA) and 2483 females (fPsA). Comparing to fPsA patients, mPsA were characterized by a higher BMI (p=0.01), longer disease duration (p=0.0001) and more frequent psoriasis (p<0.0001).Moreover, mPsA compared to fPsA exhibited a higher prevalence of the oligoarticular pattern (p=0.003), higher CRP levels (p<0.0001), and more presence of erosion (p=0.045), but lower DAPSA score (p<0.0001). Significant differences in clinical improvement were observed at each time point between mPsA and fPsA in terms of DAPSA remission and MDA achievement. Furthermore, female gender had a negative impact on retention rates of b/ts-DMARD therapy only at first- or second-line compared to male gender (p<0.0001 and p=0.023, respectively). PsA patients who achieved MDA at T4 were more likely to be male (p<0.0001), have an oligoarticular pattern (p<0.0001), lack enthesitis involvement (p<0.0001), be free of fibromyalgia comorbidity (p<0.0001) and be b-/ts-DMARDs naïve (p=0.001). Based on these findings, the five features were considered in…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Psoriatic arthritis
  topic: keywords
subject: Biological
  topic: keywords
subject: Registry
  topic: keywords
subject: Simone Perniola
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Francesco Paolo Cantatore
  topic: disciplines
subject: Angelo Semeraro
  topic: disciplines
subject: Leonardo Santo
  topic: disciplines
subject: Roberto Gorla
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
subject: Roberto Felice Caporali
  topic: disciplines
subject: Bruno Frediani
  topic: disciplines
subject: Rosario Foti
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Marco Sebastiani
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
subject: Roberta Ramonda
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
subject: Maurizio Rossini
  topic: disciplines
subject: Serena Bugatti
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Giovanni Lapadula
  topic: disciplines
subject: Gianfranco Ferraccioli
  topic: disciplines
subject: Francesca Romana Spinelli
  topic: disciplines
subject: Elisa Gremese
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2000

PO:01:004 | Real-world retention of IL-17 inhibitors in psoriatic arthritis: impact of prior IL-17 exposure across multiple treatment lines in the “BIRRA” multicentre cohort
type: item
description: Background. Several studies have explored cycling versus switching strategies in psoriatic arthritis (PsA) when TNF inhibitors are used as biological DMARD (bDMARD). Conversely, real-world evidence regarding cycling strategies within other bDMARD classes is lacking. In this study, we aimed to evaluate the retention rate of interleukin-17 inhibitors (anti-IL17) in patients with PsA, focusing on the differences between those receiving their first anti-IL17 agent and those previously exposed to anti-IL17 therapy. Methods. This was a multicentre, retrospective, observational study. All consecutive patients with PsA treated with an anti-IL17 bDMARD were included. The baseline assessment encompassed demographic and clinical characteristics, including disease domains and activity scores, IL-17 exposure status, number of prior bDMARD lines, and concomitant therapies. The primary outcomes were: a. the retention rate of anti-IL17 agents in IL-17 naïve versus IL-17 experienced patients; b. predictors of treatment discontinuation. Results. A total of 868 patients were included (59.3% female; median age 56 [48-63] years). The majority were receiving their first anti-IL17 agent (89.3% IL17 naïve vs 10.7% IL17 experienced). Secukinumab was the most frequently prescribed bDMARD (70.8%), followed by ixekizumab (28.6%), and bimekizumab (0.6%) (Figure 1.A.). At baseline, IL17 experienced patients more commonly exhibited axial involvement compared to IL17 naïve patients (59.1% vs 35.4%) and had received a higher median number of previous bDMARDs (4 [3-5] vs 2 [1-3] lines, respectively). Secukinumab was more frequently prescribed in IL17 naïve patients (76.9% vs 20.4%), whereas ixekizumab was preferentially used in IL17 experienced individuals (Figure 1.A.). Median follow-up for the overall cohort was 15.2 [7.0-33.8] months, for a total exposure of 20’014 patient-months. At 12 months, the estimated retention rate was 77.6% vs 77.0% in naïve vs experienced patients respectively, dropping…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Psoriatic Arthritis
  topic: keywords
subject: IL-17 inhibitors
  topic: keywords
subject: Treatment cycle
  topic: keywords
subject: Valentino Paci
  topic: disciplines
subject: Alarico Ariani
  topic: disciplines
subject: Eleonora Celletti
  topic: disciplines
subject: Alberto Lo Gullo
  topic: disciplines
subject: Camilla Mazzanti
  topic: disciplines
subject: Valeria Nucera
  topic: disciplines
subject: Natalia Mansueto
  topic: disciplines
subject: Rosalba Caccavale
  topic: disciplines
subject: Patrizia Del Medico
  topic: disciplines
subject: Antonella Farina
  topic: disciplines
subject: Palma Scolieri
  topic: disciplines
subject: Cecilia Giampietro
  topic: disciplines
subject: Olga Addimanda
  topic: disciplines
subject: Riccardo Bixio
  topic: disciplines
subject: Maddalena Larosa
  topic: disciplines
subject: Viviana Ravagnani
  topic: disciplines
subject: Federica Lumetti
  topic: disciplines
subject: Aldo Biagio Molica Colella
  topic: disciplines
subject: Elena Bravi
  topic: disciplines
subject: Rosetta Vitetta
  topic: disciplines
subject: Bernd Raffeiner
  topic: disciplines
subject: Gilda Sandri
  topic: disciplines
subject: Rosario Foti
  topic: disciplines
subject: Simone Parisi
  topic: disciplines
subject: Michele Maria Luchetti Gentiloni
  topic: disciplines
subject: Gianluca Moroncini
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2001

PO:01:005 | Exploring the relationship between alexithymia, pain perception, and disease burden in a cohort of patients with psoriatic arthritis
type: item
description: Background. Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects joints and periarticular structures. It is well established that PsA exerts a significant negative impact on quality of life of affected individuals, inducing functional impairment and related disability. Joint pain and stiffness may be misinterpreted or exaggerated by PsA patients, ultimately leading to unsuccessful chances of remission. We aimed to evaluate the potential impact of alexithymia and pain catastrophizing on clinical features, disease activity and comorbidities in PsA. Methods. A total of 166 PsA patients, fulfilling the 2006 CASPAR criteria, were enrolled. Time frame spanned from January to December 2024. The 20-item Toronto Alexithymia Scale (TAS-20) questionnaire along with Pain catastrophizing scale (PCS) were administered to all recruited patients. Clinical and demographic characteristics, along with disease activity measures, inflammatory indices and concomitant presence of fibromyalgia were recorded. Quality of life was assessed via the SF-36 questionnaire. Statistical analysis employed chi-square and T student tests, as well as Rho Spearman for correlation analysis. A statistical p<0.05 was considered significant. Results. We divided patients into remission-LDA (DAPSA<14) and MoDA-HDA (DAPSA>14) and compared the two groups. Significant differences were noted among groups regarding diagnostic delay (31.7±41 vs 61.8±64.5 months, p<0.001) and comorbidities burden (e.g. dyslipidaemia 32 vs 33±50, p 0.020; osteoporosis 13 vs 18±27.3, p 0.021; anxiety/depression 6 vs 13±19.7, p 0.007). As expected MoDA-HDA group exhibited a greater prevalence of bDMARDs changes and more csDMARDs and NSAID/COXIB usage. We also found a significant difference between the two groups in the clinical domains, like enthesitis (n 55 vs 53±80.3, p <0.001) and dactylitis (18 vs 23±34.8, p 0.014) (Table 1). Other significant differences were found in laboratory indices (e.g. CRP (mg/dl) 0.6±0.8…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: PSORIATIC ARTHRITIS
  topic: keywords
subject: ALEXYTHYMIA
  topic: keywords
subject: CATASTROPHISATION OF PAIN
  topic: keywords
subject: Michelina Turri
  topic: disciplines
subject: Eugenio Capparelli
  topic: disciplines
subject: Sergio Del Vescovo
  topic: disciplines
subject: Maria Iacovantuono
  topic: disciplines
subject: Benedetta Monosi
  topic: disciplines
subject: Giulia Mori
  topic: disciplines
subject: Ilaria Cristiano
  topic: disciplines
subject: Paola Conigliaro
  topic: disciplines
subject: Elisabetta Greco
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2002

https://www.reumatismo.org/reuma/article/view/2006
type: item
title: PO:01:015 | Assessment of the impact of the co-occurrence of psoriasis on the clinical and therapeutic pattern of a single-centre cohort of patients with spondyloarthritis associated with chronic inflammatory bowel disease
description: Background. To assess the influence of the co-presence of psoriasis (PsO) on the clinical and therapeutic pattern of a single-centre cohort of patients with spondyloarthritis (SpA) associated with chronic inflammatory bowel disease (IBD). Methods. This study represents a preliminary phase of an ancillary analysis of the DIAMANTE project (Early diagnosis of spondyloarthritis in a cohort of patients with chronic inflammatory bowel disease), developed with the overall objective of determining the prevalence, predictors and outcomes of SpA in a cohort of subjects with IBD, in the context of close and structured collaboration between gastroenterologists and rheumatologists. Within the DIAMANTE cohort, two subgroups of patients were identified for the study: patients with SpA and a concomitant personal diagnosis of PsO (Group 1: IBD+SpA+PsO) and patients with a diagnosis of SpA alone (Group 0: IBD+SpA). For both groups, the following demographic, clinical and therapeutic data were recorded and compared: gender, association between IBD patterns, peripheral joint involvement, axial involvement, history of dactylitis, need for biological therapy, multi-resistance to targeted drugs (discontinuation due to ineffectiveness of at least two small molecule biological drugs). A significance threshold of p<0.05 was used with Fisher's and X² tests. Results. Data from 665 consecutive patients with IBD recruited from November 2023 to April 2025 were analysed. Within this cohort, 95 (14%) had a concomitant diagnosis of SpA; among these, 21 (22%) also had a diagnosis of PsO (IBD+SpA+PsO group), while 74 (78%) had only SpA associated with IBD (IBD+SpA group). Comparative analysis of the two groups revealed significant, albeit only trending towards statistical significance, differences in terms of female prevalence (71% vs 54%, p=0.15), frequency of peripheral involvement (62% vs 49%, p=0.28) and use of biologic drugs (91% vs 77%; p=0.17). Most notably, a significantly higher frequency of …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Enteropathic spondyloarthritis
  topic: keywords
subject: IBD
  topic: keywords
subject: Psoriasis
  topic: keywords
subject: Andrea Pace
  topic: disciplines
subject: Marcella Falconi
  topic: disciplines
subject: Alberto Floris
  topic: disciplines
subject: Leonardo Sichi
  topic: disciplines
subject: Francesca Onnis
  topic: disciplines
subject: Lorenzo Meli
  topic: disciplines
subject: Raffaela Piras
  topic: disciplines
subject: Nicola Lutzu
  topic: disciplines
subject: Federica Olla
  topic: disciplines
subject: Agnese Favale
  topic: disciplines
subject: Sara Onali
  topic: disciplines
subject: Massimo Claudio Fantini
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-28
publication date: 2025-11-28
doi: 10.4081/reumatismo.2025.2006

PO:01:006 | Increased risk of cancer recurrence or mortality associated with DMARDs?
type: item
description: Background. Our study endeavoured to investigate the real-life use of immunosuppressants after cancer diagnosis in patients with spondyloarthritis (SpA) and rheumatoid arthritis (RA) and the associated risk of cancer recurrence or mortality. Methods. We retrospectively enrolled all patients with invasive cancer and SpA, psoriatic arthritis (PsA) or RA referred to two Italian centres between 2015 and 2024. Invasive cancer was defined as any solid or haematologic cancer with histological characteristics of invasiveness. Cancer recurrence or progression were recorded consulting oncologic reports. After correction for the immortal bias, we performed a survival analysis using a model with cumulative incidence for competing events and subdistribution hazard ratios (SHR) estimates. Results. Overall, we included 120 patients with SpA/RA (39 SpA, 37 PsA, 44 RA) who developed invasive cancer. Most patients were undergoing csDMARDs and bDMARDs treatment before cancer diagnosis, or initiated immunosuppressants (including TNF, IL-6, IL-17, IL-23, JAK inhibitors and CTLA4a) after cancer diagnosis. 24 (20%) patients experienced a cancer relapse or progression, of whom 7 subsequently died. 2 other patients died of other causes during follow-up. Treatment with bDMARDs/JAKi before and after cancer did not appear to significantly increase the risk of recurrence and/or death (SHR p-value = 0.26; SHR p-value= 0.78), after correction for treatment before cancer diagnosis. RA was significantly associated with a higher risk of recurrence (SHR p-value <0.05). Early introduction of bDMARDs, particularly in RA, increased the risk of recurrence/death (HR p-value <0.05). Conclusion. The management of patients with SpA and RA who develop cancer may require initiation of immunosuppressants before the 5-year safety cutoff in the most severe cases. Among biologics, IL6i, IL17i and IL23i have proven to be the safest classes for use in patients with rheumatic diseases who develop cancer (1,2). 1. Atz…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Cancer
  topic: keywords
subject: bDMARD
  topic: keywords
subject: csDMARD
  topic: keywords
subject: Laura Scagnellato
  topic: disciplines
subject: Giacomo Cozzi
  topic: disciplines
subject: Mariagrazia Lorenzin
  topic: disciplines
subject: Mariangela Salvato
  topic: disciplines
subject: Alessandro Giollo
  topic: disciplines
subject: Bernd Raffeiner
  topic: disciplines
subject: Antonia Calligaro
  topic: disciplines
subject: Teresa Del Ross
  topic: disciplines
subject: Sara Bindoli
  topic: disciplines
subject: Margherita Zen
  topic: disciplines
subject: Paolo Sfriso
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
subject: Roberta Ramonda
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2003

PO:01:007 | Modulation of cellular senescence in psoriatic arthritis: exploring the potential impact of b/tsDMARDs treatment on telomere length, mtDNA copy number, and oxidative damage
type: item
description: Background. Inflammation and cellular senescence are interrelated processes involved in aging and chronic diseases. In Psoriatic Arthritis (PsA), excessive reactive oxygen species may contribute to telomere shortening and mitochondrial dysfunction. By reducing inflammation, biologic and targeted-synthetic disease modifying anti-rheumatic drugs (b/tsDMARDs) could influence senescence pathways. This study aimed to evaluate biomarkers of cellular senescence in PsA patients receiving b/tsDMARDs, specifically telomere length (TL), mitochondrial DNA (mtDNA) copy number, and oxidative damage at therapy initiation (T0) and after 12 months (T12). Methods. PsA patients starting b/tsDMARDs (TNF-alpha-i,IL17i, or JAKi) were enrolled and monitored over 12 months using DAPsA scores to classify them as Responders or non-Responders. Blood samples were collected at baseline (T0) and at 12 months (T12); age- and sex-matched healthy controls (CTRLs) were also included. TL and mtDNA copy number were measured in PBMCs using quantitative PCR. Oxidative DNA damage in telomeric and mitochondrial regions was assessed via qPCR after enzymatic digestion with FPG, measuring DeltaCt values. Statistical comparisons were performed using non-parametric or paired tests as appropriate, with significance set at p =< 0.05. ROC curves were used to assess discriminative potential of TL and mtDNA copy number. Results. Our cohort included 50 PsA patients and 34 CTRLs, with a prevalence of female participants in both groups. PsA patients had a mean disease duration of 7.41 ± 6.43 years. (Table 1) PsA patients showed significantly shorter TL compared to CTRLs (median TL:0.025 vs. 0.050; p = 0.005). (Figure 1) TL positively correlated with disease duration (p = 0.042) and BMI (p = 0.011), and was higher in patients with metabolic comorbidities (p = 0.025). Telomeric oxidative damage showed no significant group difference but tended to increase in patients with longer disease duration and higher DAPsA. mtDNA …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Psoriatic arthritis
  topic: keywords
subject: Telomeres
  topic: keywords
subject: Cellular senescence
  topic: keywords
subject: Eneida Cela
  topic: disciplines
subject: Giada De Benedittis
  topic: disciplines
subject: Arianna D'Antonio
  topic: disciplines
subject: Andrea Latini
  topic: disciplines
subject: Chiara Morgante
  topic: disciplines
subject: Cinzia Cicacci
  topic: disciplines
subject: Paola Conigliaro
  topic: disciplines
subject: Mauro Fatica
  topic: disciplines
subject: Giulia Mori
  topic: disciplines
subject: Giuseppe Novelli
  topic: disciplines
subject: Paola Borgiani
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2004

https://www.reumatismo.org/reuma/article/view/2005
type: item
title: PO:01:008 | Active sacroiliitis at magnetic resonance enterography increases the risk of axial spondyloarthritis in Crohn’s disease patients, while greater age and disease duration are protective factors: a monocentric retrospective cohort study
description: We aim to estimate the incidence of IBD-SpA in a population of Crohn’s disease (CD) patients and to identify risk factors associated with the development of IBD-SpA. This retrospective observational cohort study included all consecutive patients with a CD diagnosis followed by our IBD outpatient clinic who underwent at least one magnetic resonance enterography (MRE) between 2011 and 2023. Patients without a full scan of sacroiliac joints (SIJs) on MRE, having other rheumatic diseases, diagnosed with SpA before CD diagnosis, missing key clinical or imaging data, death or lost to follow-up at the time of data collection, were excluded. The identification of new onset IBD-SpA during the follow-up was based on the fulfillment of the ASAS classification criteria. Baseline demographic and clinical data, and immunosuppressive therapies performed were collected. Presence of articular and intestinal lesions at MRE was established according to the most recent definitions by ASAS and the Society of Abdominal Radiology, respectively. Incidence rates were calculated as the number of new cases of SpA divided by the total person-time at risk, expressed per 1,000 person-years. Log-rank test and univariate Cox proportional hazards regression analyses were performed to estimate hazard ratios (HR) for categorical and continuous predictors. A total of 147 CD patients [M:F 1:1, median age (IQR) 46.3 (23.3) years, median CD duration (IQR) was of 4.50 (16.4) years] were selected. Descriptive statistics of the sample are shown in Table 1. The incidence rates of overall, axial, and peripheral IBD-SpA were 3.8, 2.1, and 1.7 cases per 1,000 person-year, respectively. A stricturing CD behavior (HR: 0.22; 95% CI: 0.05–0.93; p=0.040), baseline mesalazine treatment (HR: 0.24; 95% CI: 0.06–0.99; p=0.049), greater age (HR: 0.94; 95% CI: 0.89–1.00; p=0.035), and CD duration (HR: 0.84; 95% CI: 0.72–0.97; p=0.019), were associated with a reduced risk of developing IBD-arthritis. The sub-analysis condu…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: magnetic resonance enterograph
  topic: keywords
subject: Enteropathic spondyloarthritis
  topic: keywords
subject: Inflammatory bowel disease
  topic: keywords
subject: Gabriele Amati
  topic: disciplines
subject: Gilda Sandri
  topic: disciplines
subject: Giovanni Ciancio
  topic: disciplines
subject: Benedetta Bongiovanni
  topic: disciplines
subject: Martina Orlandi
  topic: disciplines
subject: Ottavio Secchi
  topic: disciplines
subject: Davide Vaccari
  topic: disciplines
subject: Annarita Pecchi
  topic: disciplines
subject: Angela Bertani
  topic: disciplines
subject: Maddalena Pecchini
  topic: disciplines
subject: Pietro Torricelli
  topic: disciplines
subject: Antonio Colecchia
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2005

https://www.reumatismo.org/reuma/article/view/2122
type: item
title: PO:01:010 | Survival of second-line treatment with TNF inhibitors vs. IL-23 inhibitors after failure of a first TNF inhibitor: a real-life observational study from the Italian multicenter BIRRA cohort in patients with psoriatic arthritis
description: Background. Since 2021, IL-23 inhibitors (IL-23i) such as guselkumab, and since 2022 risankizumab, have been available for the treatment of psoriatic arthritis (PsA). However, after failure of a first tumor necrosis factor inhibitor (TNFi), switching to a second TNFi remains common. This study aims to compare second-line drug survival between “cycling” (second TNFi) and “swapping” (IL-23i) in Italian real-life clinical practice. Materials and Methods. A multicenter retrospective observational study was conducted on PsA patients treated with second-line TNFi or IL-23i. Drug survival was analyzed using Cox regression, considering age, sex, disease duration and domains (peripheral, axial, or mixed), disease activity, year of prescription, concomitant use of DMARDs or corticosteroids, and type of second-line treatment. Results. A total of 269 patients were included (62.8% female; median age 56.0 [47.0–64.0] years), of whom 191 (71.0%) were treated with TNFi and 78 (29.0%) with IL-23i (70 with guselkumab and 8 with risankizumab). Compared with patients receiving a second TNFi, those treated with IL-23i had more severe disease at treatment initiation (longer disease duration and higher DAPSA scores) (Figure 1A). A more recent year of prescription was significantly associated with reduced drug survival, with an approximately ninefold increased relative risk per year (HR 9.17 [5.52–15.24], p<0.001). Mixed (axial and peripheral) PsA was associated with a higher risk of treatment failure compared with peripheral PsA (HR 2.94 [1.64–5.29], p<0.001). Use of IL-23i as second-line therapy was associated with a 91% lower risk of failure compared with TNFi (HR 0.09 [0.04–0.24], p<0.001) (Figure 1B). When including disease activity (DAPSA) and restricting the analysis to patients with peripheral or mixed PsA, the significant variables remained largely unchanged: year of prescription (HR 14.44 [7.32–28.49], p<0.001); axial and peripheral vs peripheral PsA (HR 2.71 [1.39–5.27], p=0.003…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Inibitori IL-23
  topic: keywords
subject: guselkumab
  topic: keywords
subject: risankizumab
  topic: keywords
subject: Francesca Ometto
  topic: disciplines
subject: Olga Addimanda
  topic: disciplines
subject: Bernd Raffeiner
  topic: disciplines
subject: Alberto Lo Gullo
  topic: disciplines
subject: Elisa Visalli
  topic: disciplines
subject: Eleonora Celletti
  topic: disciplines
subject: Antonella Farina
  topic: disciplines
subject: Maddalena Larosa
  topic: disciplines
subject: Romina Andracco
  topic: disciplines
subject: Marino Paroli
  topic: disciplines
subject: Patrizia Del Medico
  topic: disciplines
subject: Aldo Biagio Molica Collella
  topic: disciplines
subject: Federica Lumetti
  topic: disciplines
subject: Gilda Sandri
  topic: disciplines
subject: Marta Priora
  topic: disciplines
subject: Aurora Ianiello
  topic: disciplines
subject: Elena Bravi
  topic: disciplines
subject: Alessandra Bezzi
  topic: disciplines
subject: Palma Scolieri
  topic: disciplines
subject: Simone Parisi
  topic: disciplines
subject: Viviana Ravagnani
  topic: disciplines
subject: Rosetta Vitetta
  topic: disciplines
subject: Luca Idolazzi
  topic: disciplines
subject: Riccardo Bixio
  topic: disciplines
subject: Gianluca Santoboni
  topic: disciplines
subject: Francesco Girelli
  topic: disciplines
subject: Alarico Ariani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2122

PO:01:014 | Differential inflammatory responses of CD14+ and CD14– synoviocytes in psoriatic arthritis: implications for pathogenesis and targeted therapies
type: item
description: Background. Investigating the inflammatory response of synoviocytes in patients with psoriatic arthritis (PsA) is crucial due to their central role in disease pathogenesis. Recent studies have reported upregulation of interleukin-6 (IL-6) and activation of the transcription factor NF-κB as key mechanisms in PsA development. Although the role of dendritic-like CD14 synoviocytes remains unclear, these cells have been shown to contribute to the initiation and maintenance of inflammation. Furthermore, impaired dendritic cell function has been associated with dysregulated inflammatory responses that may promote chronic inflammation. Therefore, this study aimed to explore the molecular responses of non-dendritic CD14 synoviocytes under basal conditions and after stimulation with inflammatory mediators, and to characterize the basal molecular profile of CD14 synoviocytes. Materials and Methods. Fibroblast-like synoviocytes (FLS) were isolated from synovial membranes of healthy donors (h) and PsA patients. CD14 FLS were selected using immunomagnetic beads and cultured under basal conditions (wt), whereas CD14 FLS were stimulated for 24 hours with LPS and IFNγ. Cells were analyzed at passage 6 (P6) by real-time PCR. Healthy donor FLS were also analyzed by flow cytometry (FACS) at passages 2 (P2) and 6 (P6) for CD90 and CD14 expression. Results. Under basal conditions, healthy CD14 FLS (h-FLS CD14 ) exhibited higher CD64 expression than PsA CD14 FLS. Following inflammatory stimulation, h-FLS CD14 showed increased expression of all analyzed genes compared to PsA-FLS CD14 , except for HLA-DR (Fig. 1). In PsA-FLS CD14 , expression of macrophage-associated markers (CD14, Mer-TK, CD64) decreased, whereas all other genes were upregulated except CD90, CDH-11, and NF-κB (Fig. 2). FACS analysis prior to selection revealed that h-FLS wt at P2 consisted of CD14 /CD90 (67%), CD14 /CD90 (3%), and CD14 /CD90 (8%) populations. Upon activation, the CD14 /CD90 population remained nearly uncha…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: synoviocytes
  topic: keywords
subject: inflammation
  topic: keywords
subject: dendritic cells
  topic: keywords
subject: Monia Maccaferri
  topic: disciplines
subject: Monica Montanari
  topic: disciplines
subject: Francesco Zambianchi
  topic: disciplines
subject: Carlo Salvarani
  topic: disciplines
subject: Elisa Pignatti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2123

https://www.reumatismo.org/reuma/article/view/2124
type: item
title: PO:01:015 | Evaluation of the impact of concomitant psoriasis on the clinical and therapeutic pattern of a monocentric cohort of patients affected by spondyloarthritis associated with inflammatory bowel diseases
description: Background. To evaluate the influence of concomitant psoriasis (PsO) on the clinical and therapeutic pattern of a monocentric cohort of patients affected by Spondyloarthritis (SpA) associated with inflammatory bowel diseases (IBD). Materials and Methods. This study represents a preliminary phase of an ancillary analysis of the DIAMANTE project (Early diagnosis of spondyloarthritis in a cohort of patients affected by inflammatory bowel disease), developed with the general objective of determining the prevalence, predictors, and outcomes of SpA in a cohort of IBD patients, within the context of a close and structured collaboration between gastroenterologists and rheumatologists. Within the DIAMANTE cohort, two subgroups of patients were identified for the study: patients with enteropathic SpA and a concomitant personal diagnosis of PsO (Group 1: IBD+SpA+PsO), and patients with a diagnosis of SpA only (Group 0: IBD+SpA). For both groups, the following demographic, clinical, and therapeutic data were recorded and compared: sex, association with IBD pattern, peripheral joint involvement, axial involvement, history of dactylitis, need for biologic therapy, and multi-resistance to “targeted” drugs (defined as discontinuation due to inefficacy of at least two biologic drugs or small molecules). A p-value <0.05 was considered statistically significant using Fisher’s exact test and the Chi-square test. Results. Data from 665 consecutive patients with IBD recruited between November 2023 and April 2025 were analyzed. Within this cohort, 95 (14%) had a concomitant diagnosis of SpA; among these, 21 (22%) also had a diagnosis of PsO (Group IBD+SpA+PsO), while 74 (78%) had only SpA associated with IBD (Group IBD+SpA). Comparative analysis between the two groups showed notable—though only trending toward statistical significance—differences in terms of female prevalence (71% vs 54%, p=0.15), frequency of peripheral involvement (62% vs 49%, p=0.28), and use of biologic drugs (91% vs …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: enteropathic SpA
  topic: keywords
subject: IBD
  topic: keywords
subject: psoriasis
  topic: keywords
subject: Andrea Pace
  topic: disciplines
subject: Marcella Falconi
  topic: disciplines
subject: Alberto Floris
  topic: disciplines
subject: Leonardo Sichi
  topic: disciplines
subject: Francesca Onnis
  topic: disciplines
subject: Lorenzo Meli
  topic: disciplines
subject: Raffaela Piras
  topic: disciplines
subject: Nicola Lutzu
  topic: disciplines
subject: Federica Olla
  topic: disciplines
subject: Agnese Favale
  topic: disciplines
subject: Sara Onali
  topic: disciplines
subject: Massimo Claudio Fantini
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2124

PO:02:016 | Real-world evidence of upadacitinib over two years in Italian patients with axial spondyloarthritis
type: item
description: Background. This real-life investigation, conducted across multiple centres in Italy, aims to assess the 2-year effectiveness and safety of upadacitinib, a selective JAK1 inhibitor approved for the treatment of axial spondyloarthritis (axSpA). The study includes patients with both radiographic and non-radiographic axSpA and evaluates: (a) clinical outcomes at 6, 12, and 24 months; (b) drug retention rate (DRR); and (c) the influence of treatment line (LoBT), axSpA subtype, and sex on achieving low disease activity (LDA) and very low disease activity (VLDA). By analysing real-life clinical practice data, our analysis provides insight into the long-term therapeutic role of upadacitinib in managing axSpA, particularly in previously-treated patients or those with limited therapeutic options. Methods. Consecutive patients with axSpA, who received upadacitinib between December 2022 and January 2025, were prospectively evaluated across multiple Italian centres. Data collected included baseline disease characteristics, comorbidities, prior and ongoing treatments, and follow-up duration. The primary endpoints were treatment effectiveness and safety, as well as drug retention rate (DRR), assessed at 6, 12, and 24 months from treatment initiation (T0). Effectiveness was evaluated using clinimetric indices, while safety outcomes included infections and adverse events (AEs). Secondary endpoints included the impact of biologic treatment history (bDMARDs), axSpA subtype (radiographic vs. non-radiographic), and sex on the achievement of low disease activity (LDA), defined as BASDAI <4 and/or ASDAS <2.1, and very low disease activity (VLDA), defined as BASDAI <2 and/or ASDAS <1.3, at each time point. Results. A total of 203 patients were included in the analysis [48% male; median age at diagnosis: 44 years; 22.7% HLA-B27 positive -36.6% observed in Northern Italy); 71% with non-radiographic axSpA]. The median number of prior treatment lines was 3 (range: 1–12). At follow up, 170 pat…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Efficacy
  topic: keywords
subject: Safety
  topic: keywords
subject: Therapeutic survival
  topic: keywords
subject: Mariagrazia Lorenzin
  topic: disciplines
subject: Giacomo Cozzi
  topic: disciplines
subject: Stefano Gentileschi
  topic: disciplines
subject: Michele Maria Luchetti Gentiloni
  topic: disciplines
subject: Antonio Carletto
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
subject: Maria Manara
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
subject: Rosario Foti
  topic: disciplines
subject: Salvatore D'Angelo
  topic: disciplines
subject: Ariela Hoxha
  topic: disciplines
subject: Carlo Selmi
  topic: disciplines
subject: Bernd Raffeiner
  topic: disciplines
subject: Alessandro Giollo
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
subject: Carlo Salvarani
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
subject: Roberta Ramonda
  topic: disciplines
subject: Sir Study Group Spa
  topic: disciplines
subject: Psa Antonio Spadaro
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2007

PO:02:017 | Difficult-to-treat psoriatic arthritis: clinical and ultrasonographic predictors in a real-life cohort
type: item
description: Background. To investigate clinical and ultrasound (US) features as potential predictors of difficult-to-treat (D2T) psoriatic arthritis (PsA). Methods. and materials In this retrospective study, we enrolled patients diagnosed with PsA followed at our outpatient clinic (January 2020-September 2024). D2T-PsA was defined as the persistence of disease activity upon failure of >= 2 lines of biological or targeted synthetic DMARDs (b/tsDMARDs). Demographic, clinical and US data were collected. 'Index' US was defined as the assessment performed in patients before fulfilment of D2T-PsA definition. Four expert rheumatologists conducted all US assessments with a high-frequency (15-24 MHz) Esaote MyLabX8 linear probe, following EULAR and OMERACT definitions (1). Synovitis, tenosynovitis, and bone erosions were evaluated in wrists, metacarpophalangeal (MCP), proximal interphalangeal (PIP) of the hands, metatarsophalangeal (MTP) joints, shoulders, knees and ankles. Baseline predictors of D2TPSA were analysed using Cox regression adjusted for potential baseline confounders. Results. 152 patients were included, 81 classified as D2T-PsA and 71 as non-D2T. Clinical and demographic features are shown in Table 1. A diagnostic delay of >= 1 year independently predicted development of D2T-PsA (HR 1.74, 95% CI 1.05–2.88, p=0.032) in the whole cohort (fig 1) as well as in subgroups with predominant peripheral (n=143, HR 1.73, 95% CI 1.37–2.90, p=0.036) or axial involvement (n=61, HR 3.18, 95% CI 1.22–8.27, p=0.018). In the latter group, baseline fibromyalgia (HR 2.45, 95% CI 1.12–5.36, p=0.025) and enthesitis (HR 2.49, 95% CI 1.08–5.73, p=0.033) were also predictive of D2T phenotype. Among patients <40 years (n=26), a diagnostic delay of >= 1 year remained a significant risk factor for D2T-PsA (HR 4.78, 95% CI 1.25–18.28, p=0.022), in association with fibromyalgia (HR 9.04, 95% CI 2.20–37.07, p=0.002) and female sex (HR 68.26, 95% CI 3.22–1445.71, p=0.007). At index US, patients who woul…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Difficult to treat (D2T)
  topic: keywords
subject: Predictors
  topic: keywords
subject: Ultrasound
  topic: keywords
subject: Federico Favaro
  topic: disciplines
subject: Elisa Bellis
  topic: disciplines
subject: Claudio Cruciani
  topic: disciplines
subject: Gloria Crepaldi
  topic: disciplines
subject: Valeria Data
  topic: disciplines
subject: Claudia Garulli
  topic: disciplines
subject: Claudia Lomater
  topic: disciplines
subject: Elena Marucco
  topic: disciplines
subject: Marta Saracco
  topic: disciplines
subject: Mariele Gatto
  topic: disciplines
subject: Annamaria Iagnocco
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2008

PO:02:018 | After-SECs: clinical predictors of secukinumab retention in psoriatic arthritis patients with inadequate response to anti-tumor necrosis factor therapy
type: item
description: Background. A range of molecular targets is currently available for the treatment of psoriatic arthritis (PsA). Identifying clinical predictors of treatment persistence is critical for optimizing therapeutic strategies, as drug retention is often used as a proxy for long-term efficacy and safety. This study aimed to evaluate predictors of secukinumab (SEC) retention in PsA patients who previously discontinued the anti-TNF agent adalimumab (ADA). Methods. PsA patients who initiated SEC following ADA discontinuation between 2019 and 2024 were retrospectively analyzed. Clinical data were collected through systematic chart reviews, including demographic characteristics, involved disease domains, prior treatments, and metabolic comorbidities [e.g., increased body mass index (BMI), diabetes]. SEC treatment persistence was assessed over a follow-up period of up to 36 months. Survival analysis was performed using SEC discontinuation as the event, with demographic and clinical variables as predictors. Results. Among 327 PsA patients treated with SEC during the study period, 67 had previously discontinued ADA – 54 (81%) due to inadequate response and 13 (19%) due to adverse events. Patients’ characteristics are detailed in Table 1. Over a median follow-up of 1.6 years (Interquartile Range (IQR) 0.7–2.4), 26 SEC discontinuations were recorded, corresponding to an incidence rate of 24.8 per 100 patient-years. SEC retention rates at 12, 24, and 36 months were 69.8% (95% Confidence Interval (CI) 59.3–82.2), 61.6% (95% CI 49.7–76.5), and 49.1% (95% CI 36.0–67.0), respectively. The presence of enthesitis (Hazard Ratio (HR) 0.28, 95% CI 0.08–0.96) and concomitant active skin psoriasis (HR 0.21, 95% CI 0.08–0.59) were significantly associated with a lower risk of SEC discontinuation. Conclusions. Secukinumab showed higher retention rates in PsA patients with enthesitis and active skin psoriasis after ADA discontinuation. No significant associations were found with demographic variabl…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: SECUKINUMAB
  topic: keywords
subject: CLINICAL PREDICTORS
  topic: keywords
subject: INADEQUATE RESPONSE TO ANTI-TNFa
  topic: keywords
subject: Francesco Cristiano
  topic: disciplines
subject: Davide Gaspare Patti
  topic: disciplines
subject: Valentina Boni
  topic: disciplines
subject: Stefano Di Murro
  topic: disciplines
subject: Cesare Gavotti
  topic: disciplines
subject: Roberta Masnata
  topic: disciplines
subject: Giulia Calabrese
  topic: disciplines
subject: Gerlando Natalello
  topic: disciplines
subject: Giusy Peluso
  topic: disciplines
subject: Augusta Ortolan
  topic: disciplines
subject: Enrico De Lorenzis
  topic: disciplines
subject: Maria Antonietta D'Agostino
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2009

PO:02:023 | Monocentric analysis of systemic glucocorticoids in PsA: the art of balancing prescriptive appropriateness and risk factor management
type: item
description: Objective: Psoriatic Arthritis (PsA) is a pleiomorphic disease. The latest guidelines1 recommend glucocorticoids (GCs) preferentially as local therapy, emphasising that the use of systemic GCs may raise further safety issues, especially due to the high prevalence of comorbidities and cardiovascular risk factors in PsA. Literature data regarding the prevalence of GCs in PsA are scarce. The aim of this study is to analyse, in a monocentric cohort, the prevalence, dosage, and variables associated with GCs prescription in PsA. Materials and Methods: PsA patients whose latest assessment was by 31 May 2025 were recruited in a cross-sectional manner. Data analysed included disease characteristics, comorbidities, ongoing therapies and relevant GCs dosages. Student's t-test and Mann-Whitney test were used for continuous variables, and Chi-square or Fisher’s exact test for categorical variables. Results: A total of 244 patients diagnosed with PsA were enrolled (mean age 55.7 years, males 123 (50.4%), peripheral PsA phenotype 186 (76.2%), axial 16 (6.6%), enthesitis 6 (2.5%), mixed 36 (14.7%)). Demographic and clinical characteristics of the population are shown in Table 1. Patients with PsA on GCs therapy (GCs+) were 24/244 (9.8%), with a median dosage of 2.5 mg prednisolone equivalent. Comparison between the GCs+ and GCs- groups showed similar characteristics in terms of disease duration (median 12 vs 14 years, p= 0.708), similar distribution among disease subsets (p= 0.343), and similar disease manifestations (dactylitis 20.8% vs 23.8%, p= 0.732; associated IBD 4.2% vs 0.5%, p= 0.189; enthesitis detected by LEI Index, p= 0.789). The two groups (GCs+ vs GCs-) differed significantly in terms of disease activity [median DAPSA 10.2 (4.2–14.7) vs 4.1 (1.2–7.2), p<0.001], even when stratified by moderate/high disease activity (33.3% vs 6.9%, p<0.001), and in b/tsDMARD prescription (54.2% vs 81.2%, p=0.002). The distribution of comorbidities was significantly different between GCs…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: glucocorticoids (GCs)
  topic: keywords
subject: comorbidities
  topic: keywords
subject: Disease Activity
  topic: keywords
subject: Chiara Crotti
  topic: disciplines
subject: Gilberto Cincinelli
  topic: disciplines
subject: Giorgia Trignani
  topic: disciplines
subject: Luca Ingrao
  topic: disciplines
subject: Miriam Perino
  topic: disciplines
subject: Roberto Caporali
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2125

PO:02:024 | Development of anti-drug antibodies in patients with peripheral and/or axial spondyloarthritis treated with infliximab or adalimumab: a monocentric cross-sectional study
type: item
description: Background.The evaluation of the prevalence of anti-drug antibodies (ADABs) against infliximab (IFX) or adalimumab (ADA) in a monocentric cohort of patients affected by axial and/or peripheral spondyloarthritis (SpA), the variables associated with this phenomenon, the frequencies of suspected drug-related adverse events (DRAEs), and the frequencies of subsequent therapeutic choice. Materials and Methods. Cross-sectional study. All patients affected by axial and/or peripheral SpA (ASAS 2009/2011) who underwent a blood sampling (baseline) for IFX or ADA ADABs serum measurement for a suspected DRAEs or a disease relapse in the period time between 01/01/2020 and 01/01/2025, were included. Demographic and clinical data, and previous treatments at baseline, and subsequent therapeutic choices, were retrospectively gathered. Results. Forty patients (M:F 1:1, median age 51.6 (IQR 19.1)) affected by SpA (peripheral 50.0%, axial 35.0%, both 15.0%) were selected. Median disease duration was 8.3 (IQR 8.6) years. PsO and IBD were present in 32.5% and 12.5% of cases, respectively. ADABs serum measurement for IFX and ADA were 10/40 (25.0%) and 30/40 (75.0%), respectively. Median BASDAI and DAPSA at baseline were 4.4 (IQR 3.8) and 16.8 (IQR 6.8), respectively. An active axial (BASDAI>4) and/or peripheral (DAPSA>4) disease was present in 60% (12/20) and 92.3% (24/26) of cases, respectively. Median bDMARD treatment duration was of 2.5 years (IQR 4.5). Overall positivity for ADABs was 17.5% (IFX-ADABs 1/10, 10.0%, ADA-ADABs 6/30, 20.0%). Spearman matrix of correlation revealed a negative correlation between ADABs titer and the relative drug titer (ρs=-0.590, p<0.0001). Positivity for ADABs was associated to HLA-B27 negativity (p=0.036) and a lower median age (p=0.022). None of ADABs positive patients were under concomitant cDMARDs treatment (0.0% vs 27.3%, p=0.174). Reasons for ADABs serum measurement were secondary failure in 75.0% of cases and suspected DRAEs in 25.0% of cases. Ten A…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Anti-drug antibodies
  topic: keywords
subject: spondyloarthritis
  topic: keywords
subject: TNFalpha inhibitors
  topic: keywords
subject: Gabriele Amati
  topic: disciplines
subject: Gilda Sandri
  topic: disciplines
subject: Alessandra Melegari
  topic: disciplines
subject: Benedetta Bongiovanni
  topic: disciplines
subject: Giovanni Ciancio
  topic: disciplines
subject: Martina Orlandi
  topic: disciplines
subject: Ottavio Secchi
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2126

CO:07:3 | Does articular and entheseal structural damage drive pain and patient-driven reported outcomes in difficult-to-treat psoriatic arthrtis patients? Results from a cross-sectional study
type: item
description: Background. To assess difficult-to-treat psoriatic arthritis (D2T-PsA) and determine whether articular and entheseal structural damage, assessed by ultrasound (US), may drive pain and patient-driven outcomes in D2T-PsA. Methods. A multicenter cross-sectional study was conducted on PsA patients treated with b/tsDMARDs. For each patient, complete demographic data were recorded. Eligible participants were required to meet the following inclusion criteria: age >=18 years; diagnosis of PsA fulfilling the CASPAR criteria; classification as D2T-PsA, defined by failure of >=2 classes of b/tsDMARDs (with different mechanisms of action) following the failure or contraindication of >=1 csDMARD, and persistently active disease (DAPSA >14); Presence of at least one clinically significant site, defined as a tender and/or swollen joint or a tender enthesis for peripheral disease. Sonographic evaluations were performed by expert sonographers, blinded to clinical data, using the US damage score from the UPSTREAM study calculated as follow: [number of (entheseal calcifications count + entheseal bone irregularity count)*2.98 + number (tendon lesion count)* 1.1 + number (entheseal erosion count)*0.9 + number (joint erosion count*0.7 + number (joint osteoproliferation count + enthesophytes count)*0.54]. Moreover, we use Spearman rho correlation coefficient to evaluate possible correlations between US damage score and clinical features including pain on NRS, HAQ, DAPSA, PsAID, physician global assessment of disease activity on NRS (PhGA), patient global assessment of disease activity (PtGA) on NRS and deltaPtGA-PhGA. Results: A total of 517 patients with PsA identified, 191/517 (36.9%) patients were on their second mechanism of action b/tsDMARDs. Of whom, 53 out of 191 patients (27.7%) met the criteria for D2T-PsA and were included in the analysis. Table 1 shows the clinical and US characteristics of the 53 D2T patients. Of these, 34 (64.1%) showed at least one site of active inflammatio…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Difficult to Treat
  topic: keywords
subject: Psoriatic arthritis
  topic: keywords
subject: Damage
  topic: keywords
subject: Fabio Massimo Perrotta
  topic: disciplines
subject: Alen Zabotti
  topic: disciplines
subject: Mauro Fatica
  topic: disciplines
subject: Nicola Cabas
  topic: disciplines
subject: Andrea Guiotto
  topic: disciplines
subject: Nicoletta Franzolini
  topic: disciplines
subject: Giovanni Striani
  topic: disciplines
subject: Maria De Martino
  topic: disciplines
subject: Cristina De Nicola
  topic: disciplines
subject: Miriam Isola
  topic: disciplines
subject: Andrea Di Matteo
  topic: disciplines
subject: Gabriele De Marco
  topic: disciplines
subject: Denis McGonagle
  topic: disciplines
subject: Ennio Lubrano
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1978

CO:07:1 | Assessing bone fragility in systemic sclerosis: results of the Sclerobone multicentric study
type: item
description: Background: Considering the limited and conflicting data regarding prevalence and risk factors of osteoporosis (OP) in systemic sclerosis (SSc), we aimed at evaluating a large population of patients at several Italian institutions. Enrollment started in October 2024 and will end in October 2025. Materials and Methods: We are investigating the presence of OP in randomly selected subjects fulfilling the 2013 ACR/EULAR SSc classification criteria using a partially retrospective design. Exclusion criteria include ongoing pregnancy, cancer, metabolic bone diseases other than OP, and therapies interfering with bone health; exceptions are chronic kidney disease, anti-osteoporotic drugs, glucocorticoids (GC), and proton pump inhibitors. OP was defined as history of fragility fractures (FX) and/or of bone mineral density (BMD) values with T-scores < -2.5 or Z-scores < -2.0. BMD is evaluated using DXA scans within 12 months before enrollment or performed at enrollment. Demographic and anthropometric data, menopausal status, dietary calcium intake, Charlson Comorbidity Index (CCI), and concurrent medications are assessed. Sarcopenia, when detected with the SARC-F+EBM questionnaire, is evaluated with functional tests such as hand grip strength, chair stand test, and gait speed. A characterization of SSc is performed, including age at diagnosis, disease duration, and organ involvement. The cumulative SSc-related damage is expressed with the Scleroderma Clinical Trials Consortium Damage Index (SCTC-DI). We provide the results of the pre-planned interim analysis performed in April 2025; the final analysis is planned in October 2025. Results: The interim analysis focused on 315 patients, with a mean age at enrollment of 63.2±11.3 years. They were diagnosed with SSc at a mean age of 51.2±12.4 years and had been affected for a median time of 10 years (interquartile range - IQR 12). Females made up the majority (n = 292; 92.7%) of the cohort, with 266 (91.1%) having been postmenopausa…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Osteoporosis
  topic: keywords
subject: Systemic sclerosis
  topic: keywords
subject: Fragility fractures
  topic: keywords
subject: Giammarco De Mattia
  topic: disciplines
subject: Cristina Di Nicola
  topic: disciplines
subject: Davide Rozza
  topic: disciplines
subject: Manuel Sette
  topic: disciplines
subject: Veronica Gerli
  topic: disciplines
subject: Ludovica Pisapia
  topic: disciplines
subject: Chiara Sgorbini
  topic: disciplines
subject: Giulia Botticella
  topic: disciplines
subject: Pamela Bernardini
  topic: disciplines
subject: Francesca Bottazzi
  topic: disciplines
subject: Francesca Lalli
  topic: disciplines
subject: Luca Idolazzi
  topic: disciplines
subject: Laura Bogliolo
  topic: disciplines
subject: Monica Cesarotti
  topic: disciplines
subject: Alessandra Rossi
  topic: disciplines
subject: Alessandra Della Rossa
  topic: disciplines
subject: Andrea Giusti
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Carlo Alberto Scirè
  topic: disciplines
subject: Addolorata Corrado
  topic: disciplines
subject: Nicoletta Del Papa
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
subject: Chiara Crotti
  topic: disciplines
subject: Maurizio Rossini
  topic: disciplines
subject: Maurizio Mazzantini1
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1976

CO:07:6 | Hidden in plain sight: fibromyalgia prevalence and correlates in 3,000 non-clinical Italian subjects
type: item
description: Background. To determine the prevalence of fibromyalgia according to the ACR2016 criteria in a non-clinical Italian population and to identify significant demographic, clinical and lifestyle correlates. Materials and Methods. A voluntary survey was distributed across various Italian regions to randomly selected individuals from the general population. The survey included questions regarding demographic information, ACR 2016 fibromyalgia diagnostic criteria, sleep quality measures, physical activity levels, and comprehensive health history. Descriptive statistics, group comparisons, and multivariate logistic regression were employed to analyze data. Results. 3.000 participants were recruited (68.5% female, mean age 36.17±15.91, mean BMI 23.70±3.97). 5.1% (Table 1) met the ACR 2016 diagnostic criteria, with a WPI of 8.42±2.54 and SS score of 8.33±2.01, compared to 1.50±1.50 and 3.36±2.14 respectively in non-fibromyalgia subjects (p<0.0001). Fibromyalgia prevalence was higher in females (6.76%) than males (1.48%, p=0.0001), with increased prevalence in older age groups (Figure 1. 3.54% in 18-30y vs 8.23% in 51-60y, p=0.001). BMI extremes showed higher prevalence (8.11% in BMI<18.5 and 10.29% in BMI>29.9 vs 4.11% in normal BMI, p=0.0014). Those who reported physical inactivity showed higher fibromyalgia prevalence (6.46% in sedentary, 3.57% in those exercising 3-4 times/week, p=0.04). Also, fibromyalgia was more prevalent among those reporting very poor sleep (49.32%) compared to very good sleep (1.00%, p<0.001). Sleep duration was shorter in the fibromyalgia group (5.99±1.65 vs 6.85±1.00 hours, p<0.0001). In females, fibromyalgia prevalence was highest in those with surgical menopause (17.46%), followed by physiological menopause (11.04%), compared to 3.64% in those with regular cycles (p=0.001). Family history of fibromyalgia (Table 2) was higher in the fibromyalgia group (28.76% vs 6.99%, p<0.0001), as was family history for other rheumatologic disorders. In non-fibr…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Fibromyalgia
  topic: keywords
subject: Chronic widespread pain
  topic: keywords
subject: Epidemiology
  topic: keywords
subject: Sergio Del Vescovo
  topic: disciplines
subject: Vincenzo Venerito
  topic: disciplines
subject: Maria Giannotta
  topic: disciplines
subject: Maria Grazia Anelli
  topic: disciplines
subject: Maria Morrone
  topic: disciplines
subject: Angelo Troiano
  topic: disciplines
subject: Marco Capodiferro
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1981

CO:08:1 | Aquaporin-4 downregulation in dysphagic idiopathic inflammatory myopathies: association with Type 2 fiber damage and inflammation
type: item
description: Background. To assess whether Aquaporin-4 (AQP4) expression in skeletal muscle is altered in idiopathic inflammatory myopathies (IIMs), particularly in dysphagic patients, and to explore its association with muscle fiber type, regeneration, inflammation, and tissue damage. Methods. Muscle biopsies from 54 IIM patients (25 dysphagic: 11 DM, 7 PM, 2 IBM, 2 IMNM, 3 OM; 29 normophagic: 9 DM, 4 ASyS, 4 PM, 4 IBM, 8 IMNM) and 6 non-inflammatory controls were analyzed using immunofluorescence and confocal microscopy. AQP4 immunolocalization was assessed alongside markers of fiber type (MHCfast), regeneration (neonatal myosin), inflammation (CD68), and matrix remodeling (MMP2). Morphometric parameters (fiber diameter, area, atrophy factor, variability coefficient) were quantified. Clinical correlations were examined using MMT-8 and the Myositis Damage Index (MDI). Results. A significant reduction in AQP4-positive myofibers was observed in dysphagic IIM patients compared to normophagic patients and controls, predominantly affecting type 2 fibers. Dysphagic muscles showed marked hypotrophy, with reduced fiber diameter and area, and increased variability and atrophy indices. These changes were mainly driven by AQP4-negative type 2 fibers (Figure 1A-B). Dysphagic patients showed a significantly higher percentage of AQP4-negative fibers co-expressing neonatal myosin (p<0.001 vs normophagic IIMs and healthy controls), indicating impaired regeneration. AQP4-negative fibers were more frequently surrounded by CD68-positive macrophages and MMP2-positive vessels (p<0.001 vs healthy controls). The proximity of inflammatory and vascular cells to AQP4-negative sarcolemmas suggests inflammation-induced AQP4 loss. Anti-HMGCR-positive IMNM cases (red circles and triangles in Figure 1A) exhibited the most severe AQP4 reduction and fiber damage. In the overall IIM cohort, the percentage of AQP4-positive type 1 myofibers correlated positively with MMT-8 scores (r:0.383, p<0.01), while AQP4-neg…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Myositis,
  topic: keywords
subject: AQP4,
  topic: keywords
subject: Fast twitch myofibers
  topic: keywords
subject: Marco Fornaro
  topic: disciplines
subject: Margherita Giannini
  topic: disciplines
subject: Dario D'Abbicco
  topic: disciplines
subject: Maria Luisa Fiorella
  topic: disciplines
subject: Antonio Frigeri
  topic: disciplines
subject: Francesco Girolamo
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1982

PO:02:027 | Fast food, slow damage: ultra-processed foods, Western diet and inflammatory arthritis. A systematic scoping review
type: item
description: Background. Western dietary patterns, characterized by high intake of ultra-processed foods (UPFs), added sugars, and saturated fats, have been increasingly implicated in promoting systemic inflammation and disrupting gut microbiota composition. These mechanisms may influence the onset, progression, and comorbidities of chronic inflammatory arthritides. This systematic scoping review aimed to summarize current evidence on the association between Western diet (WD) or UPF consumption and the risk, activity, and related outcomes in rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), and psoriatic arthritis (PsA). Methods. We conducted a systematic review including randomized controlled trials, observational studies (cohort, case-control, cross-sectional), and preclinical models assessing the relationship between WD or UPF intake and disease-related outcomes in RA, axSpA, or PsA. Exclusion criteria comprised narrative reviews, editorials, case reports, and studies not specifically addressing both the dietary exposure and relevant disease outcomes. A comprehensive literature search was conducted in PubMed, Embase, Scopus, Web of Science, and the Cochrane Library, with the final search on May 18, 2025 and no time limit applied. Reference lists were manually screened, and forward citation tracking was performed using Google Scholar. Risk of bias was not formally assessed, consistent with the exploratory nature of this scoping review. Data were synthesized narratively and tabulated by dietary exposure, outcomes, and key findings. Results. During screening, we assessed 165 papers. Only 10 studies involving over 244,000 individuals were included. Eight studies addressed RA, comprising 7 clinical and 1 preclinical investigation. Across these, greater UPF consumption or adherence to WD was consistently associated with adverse outcomes. Cohort studies reported an increased RA incidence with adjusted hazard ratios between 1.04 and 1.17; case-control analyses found odds ra…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Psoriatic arthritis
  topic: keywords
subject: Axial spondyloarthritis
  topic: keywords
subject: Ultra-processed foods
  topic: keywords
subject: Gianluca Poncina
  topic: disciplines
subject: Federica Gardin
  topic: disciplines
subject: Giacomo Cozzi
  topic: disciplines
subject: Laura Scagnellato
  topic: disciplines
subject: Mariagrazia Lorenzin
  topic: disciplines
subject: Stefano Rizzetto
  topic: disciplines
subject: Caterina Robusto
  topic: disciplines
subject: Francesca Oliviero
  topic: disciplines
subject: Valérie Tikhonoff
  topic: disciplines
subject: Roberta Ramonda
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2010

CO:07:2 | Quantitative computed tomography analysis of pulmonary disease in systemic sclerosis: correlation between radiomics and pulmonary function tests
type: item
description: Background and objectives. High-resolution computed tomography (HRCT)-based radiomic analysis is gaining attention as a tool for quantifying interstitial lung disease (ILD) in systemic sclerosis (SSc). Pulmonary function tests (PFTs) are standard for functional assessment but have limited sensitivity in early disease stages. We aimed to explore the potential of HRCT-derived radiomic features in SSc patients with and without ILD. Methods. In this cross-sectional study, we enrolled SSc subjects who underwent both HRCT and PFTs. Radiomic parameters—skewness, kurtosis, high-attenuation areas (pHAA-700 and pHAA-600;-250), and lung volume—were extracted. Participants were classified into four groups based on HRCT pattern: no ILD, non-fibrosing NSIP (nfNSIP), fibrosing NSIP (fNSIP), and usual interstitial pneumonia (UIP). ANOVA with post-hoc comparisons, linear regressions, and ROC analyses were conducted to assess diagnostic performance and associations with PFTs. Results. Ninety-three subjects were enrolled. All radiomic parameters significantly differed across ILD patterns (p<0.001 for skewness, kurtosis, pHAA metrics; p=0.005 for lung volume). PFT values also varied among subgroups (ppFVC p=0.005; ppTLC p<0.001; ppDLCO p=0.004). Radiomic parameters were moderately correlated with ppFVC, ppTLC, and ppDLCO in ILD patients (R ranging in absolute terms from 0.33 to 0.58, p<0.001), with significant interaction terms (PFT parameter*presence of ILD). ROC analysis showed that skewness (AUC 0.897, p=0.0073) and kurtosis (AUC 0.890, p=0.010) outperformed ppTLC (AUC 0.744) in identifying ILD. Conclusions. Radiomic analysis discriminate between SSc patients with and without ILD, seemingly outperforming conventional the ppTLC assessment. The relationship between radiomics and PFTs appeared predominantly in subjects with ILD while was undetectable in those without ILD.
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: SYSTEMIC SCLEROSIS
  topic: keywords
subject: INTERSTITIAL LUNG DISEASE
  topic: keywords
subject: RADIOMICS
  topic: keywords
subject: Francesco Pollastri
  topic: disciplines
subject: Loredana Carobene
  topic: disciplines
subject: Giovanni Adami
  topic: disciplines
subject: Michele Pernigotto
  topic: disciplines
subject: Federico Aldegheri
  topic: disciplines
subject: Angela Ventura
  topic: disciplines
subject: Claudio Micheletto
  topic: disciplines
subject: Susanna Baltieri
  topic: disciplines
subject: Marco Sebastiani
  topic: disciplines
subject: Andreina Manfredi
  topic: disciplines
subject: Davide Gatti
  topic: disciplines
subject: Maurizio Rossini
  topic: disciplines
subject: Angelo Fassio
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1977

PO:03:036 | Psoriatic arthritis: does pre-existing treatment with cs/bDMARDs for psoriasis influence the characteristics and outcomes of joint disease?
type: item
description: Background. Several studies have shown that treatment of psoriasis with cs/bDMARDs reduces the risk of developing psoriatic arthritis. The aim of this study is to investigate and compare the characteristics of patients who developed psoriatic arthritis without having ever received any systemic therapy (cs/bDMARD-naïve) with those who developed it despite ongoing treatment with cs/bDMARDs (cs/bDMARD-experienced), in order to understand whether treatment differences influence the characteristics and outcomes of joint disease. Materials and Methods. This analysis represents a preliminary phase of a retrospective study conducted on a cohort of patients with psoriatic arthritis, divided into two groups based on whether or not they were receiving cs/bDMARD therapy at the onset of joint disease. For all patients, demographic (age at disease onset and at diagnosis, sex, smoking status), clinical (fibromyalgia, BMI, oligoarticular/polyarticular onset, axial involvement, dactylitis), clinimetric (DAPSA, physician VAS, patient VAS, SPARS, HAQ), and therapeutic data (use of cs/bDMARDs at disease onset, multidrug resistance) were collected and compared. Results. A total of 224 consecutive patients with psoriatic arthritis were enrolled, of whom 45 (20%) developed the disease despite ongoing cs/bDMARD therapy, while the remaining 179 (80%) developed psoriatic arthritis without having received any systemic treatment. No significant differences were observed between the two groups in terms of M/F ratio (p=0.567), age at arthritis onset (p=0.180), age at diagnosis (p=0.776), oligoarticular/polyarticular pattern (p=0.349), prevalence of axial involvement (p=0.197), radiographic damage (p=0.491), physician VAS (p=0.851) and patient VAS (p=0.340), DAPSA (p=0.585), HAQ (p=0.609), or multidrug resistance (p=0.308) (Table 1, Figure 1). A trend toward a higher prevalence of dactylitis was observed among DMARD-naïve patients compared with those receiving cs/bDMARD therapy at disease onset (…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: cs/bDMARDs
  topic: keywords
subject: psoriasi
  topic: keywords
subject: outcomes
  topic: keywords
subject: Ilenia Marchesini
  topic: disciplines
subject: Alberto Floris
  topic: disciplines
subject: Cristina Mugheddu
  topic: disciplines
subject: Laura Li Volsi
  topic: disciplines
subject: Maria Teresa Paladino
  topic: disciplines
subject: Roberta Origa
  topic: disciplines
subject: Jessica Sorgia
  topic: disciplines
subject: Mattia Congia
  topic: disciplines
subject: Elisabetta Chessa
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
subject: Caterina Ferreli
  topic: disciplines
subject: Laura Atzori
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2127

PO:04:048 | Assessment of chronic and residual pain in axial spondyloarthritis in a single-center cohort of patients treated with anti-tnf agents
type: item
description: Materials and Methods: Patients diagnosed with AxSpA (according to the ASAS 2009 criteria) who had been treated with anti-TNF agents for at least six months and had undergone a minimum of two outpatient visits spaced by at least six months were included. The following definitions were applied: chronic pain—VAS pain ≥40 at the last two outpatient visits at least three months apart; residual pain—VAS pain ≥20 and ASDAS <1.3 at the last visit. Collected variables included BASMI, ASDAS-CRP, patient VAS, last-week VAS (0–100), HAQ, BASFI, BASDAI, age, sex, BMI, disease duration, radiographic damage, and comorbidities. Statistical analyses were performed using Student’s t-test or Mann–Whitney test for quantitative variables and the Chi-square or Fisher’s exact test for qualitative variables. Results: A total of 264 patients were enrolled (see Table). Among them, 33 (12.5%) had residual pain and 67 (25.5%) had chronic pain. In patients with residual pain, no significant differences were observed compared with controls regarding age (52 ± 45.4 vs. 53 ± 52 years; p = 0.43), male sex (66.6% vs. 61%; p = 0.57), disease duration (14.2 vs. 14.9 years; p = 0.94), or HLA-B27 positivity (66.7% vs. 87%; p = 0.48). Residual pain was less frequent in patients with non-radiographic AxSpA (21.2% vs. 39.8%; p = 0.019) and was associated with significantly higher VAS scores (30 [20–46] vs. 10 [10–20]; p = 0.0008). No significant differences were found for BASMI, BMI, CRP, or comorbidities. In the chronic pain group, males were more represented (52% vs. 16%; p = 0.008), with later disease onset (33 vs. 29.3 years; p = 0.03) and higher HLA-B27 positivity (58% vs. 11.6%; p = 0.04). These patients showed increased values for ASDAS-CRP (2.59 vs. 0.92; p < 0.0001), BASDAI (5.8 vs. 1.5; p < 0.0001), and VAS at the last visit (50 [50–70] vs. 10 [10–10]; p < 0.001). The presence of fibromyalgia (34% vs. 7%; p < 0.001) and discopathies (61% vs. 39%; p < 0.001) was significantly associated with chro…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: chronic pain
  topic: keywords
subject: residual pain
  topic: keywords
subject: axial spondyloarthritis
  topic: keywords
subject: Valentina Fornero
  topic: disciplines
subject: Niccolò Melis
  topic: disciplines
subject: Emanuela Salustro
  topic: disciplines
subject: Mattia Congia
  topic: disciplines
subject: Elisabetta Chessa
  topic: disciplines
subject: Alberto Floris
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2128

CO:07:4 | Clinical and psychosocial domains in fibromyalgia: a multidimensional questionnaire approach for personalized management. Results from an Italian monocentric study
type: item
description: Background. Fibromyalgia (FM) is a chronic disorder marked by widespread pain, fatigue, sleep disturbance and psychological distress. Their interplay impairs functioning, underscoring the need for multidimensional assessment to guide personalized care. Objectives are: a) examine relationships among clinical and psychosocial symptom domains using validated questionnaires; b) compare symptom severity, demographics and diagnostic delay across severity stratified groups; c) identify independent predictors of global and domain specific symptom burden. Methods. In this monocentric cross-sectional study, FM patients diagnosed according to 2016 ACR criteria between 2019-2025 completed Revised Fibromyalgia Impact Questionnaire (FIQR), Polysymptomatic Distress Scale (PDS), modified Fibromyalgia Assessment Scale (FASmod), Insomnia Severity Index (ISI), Zung Depression Scale (ZUNG), and State-Trait Anxiety Inventory (STAI-Y1). Demographic data were recorded. Spearman’s rho was used to assess correlations. Patients were stratified into severity groups based on validated cut-offs. Group differences were evaluated using Mann–Whitney U tests. Multivariable linear regression identified independent predictors of FIQR total, FIQR Physical, FIQR Symptoms and PDS scores. Results. 443 patients (97% female) were included, median age 52 years (IQR 43–58), median age at diagnosis 46 (37–52), median diagnostic delay 4 years (2–10). Median questionnaire scores indicated substantial symptom burden: FIQR total 63 (49–76), PDS 21 (18–25), FASmod 27 (23–32), ISI 17 (12–20), ZUNG 51 (45–57), STAI-Y1 56 (46–64). Severity thresholds are illustrated in Figure 1. FIQR total correlated strongly with somatic burden (PDS, =0.61), fatigue (FASmod, =0.68), insomnia (ISI, =0.54), depression (ZUNG, =0.54), and anxiety (STAI-Y1, =0.44), all p<0.0001. Depression and anxiety showed a particularly strong association (=0.72, p<0.0001). Insomnia correlated significantly with both physical and psychosocial domains …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: chronic pain
  topic: keywords
subject: Functional impairment
  topic: keywords
subject: Psychological relapse
  topic: keywords
subject: Eleonora Pedretti
  topic: disciplines
subject: Francesca Regola
  topic: disciplines
subject: Giulia Fontana
  topic: disciplines
subject: Giulia Voltarel
  topic: disciplines
subject: Michela Riolfo
  topic: disciplines
subject: Anna Scalvini
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
subject: Roberto Gorla
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1979

PO:04:051 | Application of REMS in the assessment of fragility score and bone mineral density in axial spondyloarthritis and psoriatic arthritis with axial involvement
type: item
description: Background. Axial spondyloarthritis (axSpA) and axial psoriatic arthritis (axPsA) are known to differ in imaging features (radiography and magnetic resonance imaging) and treatment response. These conditions may also present differences in bone mass quality and bone mineral density (BMD). Radiofrequency Echographic Multi Spectrometry (REMS) is an emerging technique for bone assessment that analyzes raw, unfiltered ultrasound signals acquired during scanning of the lumbar spine and proximal femur. Unlike conventional DXA, REMS minimizes artifacts from ectopic calcifications such as syndesmophytes and osteophytes, commonly observed in these diseases. This study aimed to compare T-scores obtained with REMS and DXA to evaluate REMS reliability in assessing BMD in axSpA and axPsA, and to explore qualitative and quantitative differences in bone mass between these patient cohorts. Materials and methods. Adult patients admitted to the Rheumatology Unit of AOU Senese and Florence Careggi were included. Participants had a confirmed diagnosis of axSpA or axPsA and were receiving treatment with biological disease-modifying antirheumatic drugs (bDMARDs) or Janus kinase inhibitors (JAKi). Patients with a prior diagnosis of osteoporosis, ongoing osteoporosis treatment or previous vertebral fractures were excluded. All patients underwent lumbar spine and femoral DXA as well as REMS scans in the same anatomical sites. BMD and Fragility Score were compared between groups. A variable (Δ) was defined as the difference between REMS and DXA T-scores at the lumbar spine and femur. Results. Twenty-five patients were enrolled (13 axSpA; 12 axPsA) with comparable age and sex distribution. No significant differences in Δ T-scores at the lumbar spine and femur were observed compared to the general population. Concordance between REMS and DXA T-scores was assessed in relation to diagnosis (axSpA vs PsA), BMI and age. For the lumbar spine, T-score concordance was not statistically significant (p…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: REMS
  topic: keywords
subject: DEXA
  topic: keywords
subject: Axial spondyloarthritis
  topic: keywords
subject: Silvia Valentini
  topic: disciplines
subject: Stefano Gentileschi
  topic: disciplines
subject: Pamela Bernardini
  topic: disciplines
subject: Jurgen Sota
  topic: disciplines
subject: Caterina Baldi
  topic: disciplines
subject: Sara Torracchi
  topic: disciplines
subject: Daniela Melchiorre
  topic: disciplines
subject: Sabrina Aliberti
  topic: disciplines
subject: Emilio D'Ignazio
  topic: disciplines
subject: Carla Caffarelli
  topic: disciplines
subject: Luca Cantarini
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Bruno Frediani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2129

CO:07:5 | Enhanced fibroblast signatures in females with early rheumatoid arthritis highlights a potential basis for poorer treatment outcomes
type: item
description: Background. To investigate whether 1) cellular and molecular characteristics of synovial tissue (ST) differ between sexes in early, treatment-naïve rheumatoid arthritis (RA) at baseline and 6 months; 2) treatment modulates synovial histopathology and molecular signatures differently in males and females. Methods. 202 early RA patients [142 females (70%), 60 males (30%)] enrolled in the Pathobiology of Early Arthritis Cohort (PEAC) who met the 2010 ACR/EULAR classification criteria were analyzed. Clinical and laboratory data, and ultrasound-guided synovial biopsies of active joints were collected at baseline and 6 months. Histological analysis included Krenn synovitis scoring and immunohistochemistry for macrophages, T, B and plasma cells. Based on published criteria, three synovial pathotypes were identified [1]. RNA-seq was performed on ST samples, followed by differential gene expression analysis with DESeq package and cell-type deconvolution via MCP-counter. Adjusted p<0.05 was considered significant. Results. At baseline, a higher proportion of males showed Diffuse-Myeloid (DM) and Lympho-Myeloid (LM) pathotypes (45% and 41%) compared to females (39% and 38%), while the Fibroid (F) pathotype was more prevalent in females (23% vs 14%). Median synovitis scores were higher in males [4.5 (2.8-6)] than female [3 (2-5), p=0.073]. LM pathotype and high Krenn scores were more common in small joints in males than females (LM 38% vs 16%, p=0.0291; Krenn 5-9 50% vs 10%, p=0.005), while in large joints were more prevalent in females (LM 74% vs 14%, Krenn 5-9 70% vs 14%, p<0.001), suggesting a preferential articular involvement. Thirty-two genes were differentially expressed at baseline (1 upregulated in females, 31 in males); several male-upregulated genes (UTY, KDM5D, RPS4Y1, USP9Y, DDX3Y, EIF1AY) correlated with immune cell infiltration and tended to be more expressed in ST with high Krenn score and LM pathotype. At 6 months, females showed a smaller reduction in SJC and …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Rheumatoid arthritis
  topic: keywords
subject: Gender differences
  topic: keywords
subject: Fibroblasts
  topic: keywords
subject: Benedetta Monosi
  topic: disciplines
subject: James Perera
  topic: disciplines
subject: Alessandra Nerviani
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
subject: Felice Rivellese
  topic: disciplines
subject: Costantino Pitzalis
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1980

PO:04:054 | Clinical efficacy and drug retention rate of upadacitinib in patients with axial spondyloarthritis: results from a single-center observational study
type: item
description: Background. This single-center study aimed to evaluate the clinical efficacy of upadacitinib (UPA) in patients with axial spondyloarthritis (axSpA) and to assess its long-term treatment persistence. A secondary objective was to identify potential predictors of treatment persistence with UPA. Materials and Methods. All adult patients diagnosed with axSpA and treated with UPA for at least six months were included. Clinical data were retrospectively collected at baseline and after 3, 6, and 12 months of therapy. Outcome measures included changes in disease activity assessed by ASDAS-CRP and BASDAI, pain intensity evaluated using a visual analogue scale (VAS), and functional limitation measured with the BASFI. The UPA drug retention rate (DRR) at 18 months was estimated using Kaplan–Meier survival analysis, and the influence of potential modifying factors was assessed using the log-rank test. Results. A total of 49 patients (35 F, 14 M) with a mean ± SD age at baseline of 50.3 ± 12.7 years were included. Median (IQR) baseline values were: ASDAS-CRP = 3.2 (1.2), BASDAI = 6.5 (3.2), BASFI = 4.1 (3.2), and VAS-pain = 7.0 (3.0). From month 3 onward, there was a statistically significant reduction in median ASDAS-CRP (p < 0.01), BASDAI (p < 0.01), BASFI (p = 0.047), ESR (p = 0.02), and VAS-pain (p < 0.01). At month 6, further decreases were observed in ESR (p < 0.01), ASDAS-CRP (p < 0.01), BASDAI (p < 0.01), and BASFI (p = 0.02). A significant improvement in BASFI (p < 0.01) was also recorded between months 6 and 12, while the other parameters reached a plateau (Fig. 1). At the last follow-up, 85.4% of patients remained on UPA therapy; seven patients had discontinued treatment (n = 1 primary inefficacy; n = 5 adverse events). The UPA DRR at 6, 12, and 18 months was 95.5%, 85%, and 81.3%, respectively (Fig. 2). Sex (p = 0.32), BMI (p = 0.07), radiographic SpA (p = 0.88), prior bDMARDs use (p = 0.54), and fibromyalgia (p = 0.08) did not significantly affect treatment persisten…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: upadacitinib
  topic: keywords
subject: ax-SpA
  topic: keywords
subject: effectiveness
  topic: keywords
subject: Simona Buonanno
  topic: disciplines
subject: Carla Gaggiano
  topic: disciplines
subject: Caterina Baldi
  topic: disciplines
subject: Marco Bardelli
  topic: disciplines
subject: Cristiana Barreca
  topic: disciplines
subject: Francesca Bellisai
  topic: disciplines
subject: Marta Fabbroni
  topic: disciplines
subject: Paolo Falsetti
  topic: disciplines
subject: Anna Paola Pata
  topic: disciplines
subject: Enrico Selvi
  topic: disciplines
subject: Jurgen Sota
  topic: disciplines
subject: Antonio Vitale
  topic: disciplines
subject: Luca Cantarini
  topic: disciplines
subject: Bruno Frediani
  topic: disciplines
subject: Stefano Gentileschi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2130

PO:04:056 | Willingness of patients with psoriatic arthritis to participate in pharmacological and nutritional clinical trials: a cross-sectional study
type: item
description: Background. Psoriatic arthritis (PsA) is a chronic inflammatory disease that significantly affects patients’ quality of life. Clinical trials are fundamental tools for improving therapeutic strategies and disease management; high patient adherence is desirable to reduce selection bias and ensure the generalizability of the results. However, data regarding patients’ willingness to participate in pharmacological and nutritional interventional studies are currently limited. The aim of this study is to evaluate the willingness of patients with PsA to participate in pharmacological and nutritional clinical trials, and to identify clinical and demographic factors potentially associated with such willingness. Materials and Methods. A cross-sectional, non-profit survey was conducted using a structured questionnaire administered consecutively to patients attending the rheumatology clinic between October 31, 2024 and January 7, 2025. For each participant, demographic data (sex, age, education level, body mass index [BMI]) and clinical data (disease duration, disease activity, current therapy, and comorbidities) were collected. Descriptive analysis was used to characterize the cohort. Results. A total of 225 patients with PsA were enrolled, with a mean age of 57.68 years (range: 28–85). The sample included 96 female participants (42.6%), with a mean BMI of 25.81. The median disease duration was 14 years; 94.2% of patients had disease activity ranging from remission to low activity. The main results are shown in Figure 1. Overall, 186 patients (82.7%) expressed willingness to participate in clinical studies; among these, 129 (57.3%) were willing to take part in both pharmacological and nutritional trials, while 45 patients (20%) reported willingness to participate exclusively in nutritional studies. Chi-square analysis did not reveal statistically significant associations between sex, BMI, education level, disease duration, and willingness to participate (p > 0.05 for all varia…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Clinical trials
  topic: keywords
subject: nutritional clinical trials
  topic: keywords
subject: patients
  topic: keywords
subject: Miriam Perino
  topic: disciplines
subject: Francesca Ingegnoli
  topic: disciplines
subject: Luca Ingrao
  topic: disciplines
subject: Debora Piredu
  topic: disciplines
subject: Antonio Varvaro
  topic: disciplines
subject: Camilla Riboldi
  topic: disciplines
subject: Gilberto Cincinelli
  topic: disciplines
subject: Francesca Desiati
  topic: disciplines
subject: Martina Biggioggero
  topic: disciplines
subject: Orazio De Lucia
  topic: disciplines
subject: Silvia Casari
  topic: disciplines
subject: Maria Manara
  topic: disciplines
subject: Ennio Giulio Favalli
  topic: disciplines
subject: Roberto Caporali
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2131

PO:04:061 | Higher prevalence of baseline comorbidities in patients developing difficult to treat psoriatic arthritis
type: item
description: Background. To evaluate baseline comorbidities as influencing factors for Difficult to Treat Psoriatic Arthritis (D2T-PsA) onset. Methods. This is a retrospective case-control study, on PsA patients who had started their first bDMARD from September 2023 to May 2024 (T1). Those who had completed 1 year of continuous b/tsDMARDs therapy (T2) were enrolled. Demographic and clinical data were collected (Table 1) referred to T1, joint ultrasound (US) was performed at both evaluations. At T2, patients were divided in 2 groups: 1) D2T-PsA: according to Lubrano et al. with strictly inflammatory signs of active PsA (i.e. ultrasound-proven enthesitis/synovitis/tenosynovitis); 2) low disease activity (LDA): DAPSA<14, no ultrasound signs of active PsA. Descriptive statistics, Chi-square test, and Student’s t-test were used to compare baseline characteristics between groups. Logistic regression was used to estimate odds ratios for the association between baseline variables and D2T-PsA. Results. Out of 224 patients enrolled, 168 (75.0%) and 54 (25%) were included in the LDA and D2T-PsA groups respectively. No significant differences were found in demographic characteristics between groups at T1. On the other hand, several baseline features and comorbidities appeared associated with 1 year incidence of D2T-PsA. Namely: smoking habit (p<0.001), presence of uveitis (p=0.01), dactylitis (p=0.03), axial disease (p<0.001), US proven bone erosions (p=0.03) and non-alcoholic fatty liver disease (NAFLD, p<0.001). Similarly, baseline number of swollen joints was associated to D2T-PsA development (p=0.04), while HAQ and VAS pain resulted higher in those achieving LDA at T2 (p=0.01 and 0.04, respectively). Furthermore, presence of different clinical features and comorbidities at T1 were associated with higher odds of developing D2T-PsA after 5 years (Table 2); including: smoking habit, HLA-B27, uveitis, enthesitis, axial disease, bone erosions at US and NAFLD. No significant relation was foun…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Difficult to treat
  topic: keywords
subject: Comorbidity
  topic: keywords
subject: Treatment
  topic: keywords
subject: Mario Ferraioli
  topic: disciplines
subject: Michelina Turri
  topic: disciplines
subject: Eneida Çela
  topic: disciplines
subject: Mauro Fatica
  topic: disciplines
subject: Paola Conigliaro
  topic: disciplines
subject: Elisabetta Greco
  topic: disciplines
subject: Alberto Bergamini
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2011

CO:08:2 | Impact of comorbidities on clinical-serological phenotype of primary Sjögren's disease: a retrospective analysis of a multicenter cohort
type: item
description: Background. Primary Sjögren's disease (SjD) is characterized by significant phenotypic heterogeneity frequently associated with other autoimmune diseases or different comorbidities, which influence clinical course, phenotypic expression, quality of life and therapeutic approach. However, their clinical relevance is underestimated. We evaluated clinical and laboratory differences at diagnosis in SjD patients stratified according to presence or absence of concomitant autoimmune diseases and selected comorbidities, in order to outline their impact on clinical phenotype. Methods: A multi-center SjD chort was retrospectively analyzed. Clinical-demographic characteristics, disease activity by ESSDAI, dryness, pain and fatigue degree by ESSPRI and serological variables were collected at diagnosis. Traditional cardiovascular (CV) risk factors were recorded as cumulative data. For study aim, the following comorbidities were considered as cumulative parameter at the last follow-up: fibromyalgia, autoimmune thyroiditis, non-hematologic cancers, primary biliary cholangitis (PBC), celiac disease (CD) and history of severe infections. Results. 1231 SjD patients were included. Patients with fibromyalgia (132/1231, 10.7%) were characterized by younger age at diagnosis (mean 49.7 vs. 52.1 years, p=0.048), lower ESSDAI (2.04 vs. 3.52, p=0.029), higher ESSPRI (6.9 vs. 5.1, p=0.000), higher frequency of obesity (p=0.009) and lower anti-Ro (p=0.049), anti-La (p=0.016) and rheumatoid factor prevalence (p=0.000). Patients with autoimmune thyroiditis (263/1231, 21.4%) had higher age at diagnosis (mean 52.3 vs. 50 years, p=0.031), higher ESSDAI (4.12 vs. 3.15, p=0.034) and higher frequency of anti-Ro52 and Ro60 (p=0.01 and p=0.03, respectively), a serological finding also observed in patients with PBC (26/1231, 2.1%) (anti-Ro 52, p=0.02; anti-Ro60, p=0.000). Patients with CD (27/1231, 2.2%) were younger (mean 43 vs. 52 years, p=0.002) and had higher prevalence of anti-Ro52 (p=0.039) and Ro6…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Sjogren's disease
  topic: keywords
subject: Phenotype
  topic: keywords
subject: Comorbidity
  topic: keywords
subject: Roberto Dal Pozzolo
  topic: disciplines
subject: Maria Letizia Currò
  topic: disciplines
subject: Giacomo Cafaro
  topic: disciplines
subject: Valeria Manfrè
  topic: disciplines
subject: Gaetano La Rocca
  topic: disciplines
subject: Alessia Alunno
  topic: disciplines
subject: Francesco Carubbi
  topic: disciplines
subject: Nicoletta Del Papa
  topic: disciplines
subject: Viktoriya Pavlych
  topic: disciplines
subject: Ilenia Fischetti
  topic: disciplines
subject: Letizia Pia Di Corcia
  topic: disciplines
subject: Pamela Bernardini
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
subject: Chiara Baldini
  topic: disciplines
subject: Paola Cipriani
  topic: disciplines
subject: Roberta Priori
  topic: disciplines
subject: Onorina Berardicurti
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Serena ColaFrancesco
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
subject: Elena Bartoloni
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1983

PO:05:066 | Atypical diagnosis and manifestation of spondyloarthritis: a case report
type: item
description: Background. The aim of this case report is to illustrate how the initially most likely diagnosis is not always the correct one. Case report. A 57-year-old woman, with an unremarkable past medical history, presented to our attention following ophthalmologic referral after a first episode of acute non-granulomatous unilateral anterior uveitis, associated with arthralgias involving the shoulder and knee girdles, and prolonged morning stiffness (90 minutes). She denied previous episodes of arthritis, RS3PE, headache, transient visual loss, diplopia, scalp dysesthesias, enthesitis, dactylitis, or inflammatory low back pain. There was no personal or family history of psoriasis or inflammatory bowel disease. Based on laboratory findings (elevated nonspecific inflammatory markers), clinical presentation (EUL 3/3 with painful arc and prolonged stiffness), and ultrasound evidence (bilateral subacromial–subdeltoid bursitis with long head biceps tenosynovitis, knee and shoulder synovitis), a diagnosis of polymyalgia rheumatica (PMR) was initially made. Treatment with tapering prednisone (starting at 12.5 mg/day) was initiated, with an excellent initial response. At subsequent visits, the patient reported recurrence of symptoms at prednisone doses below 7.5 mg/day, leading to the addition of methotrexate 15 mg/week as a corticosteroid-sparing agent. Due to poor clinical response and frequent need for NSAIDs to control symptoms, a repeat joint ultrasound was performed, confirming previous findings and revealing polyenthesitis (involving subscapularis, supraspinatus, and distal patellar tendons) with bilateral microerosions. Laboratory testing showed positivity for HLA-B27. In light of these new findings, the diagnosis was revised to HLA-B27–positive peripheral spondyloarthritis with a polymyalgia-like onset, and anti–TNFα therapy (adalimumab) was initiated. Over the following months, progressive loss of drug efficacy was observed, with new-onset inflammatory pain involving the ce…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: SPONDYLOARTHRITIS
  topic: keywords
subject: polymyalgia rheumatica (PMR)
  topic: keywords
subject: non-granulomatous anterior uveitis
  topic: keywords
subject: Adele Del Giudice
  topic: disciplines
subject: Filippo Crescentini
  topic: disciplines
subject: Giorgia Citriniti
  topic: disciplines
subject: Luca Cimino
  topic: disciplines
subject: Carlo Salvarani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2132

PO:05:069 | Risankizumab efficacy in peripheral and axial involvement: monocentric experience
type: item
description: Risankizumab, an anti–IL-23 monoclonal antibody, is approved for the treatment of peripheral psoriatic arthritis (PsA), and increasing evidence suggests its potential efficacy in patients with concurrent axial involvement. This study presents a preliminary monocentric real-world experience on the use of risankizumab in PsA, with clinical follow-up over six months of treatment. 34 patients with PsA treated with risankizumab at our center were included in this study. Of these, 18 had peripheral involvement only, while 16 presented both peripheral and axial involvement. Clinical assessments included DAPSA for peripheral disease, ASDAS-CRP and modified BASDAI (mBASDAI) for axial involvement. Patients were further stratified by treatment line (naïve to fourth-line) and therapy regimen (monotherapy vs. combination with methotrexate). The aim was to evaluate the evolution of clinical parameters over the course of treatment. Moreover, MRI was used to assess sacroiliac joint inflammation in patients with axial involvement. At baseline (T0), all patients underwent clinical evaluation using DAPSA, ASDAS-CRP, and mBASDAI scores, with regular follow-up assessments over six months (T6). Among the 16 patients with both peripheral and axial involvement, there was a marked improvement in ASDAS-CRP and mBASDAI scores, indicating a beneficial effect of risankizumab in reducing both axial and peripheral symptoms, as shown in the graphs. Regarding treatment lines, 8.8% of patients were treatment-naïve, while 58.8% received risankizumab as second-line, 20.6% as third-line, and 8.8% as fourth-line therapy. Risankizumab was administered in combination with methotrexate (MTX) in 70% of cases, and as monotherapy in 30%, demonstrating efficacy across both treatment regimens, including in patients with prior biologic exposure. As a representative case, MRI images from a 50-year-old female with axial PsA are included, showing marked improvement after six months of risankizumab. Our findings are…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: risankizumab
  topic: keywords
subject: Axial psoriatic arthritis
  topic: keywords
subject: IL-23
  topic: keywords
subject: Roberta Foti
  topic: disciplines
subject: Ylenia Dal Bosco
  topic: disciplines
subject: Giorgio Amato
  topic: disciplines
subject: Elisa Visalli
  topic: disciplines
subject: Francesco De Lucia
  topic: disciplines
subject: Gabriella Paolí
  topic: disciplines
subject: Rosario Foti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2012

CO:08:4 | Paraproteinemias in Sjögren’s disease: cryoglobulinemia and monoclonal component define distinct phenotypes with a synergistic lymphoproliferative risk
type: item
description: Background. A distinctive feature of Sjögren’s disease (SjD) is the persistent activation of B lymphocytes, which may progress to lymphoma development, particularly of the MALT type. The presence of cryoglobulinemia (CRYO) and circulating monoclonal component (MC) represent two manifestations of B-cell hyperactivity and are recognized risk factors for lymphoproliferative evolution. However, it remains unclear whether CRYO and MC identify distinct clinical phenotypes. Objective. To assess whether CRYO, MC, or their combination define different SjD phenotypes in terms of disease activity (ClinESSDAI) and lymphoproliferative risk. Materials and Methods. This retrospective, multicenter study included patients enrolled by Italian centers of the GRISS (Italian Sjögren's Disease Research Group), who met the 2016 ACR/EULAR classification criteria. Patients were divided into four groups: (a) isolated MC, (b) isolated CRYO, (c) CRYO+MC, and (d) none of the above (controls). The following markers associated with increased risk of lymphoproliferative evolution were analyzed: rheumatoid factor (RF), low C4 levels, anti-La/SSB positivity, salivary gland swelling, lymphopenia, and lymph node enlargement. Disease activity was assessed based on the presence of one or more ClinESSDAI domains. Finally, the prevalence of lymphoma was evaluated across the four groups. The prevalence of risk indicators, lymphoma, and ClinESSDAI domains was analyzed for each group. Differences among groups were calculated using Fisher’s exact test, Kruskal–Wallis, and Chi-square tests. Results. A total of 1202 patients were included: 58 (4.8%) in the MC group, 32 (2.6%) in the CRYO group, 35 (2.9%) in the CRYO+MC group, and 1077 (89.7%) controls. The CRYO+MC and CRYO groups showed a significantly higher prevalence of the following lymphoproliferation-related markers: RF, low C4, anti-La, and lymph node enlargement. Salivary gland swelling and lymphopenia were more frequent only in the CRYO+MC group. [Tabl…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: cryoglobulinemia
  topic: keywords
subject: monoclonal component
  topic: keywords
subject: lymphoma
  topic: keywords
subject: Maria Teresa Rizzo
  topic: disciplines
subject: Simone Longhino
  topic: disciplines
subject: Giacomo Cafaro
  topic: disciplines
subject: Valeria Manfrè
  topic: disciplines
subject: Francesco Carubbi
  topic: disciplines
subject: Alessia Alunno
  topic: disciplines
subject: Piera Altieri
  topic: disciplines
subject: Nicoletta Del Papa
  topic: disciplines
subject: Paola Cipriani
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
subject: Francesca Cracò
  topic: disciplines
subject: Onorina Berardicurti
  topic: disciplines
subject: Andrea Pilato
  topic: disciplines
subject: Roberta Priori
  topic: disciplines
subject: Angelica Gattamelata
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Chiara Baldini
  topic: disciplines
subject: Beatrice Dei
  topic: disciplines
subject: Pamela Bernardini
  topic: disciplines
subject: Elena Bartoloni
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2119

CO:08:5 | Clinical impact of anti-Ro52 antibodies in idiopathic inflammatory myopathies: insights from a multicenter Italian cohort
type: item
description: Background. Anti-Ro52 antibodies are frequently found in idiopathic inflammatory myopathies (IIM), with a prevalence up to 30%, and are strongly associated with antisynthetase syndrome (ASyS), interstitial lung disease (ILD), and dysphagia (1;2;3). Their co-occurrence especially with anti-Jo1 or anti-MDA5, have been linked to more severe disease, including rapidly progressive ILD (1). However, they do not always correlate with worse prognosis (4). This study aimed to assess the clinical relevance of anti-Ro52 in IIM, focusing on disease phenotype and systemic involvement. Methods. This multicenter study (five Italian centers) included all patients with IIM positive for anti-Ro52 and/or myositis-specific antibodies (MSA). Patients were stratified into three groups: isolated anti-Ro52, anti-Ro52+MSA, and MSA-only. Clinical and laboratory features were collected, with emphasis on pulmonary involvement assessed by pulmonary function tests (PFTs) and high-resolution CT. Results. A total of 242 patients were included (median age: 63 years, IQR 53.75-73; median disease duration: 5 years, IQR 3-12; median follow-up: 60 months, IQR 25-120). Ro52+MSA patients showed the highest prevalence of antisynthetase syndrome (p<0.001). Baseline median DLCO was lower in Ro52+MSA (65%, IQR 54–74) than in Ro52-only (73%; IQR 62–78), and MSA (75.5%; IQR 68–84) patients. DLCO and DLCO/VA remained consistently lower in Ro52+MSA. Significant differences were observed at multiple timepoints between Ro52+MSA and the other groups for DLCO and DLCO/VA. FVC did not differ significantly, though lower medians were seen in Ro52+MSA patients (Table 1-2). ILD and dyspnoea were more frequent in Ro52+MSA (61.7% and 47.6%, respectively; p < 0.001 and p = 0.010). Arthritis showed a borderline difference (p = 0.050), with lower prevalence in Ro52-only patients. Myositis and peak CPK levels were statistically less frequent in Ro52-only patients. Raynaud’s phenomenon was not observed in Ro52-only cases (p = 0…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Ro52
  topic: keywords
subject: Myopathies
  topic: keywords
subject: Phenotypic presentation
  topic: keywords
subject: Paola Bizioli
  topic: disciplines
subject: Cesare Tomasi
  topic: disciplines
subject: Francesca Bellisai
  topic: disciplines
subject: Francesca Buzzulini
  topic: disciplines
subject: Antonio Tonutti
  topic: disciplines
subject: Angela Ceribelli
  topic: disciplines
subject: Edoardo Conticini
  topic: disciplines
subject: Anna Ghirardello
  topic: disciplines
subject: Luca Iaccarino
  topic: disciplines
subject: Danilo Villalta
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1984

PO:05:074 | A clinical case of a patient affected by long-standing psoriatic arthritis and multiple comorbidities treated with an anti-IL-23 therapy
type: item
description: Background. We describe the case of a patient affected by long-standing psoriatic arthritis, multiple joint deformities, and erythrodermic psoriasis, who was treated with an anti-IL-23 agent as first-line therapy. Materials and Methods. A 58-year-old patient, living below the poverty line, unemployed since the onset of joint symptoms, underweight (BMI 14.9 kg/m²), smoker (20 pack-years), with previous HBV and HCV infections, affected by chronic kidney disease (stage II) and depressive syndrome, presented to our clinic in March 2024 because of multiple joint pain and swelling, functional limitations, erythema, and desquamation involving the entire body surface. He reported that he had never been treated until then. Results. Physical examination and clinometric evaluation showed a PASI score of 39.2 and a DAPSA score of 55.9. Laboratory tests revealed red blood cells 3,180,000/mm³, hemoglobin 9.7 g/dL, white blood cells 15,800/mm³, neutrophils 74%, lymphocytes 16%, platelets 737,000/mm³, creatinine 1.8 mg/dL, uric acid 8.3 mg/dL, ESR 120 mm/h, and CRP 7.9 mg/dL. Radiographs of the hands and feet showed multiple deformities (ankylosis, erosions, and bone proliferation). A diagnosis of long-standing polyarticular psoriatic arthritis, erythrodermic psoriasis, and probable reactive thrombocytosis was made. In April 2024, lamivudine prophylaxis was started to prevent HBV reactivation, and in June 2024, therapy with an anti-IL-23 drug was initiated. At the follow-up visit in September 2024, the patient reported improvement in osteoarticular and cutaneous symptoms; clinometric indexes showed PASI 28.6 and DAPSA 24.6. Laboratory tests revealed white blood cells 9.0 × 10³/μL, neutrophils 50.5%, lymphocytes 33.2%, red blood cells 3.13 × 10 /μL, hemoglobin 10.8 g/dL, platelets 530 × 10³/μL, creatinine 1.40 mg/dL, uric acid 6.1 mg/dL, CRP 3.6 mg/dL, and ESR 113 mm/h. During follow-up, the clinical picture remained stable, without viral reactivation, new infections, worsening of r…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: arthritis
  topic: keywords
subject: psoriasis
  topic: keywords
subject: comorbidities
  topic: keywords
subject: Maria Letizia Currò
  topic: disciplines
subject: Angelo Tropea
  topic: disciplines
subject: Alessandra Burgio
  topic: disciplines
subject: Francesca Cracò
  topic: disciplines
subject: Antonio Pezzano
  topic: disciplines
subject: Federica Rapisarda
  topic: disciplines
subject: Antonino Palumbo
  topic: disciplines
subject: Valeria D'Amico
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2133

CO:08:6 | Prevalence, incidence and survival in interstitial lung disease secondary to primary Sjögren’s syndrome. Results from the “EMERGE” longitudinal study
type: item
description: Background. Interstitial lung disease (ILD) is a severe pulmonary complication of primary Sjögren’s syndrome (pSS), but its prevalence, natural history and survival are not completely understood. Our study aimed to investigate prevalence, incidence, and impact on survival of ILD in a cohort of unselected consecutive pSS patients. We furtherly aimed to identify clinical and serological features associated with ILD, to characterize radiological findings, and to evaluate potential prognostic factors for death. Methods. All consecutive pSS patients referred to our centre were enrolled in the study. In patients without ILD, a careful assessment for respiratory symptoms and velcro crackles was performed at enrolment and every six months. High resolution computed tomography (HRCT) was requested in case of new-onset dyspnoea, persistent dry cough, or detection of velcro crackles. Results. We enrolled 257 pSS patients, 233 females and 24 males. Mean age at enrolment was 64.8 ± 12.6 years, with a pSS duration of 83.9±78 months. At enrolment, ILD was detected in 61/257 patients with a prevalence of 23.7%. During a mean follow-up of 42.6±14.6 months, 3 new cases of ILD were recorded, with an incidence of 0.41 new cases for 100 patients/year. In a model including sex, age at pSS diagnosis, erythro-sedimentation rate (ERS), antinuclear antibodies, sicca syndrome, and smoking habit, multivariate analysis showed a direct association between ILD and male sex, age at pSS diagnosis, and ESR>40 mmh, and an inverse correlation with sicca syndrome. A nonspecific interstitial pneumonia (NSIP) was detected in 40.6% of cases, usual interstitial pneumonia (UIP) in 31.3%, organizing pneumonia in 3.1%, lymphocytic interstitial pneumonia in 18.8%, and indeterminate patterns in 6.3%. During the follow-up, 21 patients (8.2%) died. A statistically significant difference was recorded between the overall survival of patients without (88.4%±5.5) and with ILD (66.5%±11.7) (p<0.001). The estimated mean…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Sjogren's syndrome
  topic: keywords
subject: Interstitial lung disease
  topic: keywords
subject: Sycca syndrome
  topic: keywords
subject: Alessandra Rai
  topic: disciplines
subject: Caterina Vacchi
  topic: disciplines
subject: Stefania Cerri
  topic: disciplines
subject: Roberta Eufrasia Ledda
  topic: disciplines
subject: Giulia Cassone
  topic: disciplines
subject: Dario Andrisani
  topic: disciplines
subject: Filippo Gozzi
  topic: disciplines
subject: Lucia Dardani
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
subject: Athina Patsoura
  topic: disciplines
subject: Francesca Cozzini
  topic: disciplines
subject: Marco Sebastiani
  topic: disciplines
subject: Andreina Manfredi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1985

PO:06:078 | Is difficult-to-treat rheumatoid arthritis less severe in patients with autoantibody-negative disease? retrospective analysis from a monocentric cohort.
type: item
description: Background. Patients with rheumatoid arthritis (RA) are at higher risk of radiographic progression, joint damage, disability, and extraarticular manifestations when autoantibodies – such as rheumatoid factor (RF) and anti-citrullinated peptide antibodies (ACPA) are presents. Moreover, most of RA cohorts report an association between autoantibodies and polyrefractory – or difficult-to-treat (D2T) disease. However, at the moment, no data evaluated whether autoantibody-negative D2T is actually less severe than its seropositive counterpart. Methods. Data were retrieved from a cohort of RA patients under targeted-therapy [Turin Targeted-Therapies clinic (TTT), n=636], followed from the year 2000 onwards. D2T disease was defined according to the European Alliance of Associations for Rheumatology (EULAR) criteria; patients who interrupted drugs for safety/adverse events were excluded. Time-to-develop the D2T state (defined as the difference between disease onset and the time point when fulfilling the D2T criteria) was stratified for autoantibody status by Mann-Whitney U analysis. Also, disease activity state, joint deformities, extraarticular manifestations, the number of swollen joints on 28 evaluated (SJC28), the number of tender joints on 28 evaluated (TJC28), pain expressed by a visual analogue scale (VAS), the health assessment questionnaire (HAQ), and other patient reported outcomes were evaluated at the D2T time point both in seropositive and -negative patients by multivariate linear logistic regression or Mann-Whitney U test, as appropriate. Results. From the original cohort, 189/636 (30%) interrupted at least two targeted therapies, and 132/636 (21%) fulfilled EULAR D2T criteria, 100 of them (76%) with seropositive RA. Time-to-achieve the D2T state was significantly shorter in seronegative vs. seropositive patients (mean Rank 58.89 for seronegative vs. 77.04 for seropositive; p=0.024). At the D2T-time point, patients with autoantibody-positive RA had more extraart…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Difficult-to-treat
  topic: keywords
subject: Autoantibodies
  topic: keywords
subject: Patient-reported outcomes
  topic: keywords
subject: Bernardo D'Onofrio
  topic: disciplines
subject: Maria Chiara Ditto
  topic: disciplines
subject: Francesco Ghellere
  topic: disciplines
subject: Giacomo Tanti
  topic: disciplines
subject: Salvatore Panaro
  topic: disciplines
subject: Enrico Fusaro
  topic: disciplines
subject: Simone Parisi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2013

CO:09:1 | The impact of sex and gender on fibromyalgia syndrome: data from the Italian Fibromyalgia Registry
type: item
description: Background. Studies have shown that the majority of fibromyalgia (FM) patients are women, with an average global female-to-male ratio of 3:1. Although differences in the perception, description, and expression of pain between sexes have been documented, the impact of sex and gender on FM disease severity and burden remains controversial. Moreover, despite the availability of various disease severity measures, the potential occurrence of gender-related differential item functioning (DIF) within these questionnaires has not been explored. Consequently, it is unclear whether these tools are equally sensitive in both men and women with FM. The primary aim of this study was to assess potential sex differences in disease severity using data from a web-based FM patient registry. The secondary aim was to investigate the presence of gender-related DIF in three disease-specific questionnaires: the Polysymptomatic Distress Scale (PDS), the modified Fibromyalgia Assessment Status (ModFAS), and the revised Fibromyalgia Impact Questionnaire (FIQR). Methods. The study population comprised male and female patients, pair-matched for age and body mass index (BMI), diagnosed with FM according to the 2010/2011 American College of Rheumatology (ACR) criteria, and recruited from five Italian rheumatology centers. Data collected for each patient included sociodemographic characteristics (age, sex, marital status, education level, and BMI) as well as scores from the three FM-specific questionnaires. Multiple linear regression models were used to examine associations between sex and disease activity measures. Further analyses stratified by sex assessed how sociodemographic factors differentially impacted FM outcomes. DIF was analyzed using a hybrid Ordinal Logistic Regression/Item Response Theory (OLR/IRT) approach. Results. Data from 331 male and 331 female patients were retrospectively analyzed. Demographic characteristics are shown in Table 1. Multivariate analysis revealed that female s…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Fibromyalgia
  topic: keywords
subject: Sex and gender
  topic: keywords
subject: Registry data
  topic: keywords
subject: Martina Favretti
  topic: disciplines
subject: Cristina Iannuccelli
  topic: disciplines
subject: Giulio Dolcini
  topic: disciplines
subject: Sonia Farah
  topic: disciplines
subject: Marco Di Carlo
  topic: disciplines
subject: Giuseppina Tramontano
  topic: disciplines
subject: Giorgia Ferrari
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
subject: Greta Pellegrino
  topic: disciplines
subject: Piercarlo Sarzi-Puttini
  topic: disciplines
subject: Fausto Salaffi
  topic: disciplines
subject: Manuela Di Franco
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1986

PO:06:079 | Weighing the burden: how body mass index shapes clinical outcomes in rheumatoid arthritis. Insights from a large Italian cohort
type: item
description: Background. Body mass index (BMI) may influence the clinical presentation and progression of rheumatoid arthritis (RA). Understanding its impact is crucial to optimizing disease management and tailoring treatment strategies. This multicenter, cross-sectional study aimed to evaluate the impact of BMI on RA management in a real-world setting. Methods. Patients diagnosed with RA based on the 2010 ACR/EULAR Classification Criteria were enrolled from 18 academic rheumatology centers. Clinical charts were reviewed to collect demographic data, treatment information, and disease activity measures. Data were analyzed using appropriate statistical methods with GraphPad Prism v9. Results. A total of 1,432 RA patients were included (mean age 61±10 years; 81.4% female; median disease duration 120 months; 70% RF/ACPA positive). The median BMI was 25 (IQR 22.4–28.1), with males presenting significantly higher BMI values (p<0.001). Obesity (BMI >30 kg/m²) was observed in 14.7% of patients, with no significant sex difference. Overweight (BMI 25–30 kg/m²) was more common in males (1.5-fold, p<0.001), while underweight (BMI <20 kg/m²) was 10 times more prevalent in females (p<0.0001). BMI correlated positively with age, disease duration, blood pressure, triglycerides, CRP levels, and disability (assessed by HAQ-DI), but not with disease activity scores (DAS28-ESR or CDAI). A significant inverse correlation was observed with HDL cholesterol (r = -0.16, p < 0.0001). Smoking habits and diabetes prevalence (7.1%) were not significantly affected by BMI; notably, nearly half of diabetic patients were overweight or obese. The 10-year cardiovascular risk (SCORE-2) was similar between obese and non-obese RA patients. Regarding treatment, 43.5% of patients were on corticosteroids (mean prednisone-equivalent dose 4.9±3.4 mg/day), 68.7% on csDMARDs (80% on methotrexate), and 57.3% on b/tsDMARDs, with one-third receiving monotherapy. Obese patients were more likely to be treated with bDMARDs (64.3…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: BMI
  topic: keywords
subject: Rheumatoid arthritis
  topic: keywords
subject: Obesity
  topic: keywords
subject: Marco Capodiferro
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Gian Luca Erre
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
subject: Elena Bartoloni Bocci
  topic: disciplines
subject: Andreina Manfredi
  topic: disciplines
subject: Ennio Giulio Favalli
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Eleonora Celletti
  topic: disciplines
subject: Addolorata Corrado
  topic: disciplines
subject: Alessandro Giollo
  topic: disciplines
subject: Simone Parisi
  topic: disciplines
subject: Ivan Giovannini
  topic: disciplines
subject: Elisa Gremese
  topic: disciplines
subject: Garifallia Sakellariou
  topic: disciplines
subject: Ombretta Viapiana
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
subject: Francesca Romana Spinelli
  topic: disciplines
subject: Fabio Cacciapaglia
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2014

CO:09:3 | Effectiveness and safety of nintedanib in autoimmune systemic diseases: real life data from an Italian multicentre study (Island group) of the Italian Society of Rheumatology
type: item
description: Background. Nintedanib (NTD) has been shown to be useful to slow functional decline of progressive fibrosing interstitial lung disease also in Autoimmune Systemic Diseases (ASDs) beside systemic sclerosis (SSc) and rheumatoid arthritis (RA) after the positive results of the INBUILD trial. Here we describe the effectiveness and safety of NTD in ASDs in a real-life setting. Materials and Methods. The clinical data of ASDs patients with ILD (excluded SSc and RA) treated with NTD from 17 Italian centres were retrospectively evaluated at 12 months prior to NTD introduction; at baseline, and at 12 months after NTD introduction. The following parameters were recorded: ASD clinical features, NTD tolerability, pulmonary function tests (PFTs). Progressors were defined as a drop in %pFVC >= 5 and/or %pDLCO >= 10 within 12 months. Results. 114 ASD-ILD patients (46.5% male, mean age 69 ± 10 years, median disease duration 5.5 (2-12) years) treated with NTD were identified. Disease features are summarized in Table 1. The most common ASD was anti-synthetase syndrome (31, 27.2%) and the most common antibody was anti-Ro52 (44, 38.6%), most (57.9%) had been previously treated with immunosuppressants. At baseline, 107 (93.9%) patients were on immunosuppressants (see Table 1), with 74 (64.9%) patients on steroid with a median dose of 5 (1.25 – 7.5). Baseline HRCT was available in 109 patients and it showed an UIP pattern in 43 (39.4%) and a NSIP pattern in 66 (60.6%) patients. A significant decline in %pFVC and in %pDLCO was observed in the 12 months prior to NTD introduction (82.4 ± 21 versus 71 ± 16, p <0.001 and 51 ± 17 versus 44 ± 13, p <0.001, respectively) with 54 (69%) being classified as progressors. At 12 months after NTD introduction, follow-up data were available for 54 patients and they showed an improvement in both %pFVC (72 ± 15 to 75 ± 17, p < 0.001) and %pDLCO (43 ± 15 to 45 ± 17; p < 0.001); moreover, the percentage of progressors was significantly lower (69% versus 26%…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 2
  topic: category
subject: Interstitial Lung Disease
  topic: keywords
subject: Nintedanib
  topic: keywords
subject: Connective tissue disease
  topic: keywords
subject: Corrado Campochiaro
  topic: disciplines
subject: Paola Conigliaro
  topic: disciplines
subject: Gianluca Sambataro
  topic: disciplines
subject: Marco Matucci-Cerinic
  topic: disciplines
subject: Marco Sebastiani
  topic: disciplines
subject: Gianluca Bajocchi
  topic: disciplines
subject: Angelo Fassio
  topic: disciplines
subject: Elena Treppo
  topic: disciplines
subject: Elisabetta Zanatta
  topic: disciplines
subject: Elena Bartolini
  topic: disciplines
subject: Francesco Ferro
  topic: disciplines
subject: Chiara Bazzini
  topic: disciplines
subject: Nicoletta Del Papa
  topic: disciplines
subject: Gemma Lepri
  topic: disciplines
subject: Andrea Lo Monaco
  topic: disciplines
subject: Marta Favero
  topic: disciplines
subject: Annamaria Iuliano
  topic: disciplines
subject: Francesca Li Gobbi
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
subject: Giuseppe Muscato
  topic: disciplines
subject: Giacomo De Luca
  topic: disciplines
subject: Francesca Cozzini
  topic: disciplines
subject: Lucia Dardani
  topic: disciplines
subject: Francesco Pollastri
  topic: disciplines
subject: Alessandro Gattron
  topic: disciplines
subject: Beatrice Moccaldi
  topic: disciplines
subject: Caterina Antonini
  topic: disciplines
subject: Gaetano La Rocca
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
subject: Andreina Manfredi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1987

https://www.reumatismo.org/reuma/article/view/2134
type: item
title: PO:06:082 | Correlation between ultrasonographic parameters and the Krenn synovitis score in patients with chronic infiammatory arthropathy undergoing ultrasound-guided synovial biopsy: a prospective cohort study
description: Background. The aim of this study is to analyze, in a cohort of patients with chronic inflammatory arthropathy, the correlation between ultrasonographic parameters and the Krenn Synovitis Score (KSS) – a validated semi-quantitative scale for the histological classification of synovitis, used to evaluate the degree of synovial inflammation. Materials and Methods. We included patients aged ≥18 years with a diagnosis of RA, according to the 2010 ACR/EULAR classification criteria, or PsA, according to the CASPAR criteria, were recruited. Eligible participants were required to be candidates for initiation or modification of DMARD therapy and to have complete ultrasonographic data at baseline, defined as a polyarticular assessment using the Global OMERACT–EULAR Synovitis Score (GLOESS) and ultrasound evaluation of the biopsy site. Each patient underwent an ultrasound-guided synovial biopsy of a clinically involved joint (knee or wrist). Synovial tissue specimens were evaluated by an experienced pathologist to determine the KSS. Statistical analyses were conducted using Spearman’s rank correlation coefficient, a non-parametric measure of association. Results. A total of 63 patients were evaluated (58 with RA and 5 with PsA). Among them, 92% (58/63) had failed at least one csDMARD, and 51% (32/63) had failed at least one b/tsDMARD. The mean (SD) polyarticular GLOESS value was 15 (12), while the median (IQR) KSS was 6 (4.00, 6.00) (Table 1). GLOESS (rho = 0.23, p = 0.013), gray-scale (GS) intensity (rho = 0.35, p < 0.001), and the degree of joint effusion (rho = 0.27, p = 0.004) at the biopsy site showed a positive correlation with the KSS (Figure 1). Regarding the KSS sub-items, a positive correlation was observed between all ultrasound variables and the degree of inflammatory infiltrate on histological examination (rho = 0.38, p < 0.001 for GS; rho = 0.30, p = 0.002 for effusion; rho = 0.23, p = 0.014 for PD). No statistically significant correlation was found between Powe…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: chronic inflammatory arthropathy
  topic: keywords
subject: synovial biopsy
  topic: keywords
subject: Krenn score
  topic: keywords
subject: Maria Capita
  topic: disciplines
subject: Carlo Garaffoni
  topic: disciplines
subject: Marianna Tamussin
  topic: disciplines
subject: Serena Ceccato
  topic: disciplines
subject: Giovanni Lanza
  topic: disciplines
subject: Alessandra Bortoluzzi
  topic: disciplines
subject: Marcello Govoni
  topic: disciplines
subject: Ettore Silvagni
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2134

CO:09:4 | Erosive hand osteoarthritis: the impact of comorbidities in the context of joint disease
type: item
description: Background. This study aimed to determine whether cardiovascular and osteometabolic comorbidities are associated with the radiographic hallmarks of erosive hand osteoarthritis (EHOA), specifically osteophytes, joint space narrowing (JSN), malalignment, central erosions, sclerosis, and subchondral cysts. We also evaluated how these comorbidities relate to clinical and serological measures of disease activity, including pain (VAS), validated disease questionnaires, swollen and tender joint counts, and inflammatory markers. Materials and Methods. We enrolled patients exhibiting at least one central erosion in a proximal (PIP) or distal (DIP) interphalangeal joint, excluding any with metacarpophalangeal erosions. Each participant underwent a comprehensive clinical assessment by an expert rheumatologist and completed the VAS for pain, the AUSCAN index, and the DREISER algo-functional scale. We collected demographic, clinical, metabolic, and bone-metabolic data such as BMI, blood pressure, laboratory values, and bone-densitometry results. Radiographs were scored using the Altman system after specific training to ensure inter-reader reliability; we graded osteophytes, JSN, malalignment, central erosions, sclerosis, and cysts. Comorbidities were quantified with the Charlson Comorbidity Index (CCI), metabolic syndrome defined per Adult Treatment Panel (ATP) III criteria, and ten-year fracture risk estimated via the DeFRA score. Results. Eighty-seven patients (77% female; mean age 63.2 ± 8.9 years) were analysed. Radiographic scores of the different joints analysed are detailed in Table 1 . Cardiovascular risk factors were present in 76.8% of subjects: 48.2% had total cholesterol > 200 mg/dL, 9.1% were obese (BMI > 30 kg/m²), 6.9% had fasting glucose > 126 mg/dL, and 28.7% were hypertensive (>140/90 mmHg). Sixteen patients (18.4%) had osteoporosis, and 28.3% (17/60) of those with DEXA data available had lumbar T-scores <–2.5. Pain (VAS) correlated with swollen (r=0.44, p < 0.…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Erosive osteoarthritis
  topic: keywords
subject: diabetes
  topic: keywords
subject: Cardiovascular
  topic: keywords
subject: Sara Bindoli
  topic: disciplines
subject: Clarissa Benvoluti
  topic: disciplines
subject: Giacomo Cozzi
  topic: disciplines
subject: Marta Favero
  topic: disciplines
subject: Mariagrazia Lorenzin
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
subject: Paolo Sfriso
  topic: disciplines
subject: Roberta Ramonda
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1988

PO:06:083 | Clinical characteristics and outcomes of late- and young-onset rheumatoid arthritis in relation to autoantibody status
type: item
description: Background. Ageing of the society is progressively increasing the incidence of rheumatoid arthritis (RA) in the ederly, but the clinical characteristics and outcomes of late-onset RA (LORA) remain debated. If, on the one-hand, some forms of LORA have traditionally been regarded as more benign, older age is also reported as a risk factor for disease refractoriness. Aim of this study was to investigate the clinical outcomes of newly diagnosed LORA in comparison with young-onset RA (YORA) in the setting of a standardized treatment protocol, taking into account possible differences according to autoantibody status. Methods. Data were retrieved from a monocentric inception cohort of patients with new onset (symptoms <12 months) RA, tightly followed at 3-months intervals and treated according to a treat-to-target strategy with progressively increasing doses of methotrexate (MTX). Patients were classified as LORA based on the newly proposed cut-off of >= 70 years. Outcomes of interest included proportions of patients in remission at 6 and 12 months, and doses of MTX at each time point. Analyses were stratified for positivity of anti-citrullinated protein autoantibodies (ACPA). Results. Among 812 patients with early RA, 239 (29.2%) had LORA. Collectively, compared with YORA, LORA presented with higher inflammatory features, including numbers of involved joints and acute phase reactants (Table 1). After 6 and 12 months of treatment, rates of remission according to the DAS28, SDAI and Boolean criteria were comparable between LORA and YORA. Doses of MTX at 12 months did not differ (mean [SD] 13.8 [4.9] vs 13.9 [5.9] mg/w). LORA was significantly less frequent among ACPA-positive patients (16.4% vs 34.8%, p<0.001). However, in this latter serologic subgroup, LORA was characterized by more unfavourable outcomes compared with YORA, with lower rates of remission at each time point in spite of comparable doses of MTX (Table 1). At multivariable analyses corrected for gender, baseli…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: late-onset RA (LORA)
  topic: keywords
subject: Juvenile-onset RA (YORA)
  topic: keywords
subject: ACPA
  topic: keywords
subject: Federica Sabatelli
  topic: disciplines
subject: Ludovico De Stefano
  topic: disciplines
subject: Clelia Zampaglione
  topic: disciplines
subject: Lisa Bergianti
  topic: disciplines
subject: Blerina Xoxi
  topic: disciplines
subject: Antonio Manzo
  topic: disciplines
subject: Carlomaurizio Montecucco
  topic: disciplines
subject: Serena Bugatti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2015

CO:09:6 | Risk of disease flare during pregnancy and postpartum in inflammatory arthritis: association with therapy discontinuation in the prospective P-RHEUM.it study
type: item
description: Background: There is still a significant unmet need for robust data on pregnancy outcomes in patients with autoimmune rheumatic diseases (ARD), both regarding disease flare and obstetric complications. To address this gap, the Italian Registry of Pregnancies in Rheumatic Diseases (P-RHEUM.it) was designed as a nationwide, web-based longitudinal observational cohort study to collect data about pregnancy in ARD between 2018 and 2023. This analysis focuses on patients with inflammatory arthritis (IA) enrolled in the registry, aiming to describe pregnancy outcomes with special attention to disease flare during pregnancy and postpartum. We also assessed the relationship between treatment discontinuation, treatment at baseline, and flare risk. Materials and methods: Patients with rheumatoid arthritis (RA), undifferentiated arthritis (UA), juvenile idiopathic arthritis (JIA), psoriatic arthritis (PsA), and spondyloarthritis (SpA) were included. Treatment discontinuation is defined as ongoing therapy in the last 12 months, interrupted upon positive pregnancy test. Flare was defined when at least one of the following disease-specific criteria was met: • RA/UA/JIA: a variation of DAS28-CRP between two visits > 1.2, or > 0.6 if DAS28 at previous visit was > 3.2 • PsA: a variation of DAPSA > 4 or > 1.1 between two visits • SpA: variation of ASDAS >= 0.9 The same definitions of flares were applied during the post-partum period up to 6 months after delivery. Results: A total of 393 patients were included. Cohort characteristics (demographics, disease activity, use or discontinuation of medications during pregnancy) are reported in Table 1 and data on DAS-28, DAPSA and ASDAS during the follow-up in Table 2. During pregnancy, 167/393 patients (42.5%) experienced a flare; in postpartum, 12/248 (4.8%). Flare risk was higher in patients with active disease in the 12 months before pregnancy (p<0.001). Discontinuation of anti-TNF and NSAIDs used in the year before pregnancy was also ass…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Pregnancy
  topic: keywords
subject: Inflammatory arthritis
  topic: keywords
subject: Disease flare-ups
  topic: keywords
subject: Dina Zucchi
  topic: disciplines
subject: Chiara Tani
  topic: disciplines
subject: Francesca Crisafulli
  topic: disciplines
subject: Alessia Gatti
  topic: disciplines
subject: Maria Gerosa
  topic: disciplines
subject: Cecilia Chighizola
  topic: disciplines
subject: Melissa Padovan
  topic: disciplines
subject: Salvatore D'Angelo
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
subject: Claudia Lomater
  topic: disciplines
subject: Francesca Serale
  topic: disciplines
subject: Veronique Ramoni
  topic: disciplines
subject: Oscar Epis
  topic: disciplines
subject: Bernd Raffeiner
  topic: disciplines
subject: Ariela Hoxha
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
subject: Leonardo Santo
  topic: disciplines
subject: Valentina Canti
  topic: disciplines
subject: Francesca Bellisai
  topic: disciplines
subject: Giovanna Cuomo
  topic: disciplines
subject: on behalf of the P-Rheumit Investigators
  topic: disciplines
subject: Greta Carrara
  topic: disciplines
subject: Cristina Di Nicola
  topic: disciplines
subject: Davide Rozza
  topic: disciplines
subject: Carlo Alberto Scirè
  topic: disciplines
subject: Maria Chiara Gerardi
  topic: disciplines
subject: Angela Tincani
  topic: disciplines
subject: Laura Andreoli
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1989

PO:06:084 | Interstitial lung involvement in rheumatoid arthritis patients treated with abatacept: a prospective observational study
type: item
description: Background. Abatacept has been suggested to be a safe and effective drug for the treatment of rheumatoid arthritis (RA) complicated by interstitial lung disease (ILD), one of the most severe extra-articular manifestations of RA. Objectives. In this prospective multicentre observational study, we aimed to evaluate the effectiveness and safety of abatacept on RA-ILD. Concurrently, the study aimed to evaluate the incidence of new diagnosis of ILD in RA patients treated with abatacept. Methods. We enrolled all consecutive RA patients already under treatment with abatacept for at least three months referred to 12 rheumatological centres in Italy. ILD patients were followed according to the current clinical practice: forced vital capacity (FVC%) was repeated every six months, while chest high resolution computed tomography (HRCT) was performed annually or when respiratory symptoms worsened. In patients without ILD at baseline, a careful assessment for respiratory symptoms and velcro crackles was performed at enrolment and every six months. HRCT was requested in case of new-onset dyspnoea, persistent dry cough, or detection of velcro crackles. Results. We enrolled 325 RA patients treated with abatacept. Among them, ILD was already present in 20.6% of cases. A usual interstitial pneumonia (UIP) pattern was detected 25.4% of cases. The two-year retention rate of abatacept was 79.6% ±3.8 and 76.8%±10.6 in patients without and with ILD, respectively, without difference between the two groups. Two cases of infectious pneumonia were reported in ILD group, requiring a transient discontinuation of abatacept. No patients discontinued abatacept for a worsening of lung function, and no episodes of acute exacerbation of ILD were observed during the study. At the end of follow-up, the radiological picture remained stable in 71.6% of subjects, improved in 13.4%, and worsened in 14.9%. A worsening at HRCT was recorded in 29.4% of cases of UIP, and only in 10% of patients with other ILD p…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Rheumatoid arthritis
  topic: keywords
subject: Abatacept
  topic: keywords
subject: Interstitial lung disease
  topic: keywords
subject: Francesca Cozzini
  topic: disciplines
subject: Andreina Manfredi
  topic: disciplines
subject: Antonio Carletto
  topic: disciplines
subject: Elisa Bellis
  topic: disciplines
subject: Laura Cometi
  topic: disciplines
subject: Vincenzo Venerito
  topic: disciplines
subject: Caterina Vacchi
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
subject: Antonio Carriero
  topic: disciplines
subject: Rosaria Foti
  topic: disciplines
subject: Mariagrazia Catanoso
  topic: disciplines
subject: Ennio Favalli
  topic: disciplines
subject: Chiara Bazzani
  topic: disciplines
subject: Arianna Belvedere
  topic: disciplines
subject: Cecilia Burattini
  topic: disciplines
subject: Andrea Morciano
  topic: disciplines
subject: Annamaria Iagnocco
  topic: disciplines
subject: Gemma Lepri
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Antonio Pezzano
  topic: disciplines
subject: Salvatore D'Angelo
  topic: disciplines
subject: Valentina Cateni
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Marco Sebastiani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2016

CO:10:1 | High-grade synovitis and histological pathotype distribution in patients with advanced osteoarthritis undergoing joint replacement: a more inflammatory disease than we thought?
type: item
description: Background. Osteoarthritis (OA) has traditionally been regarded as a degenerative disease, with inflammation playing only a marginal role. However, recent evidence suggests that synovitis may significantly contribute to OA pathophysiology. This study aimed to describe the grade of synovitis and the distribution of synovial histological pathotypes in patients with advanced OA undergoing joint replacement, and to explore associations with clinical, laboratory, and radiographic variables. Materials and Methods. A retrospective observational study was conducted on patients with OA who underwent primary total hip or knee arthroplasty between 2000 and 2024. Synovial membrane samples collected during surgery were analyzed histologically using hematoxylin-eosin staining and immunohistochemistry. The Krenn synovitis score was applied to assess inflammation severity. Based on cellular composition, samples were classified into three main synovial pathotypes: lympho-myeloid, diffuse myeloid, and pauci-immune. Clinical and laboratory data (including ESR, CRP, BMI, Kellgren-Lawrence grade, and rheumatologic history) were retrieved from medical records. Associations between histological features and clinical parameters were evaluated through univariate and multivariate logistic regression. Resulus. Ninety-nine patients were included (mean age 74 ± 11 years; 51.5% female). High-grade synovitis (Krenn score above 4) was observed in 62.6% of cases. The most frequent synovial pathotype was lympho-myeloid (57.6%), followed by pauci-immune (30.3%) and diffuse myeloid (12.1%). No significant differences in synovitis grade or pathotype distribution were found between hips and knees (Figure 1). The Krenn score was significantly higher in lympho-myeloid samples (mean 5.8 ± 1.0 vs. 4.3 ± 1.1; p < 0.001). Histology revealed greater cellularity, organized lymphoid aggregates, and abundant CD20+, CD3+ infiltrates in this pathotype, along with increased synovial hyperplasia and neoangiogenesis. …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Pathotypes
  topic: keywords
subject: Osteoarthritis
  topic: keywords
subject: Inflammation
  topic: keywords
subject: Jacopo Ciaffi
  topic: disciplines
subject: Lorenzo Bianchi
  topic: disciplines
subject: Luana Mancarella
  topic: disciplines
subject: Federica Pignatti
  topic: disciplines
subject: Veronica Brusi
  topic: disciplines
subject: Lucia Lisi
  topic: disciplines
subject: Simona Neri
  topic: disciplines
subject: Elisa Assirelli
  topic: disciplines
subject: Alberto Righi
  topic: disciplines
subject: Marco Gambarotti
  topic: disciplines
subject: Francesco Ursini
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1990

PO:06:092 | Early achievement of remission confers better outcomes than low disease activity in both seropositive and seronegative patients with new-onset rheumatoid arthritis
type: item
description: Background. Although remission is the ideal target in patients with rheumatoid arthritis (RA), stringent definitions are difficult to achieve. In the absence of clear data demonstrating the real benefit of remission over low disease activity (LDA), the two targets often remain interchangeable in clinical practice. Aim of our study was to compare the outcomes of patients with early RA achieving remission vs LDA, taking into account possible differences in relation to autoantibody status. Methods. Data were retrieved from a monocentric inception cohort of patients with new onset (symptoms <12 months) RA, tightly followed at 3-months intervals and treated to achieve a target of LDA (DAS28 <3.2). Patients achieving remission (DAS28 <2.6) within month 6 and month 12 from treatment start were compared with those in LDA for clinical and functional outcomes at 1 year. These included: inflammatory remission (swollen joint count – SJC28 and C-reactive protein – CRP- levels both < or =1); resolution of pain (VAS pain < or =20 mm and < or =10 mm); normalization of physical function (HAQ <0.5). Analyses were stratified for positivity of anti-citrullinated protein autoantibodies (ACPA). Results. From a total cohort of 816 patients with new-onset RA, 759 (93%) had at least 6 months of follow-up and were considered for analyses. Of these, 218 (28.7%) achieved early DAS28 remission within month 6, and 176 (23.2%) were in LDA. An additional proportion of 8.7% and 9.2% achieved remission and LDA, respectively, at later points within month 12. Early remission and LDA differed significantly in inflammatory variables, such as SJC28 (mean [range] 1.2 [0-7] vs 2.2 [0-12], p<0.001) and CRP (mean [range] 0.3 [0-3.7] vs 0.5 [0-6.2] mg/dl, p=0.006). Differences were confirmed in both ACPA-positive and -negative patients. In contrast, at later time points, LDA had similar inflammatory burden as compared with remission (mean SJC28 ~1.5 in both), in spite of worse patient-reported outcomes (mean …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: New-onset rheumatoid arthritis
  topic: keywords
subject: Clinical
  topic: keywords
subject: Low disease activity
  topic: keywords
subject: Clelia Zampaglione
  topic: disciplines
subject: Ludovico De Stefano
  topic: disciplines
subject: Federica Sabatelli
  topic: disciplines
subject: Alessio D'Isanto
  topic: disciplines
subject: Blerina Xoxi
  topic: disciplines
subject: Antonio Manzo
  topic: disciplines
subject: Carlomaurizio Montecucco
  topic: disciplines
subject: Serena Bugatti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2017

https://www.reumatismo.org/reuma/article/view/1991
type: item
title: CO:10:2 | Common variable immunodeficiency patients complicated by autoimmune and inflammatory rheumatic manifestations reveal high frequency of genetic variants potentially linked to inborn errors of immunity
description: Background. Common variable immunodeficiency (CVID) is the most frequent clinically symptomatic primary immunodeficiency; its clinical spectrum is highly variable, ranging from isolated recurrent infections to autoimmune (AID) and inflammatory rheumatic diseases (IRD), which may even be the unique manifestation at disease onset [1]. CVID is mainly a polygenic disease, even if recent studies employing whole-genome and exome sequencing analysis have highlighted that 15–30% may display a monogenic origin [2]. Aim of the study is to describe our CVID patients (pts) cohort, highlighting AID and IRD, and to describe genetic variants possibly linked to immunodeficiency and autoimmunity and therapeutic implications. Methods. This is a monocentric observational retrospective study considering CVID pts followed since 1985 to 2024. Diagnosis was made according to European Society for Immunodeficiency criteria [3]. A next generation sequencing (NGS) analysis of genes potentially linked to hypo-agammaglobulinemia and to antibody deficiency was executed when considered clinically appropriate. Results. Eighty-three pts with a CVID diagnosis were included. CVID total cohort description and comparisons between CVID pts with and without AID are reported in Table 1. Autoimmune cytopenia was the most common autoimmune manifestation occurring in 22.9% of the pts, with immune thrombocytopenia being the most prevalent. Immunosuppressive treatment was necessary in 89.5% of the pts affected by autoimmune cytopenia; in 5 cases, due to refractory cytopenia, rituximab was employed, achieving persistent remission in 4 pts. A diagnosis of IRD was made in 12 pts; 75.0% suffered from inflammatory arthritis. In one pt with Adenosine Deaminase 2 deficiency, genetic analysis aided in employing a target therapy leading remission of the IRD (Table 2). Genetic analysis for variants potentially leading to CVID had been performed in 37.3% of pts; analysis resulted positive in 41.9% of the tested. Genetic …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Inborn errors of immunity
  topic: keywords
subject: Genetic analysis
  topic: keywords
subject: Rheumatic manifestations
  topic: keywords
subject: Paolo Semeraro
  topic: disciplines
subject: Micol Frassi
  topic: disciplines
subject: Silvia Clara Giliani
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
subject: Paolo Airò
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1991

PO:06:093 | Clinical and ultrasound phenotyping comparison between Difficult-To-Treat Rheumatoid Arthritis (D2TRA) and non-D2TRA patients: experience from a monocentric cohort
type: item
description: Background. To investigate clinical and ultrasound (US) findings as potential predictors of difficult-to-treat rheumatoid arthritis (D2TRA).1,2 Methods. Patients diagnosed with D2TRA assessed at our clinic between 2020 and 2024 were enrolled in the study and compared with a group of consecutive non-D2TRA patients. Demographic, US and clinical data were retrospectively collected. The first US available before developing D2TRA was analyzed. All US assessments were performed by four expert rheumatologists from our center using an Esaote MyLabX8 US machine equipped with a high-frequency (15–24 MHz) linear probe. US evaluation included the detection of synovitis, tenosynovitis and bone erosions. Assessed joints encompassed wrists, metacarpophalangeal (MCP), proximal interphalangeal (PIP), shoulders, knees and ankles. Regarding synovitis, GS and PD were considered in accordance with EULAR and OMERACT criteria.3,4,5 GLOESS grading system was also applied.6 Logistic and Cox regression models adjusted for baseline confounders was used for multivariable analysis. Results. One hundred thirty-six patients were recruited, median (±IQR) follow-up 18.75 (11.42-25.92) years, 80 of them fulfilling EULAR criteria for D2TRA. No significant differences were found between D2TRA and non-D2TRA groups regarding baseline demographics and comorbidities except for fibromyalgia, which was significantly more frequent in D2T cohort (Table 1). On survival univariate analysis, exposure to tsDMARDs was associated to longer time-to-D2T development (HR [CI] : 0.51, [0.26 - 0.99], p=0.046) (Figure 1). 136 US were included in the study. At the time of US examination, patients further-to-be D2T displayed higher DAS28 scores (median [IQR]: 4.30 [3.67-5.40] vs 2.70 [2.02-4.41], p<0.01). A significantly higher prevalence of wrist synovitis (n [%]: 62 [77.5%] vs. 31 [57.4%], p=0.023) and higher wrist GLOESS scores (mean [sd]: 2.67 [1.91] vs 1.77 [1.94]; p=0.007) were observed in furhter-to-be D2T patients (…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Ultrasound
  topic: keywords
subject: Rheumatoid arthritis
  topic: keywords
subject: Difficult to treat
  topic: keywords
subject: Silvia Perrone
  topic: disciplines
subject: Claudio Cruciani
  topic: disciplines
subject: Silvia Mascolo
  topic: disciplines
subject: Elisa Bellis
  topic: disciplines
subject: Gloria Crepaldi
  topic: disciplines
subject: Valeria Data
  topic: disciplines
subject: Claudia Garulli
  topic: disciplines
subject: Claudia Lomater
  topic: disciplines
subject: Elena Marucco
  topic: disciplines
subject: Marta Saracco
  topic: disciplines
subject: Mariele Gatto
  topic: disciplines
subject: Annamaria Iagnocco
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2018

CO:10:3 | Clinical response to JAK inhibitors or non-TNFi-targeted biologicals according to synovial tissue characteristics in patients with difficult-to-treat rheumatoid arthritis
type: item
description: Background. Patients meeting the EULAR difficult-to-treat rheumatoid arthritis (D2TRA) definition are classically non-responders to TNF inhibitors (TNFi). As such, they can be treated with biological drugs with other mechanisms of action (OMA; tocilizumab, sarilumab, abatacept, rituximab) or Janus Kinase inhibitors (JAKi). The aim of the study was to investigate whether characteristics of synovial tissue may predict treatment response to OMA or JAKi in D2TRA patients. Materials and Methods: The MATRIX-D2T was a prospective cohort, multi-centre study that included RA patients with moderate to high disease activity undergoing ultrasound-guided synovial tissue biopsy (UGSTB) at two institutions. In this post-hoc analysis, patients were eligible for inclusion if they fulfilled the EULAR D2TRA definition. The primary outcome was a change in CDAI after six months; the secondary outcome was low disease activity (LDA or CDAI<=10). Predictors were synovial grading according to Krenn Synovial Score (2-4, low grade; 5-9, high grade); synovial pathotypes (lympho-myeloid, diffuse-myeloid, pauci-immune fibroid); and the count of lymphoid aggregates. Outcome comparisons between treatment groups (JAKi vs. OMA) were assessed through repeated measures ANOVA corrected for ACPA titre. Results. Among 132 patients undergoing USGTB during the study period, 26 patients met the study criteria and were included (mean (SD) age 58 (11) years, duration 15 (10) years, females 62%). Twelve patients initiated JAKi and 14 OMA; the two groups were comparable for baseline characteristics (Table 1). The median (IQR) number of failed b/tsDMARDs was 3 (3), and for csDMARDs, it was 2 (3). Median (IQR) KSS was 5 (7). After 6 months, the mean (SD) CDAI significantly decreased more in JAKi than OMA (mean difference -10.7, 95% CI -19.4 to -2.0, p=0.018). Compared to OMA, a stronger CDAI decrease with JAKi was shown in patients having high-grade synovitis only (Figure 1a-b), with no clear association with syn…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: synovial tissue
  topic: keywords
subject: Difficult to treat
  topic: keywords
subject: JAK
  topic: keywords
subject: Mariangela Salvato
  topic: disciplines
subject: Alessandro Giollo
  topic: disciplines
subject: Francesca Frizzera
  topic: disciplines
subject: Kiren Khalid
  topic: disciplines
subject: Lorenzo Di Luozzo
  topic: disciplines
subject: Maria Capita
  topic: disciplines
subject: Marianna Tamussin
  topic: disciplines
subject: Carlo Garaffoni
  topic: disciplines
subject: Marny Fedrigo
  topic: disciplines
subject: Annalisa Angelini
  topic: disciplines
subject: Ettore Silvagni
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1992

PO:06:094 | Exploring the relationship between inflammation and collagen deposition in synovial tissue and clinical outcomes in active arthritis: insights from a monocentric pilot study
type: item
description: Background. Synovial collagen remodelling may mirror chronic inflammation and repair processes, potentially serving as a structural correlate of disease activity in arthritis. Based on this, the aim of this study was to investigate the relationship between synovial inflammatory histopathology and collagen remodelling in patients with active rheumatoid arthritis (RA) or psoriatic arthritis (PsA). Methods. US-guided synovial biopsies were obtained from inflamed joints (knee/wrist) in 30 patients (18 RA, 12 PsA) with active arthritis, undergoing therapeutic re-evaluation.Synovial inflammation was evaluated considering Krenn Synovitis Score (KSS), immunohistochemical analysis (sublining CD68, CD3, CD20, CD138), pathotype classification, and evaluation of neutrophil infiltration.For 12 patients (RA, PsA),3-micrometer sections were stained with fresh Picrosirius red,then digitized via brightfield and polarized light microscopy for morphometry and collagen typing.Stained area and collagen maturation index were quantified using computer-aided image analysis.Clinical disease activity was recorded at baseline and at 3-month follow-up. Results. The mean age of patients was 52 years and 64.5% were female;the mean disease duration was 5.6 years. Mean KSS was 4.5±0.5 in RA and 4.2±0.5 in PsA. 17 (56.7%) patients were classified as lympho-myeloid, 10(33.3%) as diffuse-myeloid,and 3(10%) as pauci-immune pathotype.Moreover, neutrophil infiltration of ST was present in 12(40%) of the overall cohort and was associated with higher KSS (p = 0.003).Higher KSS also tended to correlate with the number of previous bDMARDs, and pathotype distribution differed by prior biologic exposure (p = 0.029);notably, patients with a pauci-immune synovitis had received the highest number of previous bDMARDs. Considering collagen deposition,the mean collagen area was 39.48±7.52% in RA and 40.79±12.09% in PsA, while the mean collagen maturity index was 0.73±0.04 and 0.72±0.03, respectively.No associations…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Synovial tissue inflammation
  topic: keywords
subject: Biopsy
  topic: keywords
subject: Collagen
  topic: keywords
subject: Dario Bruno
  topic: disciplines
subject: Barbara Tolusso
  topic: disciplines
subject: Daniela Renna
  topic: disciplines
subject: Mohamed Hegazi
  topic: disciplines
subject: Fabio Pasqualini
  topic: disciplines
subject: Marta Caprioli
  topic: disciplines
subject: Giacomo Maria Guidelli
  topic: disciplines
subject: Tommaso Hubert
  topic: disciplines
subject: Nicoletta Luciano
  topic: disciplines
subject: Marzia Monferini
  topic: disciplines
subject: Natasa Isailovic
  topic: disciplines
subject: Fabio Grizzi
  topic: disciplines
subject: Salvatorelorenzo Renne
  topic: disciplines
subject: Costantino Pitzalis
  topic: disciplines
subject: Elisa Gremese
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2019

CO:10:4 | Lung vasculature quantification on computed tomography predicts new onset of interstitial lung disease in systemic sclerosis
type: item
description: Interstitial lung disease (ILD) is common in systemic sclerosis (SSc) and a major cause of death. While clinical risk factors for ILD onset at 1-year and long-term follow-up have been identified (1,2), risk stratification remains suboptimal. Pulmonary vascular volume (PVV) on HRCT is linked to both presence and severity of SSc-ILD (3). Here, we investigate the potential of radiomics in identifying patients at risk of developing ILD. We included patients from a single referral centre, with no ILD on baseline HRCT and at least one clinical and HRCT follow-up. Images 1) were assessed for presence/absence of ILD at all timepoints, 2) underwent lung texture analysis (LTA,Imbio), quantifying PVV, normal lung, lung pathologies (hyperlucency, ground-glass, reticular, honeycombing), as percentage of the lung volume, for whole lungs and upper, middle, lower zones. Univariable and multivariable prediction models were developed to identify risk factors for ILD onset, using Cox regression and generalizes estimating equation (GEE) analysis for ILD onset ever and at 1-year, the latter allowing for multiple observations of the same patient. Both models were adjusted for the established clinical risk factors (1,2). Among 248 SSc patients with no ILD at baseline HRCT, new onset of ILD occurred in 54 (22%) cases over a median follow-up of 39(24-72)months. Patients developing ILD were more frequently males, with diffuse skin involvement, anti-topoisomerase I antibodies and shorter disease duration (Table I). Additionally, patients with new onset ILD over the study period presented higher values of PVV across all lung zones at baseline HRCT (Table II). In multivariable Cox regression analysis, new ILD onset was independently predicted by PVV% from the whole lung [HR 1.054 (1.030-1.078)], as well as from each individual zone. When integrating the PVV% of each single zone with the clinic risk factors in the multivariable analysis, we observed the significant, independent impact of the low…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Systemic sclerosis
  topic: keywords
subject: Pulmonary interstitial disease
  topic: keywords
subject: Radiomics
  topic: keywords
subject: Maria Iacovantuono
  topic: disciplines
subject: Nicholas Landini
  topic: disciplines
subject: Lisa Jungblut
  topic: disciplines
subject: Gesa Sauer
  topic: disciplines
subject: Rucsandra Dobrota
  topic: disciplines
subject: Maria Sinziana Muraru-Carbune
  topic: disciplines
subject: Muriel Elhai
  topic: disciplines
subject: Carmen-Marina Mihai
  topic: disciplines
subject: Mike Oliver Becker
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
subject: Thomas Frauenfelder
  topic: disciplines
subject: Anna-Maria Hoffmann-Vold
  topic: disciplines
subject: Oliver Distler
  topic: disciplines
subject: Cosimo Bruni
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1993

https://www.reumatismo.org/reuma/article/view/2135
type: item
title: PO:07:095 | Clinical impact of therapeutic modification following changes in AIFA reimbursement criteria for JAK inhibitors in patients with RA in remission/low disease activity: analysis of the multicenter JAK-SWAP RER study in Emilia-Romagna
description: Background. Since March 2023, AIFA has introduced new reimbursement criteria for JAK-inhibitors (JAKis), restricting their use to patients with rheumatoid arthritis (RA) without specific risk factors and with previous failure of bDMARD therapy. These restrictions have influenced prescribing behavior, leading in some cases to treatment changes in patients already receiving JAKis. The primary objective of this study is to evaluate the frequency of maintenance of remission/low disease activity (REM/LDA) at 6 months, and to identify potential associated factors, in patients undergoing treatment modification compared with those who continued the ongoing therapy. Materials annd Methjods. In this prospective, multicenter, observational cohort study, we enrolled patients with RA in stable REM/LDA for at least 6 months on JAKi therapy (03/2023–07/2024), for whom a therapeutic modification was proposed (dose reduction, treatment discontinuation with switch to another bDMARD, or discontinuation without switching) due to non-fulfillment of AIFA reimbursement conditions. At 6-month follow-up (T6), the frequency of REM/LDA maintenance was assessed, while additional therapeutic modifications (cs/b/tsDMARDs) and adverse events (AEs) were evaluated during the 12-month total follow-up. Associations between clinical-demographic characteristics and T6 outcomes were analyzed using univariate logistic regression. Results. A total of 127 patients were enrolled (Table 1). Among them, 36 underwent JAKi modification at baseline (17 switches, 14 dose reductions, 5 discontinuations), while 91 maintained JAKi therapy, of whom 16 remained eligible for reimbursement according to AIFA criteria (Figure 1A). At T6, 109 patients were reassessed. Maintenance of REM/LDA at T6 was significantly less frequent in the group that modified therapy at baseline compared to those who continued treatment (23 (76.7%) vs 73 (92.3%), p=0.024; OR 0.27, 95% CI 0.08–0.88) (Figure 1B). Univariate analysis showed that d…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: rheumatoid arthritis
  topic: keywords
subject: JAK-inhibitors
  topic: keywords
subject: JAK-SWAP
  topic: keywords
subject: Marta Raschella
  topic: disciplines
subject: Giulia Furia
  topic: disciplines
subject: Martina Di Nunzio
  topic: disciplines
subject: Francesco Luca Renzullo
  topic: disciplines
subject: Francesco Girelli
  topic: disciplines
subject: Federica Pignatti
  topic: disciplines
subject: Francesco Ursini
  topic: disciplines
subject: Licia Vultaggio
  topic: disciplines
subject: Pierluigi Cataleta
  topic: disciplines
subject: Elena Bravi
  topic: disciplines
subject: Eugenio Arrigoni
  topic: disciplines
subject: Francesca Bergossi
  topic: disciplines
subject: Enrica Vandelli
  topic: disciplines
subject: Massimo Reta
  topic: disciplines
subject: Viola Magnani
  topic: disciplines
subject: Andreina Manfredi
  topic: disciplines
subject: Giuseppe Germanò
  topic: disciplines
subject: Alessandra Bortoluzzi
  topic: disciplines
subject: Marcello Govoni
  topic: disciplines
subject: Ettore Silvagni
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2135

CO:10:5 | Beyond major glands: high-resolution ultrasound mapping of labial salivary and lacrimal gland involvement in Sjögren’s disease
type: item
description: Background: Ultra-high frequency ultrasound (UHFUS) has emerged as a valuable tool for assessing the lacrimal glands (LGs) and labial salivary glands (LSGs) in patients with Sjögren’s disease (SD). However, only a few studies have investigated the diagnostic utility of evaluating these two gland types in combination. This study aimed to determine whether assessing both the number of glands involved and the severity of their involvement, based on the presence of very hypoechoic areas (VHA), could enhance diagnostic accuracy and support phenotypic stratification in patients with suspected SD. Methods: Consecutive patients with suspected SD, undergoing LSG biopsy, were included. LSGs and LGs were examined using 48 MHz and 18 MHz probes, respectively. Glandular inhomogeneity was evaluated using a semiquantitative OMERACT score ranging from 0 to 3 for each gland, and a combined score for the LSGs and LGs was calculated (range 0–6). We specifically investigated the presence of very hypoechoic areas ( either lymphoma pattern and/or multiple very hypoechoic areas pattern (1,2)). Serum from each patient was tested for anti-Ro52, anti-Ro60, and anti-SSB/La abs, evaluating the quantitative titer of the autoantibodies with band densitometry. Results: A total of 71 subjects (10 males, 61 females) were enrolled in the study, of whom 28 fulfilled the ACR 2016 classification criteria for Sjögren’s disease (SD). Cohen’s kappa analysis demonstrated moderate concordance in grayscale assessment between LGs and LSGs (k = 0.600, p < 0.001). Receiver operating characteristic (ROC) curve analysis showed that both LG and LSG UHFUS scores, using an optimal cut-off of 2, could effectively differentiate patients with SD from sicca controls, with area under the curve (AUC) values of 0.836 (95% CI: 0.702–0.970) and 0.899 (95% CI: 0.807–0.991), respectively. The combined score yielded excellent diagnostic accuracy (AUC = 0.909, 95% CI: 0.820–0.997; Fig. 1, A-B). All individuals with UHFUS scores …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Ultrasonography
  topic: keywords
subject: Lacrimal and labial glands
  topic: keywords
subject: Disease severity
  topic: keywords
subject: Giovanni Fulvio
  topic: disciplines
subject: Rossana Izzetti
  topic: disciplines
subject: Valentina Donati
  topic: disciplines
subject: Caterina Porciani
  topic: disciplines
subject: Silvia Fonzetti
  topic: disciplines
subject: Gaetano La Rocca
  topic: disciplines
subject: Beatrice Dei
  topic: disciplines
subject: Francesco Ferro
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
subject: Chiara Baldini
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1994

PO:07:096 | Safety of filgotinib in the treatment of rheumatoid arthritis: results from the multicentre SOFIA study
type: item
description: Background. To evaluate safety of filgotinib in terms of frequency, severity, and type of adverse events (AEs) and to identify predictors of AEs in a multicentre cohort of patients with rheumatoid arthritis (RA). Materials and Methods. This is a prospective multicentre study that included patients with RA (ACR/EULAR 2010 criteria) treated with filgotinib in six different Italian centres. At follow-up visits, conducted every 3-6 months, AEs were recorded and classified as attributable to drug use with almost certain/high/low/no probability according to clinical judgement. AEs were described as severe in accordance with the EMA definition. Possible risk factors for AEs were examined using the t-test, chi-square test or Fisher's exact test as appropriate. The analysis was performed using SPSS version 29. Results. A total of 190 patients with RA were enrolled, with a mean age of 59±11 years and a mean disease duration of 17±10 years. The mean baseline Charlson Comorbidity Index (CCI) was 2±1 (Table 1). Out of 463 follow-up visits, 128 AEs and one death were recorded, the latter considered unlikely to be associated with filgotinib use (Table 2). The most frequent AEs were infections (53 events), only 5 of which were classified as severe (9.5%). We recorded 18 AEs attributable to cardiovascular risk, all of which were considered mild except for one serious cardiovascular event, which was judged unlikely to be drug-related (Table 2). Overall, in 8% of cases, AE was considered almost certainly associated with the use of the drug, while in 27% of cases, the association was denied (Table 2). AEs caused discontinuation of therapy in 14 cases (7.3% of patients). The only factor associated with AEs that emerged at multiple time points was male gender (6 months p=0.04, 12 months p=0.02, 24 months p=0.04). Besides, a lower baseline CCI was associated with a significant reduction in AEs at 24 months (p<0.001). Conclusions. In a large cohort of patients with RA, non-severe infection…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Filgotinib
  topic: keywords
subject: Safety
  topic: keywords
subject: multicentre study
  topic: keywords
subject: Anna Giorgia Osele
  topic: disciplines
subject: Matteo Filippini
  topic: disciplines
subject: Eugenio Capparelli
  topic: disciplines
subject: Eleonora Bruschi
  topic: disciplines
subject: Bernd Raffeiner
  topic: disciplines
subject: Silvano Bettio
  topic: disciplines
subject: Mariangela Salvato
  topic: disciplines
subject: Federico Arru
  topic: disciplines
subject: Massimiliano Limonta
  topic: disciplines
subject: Paola Faggioli
  topic: disciplines
subject: Elda Piovani
  topic: disciplines
subject: Eleonora Zaccara
  topic: disciplines
subject: Alessandro Giollo
  topic: disciplines
subject: Margherita Zen
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2136

CO:10:6 | Impact of pregnancy on organ damage in systemic lupus erythematosus: a prospective multicenter study
type: item
description: Background. Pregnancy in systemic lupus erythematosus (SLE) is associated with increased risk of fetal and maternal complications, as well as a higher risk of disease flares. Data on pregnancy’s impact on damage accrual in SLE are limited. We aimed to assess the role of pregnancy and related factors in damage increase in SLE patients. Methods. Consecutive patients fulfilling the 2019-ACR/EULAR SLE criteria were prospectively enrolled at pregnancy detection and monitored every 4 weeks at two referral centers. At baseline, demographic, clinical, and treatment data were collected. Disease activity was assessed by SLE Disease Activity Index-2k score(SLEDAI-2k); flares during pregnancy by the modified SELENA-SLEDAI flare index. Remission was defined by DORIS-criteria, and low disease activity state (LLDAS) by the Asian Pacific definition. Disease was defined as active if SLEDAI-2K>4. Pregnancy outcomes included preeclampsia, premature membrane rupture <37 gestational-weeks, small for gestational-age, intrauterine growth restriction, intrauterine fetal death and birthweight <2500 gr. Damage accumulation was assessed using the SLICC Damage Index score over two years pre-pregnancy, one year pre- and one year post-pregnancy. Factors influencing damage accrual during pregnancy were analyzed by logistic regression. To assess the effect of pregnancy per se on damage accrual, we examined this relationship using a cross-over design. The year before pregnancy was compared with the year post-pregnancy in terms of damage accrual; results are expressed as delta damage. Results. We analyzed 165 pregnancies in 122 patients. Figure1 shows demographic, clinical, and serological features; Figure2 reports obstetric outcomes and first pregnancy visit data. At conception, 26 pregnancies(15.8%) had pre-existing damage(mean 1.1, SD±0.32). In the year after pregnancy, 29 cases (17.6%) had a SLICC score of 1 or higher(mean 1.24, SD ±0.51), including 3 new damage cases in previously unaffected pa…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Systemic Lupus Erythematosus
  topic: keywords
subject: Pregnancy
  topic: keywords
subject: Organ damage
  topic: keywords
subject: Giancarlo Cascarano
  topic: disciplines
subject: Greta Hulej
  topic: disciplines
subject: Dina Zucchi
  topic: disciplines
subject: Antonia Calligaro
  topic: disciplines
subject: Elena Elefante
  topic: disciplines
subject: Luca Iaccarino
  topic: disciplines
subject: Sabrina Gori
  topic: disciplines
subject: Margherita Zen
  topic: disciplines
subject: Chiara Tani
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1995

PO:07:099 | Survival on therapy of certolizumab pegol in rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis: 8-year data from an Italian multicenter register
type: item
description: Background. To evaluate the persistence in therapy of certolizumab pegol in a multicenter Italian registry of patients affected by rheumatoid arthritis (RA), psoriatic arthritis (PsA) or axial and peripheral spondyloarthritis (SpA). Materials and Methods. Data were collected prospectively from a multicenter Italian registry of patients with RA, PsA, and SpA treated with certolizumab pegol through March 2025. Persistence in therapy was calculated using the Kaplan-Meier method for the three diagnoses. Comparative subanalyses of retention rate were performed using Cox regression across the different populations, by treatment line, sex, concomitant csDMARD, and rheumatoid factor positivity. Results. A total of 1167 patients were included in the analysis. Of these, 401 were affected by RA (87.8% female, mean age [± standard deviation (SD)] 50.5 [±14.6] years, mean disease duration 10.5 [±9.3] years, 50.4% in first-line biologic, 54.9% in combination with csDMARDs), 448 by PsA (73% female, mean age [±SD] 48.5 [±14] years, mean disease duration 7.6 [±6.7] years, 38.4% in first-line biologic, 65% in combination with csDMARDs) and 318 by SpA (76.4% female, mean age 47.7 [±13.7] years, mean disease duration 7 [±7.4] years, 44.3% in first-line biologic). The retention rate in the RA, PsA, and SpA groups was 78.2%, 74.2%, and 75.5% at 12 months, 63.3%, 56.6%, and 60.4% at 24 months, and 52.7%, 48.5%, and 53.5% at 36 months, respectively. At 8 years, the retention rate was 33.8%, 27.6%, and 35.6% in RA, PsA, and SpA, with no significant difference between the three diagnoses (Figure). Among patients who discontinued the drug in the RA, PsA, and SpA groups, 19.2%, 27%, and 20.1% discontinued due to inefficacy, and 3%, 6.7%, and 6.6% due to adverse events, respectively. In subanalyses stratified by treatment line, first-line survival in RA was not different from second-line survival, but significantly superior to subsequent lines; conversely, in PsA and SpA the retention rate in t…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Certolizumab pegol
  topic: keywords
subject: Rheumatoid arthritis
  topic: keywords
subject: Psoriatic arthritis
  topic: keywords
subject: Maria Manara
  topic: disciplines
subject: Gilberto Cincinelli
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Simone Perniola
  topic: disciplines
subject: Elisa Gremese
  topic: disciplines
subject: Chiara Bazzani
  topic: disciplines
subject: Serena Bugatti
  topic: disciplines
subject: Francesca Romana Spinelli
  topic: disciplines
subject: Rosario Foti
  topic: disciplines
subject: Marco Sebastiani
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
subject: Giovanni Lapadula
  topic: disciplines
subject: Gianfranco Ferraccioli
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Roberto Caporali
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2137

CO:11:2 | Systemic lupus erythematosus with major neuropsychiatric involvement treated with anifrolumab: literature review and a case report
type: item
description: Background. Anifrolumab is a biologic agent approved for the treatment of Systemic Lupus Erythematosus (SLE). Clinical trials evaluating its efficacy (TULIP-1 and TULIP-2) excluded patients with active neuropsychiatric manifestations (NPSLE). The aim of this study was to review the published cases of NPSLE treated with Anifrolumab (ANI) and to describe a clinical case from our cohort. Materials and Methods. A literature search was conducted on Medline/PubMed and Embase for reports of NPSLE patients treated with ANI. In addition, we describe a case from our local cohort. Results. The literature review identified seven published cases of NPSLE successfully treated with ANI, including two with confusional states, one with acute psychosis, one with headache, one with cerebral vasculitis, one with aseptic meningitis, and one with demyelinating polyneuropathy. The data are summarized in Table 1. We also report the case of a 63-year-old woman with a 26-year history of SLE and antiphospholipid syndrome (APS), who initially presented with polyarthritis, lymphopenia, an ischemic stroke, and positivity for ANA, anti-dsDNA, anti-Ro/SSA, lupus anticoagulant, anti-cardiolipin IgG, and hypocomplementemia. Over the years, she experienced a relapsing-remitting course characterized by cutaneous vasculitis of the hands and feet, thrombocytopenia, leukopenia, and epileptic seizures with spatiotemporal disorientation. Electroencephalography revealed left-hemispheric irritative electrical abnormalities, interpreted as secondary to ischemic damage. The patient’s treatment history included several immunosuppressants—cyclophosphamide, azathioprine, mycophenolate mofetil, belimumab, and hydroxychloroquine (discontinued due to gastrointestinal intolerance, INR abnormalities, and arrhythmia). Levetiracetam was escalated to 2500 mg/day due to worsening seizures, without achieving clinical remission (DORIS). In 2022, following prednisone tapering to 5 mg/day, disease flare occurred with hand vas…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Neuropsychiatric
  topic: keywords
subject: achieving remission
  topic: keywords
subject: Anifrolumab
  topic: keywords
subject: Giulia Rizzo
  topic: disciplines
subject: Fabio Congiu
  topic: disciplines
subject: Elisabetta Chessa
  topic: disciplines
subject: Marta Paola Pireddu
  topic: disciplines
subject: Elena Ragusa
  topic: disciplines
subject: Alessandra Oliva
  topic: disciplines
subject: Marianna Salis
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2120

PO:07:101 | Efficacy and safety of methotrexate in a cohort of patients affected by early-onset rheumatoid arthritis: a monocentric real-life study
type: item
description: Background. Methotrexate (MTX) is the first-line Disease Modifying Anti-Rheumatic Drug (DMARD) in the treatment of rheumatoid arthritis (RA). According to EULAR guidelines, patients with RA should start immunosuppressive therapy at the time of diagnosis, achieve clinical improvement within 3 months, and remission within 6 months. The objective of this monocentric, retrospective, real-life study was to evaluate the achievement of the therapeutic target in a cohort of patients affected by early-onset RA treated with MTX. Further objectives were to evaluate the MTX ability to act as a “steroid sparing” agent, assess its safety, and the monotherapy maintenance rate. Materials and Methods. Patients attending the Early Arthritis Clinic from 2006 to the present, affected by RA (ACR 2010 criteria) who had started MTX therapy within 24 weeks from symptom onset, were enrolled. Demographic, clinical, pharmacological, clinimetric indices, and any adverse events associated with therapy were recorded at baseline (T0) and during follow-up until MTX discontinuation or switch to biotechnological therapy. Results. Table 1 reports demographic and clinical data of the 78 enrolled patients. Graph 2 shows disease activity according to DAS28-PCR and SDAI (2a; 2b) and the percentage of Boolean remission (2c) at follow-up. The median time to achieve remission or low disease activity was 3 months, both according to DAS28-PCR and SDAI (graph 3a). Referring to remission only, the median was 6 months according to DAS28-PCR, while it was 24 months according to SDAI and Boolean Remission 2.0 definition (graph 3b). It emerged that in patients treated with MTX, the mean prednisone dose progressively decreases by 0.08 mg per month, while the probability of continuing steroid therapy decreases by 10% for each month of treatment. Therapy persistence was 7 years in half of the patients (graph 4a), while the median MTX monotherapy maintenance was 6 years (graph 4b). Conclusions. To our knowledge, this i…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: methotrexate
  topic: keywords
subject: arthritis
  topic: keywords
subject: efficacy
  topic: keywords
subject: Carlo Cauli
  topic: disciplines
subject: Martina Favretti
  topic: disciplines
subject: Giulio Dolcini
  topic: disciplines
subject: Vincenzo Ferraro
  topic: disciplines
subject: Cristina Iannuccelli
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Manuela Di Franco
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2138

CO:11:4 | Unveiling frailty in active systemic lupus erythematosus in the modern era of rheumatology: first real-life use of the SLICC-FI in a cohort diagnosed after 2000
type: item
description: Background. In patients with active systemic lupus erythematosus (SLE), therapeutic decisions should consider frailty, which reflects disease activity, organ damage, and comorbidities. The SLICC Frailty Index (SLICC-FI) has proven useful in predicting mortality, damage accrual, and hospitalizations. This study applied the SLICC-FI in an active SLE cohort to estimate frailty prevalence and identify key clinical determinants. Materials and Methods. This was a retrospective analysis of prospectively collected data from a monocentric SLE cohort fulfilling the 2019 EULAR/ACR classification criteria. Eligible patients were diagnosed after 2000 and had active disease requiring therapeutic modification. The SLICC-FI (FI) was calculated at study entry using a modified 37-item version (clinician-reported variables only). Based on FI score, patients were classified as robust (FI < 0.03), relatively less fit (0.03 < FI < 0.10), less fit (0.10 < FI< 0.21), or frail (FI > 0.21). Demographic, clinical, and serological data were collected. Results. A total of 119 patients were included (94.1% female; mean age 37.1 ± 10.7 years; median disease duration 12 years IQR). At study entry, median SLEDAI was 8 (IQR), median SLICC was 1 (range 1–4); median daily dose of glucocorticoids (GC) was 4 mg (IQR). The mean FI was 0.20 ± 0.08; 5.9% (7/119) were relatively less fit, 53.8% (64/119) less fit, and 40.3% (48/119) frail, no patients were categorized as robust. The most important determinants of frailty in frail patients are shown in Figure 1. No differences emerged between frail and non-frail patients in age at diagnosis, disease duration, SLICC, SLEDAI, or baseline steroid dose. Regarding cumulative organ involvement, kidney (p=0.028), articular (p=0.023), constitutional (p=0.006), and pulmonary (p=0.005) systems were significantly more affected in frail patients. Frail patients were more frequently SSA-positive (p=0.025), SSB-positive (p=0.007), and had more overlap syndromes (Sjogren or…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 2
  topic: category
subject: frailty
  topic: keywords
subject: Lupus
  topic: keywords
subject: Real life
  topic: keywords
subject: Angela Elia
  topic: disciplines
subject: Dina Zucchi
  topic: disciplines
subject: Michele Moretti
  topic: disciplines
subject: Elena Elefante
  topic: disciplines
subject: Chiara Cardelli
  topic: disciplines
subject: Linda Carli
  topic: disciplines
subject: Viola Signorini
  topic: disciplines
subject: Chiara Stagnaro
  topic: disciplines
subject: Chiara Tani
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1996

PO:07:102 | Predicting success with baricitinib in rheumatoid arthritis: efficacy across ages and serological profiles
type: item
description: Background. Evaluate the real-world effectiveness of baricitinib in 423 rheumatoid arthritis (RA) patients, compare outcomes in <65 years (n=264) versus 65 years and older (n=159) patients, and identify predictors of DAS28-ESR remission/LDA at 6 and 12 months. Methods. Retrospective multicenter cohort; recorded baseline age, sex, disease duration, and comorbidities. DAS28-ESR was measured at baseline, 6 and 12 months; remission was defined as DAS28-ESR <2.6 and LDA as <3.3. Response predictors were assessed by multivariate logistic regression, reporting OR with 95% CI and p values. Results. Median age was 59 years (IQR 51–67); 79% female; median disease duration 76 months (IQR 31–157). Patients of 65 years and older experienced longer disease duration (94 vs 65 months; p<0.01) and higher rates of diabetes (16% vs 5%; p<0.01), dyslipidemia (47% vs 19%; p<0.01) and hypertension (62% vs 33%; p<0.01). Median DAS28-ESR fell from 5.42 (IQR 4.84–6.06) at baseline to 3.71 (IQR 2.83–4.59) at 6 months and 3.29 (IQR 2.42–4.19) at 12 months (both p<0.01). Remission/LDA was achieved by 246/422 (58.3%) at 6 months and 259/423 (61.2%) at 12 months. Age of 65 and older was not associated with response at 6 months (OR 0.71; 95% CI 0.44–1.14; p=0.16) or 12 months (OR 0.83; 95% CI 0.55–1.24; p=0.37). ACPA-positivity independently predicted remission/LDA at 6 months (OR 2.32; 95% CI 1.43–3.77; p<0.01) and 12 months (OR 1.71; 95% CI 1.12–2.59; p<0.01). Conclusion. Baricitinib significantly reduced RA disease activity over 12 months regardless of age or comorbidities, with ACPA-positivity as a strong independent predictor of clinical response.
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Rheumatoid Arthritis
  topic: keywords
subject: Baricitinib
  topic: keywords
subject: Ageing
  topic: keywords
subject: Daniele Lini
  topic: disciplines
subject: Matteo Colina
  topic: disciplines
subject: Romina Andracco
  topic: disciplines
subject: Francesca Ometto
  topic: disciplines
subject: Viviana Ravagnani
  topic: disciplines
subject: Alberto Lo Gullo
  topic: disciplines
subject: Simone Parisi
  topic: disciplines
subject: Antonella Farina
  topic: disciplines
subject: Patrizia Del Medico
  topic: disciplines
subject: Marino Paroli
  topic: disciplines
subject: Olga Addimanda
  topic: disciplines
subject: Alessandra Bezzi
  topic: disciplines
subject: Federica Lumetti
  topic: disciplines
subject: Aldo Biagio Molica Colella
  topic: disciplines
subject: Davide Murgia
  topic: disciplines
subject: Maddalena Larosa
  topic: disciplines
subject: Aurora Ianniello
  topic: disciplines
subject: Elena Bravi
  topic: disciplines
subject: Marta Priora
  topic: disciplines
subject: Palma Scolieri
  topic: disciplines
subject: Alessandro Volpe
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2020

https://www.reumatismo.org/reuma/article/view/1997
type: item
title: CO:11:5 | Laboratory preliminary results from an open label, prospective, phase ii descriptive pilot trial of belimumab therapy for refractory and/or non criteria manifestations of antiphospholipid syndrome
description: Background. The aim of this study was to evaluate preliminary laboratory results of the BLAST trial. Belimumab was given for 40 weeks in 15 patients positive for antiphospholipid antibodies (aPL) showing refractory and/or non criteria APS manifestations. Materials and Methods This is an open-label, single-centre trial. Laboratory endpoints were determined at baseline, 8, 20 and 40 weeks. Outcomes included routine tests, aPL, thrombin generation assay, lymphocytes immunophenotyping and BAFF determination. Results. We observed a reduction of aPL levels following 40 weeks of treatment: 60% showed a reduction of aCL IgG levels, 53% showed a reduction of aB2GPI IgG levels , 47% showed a reduction of aB2GPI Domain I levels, 33% showed a reduction of aPS/PT IgG levels and 40% showed a reduction of aPS/PT IgM levels (Figure 1). When considering TGA profile, a normalization of the curves were observed following treatment: 40% of patients showed a normalization of TGA parameters at week 40, meaning a reduction of tLag and tPeak and an increase of Peak and AUC. Table 1 summarizes the delta of aPL levels and TGA parameters between week 40 and baseline. When analyzing aPL levels and TGA parameters, significant correlations were demonstrated showing a normalization of the thrombogram and reduction of aPL levels following treatment. This finding was confirmed for the following specificities: aPS/PT IgG [tLag (p=0.001/Pearson+0.4), tPeak (p=0.001/Pearson+0.4), Peak (p=0.001/Pearson-0.4) and AUC (p=0.002/Pearson-0.4)]; aCL IgG [tLag (p<0.001/Pearson+0.6), tPeak (p<0.001/Pearson+0.6), Peak (p<0.001/Pearson-0.5) and AUC (p=0.002/Pearson-0.4)]; aB2GPI IgG [tLag (p<0.001/Pearson+0.6), tPeak (p<0.001/Pearson+0.6), Peak (p=0.001/Pearson-0.4) and AUC (p=0.002/Pearson-0.4)]; aB2GPI Domain I [tLag (p<0.001/Pearson+0.5), tPeak (p<0.001/Pearson+0.5), Peak (p=0.001/Pearson-0.4) and AUC (p=0.002/Pearson-0.3)]. When considering the whole cohort, a statistically significant reduction of BAFF serum…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Belimumab
  topic: keywords
subject: Extra-criteria APS
  topic: keywords
subject: Refractory APS
  topic: keywords
subject: Alice Barinotti
  topic: disciplines
subject: Massimo Radin
  topic: disciplines
subject: Irene Cecchi
  topic: disciplines
subject: Beatrice Ala
  topic: disciplines
subject: Chiara Raymondi
  topic: disciplines
subject: Elena Rubini
  topic: disciplines
subject: Silvia G. Foddai
  topic: disciplines
subject: Lois Ira Maniulit Capulong
  topic: disciplines
subject: Alessio Conti
  topic: disciplines
subject: Alessandro Morotti
  topic: disciplines
subject: Dario Roccatello
  topic: disciplines
subject: Roberta Fenoglio
  topic: disciplines
subject: Savino Sciascia
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1997

PO:07:103 | Tocilizumab use in patients with rheumatoid arthritis and malignancy: a monocentric experience
type: item
description: Background. In 2024, the EULAR published a set of points to consider for initiating targeted therapy in rheumatoid arthritis (RA) patients with a history of malignancy, indicating TNF inhibitors are preferred in solid tumors, while rituximab is recommended for hematological malignancies. Although the interleukin-6 receptor inhibitor tocilizumab (TCZ) showed a favourable oncological safety profile, the EULAR taskforce did not issue specific recommendations in favour of its use in this clinical context due to a lack of robust evidence. Our aim was to evaluate in a single-center study the oncological safety of TCZ in RA patients with prior malignancy. Methods. Within the cohort of patients followed at the Arthritis Clinic of our hospital, we retrospectively identified RA patients (according to 2010 ACR/EULAR criteria) treated with TCZ for at least 3 months following cancer diagnosis, either active or in remission at treatment start. Data were collected on the characteristics of both rheumatologic and oncologic diseases, treatments before and after TCZ, and outcomes including rheumatic disease activity (based on the Disease Activity Score, DAS28) and oncologic response (complete remission, partial response, stable disease, progression, relapse). Results. We identified and included 34 patients who met the study criteria. Their demographic, rheumatologic, and oncologic characteristics are summarized in Table 1. Patients had a median age of 60 years (IQR, 51-69) at RA diagnosis and 68 years (IQR, 62-75) at TCZ start. TCZ was started in 21 patients in remission and in 13 with active malignancy. Median interval between cancer diagnosis and TCZ start was 35 months (IQR, 11–70). Ten patients had another bDMARD between cancer diagnosis and TCZ start. Two patients were already on TCZ at cancer diagnosis and continued uninterrupted. Median TCZ duration was 19 months (IQR 8–43). Concomitant csDMARDs were used in 19 cases, and methotrexate was the most frequently used (11 cases). T…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: bDMARDs
  topic: keywords
subject: Oncology
  topic: keywords
subject: Rheumatoid arthritis
  topic: keywords
subject: Vittorio Dibenedetto
  topic: disciplines
subject: Nicola Farina
  topic: disciplines
subject: Nicola Boffini
  topic: disciplines
subject: Alessandro Tomelleri
  topic: disciplines
subject: Adriana Cariddi
  topic: disciplines
subject: Elena Baldissera
  topic: disciplines
subject: Marco Matucci-Cerinic
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2021

CO:11:6 | Off-therapy remission in systemic lupus erythematosus: the BLys lupus flare index (BLyFI) as a decision tool for immunosuppressive therapy withdrawal in remitted patients
type: item
description: Background. The most recent literature regarding the discontinuation of immunosuppressive therapy (IS) in patients with systemic lupus erythematosus (SLE) in remission highlights that approximately one in four patients experience a relapse. We have learned how flare-ups impact the extent of accumulated damage, caused on the one hand by disease activity and on the other by prolonged exposure to IS therapy. This clearly supports the need for a tool that guides clinicians towards safe management of therapy in patients in remission. We therefore evaluated several serological biomarkers, such as anti-native DNA, C3, C4, anti-C1q, anti-PTX3, APRIL, BLyS, C3a and C3c. Based on the results observed, we created an algorithm capable of estimating the risk of relapse in patients in remission following the discontinuation of IS therapy. Materials and methods. We conducted a retrospective study of 57 patients with SLE who had discontinued IS therapy after achieving remission. Clinical SLEDAI-2K = 0, associated with stable background therapy and/or a prednisone dose ≤5 mg/day, identified remission status. Flares were defined according to the SLEDAI-Flare-Index. A multivariate logistic regression model was applied to evaluate the association between the risk of flare and clinical and serological data collected in the 6 months following discontinuation of IS therapy. The variables found to be significant were then combined to create a flare predictor algorithm. Results. Fifteen patients (26.3%) experienced a relapse, on average 4.35 (± 4.1) years after discontinuation of IS therapy. Serum BLyS levels were significantly higher in patients with relapse (median 0.869 ng/mL, IQR 0.669–1.262; p = 0.033) than in patients who remained in remission. Maintenance therapy with hydroxychloroquine (HCQ) at the time of IS therapy discontinuation showed a protective effect (OR = 0.21; p = 0.019). BLyS values, native anti-DNA antibody positivity, remission greater than 3 years at the time of IS th…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: BLyS
  topic: keywords
subject: remission
  topic: keywords
subject: immunosuppressive therapy
  topic: keywords
subject: Noemi Merra
  topic: disciplines
subject: Anna Giorgia Osele
  topic: disciplines
subject: Davide Ragno
  topic: disciplines
subject: Greta Hulej
  topic: disciplines
subject: Zahrà Rahmé
  topic: disciplines
subject: Ilenia Anna Gennaio
  topic: disciplines
subject: Filippo Vesentini
  topic: disciplines
subject: Margherita Zen
  topic: disciplines
subject: Luca Iaccarino
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2121

PO:08:113 | Shaping rheumatoid arthritis treatment: clinical and demographic drivers of tsDMARDs versus bDMARDs prescription post-EMA pronouncement on JAK inhibitors - insights from the AMBI-RA study
type: item
description: Background. The AMBI-RA study aimed to assess the influence of clinical and demographic factors on the choice between JAK inhibitors (JAKis), TNF inhibitors (TNFis), and non-TNFi bDMARDs in patients with rheumatoid arthritis (RA), before and after the publication of the EMA safety recommendations on JAKis (January 2023). Six-month outcomes were analyzed to determine whether these recommendations affected the achievement of therapeutic targets. Materials and Methods. In this single-center, ambidirectional cohort study, clinical, laboratory, and clinimetric data were collected at baseline and after 6 months of follow-up following the initiation of a new therapeutic line with JAK inhibitors (JAKis), TNF inhibitors (TNFis), or non-TNFi bDMARDs in patients with rheumatoid arthritis (RA). Patients were divided into two cohorts: retrospective (pre-EMA) and prospective (post-EMA). The association between clinical and demographic factors and treatment selection was assessed using univariate and multivariate logistic regression analyses. Additionally, we evaluated the relationship between these factors and non-response at 6 months, defined as failure to achieve remission or low disease activity (REM/LDA) according to DAS28-CRP, or early discontinuation of the bDMARD due to lack of efficacy. Results. A total of 539 treatment courses were analyzed: 300 in the retrospective cohort (pre-EMA: 2019-2022) and 239 in the prospective cohort (post-EMA: 2023-09/2024). Following the EMA safety recommendations, the use of TNFis increased from 32% to 41.4%, while JAKi prescriptions declined from 26% to 16.3%. TNF is also became the most frequently prescribed first-line agents, rising from 51.6% to 74%, whereas JAKis and non-TNFi bDMARDs decreased from 18% to 4.1% and from 30.5% to 21.9%, respectively (Table 1). Except for older age, the EMA-identified risk factors did not significantly influence JAKi prescriptions in the prospective cohort. TNFis were consistently associated with first-lin…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: AIFA and EMA recommendations.
  topic: keywords
subject: JAK inhibitors
  topic: keywords
subject: Treat-2-target
  topic: keywords
subject: Riccardo Bertola
  topic: disciplines
subject: Beatrice Maranini
  topic: disciplines
subject: Carlo Garaffoni
  topic: disciplines
subject: Maria Pozzuto
  topic: disciplines
subject: Anna Laura Riva Cambrino
  topic: disciplines
subject: Alessandro Spinelli
  topic: disciplines
subject: Letizia Mamprin
  topic: disciplines
subject: Federico Agostini
  topic: disciplines
subject: Martina Di Nunzio
  topic: disciplines
subject: Marcello Govoni
  topic: disciplines
subject: Alessandra Bortoluzzi
  topic: disciplines
subject: Ettore Silvagni
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2139

CO:12:4 | Predicting 12-month clinical relapse in Takayasu arteritis using [18F]FDG PET and convolutional neural networks
type: item
description: Background. Takayasu arteritis (TAK) is a large-vessel vasculitis with fluctuating disease activity and a lack of validated biomarkers for relapse prediction. While [18F]FDG PET provides diagnostic sensitivity, its prognostic role remains debated. This study aimed to assess whether convolutional neural networks (CNNs) applied to baseline [18F]FDG PET scans can predict clinical relapses within 12 months in patients with TAK. Methods. We retrospectively analysed [18F]FDG PET scans acquired from patients with TAK between 2013 and 2023 at a tertiary centre. All scans were harmonised using a liver-based standardisation method to correct inter-scanner variability. Clinical relapse was defined as recurrence of TAK-related signs or symptoms, based on blinded chart review. CNNs were trained using four architectures: Baseline model (4 convolutional layers), Residual bottleneck model (3 blocks), and two models retrieved from the MONAI library – ResNet18 and DenseNet121. The dataset was split into training, validation, and test sets. To address class imbalance, we applied class weighting, early stopping, and 10-fold subsampling of the majority class. Data augmentation techniques included RandAffine and RandAxisFlip. Performance was evaluated using accuracy, class-specific precision and recall, specificity, and normalised Matthews correlation coefficient (nMCC). Results. A total of 306 scans from 74 patients with TAK (median age: 47 years [range: 14–75]; 62 females) were included. Sixty-four scans (21%) were followed by clinical relapse within 12 months. Of these, 25 were correctly identified by blinded nuclear medicine readers. The Baseline model-1 achieved the best overall performance with 82% accuracy, 85% precision for class 0, 62% precision for class 1, 38% recall, 94% specificity, and 70% nMCC. DenseNet121-2 yielded 81% accuracy, 100% precision for class 1 (relapse), 8% recall, 100% specificity, and 62% nMCC, maintaining 100% precision and specificity in the subsampled tes…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: Takayasu arteritis
  topic: keywords
subject: FDG-PET
  topic: keywords
subject: Machine learning
  topic: keywords
subject: Alessandro Tomelleri
  topic: disciplines
subject: Carolina Bezzi
  topic: disciplines
subject: Sara Resta
  topic: disciplines
subject: Corrado Campochiaro
  topic: disciplines
subject: Federico Fallanca
  topic: disciplines
subject: Elena Baldissera
  topic: disciplines
subject: Samuele Ghezzo
  topic: disciplines
subject: Nicola Farina
  topic: disciplines
subject: Arturo Chiti
  topic: disciplines
subject: Paola Mapelli
  topic: disciplines
subject: Marco Matucci-Cerinic
  topic: disciplines
subject: Maria Picchio
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1998

https://www.reumatismo.org/reuma/article/view/2022
type: item
title: PO:07:111 | Worsening of patient-reported outcomes is an early predictor of disease flare in patients with rheumatoid arthritis in course of treatment with conventional synthetic disease modifying anti-rheumatic drugs
description: Background. Rheumatoid arthritis (RA) has a relapsing-remitting course that impedes the achievement of sustained remission and impairs quality of life in many patients. The ability to predict flares of the disease could assist personalized management and treatment approaches. Aim of this study was to test whether longitudinal variations in measures of disease activity and patient-reported outcomes (PRO) after the achievement of stable disease control could predict imminent flares in patients with RA. Methods. From a larger dataset of 817 patients with early RA (duration of symptoms at referral <12 months) undergoing a treat-to-target strategy with methotrexate (MTX) and followed tightly at 3-month intervals, we extracted those who had achieved at least low disease activity (DAS28 <3.2) at two consecutive visits during the first year of treatment. Flare was defined as any increase in DAS28 >1.2, or final DAS28 >3.2 at the visit immediately following the achievement of stable disease control. Longitudinal variations of swollen and tender joint counts, C-reactive protein (CRP) levels, patient global assessment of disease activity (PGA) and pain scores in course of stable DAS28 <3.2 were tested for their ability to predict disease flare. Results. We analyzed 927 visits from 309 patients with early RA achieving stable disease control (DAS28 <3.2 in two consecutive occasions) during the first year of treatment. Flare at the subsequent visit was experienced by 21.4% of the patients. Demographic variables, disease activity measures, autoantibody status, dose of MTX and glucocorticoids at the first visit in DAS28 <3.2 failed to predict future RA flare. As shown in Figure 1A, B, the number of swollen joints an CRP levels remained stable until the time of flare. In contrast, worsening of PGA and VAS pain scores pre-dated the occurrence of flare (Figure 1C, D). Using the Youden index to derive a cut-point that optimally balanced sensitivity with specificity, an increase in PGA …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Flare
  topic: keywords
subject: patient-reported outcomes
  topic: keywords
subject: citrullinated
  topic: keywords
subject: Ludovico De Stefano
  topic: disciplines
subject: Federica Sabatelli
  topic: disciplines
subject: Clelia Zampaglione
  topic: disciplines
subject: Blerina Xoxi
  topic: disciplines
subject: Antonio Manzo
  topic: disciplines
subject: Carlomaurizio Montecucco
  topic: disciplines
subject: Serena Bugatti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2022

CO:12:5 | Aortic inflammation and aneurysm risk in giant cell arteritis: a multicenter imaging study
type: item
description: Background. The study’s aims were to evaluate the prevalence of aortitis and aortic aneurysm in patients with newly diagnosed giant cell arteritis (GCA), to estimate the rate of aortic growth, and to identify clinical and imaging predictors of aortic aneurysm development. Materials and Methods. We conducted a retrospective cohort study involving patients with new-onset GCA from two European centers. Included patients underwent baseline thoracic aortic imaging (PET/CT or MRI) within 6 months of the diagnosis and had at least one follow-up imaging of the thoracic aorta at least 6 months later. Aortitis was defined by FDG uptake (equal or greater than grade 2 according to Meller’s scale) on PET/CT or vessel wall thickening/oedema on MRI. Outcomes included aortic diameter and prevalent aortic aneurysms at baseline, aortic growth during follow-up assessed by annualized area changes in mm2/year per segment, and incident aneurysms. Analyses were performed at both patient’s and aortic segment’s level. Multivariable regression models were adjusted for sex and age. Results. A total of 157 patients were included, (mean age 67.9±9.1 years; 69.4% female). Aortitis was present in 93/154 (60.4%) patients at baseline (detected in 32.6% of MRIs and in 71.2% of PET/CT scans) and was associated with younger age (66.5 vs 69.7 years, p=0.028) and fewer cranial ischemic symptoms at disease onset (18.5% vs. 41.7%, p=0.002). Baseline aortic aneurysms were identified in 19.6% of patients and in 5.8% of aortic segments, predominantly in the mid-ascending aorta. Aortitis at baseline was associated with larger aortic diameters (beta = 0.184; p<0.0001) and higher odds of prevalent aneurysm (ORadj=2.3; 95% CI: 1.0–5.1). Over a median follow-up of 30 months, incident aneurysms developed in 9.8% of patients and 4.1% of aortic segments without baseline dilation (Figure). Baseline aortic diameter was the strongest predictor of aortic growth (beta= 0.088; p=0.006) and incident aneurysm formation (HRa…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Oral Communications - Day 3
  topic: category
subject: GCA
  topic: keywords
subject: Aortic aneurysm
  topic: keywords
subject: Aortitis
  topic: keywords
subject: Caterina Ricordi
  topic: disciplines
subject: Chiara Marvisi
  topic: disciplines
subject: Konstanze V. Guggenberger
  topic: disciplines
subject: Rudolf A. Werner
  topic: disciplines
subject: Pamela Mancuso
  topic: disciplines
subject: Giulia Besutti
  topic: disciplines
subject: Sebastian E. Serfling
  topic: disciplines
subject: Roberto Farì
  topic: disciplines
subject: Matthias Frohlich
  topic: disciplines
subject: Rexhep Durmo
  topic: disciplines
subject: Michael Gernert
  topic: disciplines
subject: Lucia Spaggiari
  topic: disciplines
subject: Annibale Versari
  topic: disciplines
subject: Paolo Giorgi Rossi
  topic: disciplines
subject: Pierpaolo Pattacini
  topic: disciplines
subject: Marc Schmalzing
  topic: disciplines
subject: Carlo Salvarani
  topic: disciplines
subject: Thorsten Bley
  topic: disciplines
subject: Francesco Muratore
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.1999

https://www.reumatismo.org/reuma/article/view/2140
type: item
title: PO:08:114 | The adjuvanted recombinant zoster vaccine is effective in preventing herpes zoster among patients ≥50 years of age with selected autoimmune diseases in the united states: a real-world database analysis (2018–2021)
description: Background. The adjuvanted recombinant zoster vaccine (RZV) was approved by the US Food and Drug Administration (FDA) for HZ prevention in adults ≥50 YOA in 2017 and for adults ≥18 YOA who are at increased risk of HZ due to immunodeficiency or immunosuppression in 2021. Autoimmune disease (AID) patients are at increased risk of developing HZ compared to the general population. This real-world evidence (RWE) study assessed RZV vaccine effectiveness (VE) in patients ≥50 YOA with selected AIDs (rheumatoid arthritis, inflammatory bowel disease, systemic lupus erythematosus, multiple sclerosis, psoriasis and psoriatic arthritis). Materials and Methods. This retrospective matched cohort study was conducted in patients ≥50 YOA with selected AIDs using Optum’s de-identified Clinformatics Data Mart database from Jan 2018 to Dec 2021. Patients who received 2 doses of RZV (RZV 2-dose cohort) were matched (1:3) by age, medication category and propensity scores to unvaccinated counterparts (non-RZV cohort) [Figure 1]. Incidence rates (IRs) of HZ and VE were calculated overall, stratified by condition, age, gender, time interval between the 2 doses, and time since vaccination. Cox regression models were used to estimate hazard ratios (HRs). VE as % was calculated as (1−HR) × 100. A similar approach was used to evaluate VE for patients who received 1 RZV dose. Results. We identified 36,645 RZV vaccinated and 109,229 matched non-RZV vaccinated AID patients. Median follow-up was 1.29 (interquartile range [IQR]: 0.73–2.12) and 1.07 (IQR: 0.59–1.95) years for RZV and non-RZV cohorts. IR of HZ was 4.33/1,000 person-years (PY) in the RZV 2-dose cohort and 12.86/1,000 PY in the non-RZV cohort, resulting in an overall VE of 66.3% (95% confidence intervals [CIs]: 61.4–70.7) for AID patients. IRs and VE overall and stratified by each selected AID and variables are presented in Figure 2. Overall VE for AID patients who received 1 RZV dose was 58.3% (95% CIs: 45.8–68.0). Conclusions. This ana…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: herpes zoster
  topic: keywords
subject: Autoimmune disease
  topic: keywords
subject: vaccine effectiveness
  topic: keywords
subject: Rosaria Silvestri
  topic: disciplines
subject: Dagna Constenla
  topic: disciplines
subject: Germain Lonnet
  topic: disciplines
subject: Emmanuel Aris
  topic: disciplines
subject: Nathalie Servotte
  topic: disciplines
subject: Ramsanjay Rk
  topic: disciplines
subject: Agnes Mwakingwe-Omari
  topic: disciplines
subject: Huifeng Yun
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2140

https://www.reumatismo.org/reuma/article/view/2141
type: item
title: PO:08:116 | Rheumatoid nodulosis: incidence, clinical/instrumental description, and phenotypic correlations in patients with rheumatoid arthritis treated with b-DMARDs. A real-life analysis from a monocentric cohort
description: Background. Rheumatoid nodulosis is the most common cutaneous manifestation of rheumatoid arthritis (RA), with an estimated prevalence of 20–30%. Less frequently, it involves the lungs (<1%), presenting as rheumatoid pulmonary nodulosis. This preliminary study describes a group of RA patients treated with b-DMARDs, analyzing the prevalence of pulmonary and extrapulmonary nodules and potential clinical associations. Materials and Methods. A retrospective, monocentric, observational study was conducted on 82 RA patients treated with b-DMARDs for at least 12 months. One patient was excluded due to insufficient data. Demographic and clinical features, presence and type of nodules (radiological/histological), and variations in DAS28 at baseline and after 12 months of b-DMARD therapy were analyzed. Results. Of the 82 patients, 65 were women (79.3%), with a median age of 62.5 years and a median disease duration of 11.8 years. Active smoking was reported in 18.3% and previous smoking in 29.3% of cases. RF and CCP tests were negative in about 23% of patients. At diagnosis, 2 patients were untreated; 24 were on monotherapy (predominantly methotrexate), and 56 on combination therapy. The median time between diagnosis and initiation of biologic therapy was 6.14 years (mean 10.33; skewness 1.13). At baseline, DAS28-4v indicated high disease activity in 30.5% of patients, moderate activity in 41.5%, and remission in 13.4%. After 12 months, 50% achieved remission, 62.2% showed clinical improvement, 20.7% remained stable, and 6.1% worsened. The mean DAS28 reduction was similar across different b-DMARD classes, consistent with literature data. Pulmonary nodules were detected in 23 patients, extrapulmonary in 12, and multiple-site nodules in 5. Among patients with pulmonary nodules, 6 had overlap syndromes (Sjögren’s, systemic sclerosis, or mixed connective tissue disease), and 65.2% were current or former smokers. Nodules were bilateral in 15 cases, cavitated in 3, and located rando…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Rheumatoid Nodulosis
  topic: keywords
subject: b-DMARDs
  topic: keywords
subject: rheumatoid arthritis (RA
  topic: keywords
subject: Stefano Ruggiero
  topic: disciplines
subject: Elisa Montebelli
  topic: disciplines
subject: Simone Bernardi
  topic: disciplines
subject: Marcello Natali
  topic: disciplines
subject: Francesca Martelli
  topic: disciplines
subject: Alessandra Caula
  topic: disciplines
subject: Federica Landolfini
  topic: disciplines
subject: Gabriella Cucinotta
  topic: disciplines
subject: Sofia Giulianelli
  topic: disciplines
subject: Francesco Girelli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2141

PO:08:117 | Association between the use of oral contraceptives and the development of rheumatoid arthritis: a systematic review and meta-analysis
type: item
description: Background. Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that significantly impacts patients' quality of life, particularly affecting women. Although previous research has suggested that oral contraceptive (OC) use might influence the risk of developing RA, earlier meta-analyses have yielded inconsistent results. Given these conflicting findings and the emergence of new data, we performed an updated systematic review and meta-analysis of observational studies to clarify the association between OC use and RA risk. Materials and Methods. A systematic literature review and meta-analysis were conducted by searching MedLine (via PubMed), Scopus, and Cochrane databases up to March 2025. Observational studies examining the relationship between OC use and RA risk were included. Odds ratios (OR) and corresponding 95% confidence intervals (CI) were calculated. Additionally, cumulative meta-analysis was performed to assess temporal trends in risk estimates over time. Results. Our analysis demonstrated that ever use (current or prior use) of OCs is associated with a statistically significant reduction in RA risk (OR 0.80, 95% CI 0.70-0.91). In contrast, the associations for current use (OR 0.59, 95% CI 0.34-1.02) and past use (OR 0.83, 95% CI 0.69-1.01) were less definitive, likely due to substantial heterogeneity among studies. Cumulative meta-analysis revealed a modest temporal trend toward a protective effect of OC use. Conclusions: This meta-analysis supports a protective association between current or prior OC use and the development of RA, highlighting the potential role of hormonal factors in RA pathogenesis. CONCLUSIONI This meta-analysis supports a protective association between current or prior OC use and the development of RA, highlighting the potential role of hormonal factors in RA pathogenesis.
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Rheumatoid Arthritis
  topic: keywords
subject: Oral contraceptives
  topic: keywords
subject: Meta-analysis
  topic: keywords
subject: Annalisa Marino
  topic: disciplines
subject: Damiano Currado
  topic: disciplines
subject: Onorina Berardicurti
  topic: disciplines
subject: Marta Vomero
  topic: disciplines
subject: Lyubomyra Kun
  topic: disciplines
subject: Letizia Pia Di Corcia
  topic: disciplines
subject: Erika Corberi
  topic: disciplines
subject: Francesca Trunfio
  topic: disciplines
subject: Francesca Saracino
  topic: disciplines
subject: Ludovica Lamberti
  topic: disciplines
subject: Leonardo Frasca
  topic: disciplines
subject: Angelo Battista
  topic: disciplines
subject: Marta Alfano
  topic: disciplines
subject: Silvia Schiavone
  topic: disciplines
subject: Roberto Giacomelli
  topic: disciplines
subject: Luca Navarini
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2023

PO:08:118 | “Posting Arthritis”: rheumatoid arthritis vs. juvenile idiopathic arthritis contents on social media
type: item
description: Background. Social media platforms are among the most popular sources used by patients and caregivers to obtain information on health-related topics, including rheumatological diseases (1). The aim of this study was to evaluate the social media content related to the most common types of autoimmune arthritis in both adults and children, rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA). We also aimed to assess differences between adult and pediatric rheumatology content and between content published by health professionals (HPs) and non-health professionals (NHPs). Methods and Materials The 150 most popular posts related to RA (assessed through “rheumatoid arthritis”) and JIA (assessed through “juvenile idiopathic arthritis,” “juvenile rheumatoid arthritis,” and “juvenile arthritis”) were evaluated on the popular social media platforms Instagram, Facebook, and TikTok. For each content, either photo or video, we collected data on the type of content creator, engagement metrics (likes, comments, saves, shares, and interactions), and the primary purpose of the content. For videos, additional data on views and duration were recorded. Educational videos were evaluated using validated and standardized tools: quality was assessed using the Journal of the American Medical Association (JAMA) Benchmark Scale, while understandability and actionability were measured using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). The presence of disinformation was categorized as “absent,” “minimal,” or “significant.” Results We included 1.713 posts (572 on RA and 1.141 on JIA) from TikTok (666; 39%), Instagram (590; 34%), and Facebook (457; 27%), achieving 179.9 million views and 5.4 million interactions. NHPs were the majority of creators (1.336; 78%), mostly consisting of patients (801; 47%), while rheumatologists (34; 2%) and pediatric rheumatologists (17: 1%) were a minority. Most content was shared for reporting a patient experie…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Social media
  topic: keywords
subject: Rheumatoid arthritis
  topic: keywords
subject: Juvenile idiopathic arthritis
  topic: keywords
subject: Daniele Domanico
  topic: disciplines
subject: Saverio La Bella
  topic: disciplines
subject: Angelica Napoletano
  topic: disciplines
subject: Teresa Caferri
  topic: disciplines
subject: Angela Carenza
  topic: disciplines
subject: Armando Di Ludovico
  topic: disciplines
subject: Marta Rinaldi
  topic: disciplines
subject: Simone Perniola
  topic: disciplines
subject: Vincenzo Venerito
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2024

PO:08:121 | Correlation between SENS score and perceived disability in a monocentric cohort of patients affected by rheumatoid arthritis: preliminary analysis of 209 patients
type: item
description: Bacgound. To demonstrate the correlation between structural joint damage, measured through the SENS score, and perceived disability in a monocentric cohort of patients affected by Rheumatoid Arthritis (RA). Materials and Methods. Out of a cohort of 1262 patients, 209 consecutive patients affected by RA (diagnosis according to the 2010 ACR/EULAR classification criteria) were evaluated. For each patient, demographic, clinical, and treatment characteristics were collected: sex, date of birth, disease duration, therapy with b-DMARDS, cs-DMARDS and steroids, positivity for rheumatoid factor and/or anti-CCP, BMI, CRP, fibromyalgia, comorbidities, Visual Analogue Score (VAS), Disease Activity Score 28 (DAS28), Health Assessment Questionnaire (HAQ). The SENS score was calculated on the most recent X-rays of hands and feet available. The correlation between HAQ and SENS (total, hands and feet) was evaluated using the correlation coefficient r. Moreover, a multivariate analysis was performed with other variables known to be associated with the HAQ score. Results. The patients (74% female) had a mean age of 63.5 (55–72) years and a disease duration of 13.65 (5.8–23.7) years. The remaining characteristics of the patients are shown in the table. The median total SENS score was 10 (4–25). Patients showed greater erosive damage in the hands compared to the feet (SENS score hands 8 (1–16.33); SENS score feet 2 (0–5). A positive linear correlation was found between erosive damage, both total and for hands and feet separately, and the HAQ score; total SENS score vs HAQ r = 0.33, p = 0.001; hands SENS score vs HAQ r = 0.33, p = 0.001; feet SENS score vs HAQ r = 0.23, p = 0.008. The multivariate analysis showed an independent association with total SENS score (p = 0.0009), age (p = 0.0217), and fibromyalgia (p = 0.0146). No independent association was found with BMI, presence of comorbidities, disease duration, or DAS28. Conclusions. The study highlighted a linear correlation between e…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: rheumatoid arthritis
  topic: keywords
subject: Radiographic damage
  topic: keywords
subject: disability
  topic: keywords
subject: Francesco Angius
  topic: disciplines
subject: Nicoleta Anamari Costin
  topic: disciplines
subject: Mattia Fadda
  topic: disciplines
subject: Davide Corradini
  topic: disciplines
subject: Mattia Congia
  topic: disciplines
subject: Elisabetta Chessa
  topic: disciplines
subject: Alberto Floris
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2142

PO:08:126 | Use of upadacitinib in real-life: the experience of Calabrian rheumatology
type: item
description: Background. Upadacitinib (UPA), demonstrated efficacy and safety in the treatment of Rheumatoid Arthritis (RA) in several randomized clinical trials (RCTs) and in long-term extension (LTE) studies. However, it is well known that experiences in real world evidence (RWE) play a pivotal and complementary role to RCTs. On this basis, Calabrian rheumatologists has decided to collect data aiming at providing futher evidences on the efficacy and safety of UPA in RA patients. Materials and Methods. To evaluate efficacy and safety, 87 RA patients (>18 years old) were enrolled retrospectively from January 2021 to December 2023 from 11 different Rheumatology Units in Calabria. Data were collected at baseline and the at 3, 6, 12 and 24 months from the start of therapy, including demographic features, prior therapies, comorbidities, RA features, clinimetric data and adverse events (AEs). Of the 87 enrolled patients, 80.5% are women. The mean age is 61.4 ± 10.9 years. The median disease duration is 96 months. The mean BMI is 26.07± 5.23. Eight patients (9.3%) had a history of previous cardiovascular events, ten patients (11.6%) were smokers and two patients (2.3%) ex smokers. Ten patients (11.8%) had a concomitant diagnosis of diabetes, thirty patients (34.9%) had hypertension, two (6.9%) hyperuricemia, thirteen patients (36.1%) had dyslipidemia, three patients (3.5%) had recurrent infections and five patients (5.8%) had a family history of neoplasm. No patients had a history of thromboembolism and four patients (4.6%) had previous events of herpes zoster (HZ), only 6 patients receveid vaccine anti-HZ virus. Twenty-five patients (71.4%) had a positivity for rheumatoid factor (RF) and twenty-two (61.6%) were positive to anti-citrullinated protein antibodies (ACPA). Ninenty-three percent of patients were previously treated with at least one bDMARDs and only one patient with another tsDMARD. During the follow-up, four patients discontinued UPA for lack of efficacy (n=1) or for adver…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Upadacitinib (UPA)
  topic: keywords
subject: efficacy
  topic: keywords
subject: safety
  topic: keywords
subject: Vincenzo Raimondo
  topic: disciplines
subject: Maurizio Caminiti
  topic: disciplines
subject: Pietro Gigliotti
  topic: disciplines
subject: Giuseppe Varcasia
  topic: disciplines
subject: Massimo L'Andolina
  topic: disciplines
subject: Domenico Olivo
  topic: disciplines
subject: Roberta Pellegrini
  topic: disciplines
subject: Pietro Muto
  topic: disciplines
subject: Marilena Calabria
  topic: disciplines
subject: Laura Massaro
  topic: disciplines
subject: Jessica Maria El Luppino
  topic: disciplines
subject: Salvatore De Bonis
  topic: disciplines
subject: Giuseppa Pagano Mariano
  topic: disciplines
subject: Stefania Sorbara
  topic: disciplines
subject: Virginia Caira
  topic: disciplines
subject: Mariateresa Cirillo
  topic: disciplines
subject: Caterina Bruno
  topic: disciplines
subject: Clodoveo Ferri
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2143

PO:09:134 | The impact of intra-articular hyaluronic acid injections on osteoarthritis synovitis: a study on synovial tissue of total knee arthroplasty patients
type: item
description: Background. Intra-articular hyaluronic acid injections (IA-HA) represent a therapeutic strategy widely used to manage knee osteoarthritis, aiming to reduce pain and to improve joints’ range of movement. However, the effect of this treatment on histological synovial inflammation is still quite unexplored. Krenn’s score is a validated semi-quantitative histopathological scoring system to evaluate synovitis and it is particularly useful in identifying inflammation in advanced osteoarthritis patients. Objective. Evaluating the correlation between IA-HA treatment and synovial inflammation, which was measured by Krenn’s score, in total knee arthroplasty (TKA) patients. Methods. We included 108 patients affected by knee osteoarthritis who had undertaken TKA. 48 patients, who had been treated with steroid intra-articular injections, were excluded from the analysis to avoid confounding factors. Out of the remaining 60 patients, 45/60 had been treated with IA-HA in the pre-operative period and 15/60 had not been treated with IA-HA. We then calculated the mean time from knee osteoarthritis diagnosis and TKA (yearsOATKA) and we analysed the bivariate correlation between total number of intra-articular hyaluronic acid injections (NHAinj) and the time from diagnosis to surgery. During the surgical procedure of 36 patients, it was taken a sample of synovial membrane for histopathological analysis and Krenn’s score evaluation. Statistical analysis included the evaluation of the correlation between Krenn’s score and the number of intra-articular injections, as well as the comparison between groups (IA-HA vs non-IA-HA) to identify differences in synovial inflammation. Results. Patients treated with IA-HA (n=45) had a mean time from diagnosis to TKA of 10,91 years (SD: 8,96), in comparison to those non treated with IA-HA (n=15), whose mean time was 5,33 years (SD: 3,94). Mean Krenn’s score in IA-HA patients (n=26) was 3,0 (SD: 1,88), while in non-IA-HA patients (n=10) was 2,4 (SD: 0,8…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Krennճ score
  topic: keywords
subject: hyaluronic acid
  topic: keywords
subject: synovitis
  topic: keywords
subject: Orazio De Lucia
  topic: disciplines
subject: Laura Giudice
  topic: disciplines
subject: Carolina Artusi
  topic: disciplines
subject: Luca Ingrao
  topic: disciplines
subject: Giorgia Trignani
  topic: disciplines
subject: Matteo Ferrito
  topic: disciplines
subject: Andrea Amati
  topic: disciplines
subject: Marta Arese
  topic: disciplines
subject: Camilla Riboldi
  topic: disciplines
subject: Isabella Scotti
  topic: disciplines
subject: Antonella Murgo
  topic: disciplines
subject: Ennio Giulio Favalli
  topic: disciplines
subject: Antonina Parafioriti
  topic: disciplines
subject: Elisabetta Armiraglio
  topic: disciplines
subject: Andrea Di Bernardo
  topic: disciplines
subject: Filippo Calanna
  topic: disciplines
subject: Chiara Fossati
  topic: disciplines
subject: Pietro Simone Randelli
  topic: disciplines
subject: Roberto Felice Caporali
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2144

PO:09:139 | Comparative evaluation of GPT-4.0, Claude 4, and MedGEMMA in automatic Kellgren-Lawrence grading of knee osteoarthritis
type: item
description: Background. Automated grading of knee osteoarthritis (OA) severity using the Kellgren-Lawrence (KL) scale is a critical task in musculoskeletal radiology. Recently developed multimodal large language models (LLMs) offer the potential to interpret clinical images alongside text, but their performance on fine-grained ordinal classification tasks remains poorly characterized. Methods. We evaluated three multimodal LLMs—Open AI GPT-4o (vision-enabled), Anthropic Claude 4, and the open source Google MedGEMMA—on their ability to predict KL grades from knee radiographs in a publicly available, expert-annotated dataset¹. Model predictions were compared to ground truth labels using exact match accuracy, ±1 tolerance accuracy (i.e., prediction within one KL grade)(Figure 1), and macro-averaged precision and recall. Confusion matrices were also analyzed to examine misclassification trends. Results. The dataset included 100 radiographic images, equally distributed across KL grades: • Grade 0: 20 images • Grade 1: 20 images • Grade 2: 20 images • Grade 3: 20 images • Grade 4: 20 images GPT-4o demonstrated the best overall performance with 26% exact match accuracy, 63% ±1 tolerance accuracy, macro precision 0.38, and macro recall 0.26. Claude 4 and MedGEMMA each reached 21% exact match, 58% ±1 tolerance, with macro precision/recall of 0.23/0.21 and 0.20/0.21, respectively (Figure 2). All models exhibited frequent misclassification between adjacent KL grades, particularly underestimating moderate to severe OA (grades 3–4). Conclusion. Although GPT-4o outperformed the other models, its accuracy remains insufficient for clinical reliability. These findings reveal that current multimodal LLMs, while promising, still struggle with ordinal radiographic interpretation tasks. Targeted training on medical imaging datasets and improved domain adaptation are necessary to enhance their diagnostic utility. ¹
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Osteoarthritis
  topic: keywords
subject: Large language model
  topic: keywords
subject: Artificial intelligence
  topic: keywords
subject: Teresa Caferri
  topic: disciplines
subject: Vincenzo Venerito
  topic: disciplines
subject: Angela Carenza
  topic: disciplines
subject: Daniele Catamerò
  topic: disciplines
subject: Daniele Domanico
  topic: disciplines
subject: Sergio Del Vescovo
  topic: disciplines
subject: Lucia Cristiana Colaprico
  topic: disciplines
subject: Lavista Marlea
  topic: disciplines
subject: Maria Giannotta
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2025

PO:10:146 | Dorsal myelopathy in a patient with radiographic axial spondyloarthritis
type: item
description: Background. Neurological involvements in axial spondyloarthritis (axSpA) are uncommon but can lead to serious complications. Among these, the occurrence of an epidural fluid–cellular collection is extremely rare and scarcely reported, representing a significant diagnostic challenge in differentiating infectious, neoplastic, and inflammatory etiologies. We describe the case of a patient with radiographic axSpA complicated by dorsal myelopathy secondary to an inflammatory epidural collection. Materials and Methods. A 29-year-old man with a history of inflammatory back pain and family history of spondyloarthritis presented with worsening thoracolumbar pain, sphincter dysfunction, and progressive lower limb paraparesis. Laboratory investigations revealed elevated CRP (22.6 mg/L), HLA-B27 positivity, and a positive TB Quantiferon test. Contrast-enhanced spinal MRI demonstrated a large posterior epidural fluid–cellular collection extending from D4 to D6, causing spinal cord compression and signal alterations consistent with myelopathy. Bone marrow edema was also observed in the cervical, thoracic, and lumbar vertebrae, as well as in the sternal manubrium. Radiographic imaging showed syndesmophytes, bilateral sacroiliac ankylosis, and thoracolumbar Romanus lesions. The patient underwent neurosurgical decompression with laminectomy and paravertebral tissue biopsy. Results: Histopathological analysis revealed compact and trabecular bone with preserved architecture, surrounded by fibro-adipose tissue showing inflammatory infiltrates occasionally organized into small B- and T-cell germinal-like centers, consistent with a reactive inflammatory process. Microbiological studies, including cultures and PCR for Mycobacterium tuberculosis, were negative. PET-CT did not reveal hypermetabolic foci suggestive of lymphoproliferative disease. Given the high disease activity (ASDAS-CRP 4.76; BASDAI 7.4), HLA-B27 positivity, and characteristic radiological features of axSpA, an inflammator…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: axial spondyloarthritis
  topic: keywords
subject: myelopathy
  topic: keywords
subject: thoracolumbar pain
  topic: keywords
subject: Chiara Nobili
  topic: disciplines
subject: Siria Ripiccini
  topic: disciplines
subject: Marco Panetta
  topic: disciplines
subject: Elisabetta Greco
  topic: disciplines
subject: Barbara Kroegler
  topic: disciplines
subject: Paola Conigliaro
  topic: disciplines
subject: Alberto Bergamini
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2145

PO:10:149 | Efficacy of anifrolumab in a case of systemic lupus erythematosus with pulmonary involvement
type: item
description: Background. Pulmonary involvement in systemic lupus erythematosus (SLE) is a heterogeneous and usually non-severe complication, affecting 50–70% of patients (and up to 4–5% at disease onset). Pleuro-parenchymal manifestations include pleuritis (30%), interstitial lung disease (ILD, 1–15%), and lupus pneumonitis (1–4%), the latter often requiring differential diagnosis from infectious forms. Vascular manifestations comprise pulmonary arterial hypertension (PAH, 0.5–17.5%), diffuse alveolar hemorrhage (DAH, 1–5.4%), and venous thromboembolism (VTE, 9%; 35–42% in the presence of antiphospholipid antibodies), as well as acute reversible hypoxemia (ARH). Rare forms include airway disease and shrinking lung syndrome. Anifrolumab, a monoclonal antibody that blocks the type I interferon receptor, has shown efficacy in moderate to severe SLE, particularly for mucocutaneous, articular, and serological manifestations. According to European guidelines, Anifrolumab is recommended as first-line therapy for extra-renal (non–major organ) manifestations, especially cutaneous, and as add-on therapy for severe disease. We report a case of SLE with lupus pneumonitis and antiphospholipid syndrome (APS) successfully treated with Anifrolumab. Materials and Methods. A 45-year-old Caucasian man, with no significant past medical history, experienced three episodes of bilateral pneumonia (bibasilar consolidations) since mid-2022, all requiring hospitalization. One episode was complicated by pulmonary embolism and another by a generalized rash, both treated with antibiotics and corticosteroids. Laboratory findings revealed positivity for ANA (1:2560, homogeneous nuclear pattern), anti-dsDNA, anti-Ro52, anti-nucleosome, anti-histone antibodies, rheumatoid factor, and lupus anticoagulant. Rheumatologic assessment revealed Jaccoud arthropathy and widespread erythematous maculopapular lesions on the trunk, back, and limbs. Given the absence of infectious findings (including negative BAL), the pulm…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: lupus erythematosus
  topic: keywords
subject: Lung
  topic: keywords
subject: Anifrolumab
  topic: keywords
subject: Fabio Brandolino
  topic: disciplines
subject: Giulia Pazzola
  topic: disciplines
subject: Luca Ronzoni
  topic: disciplines
subject: Andreina Teresa Manfredi
  topic: disciplines
subject: Carlo Salvarani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2146

PO:10:150 | A case of pulmonary hypertension in Whipple's disease
type: item
description: Background. Whipple’s disease is a rare and multisystemic disorder caused by T. whipplei and pulmonary hypertension (PH) is a rare complication. Case presentation. A 41-year-old Caucasian woman, with wrist arthritis and elevated inflammatory markers was diagnosed with seronegative arthritis in 2017. She was initially treated with hydroxychloroquine (ineffective), and anti- inflammatory drugs. We first evaluate her in 2022 with mild articular pain, occasional low-grade fever < 38°C, non-specific perivascular dermatitis and elevated inflammatory markers C-Reactive Protein (CRP 50 mg/L), Serum Amyloid A (SAA, 182 mg/L). Routine, immunological and infectious blood tests were negative or in normal range. PET and CT scans showed mediastinal, mesenteric, axillary and inguinal enlarged lymph nodes and a tru-cut biopsy showed non-specific micro-granulomatous inflammation. In the suspect of an autoinflammatory disease Colchicine was started with no clinical improvement and persistent elevated inflammatory markers (CRP 45 mg/L, SAA 76 mg/L). In July 2023, Anakinra was started with clinical improvement and CRP reduction but persistently elevated SAA (56 mg/L). NGS for recurrent periodic fever resulted negative. In March 2024, the patient was hospitalized for dyspnoea. HRTC showed dilation of pulmonary arteries and lymph nodes enlargement. Because echocardiography revealed elevated pulmonary pressure the patient underwent right heart catheterization (RHC) that showed mild pre-capillary PH. The patient was discharged with diuretic therapy. The patient was admitted again in April and immediately referred an Italian center for PH. RHC confirmed precapillary PH [mean PAP 34 mmHg; cardiac output 4.4 l/min; pulmonary vascular resistance 6.1 uW]. Vasoreactivity testing with nitric oxide was positive. Spirometry revealed severe reduction of DLCO (34%). Diuretic and 5 mg tid of sildenafil were started. The repeated lymph node biopsy showed granulomas suggestive for lymph node sarcoidosis…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Whipple's Disease
  topic: keywords
subject: Pulmonary hypertension
  topic: keywords
subject: Sarcoidosis
  topic: keywords
subject: Alba Chiara Pozzi
  topic: disciplines
subject: Giulia Fontana
  topic: disciplines
subject: Francesca Crisafulli
  topic: disciplines
subject: Guarino Daniele
  topic: disciplines
subject: Monica Salvi
  topic: disciplines
subject: Massimiliano Palazzini
  topic: disciplines
subject: Francesco Biagi
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
subject: Micol Frassi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2026

PO:10:153 | Isolated sarcoidosis of the parotid gland: a rare case of unilateral presentation
type: item
description: Sarcoidosis is a chronic multisystem inflammatory disease of unknown etiology, histologically characterized by non-necrotizing granulomas. Pulmonary and mediastinal lymph node involvement is most common, but the skin, eyes, liver, spleen, and salivary glands may also be affected. Salivary gland involvement is rare (<6%) and isolated unilateral presentation is even more exceptional. We describe the case of a 52-year-old Caucasian woman, with no previous medical conditions, who presented with progressive enlargement of the right parotid gland over approximately two months. She reported no systemic or local symptoms (xerostomia, dysphagia, dyspnea, skin lesions). Physical examination revealed an oval mass of approximately 5 cm, with irregular borders, non-tender and poorly mobile, along with enlarged submandibular and cervical lymph nodes (up to 2 cm), mobile and painless (Fig. 1a). Blood tests showed elevated serum ACE levels (124 U/L; normal range 13.3–63.9), mildly elevated ESR (17 mm/h), normal calcium levels, negative Quantiferon test, and normal liver and kidney function. Ultrasound revealed solid, hypoechoic, vascularized lesions (up to 29×15 mm) in the anterior portion of the gland, compatible with pathological lymph nodes (Fig. 1b). MRI confirmed right parotid nodules up to 17 mm with irregular margins, marked diffusion restriction, and minimal central enhancement. Similar lesions were observed in the ipsilateral submandibular and supraclavicular regions (Fig. 1c and 1d). Fine-needle aspiration revealed non-necrotizing granulomas composed of CD68-positive epithelioid histiocytes, multinucleated giant cells, and lymphocytic infiltrate, with no evidence of infection or malignancy. Chest CT excluded mediastinal or pulmonary involvement. The left parotid gland was unaffected. A diagnosis of isolated sarcoidosis of the right parotid gland was therefore made. Treatment was initiated with prednisone 25 mg/day for 14 days, followed by gradual tapering. After two month…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Sarcoidosis
  topic: keywords
subject: parotid gland
  topic: keywords
subject: Non-caseous granulomas
  topic: keywords
subject: Irene Carlino
  topic: disciplines
subject: Giorgio Carlino
  topic: disciplines
subject: Silvia Lombardo
  topic: disciplines
subject: Luigi Gennari
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2147

PO:10:154 | Pudendal nevralgia as an unusual presenting symptom of axial spondyloarthritis
type: item
description: Background. The aim of the present study was to describe a case of axial spondyloarthritis (axSpA) presenting unusually with symptoms of pudendal neuralgia. Case report: S.F., woman, 32 years old. In October 2024, four months after surgical removal of epidermoid cysts complicated by phlegmon in the genito-inguinal region, the patient developed burning and paresthetic pain localized in the inguinal and ischial areas, which later radiated to the genital region, lower buttocks, thighs, and transiently to the legs. Pelvic pain progressively worsened, extending to the perineal and anal regions and severely impaired the ability to maintain a seated position. An electromyography of the lower limbs prescribed by the general practitioner resulted negative. In December 2024, the patient underwent a rheumatologic consultation at our center and a neurology consultation was requested, in addition to routine blood tests. The neurologist, recommended a pelvic magnetic resonance (MRI), suspecting pudendal neuralgia due to possible post-surgical neurogenic injury. MRI findings included: bilateral active sacroiliitis (Figure 1); enthesitis at the insertion sites of tendinous and ligamentous structures at the level of the ischial tuberosity and antero-inferior portion of the pubic symphysis; edema in the adipose tissue underlying the ischiopubic rami and urogenital triangle. No signs of pudendal nerve lesions or space-occupying masses were detected. Laboratory tests revealed: ESR: 60 mm/h; CRP: 1.1 mg/dL; negative rheumatoid factor and anti-citrullinated peptide antibodies. The Schober test was measured at 4 cm. The BASDAI score was 7.6. HLA typing revealed the presence of B35-44 loci. An axSpA diagnosis was made, in accordance with the 2009 ASAS classification criteria, and treatment with adalimumab was initiated. Discussion: Although it is possible that pudendal neuralgia may be part of the symptomatology of axSpA in more advanced stages — due to calcification of the sacrotuberous a…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: spondyloarthritis
  topic: keywords
subject: Pudendal neuralgia
  topic: keywords
subject: magnetic resonance
  topic: keywords
subject: Benedetta Bongiovanni
  topic: disciplines
subject: Gabriele Amati
  topic: disciplines
subject: Gilda Sandri
  topic: disciplines
subject: Giovanni Ciancio
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2148

PO:10:155 | Etanercept-induced lupus in a patient with rheumatoid arthritis: diagnostic challenges and multidisciplinary therapeutic approach
type: item
description: Background. To present a case of anti-TNFα drug-induced lupus (DIL) in a patient with rheumatoid arthritis (RA) and progressive respiratory complications. Materials and Methods: Review of clinical records and multidisciplinary follow-up. Results: A 60-year-old female smoker with a history of GERD, bronchial asthma, and OSAS was diagnosed with RA in 2022 due to polyarthritis (ANA 1:320, low-titer RF, negative ACPA). After failure of methotrexate, abatacept and tocilizumab, etanercept was initiated. In April 2024, purpuric lesions appeared on the upper back and chest, associated with resting dyspnea and a right-sided pleural effusion on chest X-ray, initially treated as parapneumonic. In May 2024, the patient was hospitalized for a widespread maculopapular rash and active arthritis (SDAI 39.3). Laboratory tests showed elevated ESR and CRP, ANA 1:1280, positive anti-dsDNA, anti-histone, and anti-nucleosome antibodies. ENA, ANCA and antiphospholipid antibodies were negative. Skin biopsy was consistent with a drug-induced toxic-allergic rash. Chest CT revealed post-inflammatory bibasal atelectasis. A diagnosis of etanercept-induced DIL was made based on clinical and serological criteria. The biologic was discontinued and steroid therapy, azithromycin, and antihistamines were started, with subsequent cutaneous improvement. However, dyspnea persisted with bilateral pleural effusion and severe mixed ventilatory syndrome requiring nocturnal CPAP. In September 2024, due to anti-dsDNA normalization and ongoing arthritis (with previous methotrexate failure), filgotinib 200 mg/day was started, achieving good cutaneous and joint response (SDAI 12.1 at 3 months). In December 2024, the patient was rehospitalized for acute type I respiratory failure due to worsening bilateral pleural effusion, treated with oxygen therapy, nebulization bronchodilator therapy and levofloxacin. In March 2025, due to residual debilitating dyspnea, medical cannabis was initiated. Discussion. Anti-TNFα DI…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Drug-induced Lupus
  topic: keywords
subject: Anti-TNF agents
  topic: keywords
subject: Rheumatoid arthritis
  topic: keywords
subject: Camilla Riboldi
  topic: disciplines
subject: Claudia Iannone
  topic: disciplines
subject: Maria Gerosa
  topic: disciplines
subject: Roberto Felice Caporali
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2149

PO:10:157 | Sjögren’s syndrome with cryoglobulinemia associated with POEMS syndrome
type: item
description: Background. We report the clinical case of a patient affected by Sjögren’s syndrome (SS) and cryoglobulinemic purpura presenting with a progressive sensorimotor polyneuropathy. Materials and Methods. A retrospective analysis was conducted in a patient with progressive sensorimotor polyneuropathy and diagnosis of Sjögren’s Syndrome. Laboratory investigations revealed the presence of cryoglobulins and an IgG-lambda monoclonal gammopathy of undetermined significance (MGUS). Results. The patient, diagnosed with Sjögren’s Syndrome characterized by sicca symptoms, multiple lymphadenopathies, recurrent swelling of the submandibular and parotid glands, and positivity for anti-SSA/Ro, rheumatoid factor (IgM), and IgG-lambda MGUS, developed acute painful paresthesias and lower limb weakness in March 2025. Physical examination revealed bilateral ascending purpura up to the knees, associated with sensorimotor deficits and pitting edema of the lower limbs. Electromyography demonstrated a sensorimotor axonal polyneuropathy with marked distal muscle denervation. Laboratory tests confirmed the presence of cryoglobulins (cryocrit 8%), low C4 complement levels, positive rheumatoid factor (IgM), and an IgG-lambda monoclonal component of undetermined significance. Given the suspicion of POEMS syndrome, serum VEGF (vascular endothelial growth factor) levels were measured and found to be elevated. Additional endocrinological tests showed reduced testosterone levels and hyperprolactinemia. Bone marrow biopsy excluded progression to multiple myeloma. The coexistence of polyneuropathy, MGUS, endocrinopathy, elevated VEGF, and lower-limb edema supported the diagnosis of POEMS syndrome. Rituximab therapy was initiated, resulting in marked clinical improvement, with resolution of both the Sjögren’s syndrome related cryoglobulinemia and the POEMS associated manifestations, including regression of polyneuropathy and normalization of endocrine abnormalities. Conclusions. This case suggests that S…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Poems syndrome
  topic: keywords
subject: Sjgren's syndrome
  topic: keywords
subject: neuropathy
  topic: keywords
subject: Andrea Mazzon
  topic: disciplines
subject: Elena Bianchi
  topic: disciplines
subject: Virginia Berlengiero
  topic: disciplines
subject: Luca Cantarini
  topic: disciplines
subject: Enrico Selvi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2150

PO:11:158 | Osteomyelitis of the jaw: a rare mimick of giant cell arteritis
type: item
description: Background. Osteomyelitis of the jaw is a complication of odontogenic infections, primarily involving the dentate portion of the mandible. Osteomyelitis of the mandibular condyle is exceptionally rare, and spread may occur via hematogenous or contiguous routes (1). We here present a case of osteomyelitis of the mandibular condyle initially diagnosed as Horton's arteritis. Case report. An 87-year-old woman with a recent diagnosis of giant cell arteritis underwent rheumatological evaluation (Figure 1). The patient had been complaining for 1 year of non-NSAIDs-responsive headache in the temporal and preauricular regions and jaw claudication. A few months earlier the headache onset, she underwent a tooth extraction with the positioning of a mobile prosthesis. The patient reported that she was first evaluated by a neurologist who, considering the elevation of inflammatory lab tests (CRP 2.8 mg/dL), diagnosed Horton's arteritis and started prednisone 50 mg/day, with remission of the symptoms, but relapse at steroids tapering. At the first rheumatological evaluation, the patient reported pain in the right temporal region, greater at night, with a sense of ear fullness, hyporexia, and weight loss. In laboratory tests conducted under a low-dose steroids regimen (prednisone 7.5 mg/day), a modest increase in inflammation (CRP 1.5 mg/dL) was observed. For a better diagnostic review, the steroids were discontinued, and the patient underwent a temporal artery Doppler ultrasound, which detected no arteritis-compatible abnormalities. Given the worsening of pain, the rise in inflammation (CRP 4 mg/dL) and the swelling of the soft tissues upon discontinuation of the steroids, the patient underwent an 18FDG-PET/CT scan, which excluded vascular uptake but demonstrated intense uptake of the mandibular condyle, pterygoid muscle, and zygomatic bone. She also underwent a contrast-enhanced CT scan, which revealed erosions and periosteal reaction in the jaw, suggestive of osteomyelitis, alon…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Horton's arteritis
  topic: keywords
subject: OSTEOMYELITIS
  topic: keywords
subject: GIANT CELL ARTERITIS
  topic: keywords
subject: Laura Gigante
  topic: disciplines
subject: Giovanni B. Canestrari
  topic: disciplines
subject: Olga Addimanda
  topic: disciplines
subject: Francesca Bergossi
  topic: disciplines
subject: Angela Buffa
  topic: disciplines
subject: Francesco Cianci
  topic: disciplines
subject: Daniela Chiarini
  topic: disciplines
subject: Niccolò Girolimetto
  topic: disciplines
subject: Daniele Lini
  topic: disciplines
subject: Luca Magnani
  topic: disciplines
subject: Mirco Magnani
  topic: disciplines
subject: Erika Meleddu
  topic: disciplines
subject: Francesca Pignataro
  topic: disciplines
subject: Sofia Testoni
  topic: disciplines
subject: Alarico Ariani
  topic: disciplines
subject: Rita Mulè
  topic: disciplines
subject: Elisa Rossi
  topic: disciplines
subject: Enrica Vandelli
  topic: disciplines
subject: Gentiana Vukatana
  topic: disciplines
subject: Antonella Gamberini
  topic: disciplines
subject: Massimo Reta
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2151

PO:11:162 | DRESS syndrome: a case treated with mepolizumab
type: item
description: Background. DRESS syndrome is a serious delayed drug hypersensitivity reaction and it’s a medical emergency that requires rapid recognition and treatment. Symptoms do not always occur immediately after drug administration, and this latency can make diagnosis difficult and delay identification of the causative drug. Corticosteroids are the first-line therapy. Endovenous immuniglobulines can be used in combination with corticosteroids, and cyclosporine is considered a second-line therapy for patients unresponsive to steroids. Biologics, such as anti-IL-5 agents, should be considered in refractory cases. Materials and Methods. Retrospective data collection from the medical records. Results. A 50-year-old Caucasian patient was admitted on June 26th 2024, for pleuropericarditis, fever, and skin rash. He underwent treatment with indomethacin and colchicine, with initial benefit. On July 7th, dyspnea on exertion, increased pleural effusion, and worsening skin rash occurred, so oxygen therapy and antihistaminic treatment were started. Subsequently, pitting edema was observed in all four limbs, and the first evidence of hypereosinophilia (>13,000/mm3) was detected at the blood test on July 8th. Indomethacin and colchicine were discontinued due to suspected adverse reactions. In the suspicion of EGPA (eosinophilic granulomatosis with polyagitiis) the following were requested: skin biopsy (eosinophilic infiltrate without signs of vasculitis ENT, pulmonary, hematological (excluding organ involvements), and nephrological evaluations (no signs of glomerular disease). In the meantime, therapy with methylprednisolone 60 mg/day was started with subsequent reduction of the eosinophil count and stabilization of the pulmonary involvement, but worsening of renal function (creatinine 4.7 mg/dl), reduction of the platelet count (26,000/mm3), haptoglobin consumption, increased transaminases, reduction of C3 and C4, negativity of ANCA (Antineutrophil Cytoplasmatic Antibodies) PR3 (proteinas…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: DRESS
  topic: keywords
subject: MEPOLIZUMAB
  topic: keywords
subject: hypereosinophilia
  topic: keywords
subject: Alessandro Belotti Masserini
  topic: disciplines
subject: Stefania Bertocchi
  topic: disciplines
subject: Eleonora Bruschi
  topic: disciplines
subject: Silvia Breda
  topic: disciplines
subject: Valeria Rossi
  topic: disciplines
subject: Elide Lupi
  topic: disciplines
subject: Tania Ubiali
  topic: disciplines
subject: Fabrizio Angeli
  topic: disciplines
subject: Massimiliano Limonta
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2152

PO:11:167 | Subtle symptoms masking a challenging diagnosis: a clinical case of intestinal vasculitis in systemic lupus erythematosus
type: item
description: Background. Lupus enteritis is a rare but potentially life-threatening manifestation of systemic lupus erythematosus (SLE). This report highlights the importance of early diagnosis and prompt treatment, by describing a case of SLE complicated by intestinal involvement, initially presenting with nonspecific symptoms. Materials and Methods. A 59-year-old woman with Sjögren’s syndrome (diagnosed in 2021), intolerant to disease modifying antirheumatic drugs (DMARDs) and with urticarial–angioedema reactions to NSAIDs, paracetamol, antibiotics and glucocorticoids (GCs), was first admitted in November 2024 to the Internal Medicine Unit for abdominal pain, diarrhea, vomiting and fever. Contrast-enhanced abdominal computed tomography (ceCT) revealed a right common iliac artery dissection and a penetrating aortic ulcer. In the absence of surgical indication, she was discharged with a diagnosis of viral gastroenteritis and started empirical antibiotics and anti-platelets. Due to persistent fever, periorbital edema and hypocomplementemia, she was transferred to our Rheumatology Unit. On admission, she had fever, purpura on the lower limbs, diffuse alopecia and erythematous–pomphoid lesions on the chest and trunk. Laboratory tests showed hemoglobin 9.2 g/dL, CRP 14 mg/L (normal values <5), ESR 49 mm/h, ANA 1:640 (granular pattern), anti-SSA/SSB positive, anti-dsDNA negative, direct Coombs test positive, C3 45 mg/dL (nv<90), C4 4 mg/dL (nv<12), hypergammaglobulinemia (27.2%). During hospitalization, she developed recurrent urticaria–angioedema episodes unrelated to drug exposure: allergologic evaluation suggested Urticaria–Angioedema Syndrome (normal C1q inhibitor). She was diagnosed with “SLE and Urticaria–Angioedema Syndrome” (SLEDAI=15, Physician Global Assessment [PGA]=1.5), and treated with GCs pulses, azathioprine and omalizumab. In January 2025, she was readmitted for palatal petechiae, urticarial lesions on face and trunk, periorbital edema and palpable purpura on the low…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: lupus enteritis
  topic: keywords
subject: abdominal pain
  topic: keywords
subject: early diagnosis
  topic: keywords
subject: Ilaria Pace
  topic: disciplines
subject: Giulia Rizzo
  topic: disciplines
subject: Elisabetta Chessa
  topic: disciplines
subject: Davide Corradini
  topic: disciplines
subject: Roberta Origa
  topic: disciplines
subject: Valentina Ibba
  topic: disciplines
subject: Alberto Floris
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2153

PO:11:171 | Subcutaneous tocilizumab use in a young-onset mixed connective tissue disease patient with multiple treatment failures
type: item
description: Background. Mixed Connective Tissue Disease (MCTD) is a systemic autoimmune disorder characterized by the presence of anti-U1 ribonucleoprotein (U1-RNP) antibodies associated with clinical features commonly observed in systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis (RA), and polymyositis/dermatomyositis. The pediatric-onset form of the disease is among the rarest entities in pediatric rheumatology. Case Report. We present the case of a 21-year-old Pakistani woman diagnosed with MCTD at the age of 11 (2015), with onset characterized by Raynaud’s phenomenon (scleroderma capillaroscopic pattern), polyarthritis, and recurrent parotitis. Laboratory findings showed ANA 1:640 speckled pattern, anti-U1-RNP 643 U/mL, rheumatoid factor (RF) 1750 IU/mL, and elevated ESR and CRP. She was treated in the pediatric setting with oral corticosteroids, hydroxychloroquine (HCQ) 300 mg/day, and methotrexate (MTX) up to 20 mg/week. In 2021, due to partial disease control, mycophenolate mofetil (MMF) 1.5 g/day was added, achieving a good response. At age 18 (2022), upon transfer to our care, she presented with active arthritis and elevated inflammatory markers. Instrumental assessment ruled out cardiac and pulmonary involvement. In December 2022, arthritis of the hands and wrists persisted, with ESR 120 mm/h and CRP 2.3 mg/dL (normal <1 mg/dL). Prednisone (PDN) was increased up to 12.5 mg/day and MMF to 2 g/day (in combination with MTX 20 mg/week and HCQ 300 mg/day). Throughout 2023, she experienced recurrent episodes of painful left parotid swelling without fever (ESR 120, CRP 4.5 mg/dL), which responded to tapered corticosteroid therapy (PDN 25 mg/day). In early 2024, she developed progressive fatigue, worsening arthritis of hands and feet, bilateral parotid swelling, and persistently elevated inflammatory markers. MTX was replaced with azathioprine for approximately four months, without clinical improvement (MMF 2 g + HCQ 200 mg + PDN 15 mg/day). In April 2024,…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: mixed connective tissue disease
  topic: keywords
subject: treatment
  topic: keywords
subject: Tocilizumab
  topic: keywords
subject: Rhaysa Araujo Mousinho
  topic: disciplines
subject: Elide Lupi
  topic: disciplines
subject: Massimiliano Limonta
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2154

PO:11:172 | Not all vasculitis look the same: a difficult diagnosis
type: item
description: Background. Vasculitides represent a heterogeneous group of systemic inflammatory diseases, often difficult to classify and requiring multidisciplinary management. Case Report. We present the case of a 68-year-old woman with a thoracic aortic aneurysm and a history of recurrent episodes of pneumonia with pleuritis. Since March 2024, she reported worsening pruritus (with a history of contact dermatitis) and alopecia. Starting in October, low-grade fever (T max 38°C), exertional dyspnea, and weight loss appeared. Chest CT scan showed bronchiolar wall thickening with fibrotic-disventilatory strands and an aortic aneurysm (53–55 mm). Admitted to cardiac surgery, on 14/03/2025, she underwent replacement of the ascending aorta with a Dacron valved conduit and aortic valve repair/plasty. Histological examination documented a marked lymphomonocytic infiltrate with tertiary germinal centers in the intima, involvement of the vasa vasorum, mucinoid degeneration, neoangiogenesis of the tunica media, and adventitial thickening with hyalinosis, consistent with giant cell aortitis , even in the absence of granulomas and macrophages and skip lesions. From May 5 to 23, she was admitted to our Rheumatology department for diagnostic work-up. Color Doppler ultrasound of the carotid and vertebral arteries, temporal arteries, renal arteries, and aortic axis was normal. FDG-PET scan showed vascular uptake solely in the ascending aorta, and multiple pulmonary accumulations (right lower lobe, parascissural regions, apices, hilar/paratracheal lymph nodes). HRCT revealed vague peribronchial consolidations suggestive of inflammation. Serology was negative for active infections (Quantiferon, EBV, CMV, HIV, Toxoplasma, Treponema pallidum); ANCA, ENA, RF, IgG4, anti-DNA, and liver autoantibodies were negative. ACPA was weakly positive; Lupus Anticoagulant (LAC) and IgG anticardiolipin antibodies were positive, leading to the initiation of anticoagulation therapy with warfarin (INR target 2.5). ES…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: gigantocellular aortitis
  topic: keywords
subject: SLE
  topic: keywords
subject: pneumonia
  topic: keywords
subject: Marta Arese
  topic: disciplines
subject: Miriam Perino
  topic: disciplines
subject: Sofia Aliprandi
  topic: disciplines
subject: Antonella Murgo
  topic: disciplines
subject: Maria Gerosa
  topic: disciplines
subject: Roberto Felice Caporali
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2155

PO:11:175 | Dermatomyositis and immunosuppressant treatment: a case of Staphylococcus aureus pneumonia in a hospitalized patient
type: item
description: Background. Dermatomyositis (DM) is an autoimmune connective tissue disorder characterized by cutaneous manifestations and muscular involvement. Staphylococcus aureus nosocomial pneumonia is an infection with a high mortality rate, typically characterized by lower respiratory tract symptoms, pulmonary infiltrates on chest X-ray, and at least one positive blood culture in the absence of other sources of bacteremia. Clinical case. At the time of admission, the 49-year-old male patient exhibited a heliotrope rash on the face and 'V' of the neck, shawl sign, and Gottron's papules (Figure 1.d). He also experienced progressive proximal muscle weakness affecting the shoulder and pelvic girdles, along with new-onset dysphagia (Dysphagia Risk Assessment Scale [DRAS]: 10), confirmed by fibrolaryngoscopy exam. Autoimmunological workup revealed positive antinuclear antibodies (ANA) at a titer of 1/640 and positive anti-fibrillarin autoantibodies. Thigh MRI showed diffuse inflammatory oedema of the pelvic girdle muscles (Figure 1.c). Inflammatory markers were within normal limits, while creatine phosphokinase (CPK) was 579 U/L, aspartate aminotransferase (AST) was 73 U/L, and alanine aminotransferase (ALT) was 66 U/L. On these bases, a diagnosis of DM was established. Treatment was initiated with Methotrexate (MTX) 15 mg/week and Methylprednisolone (MPDN) 1 mg/kg. This regimen led to an improvement in the cutaneous manifestations and partial remission of asthenia, though dysphagia persisted. Consequently, off-label intravenous immunoglobulin (IVIG) at 2 g/kg was requested. Concurrently, approximately two weeks into MTX + MPDN treatment and prior to the first IVIG administration, the patient developed productive cough, general clinical deterioration, episodes of pyrexia (max 38.5°C), and a painful oedematous-pustular lesion on the right hand at a venous access site. Concomitantly, inflammatory markers rose (C-reactive protein [CRP] 77 mg/L, procalcitonin [PCT] 0.19 ng/mL), and bl…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Dermatomyositis
  topic: keywords
subject: Staphylococcus aureus
  topic: keywords
subject: Pneumonia
  topic: keywords
subject: Simona Fichera
  topic: disciplines
subject: Andrea Cito
  topic: disciplines
subject: Martina Vigilia
  topic: disciplines
subject: Maria Morrone
  topic: disciplines
subject: Teresa Caferri
  topic: disciplines
subject: Crescenzio Scioscia
  topic: disciplines
subject: Simone Perniola
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2027

PO:12:178 | Don't count your chickens before they hatch! Analysis of cardiovascular definitions in studies on rheumatic diseases: a systematic literature review
type: item
description: Background. Interest in defining the cardiovascular (CV) burden of rheumatologic diseases has progressively increased. The focus has been on rheumatoid arthritis (RA), but an increased CV risk has also been recognized in connective tissue diseases (CTD). FDA provided a definition of major cardiac adverse event (MACE), and WHO states a definition of cardiovascular diseases (CVD). Nonetheless, there is a considerable variability regarding the denotation of CV outcomes and exposures among both observational studies and clinical trials (RCT). This leads to a lack of reproducibility that hinders future research and possible interventions. The primary aim of this review is to investigate the variability of CV definitions in the scientific literature on CTD and RA. Secondary aims are to compare the use of FDA MACE definition according to study design, pharmacological intervention, and diseases evaluated. Methods. A systematic search from PubMed, Embase and Cochrane Central Library was performed from January 2008 to 22 May 2025. Literature screening and data extraction were independently performed by two researchers. The research included papers on Systemic Lupus Erythematosus, primary Antiphospholipid Syndrome, Systemic Sclerosis, Sjogren Syndrome and RA. We divided CV definitions into categories: “MACE”, “CVD”, “other MACE definition” or “other CVD definition” if the authors referred to the composite endpoint as MACE or CVD without it matching the original standard definitions. When CV definitions did not fit into the above categories, they were referred to as “other CV events”. We reported studies where an instrumental tool was employed as CV outcome, or the CV definition was not provided. Results. From an initial pool of 7644 articles, 549 were included in the final evaluation (Fig. 1). FDA MACE and WHO CVD definitions were employed respectively in 49 and 27 articles (Table 1). 38 articles fell under the “other MACE definition” category, 31 studies under “other CVD defi…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: connective tissue diseases
  topic: keywords
subject: Serious adverse cardiac event
  topic: keywords
subject: Systematic review
  topic: keywords
subject: Laura Pezzoni
  topic: disciplines
subject: Silvia Sirotti
  topic: disciplines
subject: Georgios Filippou
  topic: disciplines
subject: Piercarlo Sarzi Puttini
  topic: disciplines
subject: Greta Pellegrino
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2028

PO:12:180 | Echocardiographic screening of pulmonary hypertension in a multidisciplinary cohort of patients with interstitial lung disease
type: item
description: Background. Pulmonary hypertension (PH) may complicate parenchymal lung diseases, and current international guidelines recommend echocardiographic study of patients with suspected PH. Right heart catheterization (RHC) is recommended if hemodynamic results can modify the therapeutic approach. The objective of the study is to verify, by means of echocardiography, the prevalence of PH and/or right ventricular dysfunction in a cohort of patients with ILD (Interstitial Lung Disease) followed in a multidisciplinary pneumo-rheumatological outpatient clinic, and to evaluate any associated clinical, serological, or radiological findings. Materials and Methods. Consecutive patients with ILD attending the multidisciplinary outpatient clinic of a third-level national reference center for lung transplantation, excluding patients with already known PH. All patients underwent a Standard 2-D and Doppler echocardiogram with a Vivid E9 or Vivid E80 machine (GE Medical Systems, Norway); clinical, laboratory, and radiographic data were collected. When required by clinical suspicion or for inclusion in the lung transplant list, RHC was performed, and information was collected. Statistical analysis was conducted using SPSS (IBM for Mac (v13)). Results. 113 patients were included, 66 women and 47 men. The mean age was 67.94 15 15.62 years, and the follow-up was 9.6 (3-13) years. Diagnoses were distributed as follows: 60 (53%) ILD in Systemic Sclerosis (SSc), 19 (17%) with anti-synthetase syndrome (ASSD), 8 (7%) interstitial pneumonia with autoimmune features (IPAF), 4 (3.5%) with rheumatoid arthritis (RA), 22 (19.5%) with idiopathic pulmonary fibrosis (IPF). 53/113 (47%) patients were smokers/ex-smokers, 28 (25%) had chronic respiratory failure requiring oxygen therapy, 35 (31%) desaturated during the six-minute walk test, with a mean distance of $395.8 \pm 87.6$ m, 29 (26%) were taking an antifibrotic agent. Mean respiratory functional parameters were(%) 106,8±19,7, TLC (%) 72,8±21,8, IT…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Interstitiopathy
  topic: keywords
subject: multidisciplinary
  topic: keywords
subject: pulmonary hypertension
  topic: keywords
subject: Lorenzo Mattia Bianchessi
  topic: disciplines
subject: Veronica Piccin
  topic: disciplines
subject: Federica Sabatelli
  topic: disciplines
subject: Lorenzo Cavagna
  topic: disciplines
subject: Giovanni Zanframundo
  topic: disciplines
subject: Domenicafederica Briganti
  topic: disciplines
subject: Mauro Acquaro
  topic: disciplines
subject: Ghio Stefano
  topic: disciplines
subject: Domenico Sorace
  topic: disciplines
subject: Valentina Vertui
  topic: disciplines
subject: Ilaria Giana
  topic: disciplines
subject: Andrea Patanè
  topic: disciplines
subject: Veronica Codullo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2156

PO:12:186 | Clinical, functional, and microvascular features in the early diagnosis and management of pulmonary hypertension in systemic sclerosis: the importance of multimodal screening strategies
type: item
description: Background. Pulmonary hypertension (PH) is one of the most severe and potentially life-threatening complications of systemic sclerosis (SSc), with a major impact on prognosis and patient quality of life. It is often related to microvascular dysfunction and, in some cases, to interstitial lung involvement. Early diagnosis is essential but remains challenging, as initial symptoms are frequently nonspecific and may overlap with other manifestations of the disease. In this context, the use of multimodal screening strategies combining clinical, functional, imaging, and microvascular assessments may significantly improve early identification of patients at risk. Objectives. To assess the prevalence of PH in a cohort of patients with SSc, and to analyze its correlations with pulmonary function parameters, echocardiographic findings, and microvascular abnormalities observed through nailfold videocapillaroscopy. Materials and Methods. We conducted a retrospective analysis of 120 patients with SSc followed at our center. Pulmonary hypertension was defined echocardiographically as a systolic pulmonary artery pressure greater than 30 mmHg. All patients underwent high-resolution computed tomography (HRCT) of the chest, pulmonary function tests, echocardiography, and nailfold videocapillaroscopy. Clinical, serological, and instrumental data were collected and analyzed. Statistical analysis included t tests, chi-square tests, and logistic regression. Results. Twenty-seven percent of patients met criteria for PH. Subjects with PH exhibited a significant reduction in DLCO (mean 47.2 ± 13.3 vs 58.8 ± 11.8; p<0.001), a lower FVC/DLCO ratio, and signs of right ventricular dysfunction (mean TAPSE: 19.5 ± 3.8 mm vs 23.1 ± 3.1 mm; p<0.001). Capillaroscopic findings showed a significantly higher prevalence of the “late” pattern in patients with PH (62% vs 23%; p<0.01), characterized by avascular areas, giant capillaries, and loss of microvascular architecture. sPAP was inversely correlated…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: of systemic sclerosis (SSc)
  topic: keywords
subject: pulmonary hypertension
  topic: keywords
subject: early diagnosis
  topic: keywords
subject: Irene Carlino
  topic: disciplines
subject: Stefania Bisogno
  topic: disciplines
subject: Alberto Palazzuoli
  topic: disciplines
subject: Luigi Gennari
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2157

PO:13:188 | Menstrual alterations among women with rheumatoid arthritis: a comparative study across treatment modalities with focus on JAK inhibitors
type: item
description: Background. Rheumatoid arthritis (RA) often affects women during reproductive age. While the reproductive safety of conventional and biologic DMARDs is well described, evidence regarding Janus kinase inhibitors (JAKi) remains limited. Recent studies on human ovarian sections have demonstrated the expression of the JAK-STAT pathway in granulosa cells, suggesting a possible alteration of menstrual characteristics in women taking JAKi. This study aimed to assess menstrual alterations among women with RA receiving different treatment classes, with particular focus on JAKi. Methods. We conducted a cross-sectional study at rheumatology and gynecology centers using structured questionnaires to evaluate menstrual cycle characteristics before and during therapy. Clinical and treatment data were collected. Menstrual outcomes were compared across treatment groups using chi-square tests. Multivariable logistic regression assessed the association between JAKi use and amenorrhea, adjusting for disease activity (DAS28). Results. A total of 100 women with RA were included. The median age was 34.8 years (IQR 27.0–42.8), BMI 26.0 (IQR 24.0–27.0), and DAS28 score 2.99 (IQR 2.70–3.24) (Table 1). Thirty patients (30.0%) were treated with JAK inhibitors: Upadacitinib (n=17, 56.7%), Filgotinib (n=11, 36.7%), and Baricitinib (n=2, 6.7%) (Figure 1). Amenorrhea during therapy was reported by 10 patients (10.0%). Metrorrhagia was reported by 20 patients (20.0%), and menorrhagia by 14 patients (14.0%). Changes in menstrual frequency were noted in 41 patients (41.0%), including increased frequency in 12 (12.0%) and decreased frequency in 29 (29.0%). There were no statistically significant differences in these outcomes across treatment groups (p > 0.25 for all) (Figure 2). In multivariable analysis adjusting for DAS28, JAKi use was not associated with increased odds of amenorrhea (adjusted OR = 3.05, 95% CI: 0.31–30.37; p = 0.341). Conclusions. In this cross-sectional study of women with RA, tre…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: JAK inhibitors
  topic: keywords
subject: Rheumatoid arthritis
  topic: keywords
subject: Menstrual cycle
  topic: keywords
subject: Angelica Napoletano
  topic: disciplines
subject: Francesca Arezzo
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Gennaro Cormio
  topic: disciplines
subject: Vincenzo Venerito
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2029

PO:13:189 | Greater impact of psoriatic arthritis in females: is this mediated primarily by disease activity?
type: item
description: Background. Sex-related differences have been observed in psoriatic arthritis (PsA), with women often reporting a higher disease burden. Previous studies suggest that female patients experience more pain, fatigue, and reduced quality of life. However, it remains unclear whether this increased disease impact is primarily mediated by disease activity. Objective To evaluate whether the higher disease impact (measured by PSAID) observed in female patients with PsA is mediated by disease activity (measured by DAPSA). Methods. A cross-sectional study was conducted on consecutive patients who met CASPAR criteria for PsA. Demographic, clinical, and lifestyle information was collected, including socio-economic characteristics and comorbidities (with a focus on fibromyalgia). Disease activity was assessed using the Disease Activity index for Psoriatic Arthritis (DAPSA), and disease impact was measured using the Psoriatic Arthritis Impact of Disease (PSAID) questionnaire. Comparisons between males and females were performed using Mann-Whitney U or Chi-square tests. Mediation analysis was conducted following the Baron and Kenny approach, testing the significance of each association across three linear regression models: (1) total effect of sex on PSAID; (2) effect of sex on DAPSA; and (3) effect of DAPSA on PSAID adjusted for sex (Figure). All models were adjusted for age, BMI, comorbidity index (RDCI), and fibromyalgia. Results were expressed as beta (95% confidence interval). Results. A total of 136 PsA patients were included (54% female; mean age 58.9±12.0 years). The characteristics of female and male patients are displayed in Table. No major differences in disease manifestations were observed between sexes. Fybromialgia was more frequent in males. Females consistently reported higher scores in patient-reported outcomes, including DAPSA components related to pain and global disease activity, and across all PSAID items. In multivariable analysis, all associations required fo…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Psoriatic Arthritis
  topic: keywords
subject: DAPSA
  topic: keywords
subject: PSAID
  topic: keywords
subject: Roberta Masnata
  topic: disciplines
subject: Valentina Boni
  topic: disciplines
subject: Giusy Peluso
  topic: disciplines
subject: Giulia Calabrese
  topic: disciplines
subject: Enrico De Lorenzis
  topic: disciplines
subject: Gerlando Natalello
  topic: disciplines
subject: Maria Antonietta D'Agostino
  topic: disciplines
subject: Augusta Ortolan
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2030

PO:14:195 | Real-world effectiveness of anifrolumab in achieving treatment targets and reducing systemic lupus erythematosus disease burden: 6-month interim analysis of the REVEAL study
type: item
description: Background. Following the recent approval of anifrolumab (ANI) for the treatment of moderate-to-severe Systemic Lupus Erythematosus (SLE), real-world data remain limited beyond those from clinical trials. Real-world eVidencE of Anifrolumab in systemic Lupus erythematosus (REVEAL) is a 5-years, multicenter, prospective, observational study designed to collect real-life data on ANI use, which are currently scarce especially from the patient’s perspective. This analysis evaluates the effectiveness of ANI in routine clinical practice and its impact on disease burden and patients’ quality of life (QoL). Materials and Methods. Adult SLE patients (2019 EULAR/ACR criteria) were enrolled at ANI prescription across referral Italian centers. Data on demographics, clinical history, prior treatments and organ damage (SLICC-DI) were retrospectively collected from medical charts at enrolment. Patients were evaluated at baseline and after 1, 3 and 6 months of ANI treatment, assessing disease activity (SLEDAI-2K, SLE-DAS, Physician Global Assessment (PhGA), CLASI, joint count), concomitant therapies, and QoL through Patient Reported Outcomes (PROs, including Patient Global Assessment (PtGA), Lupus Impact Tracker (LIT) and FACIT-F). Achievement of remission (DORIS criteria) or low disease activity state (LLDAS5, modified from Franklin) at 3 and 6 months was assessed. Results. We included 236 patients (92.8% female, 92.4% Caucasian) from 25 centers. ANI was most frequently prescribed for mucocutaneous (66.5%) and articular involvement (49.2%), followed by haematological manifestations (22.5%, mainly leukopenia (36/236, 15.3%) and thrombocytopenia (25/236, 10.6%)). Thirteen patients (5.5%) had fever attributable to SLE per SLEDAI-2K. Table1 depicts detailed baseline characteristics of the cohort. Notably, in 100 patients (42.4%) ANI was the first biologic and 20 (8.5%) were naïve to immunosuppressants; 38 patients (16.1%) started ANI within 2 yrs of SLE diagnosis. In 18 cases (7.6%) AN…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Systemic Lupus Erythematosus
  topic: keywords
subject: Anifrolumab
  topic: keywords
subject: Real-world evidence
  topic: keywords
subject: Chiara Cardelli
  topic: disciplines
subject: Chiara Tani
  topic: disciplines
subject: Luca Moroni
  topic: disciplines
subject: Filippo Vesentini
  topic: disciplines
subject: Francesca Bottazzi
  topic: disciplines
subject: Micaela Fredi
  topic: disciplines
subject: Ettore Silvagni
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
subject: Flavia Riccio
  topic: disciplines
subject: Fulvia Ceccarelli
  topic: disciplines
subject: Ginevra De Marchi
  topic: disciplines
subject: Edoardo Biancalana
  topic: disciplines
subject: Gianluca Moroncini
  topic: disciplines
subject: Rita Mulè
  topic: disciplines
subject: Mariele Gatto
  topic: disciplines
subject: Laura Coladonato
  topic: disciplines
subject: Paola Conigliaro
  topic: disciplines
subject: Maria Gerosa
  topic: disciplines
subject: Andrea Picchianti Diamanti
  topic: disciplines
subject: Benedetta Bianchi
  topic: disciplines
subject: Federica Maiolini
  topic: disciplines
subject: Michela Gasparotto
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Maria Ilenia De Andres
  topic: disciplines
subject: Alberto Lo Gullo
  topic: disciplines
subject: Silvia Noviello
  topic: disciplines
subject: On Behalf Of The Reveal Investigators
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2031

https://www.reumatismo.org/reuma/article/view/2158
type: item
title: PO:14:197 | Safety of biologic and conventional immunosuppressants in an Italian cohort of patients with systemic lupus erythematosus: a longitudinal analysis from the Lupus Italian Registry pharmacoepidemiologic study promoted by the Italian Society of Rheumatology
description: Background. The safety of biologic immunosuppressants in systemic lupus erythematosus (SLE) has been demonstrated in several interventional studies. However, estimates from unselected, real-world clinical populations remain scarce. This study aims to assess the safety of biologic immunosuppressants used as monotherapy (MONO-BIS) or in combination (COMB-BIS), compared to the exclusive use of non-biologic immunosuppressants (NBIS), in patients with SLE starting a new immunosuppressive treatment. Materials and Methods. LIRE is a prospective, multicentre, pharmacoepidemiologic observational study promoted by the Italian Society of Rheumatology (SIR) (full list of investigators: https://redcap.reumatologia.it/surveys/?s=LWL7WJM4KHDR97CC). SLE patients who started a new immunosuppressive therapy between 2015 and 2022 were followed every six months for up to 5 years. Adverse events (AEs) were classified according to CTCAE v4.0 criteria and categorized as serious adverse events (SAEs), infections (INF), adverse events of special interest (AESI: infections, neoplasms, cardiovascular events), hospitalizations (HOSP), and deaths (DEA). Incidence rates and relative risks of AEs were estimated using weighted Cox models adjusted for baseline treatment indication. In addition to demographic factors, estimates were adjusted for anti-DNA antibody positivity, organ involvement (SLEDAI and/or BILAG), disease damage (SLICC-DI), disease activity (SLEDAI-2K), concomitant hydroxychloroquine use, and cumulative steroid dose (>10 g). Results. Among the 338 included patients (87% women), 179 started NBIS, 55 MONO-BIS, and 104 COMB-BIS therapy. Belimumab (39%), rituximab (7%), mycophenolate (31%), and methotrexate (21%) were the most frequently used immunosuppressants. Infections were more frequent among BIS users (40%) compared to NBIS (18%), with higher rates in COMB-BIS (42%) than in MONO-BIS (35%). The COMB-BIS group had a higher prevalence of lupus nephritis (46%), higher cumulative cort…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Biological immunosuppressants
  topic: keywords
subject: safety
  topic: keywords
subject: Lupus Italian REgistry (LIRE)
  topic: keywords
subject: Davide Rozza
  topic: disciplines
subject: Carlo Alberto Scirè
  topic: disciplines
subject: Paola Conigliaro
  topic: disciplines
subject: Giacomo Emmi
  topic: disciplines
subject: Laura Coladonato
  topic: disciplines
subject: Salvatore Scarpato
  topic: disciplines
subject: Luca Iaccarino
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Giulia Pazzola
  topic: disciplines
subject: Francesca Romana Spinelli
  topic: disciplines
subject: Micol Frassi
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
subject: Chiara Scirocco
  topic: disciplines
subject: Valeria Orefice
  topic: disciplines
subject: Immacolata Prevete
  topic: disciplines
subject: Alessandra Bortoluzzi
  topic: disciplines
subject: Marcello Govoni
  topic: disciplines
subject: Elena Bartoloni
  topic: disciplines
subject: Luca Moroni
  topic: disciplines
subject: Giuseppe Alvise Ramirez
  topic: disciplines
subject: Valentina Canti
  topic: disciplines
subject: Giorgio Pettiti
  topic: disciplines
subject: Maria Chiara Ditto
  topic: disciplines
subject: Enrico Fusaro
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
subject: Lorenzo Cavagna
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
subject: Gian Domenico Sebastiani
  topic: disciplines
subject: Sperimentatori Gruppo Lire
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2158

PO:14:202 | Use of anifrolumab in the treatment of the hematological manifestations of systemic lupus erythematosus: a single-centre case series
type: item
description: Background. The efficacy of anifrolumab has been documented in several studies (1,2), however data regarding its use in the haematological domain of SLE remain limited (3). The aim of this case series is to describe a single-centre experience with anifrolumab in patients with SLE predominantly affecting the haematological domain, particularly thrombocytopenia and haemolytic anaemia. Materials and Methods. We retrospectively evaluated data from six patients with haematological involvement treated with intravenous anifrolumab at a dosage of 300 mg every four weeks. Assessments were performed at baseline (T0) and after one (T1), three (T3), and six months (T6) of therapy. Changes in complete blood counts and corticosteroid dosages were analysed. Results. Among the six patients, five had thrombocytopenia and one had haemolytic anaemia. All patients were corticosteroid-dependent at baseline. The epidemiological and clinical characteristics of the cohort are detailed in Tables 1 and 2. Four patients with thrombocytopenia received anifrolumab therapy for at least six months. In these cases, an increase in platelet counts was observed, allowing a reduction in corticosteroid therapy — in two cases to a prednisone dose below 5 mg/day, and in one case complete discontinuation was achieved. At the time of reporting, one patient has been treated for three months, showing an improvement in platelet count after the first infusion and a reduction in corticosteroid dosage after the third one (Figure 1). A single patient was treated with anifrolumab for haemolytic anaemia and lymphopenia. At six months after treatment initiation, improvements were observed in lymphocyte counts, haemoglobin levels and haptoglobin values, previously undetectable, allowing a reduction in corticosteroid dosage (Figure 2). No significant adverse events occurred during treatment. In one case, therapy was discontinued after twelve months due to loss of efficacy and diagnosis of colon cancer. In this instanc…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: thrombocytopenia
  topic: keywords
subject: anifrolumab
  topic: keywords
subject: haemoglobin levels
  topic: keywords
subject: Gaia Ferracane
  topic: disciplines
subject: Jessika Dichiara
  topic: disciplines
subject: Elena Manna
  topic: disciplines
subject: Lorenzo Mattia Bianchessi
  topic: disciplines
subject: Giovanni Zanframundo
  topic: disciplines
subject: Serena Bugatti
  topic: disciplines
subject: Veronica Codullo
  topic: disciplines
subject: Lorenzo Cavagna
  topic: disciplines
subject: Francesca Bottazzi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2159

PO:14:203 | Impact of anifrolumab on depressive symptoms in systemic lupus erythematosus: results from a single-centre prospective observational study
type: item
description: Background. Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease characterised by multisystem involvement, where neuropsychiatric manifestations, including depression, are prevalent. Dysregulated activation of the type I interferon (IFN) pathway contributes to SLE pathogenesis and has been implicated in depressive behaviour through mechanisms such as serotonin modulation and neurogenesis inhibition. Anifrolumab, a monoclonal antibody targeting the Type I IFN receptor, is effective in reducing SLE disease activity and glucocorticoid burden. However, its potential impact on depressive symptoms remains underexplored. The aim of this study is to assess the impact of intravenous anifrolumab 300 mg on depressive symptoms in adult patients with moderately to severely active SLE, alongside secondary outcomes evaluating patient-reported quality of life. Materials. This single-centre, prospective, observational study enrolled adult SLE patients meeting 2019 EULAR/ACR classification criteria with autoantibody positivity and active disease (SLEDAI-2K >=6). Participants received 300 mg of anifrolumab intravenously every 4 weeks in combination with standard-of-care (SOC). Depression severity was assessed using Beck’s Depression Inventory (BDI) and Patient Health Questionnaire-9 (PHQ-9) at baseline, 3, 6, and 12 months. Patient-reported outcomes included FACIT score and Lupus Quality of Life (Lupus QoL). Wilcoxon signed-rank test was used to compare with baseline median values of all variables at different timepoints. Cohen’s effect size was calculated to outline clinical impact of treatment. Results. Thirty-two (32) patients have been enrolled. Female sex is predominant (n=25; 78%), with a mean age of 46 (SD ± 14.0) and disease duration of 11 years (SD ± 9). The commonest disease manifestations were cutaneous and musculoskeletal, observed in 93% of the sample. Four patients (14%) had a history neuropsychiatric SLE. A clinically relevant reduction in median BDI and P…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Depression
  topic: keywords
subject: Quality of life
  topic: keywords
subject: Patient-reported outcomes
  topic: keywords
subject: Luca Moroni
  topic: disciplines
subject: Biancamaria Venerandi
  topic: disciplines
subject: Maria Cilona
  topic: disciplines
subject: Anna Vivona
  topic: disciplines
subject: Gabriele Gallina
  topic: disciplines
subject: Giovanni Benanti
  topic: disciplines
subject: Enrica Bozzolo
  topic: disciplines
subject: Giuseppe Ramirez
  topic: disciplines
subject: Marco Matucci-Cerinic
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2032

PO:14:204 | Risk stratification in systemic lupus erythematosus patients: improving the performances of a prediction model
type: item
description: Background. Systemic lupus erythematosus (SLE) has an unpredictable course, with alternating periods of remission and activity. Predicting disease activity in the medium term could allow timely therapeutic adjustments. To support this, a Random Forest machine learning model was developed to predict the likelihood of an activity event within 12 months, using features from the patient’s current contact, previous visit, and overall disease history. Objectives: · To evaluate the performance of the main model; · To analyze characteristics of patients with low prediction reliability; · To demonstrate improved prediction through a cascade model. Methods. The main model generates a predicted probability (PP) of an activity event within 12 months. A threshold of 0.45 was used to classify patients as high (PP > 0.45) or low risk (PP < 0.45). Cases close to the threshold were flagged as uncertain and analyzed further. Reliability boundaries were established based on distributions of true positives and negatives (Figure 1). Patients with uncertain predictions (“weak” cases) were compared to those with strong predictions using Mann-Whitney or Chi-squared tests (Table 1). To improve reliability for weak cases, a decision tree model (cascade model) was developed using a reduced feature set (e.g., demographic and treatment variables not used in the main model). This model provided rule-based predictions for cases where the main model’s predictions lacked confidence. Results. The study included 262 SLE patients with 5,952 recorded contacts from 2012 to 2020. Seventy percent of the data was used for model training and 30% (1,845 contacts) for evaluation. In the test set, 590 contacts were classified as weak predictions, while 1,255 were confidently predicted. Weak cases were associated with older age, male gender, higher serosal, vascular, and cutaneous involvement, greater corticosteroid use, and lower antimalarial use. Use of Rituximab was linked to improved reliability, suggesting…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Machine learning and AI
  topic: keywords
subject: LES
  topic: keywords
subject: Predictive models
  topic: keywords
subject: Lucia Lanzo
  topic: disciplines
subject: Silvia Laura Bosello
  topic: disciplines
subject: Livia Lilli
  topic: disciplines
subject: Laura Antenucci
  topic: disciplines
subject: Carlotta Masciocchi
  topic: disciplines
subject: Marco Gorini
  topic: disciplines
subject: Gabriella Castellino
  topic: disciplines
subject: Luca Petricca
  topic: disciplines
subject: Maria Rita Gigante
  topic: disciplines
subject: Vivianaantonella Pacucci
  topic: disciplines
subject: Pier Giacomo Cerasuolo
  topic: disciplines
subject: Silvia Piunno
  topic: disciplines
subject: Francesco Cristiano
  topic: disciplines
subject: Cesare Gavotti
  topic: disciplines
subject: Pier Luigi Rizzuti
  topic: disciplines
subject: Rebecca Ventura
  topic: disciplines
subject: Jacopo Lenkowicz
  topic: disciplines
subject: Alfredo Cesario
  topic: disciplines
subject: Stefano Patarnello
  topic: disciplines
subject: Maria Antonietta D'Agostino
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2033

PO:14:205 | Primary antiphospholipid antibody syndrome: association between new classification criteria manifestations and a higher-risk disease phenotype
type: item
description: Background. The 2023 ACR/EULAR classification criteria for primary antiphospholipid antibody syndrome (PAPS) included new disease manifestations contributing to the definition of the syndrome. However, their prognostic role and association with clinical and serological features have yet to be well elucidated. Aim of the study was to evaluate prevalence of new criteria manifestations both in a PAPS and in an antiphospholipid antibodies (aPL) carrier cohort. Additionally, we investigated their associations with PAPS clinical and serological characteristics. Methods. We enrolled a cohort of PAPS patients meeting the Sapporo classification criteria. Demographic, clinical and serological data were retrospectively collected, including type of first thrombotic/obstetric event, recurrence, presence of traditional cardiovascular (CV) risk factors (hypertension, dyslipidemia, diabetes, chronic kidney failure), serologic profile, ongoing treatments. The presence of the new manifestations included in the 2023 ACR/EULAR classification criteria was also evaluated. Same parameters were collected from a cohort of aPL carriers. Patients with autoimmune diseases were excluded. Categorical variables were compared using the 2 test, continuous variables were compared using t-test or Mann-Whitney U test. Variables with statistical significance were further tested in a binary logistic regression model. Results. 65 PAPS patients, 41 with thrombotic, 16 with obstetric syndrome, 8 with both, and 66 aPL carrier were enrolled (Table 1). PAPS patients showed significantly higher prevalence of new classification criteria manifestations compared to aPL carriers, as expected. Moreover, PAPS patients had higher prevalence of CV risk factors compared to carriers, but similar aPL serologic profiles. Among the PAPS cohort, 19 patients had at least one New classification Criteria manifestation in their clinical history (NC-PAPS). Particularly, 2 patients had cardiac valve thickening, 9 livedoid vasculo…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: primary APS
  topic: keywords
subject: New classification criteria
  topic: keywords
subject: Arterial thrombosis
  topic: keywords
subject: Sara Ferrigno
  topic: disciplines
subject: Vittorio Forte
  topic: disciplines
subject: Marco Panetta
  topic: disciplines
subject: Sergio Lisena
  topic: disciplines
subject: Giorgia Ranucci
  topic: disciplines
subject: Luigi De Marco
  topic: disciplines
subject: Elisabetta Greco
  topic: disciplines
subject: Alberto Bergamini
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
subject: Paola Conigliaro
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2034

PO:14:206 | Factors impacting subjective cognitive impairment in systemic lupus erythematosus patients: clearing away the lupus brain fog
type: item
description: Background. Systemic lupus erythematosus (SLE) patients (pts) often suffered from an impairment in cognitive functions, but a universal definition of “brain fog” does not exist. The objective of the study was to evaluate the prevalence of subjective impairment and objective mental alterations (depression, cognition, fatigue) adopting screening tools validated in SLE; also we aimed to investigate which factors were associated with brain fog. Methods. A Cross-sectional study was conducted enrolling adult SLE pts. Brain fog referred to the presence of mental alterations (i.e.; memory, concentration, attention...) as reported by SLE participants. To minimize contribution of type B symptoms, we made a subanalysis of brain fog involving pts with active disease, namely lupus fog. Demographic, clinical, therapeutic data were collected (Table). Serum anti-ribosomal P antibodies (anti-RibP) were quantified using ELISA kits. Cognitive deficits were assessed by a neuropsychologist exploring deficits in 8 cognitive domains with a battery of neuropsychological tests and screened using the Montreal Cognitive Assessment (MoCA) test performed by certified personnel (cut-off<26/30). Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale (CES-D) (>15). Fatigue was measured using FACIT-F (<34). Chi-squared test and the Mann-Whitney test were used for univariate analysis (UV-A); multivariate analysis (MV-A) was performed building logistic regression models including variables showing p <0.10. Results. 114 SLE pts were enrolled (Table), 105 female (92.1%), mean age 43.7 years (+-12.2). Brain fog was found in 54% pts, with memory deficit reported in 49.1%, attention in 38.6%, concentration in 10.5% and afasia nominum in 5.3%. CES-D>15 was altered in 53.3%, MoCA<26 in 45% and FACIT<34 in 52.9%. At UV-A, an association emerged between the presence of brain fog and CES-D (Fig1A, score p<0.001), FACIT (Fig1A, score p=0.012), fibromyalgia (p<0.001), the …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Brain fog
  topic: keywords
subject: depression
  topic: keywords
subject: cognitive deficits
  topic: keywords
subject: Elisabetta Chessa
  topic: disciplines
subject: Marta Paola Pireddu
  topic: disciplines
subject: Fabio Congiu
  topic: disciplines
subject: Giulia Rizzo
  topic: disciplines
subject: Cristina Serafini
  topic: disciplines
subject: Elena Ragusa
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2035

PO:14:207 | Nailfold capillaroscopy in systemic lupus erythematosus: microvascular alterations and their clinical relevance
type: item
description: Background. Nailfold videocapillaroscopy (NVC) is a valuable tool for assessing microvascular abnormalities in connective tissue diseases. While well established in systemic sclerosis, its role in systemic lupus erythematosus (SLE) remains less defined. This study aims to systematically analyze capillaroscopic patterns in SLE patients, describe their most frequent features, and compare them with findings observed in individuals with primary Raynaud’s phenomenon (pRP). Methods. We retrospectively analyzed NVC images from 64 SLE patients (mean age 49.5 years) and a matched control group of 70 pRP patients. Parameters assessed included capillary density, giant capillaries, microhemorrhages, neoangiogenesis, ectasias, tortuosity, and capillary loss. Findings were correlated with clinical and serological markers, including organ involvement and autoimmune markers (ANA, ENA, antiphospholipid antibodies). Results. NVC abnormalities were observed in 58 (90.6%) of SLE patients. The most frequent alterations in SLE were tortuosity (76.6%), ectasia (42.2%), microhemorrhages (29.7%), neoangiogenetic features (20.3%), and giant capillaries (10.9%). Compared to pRP patients, SLE patients exhibited a significantly higher prevalence of giant capillaries and angiogenetic features (p = 0.028 and p < 0.001, respectively). An SSc-like pattern was detected in 7.8% of cases, though no direct correlation was found with autoimmunity markers or clinical manifestations. Notably, both neoangiogenetic features and giant capillaries demonstrated a strong positive correlation with interstitial lung disease (ILD) (p = 0.012 and p = 0.021, respectively), highlighting the potential role of capillaroscopic markers in identifying lupus patients at risk for pulmonary involvement. Conclusion. Capillaroscopic alterations serve as key microvascular markers in SLE, providing insights into their prevalence and clinical significance. The strong correlation between neoangiogenesis, giant capillaries, and ILD…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Nailfold Capillaroscopy
  topic: keywords
subject: Systemic lupus erythematosus
  topic: keywords
subject: Interstitial lung disease
  topic: keywords
subject: Giulia Cassone
  topic: disciplines
subject: Filippo Santoro
  topic: disciplines
subject: Maria Grazia Malandra
  topic: disciplines
subject: Bruno Biasi
  topic: disciplines
subject: Elena Vanni
  topic: disciplines
subject: Caterina Vacchi
  topic: disciplines
subject: Alessandra Carobbio
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2036

PO:15:208 | Impact of disease control on organ damage accrual in patients with systemic lupus erythematosus with and extra-renal flares: a 12-month single-center longitudinal study
type: item
description: Background. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by periods of flare and remission, often leading to progressive organ damage. This study aimed to describe damage accrual occurring early after a disease flare in SLE patients and to identify potential predictors. Methods. A 12-month longitudinal study was conducted involving SLE patients who met the 2019 EULAR/ACR criteria and experiencing an extra-renal flare between 2015 and 2024. At study entry, demographic and clinical variables were collected. Disease activity was measured using the Systemic Lupus Erythematosus Disease Activity (SELENA-2K). Active organ involvement was categorized according to the BILAG domains. Disease status was evaluated using the modified Lupus Low Disease Activity State (LLDAS5), defined by a daily prednisolone dose of less than 5 mg, and the Definition of Remission in SLE (DORIS). Organ damage was quantified using the SLICC-DI at baseline (T0) and after 12 months (T12). Results. A total of 98 extra-renal flares were recorded. At T0, the median SLEDAI score was 7 (IQR 4–10). Active manifestations manifestations were: musculoskeletal 79%, mucocutaneos 69 %, hematological 65%, serositic 27%, renal 24%, neuropsychiatric 7%. At T0, 29 patients (29.6%) had pre-existing organ damage, with a median SLICC score of 2 (IQR 1–3); of these, 21 (%) had pre-existing glucocorticoids (GCs)-related damage. At T12, althought the median SLICC score resulted similar to the baseline one (median =2, IQR 1–3), in 39 patients (39.8%) at least one item of organ damage was recorded, indicating de-novo damage development in 10 cases. Moreover, in a total of 15 patients (15.33%) an increase in the SLICC score was recorded (deltaSLICC). In 46,6 (%) of patients who developed new damage at T12, the damage was GCs-related. A comparison of patients with and without organ damage is repoted in table 2. Univariate analysis revealed that the SLEDAI-2K score at flare (OR 1,1, p=0.005)…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Systemic Lupus Erythematosus
  topic: keywords
subject: Organ damage (SLICC-DI)
  topic: keywords
subject: Extrarenal flares of SLE
  topic: keywords
subject: Giorgia Capozzo
  topic: disciplines
subject: Marco Oliva
  topic: disciplines
subject: Giancarlo Cascarano
  topic: disciplines
subject: Chiara Cardelli
  topic: disciplines
subject: Dina Zucchi
  topic: disciplines
subject: Chiara Stagnaro
  topic: disciplines
subject: Viola Signorini
  topic: disciplines
subject: Elena Elefante
  topic: disciplines
subject: Chiara Tani
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2037

https://www.reumatismo.org/reuma/article/view/2160
type: item
title: PO:15:217 | Improved efficacy and safety outcomes in patients with systemic lupus erythematosus treated with belimumab vs. immunosuppressants, in addition to antimalarials and glucocorticoids: a post-hoc summary of five phase 3 trials
description: Background. To assess efficacy and safety of BEL relative to being on IS at baseline, in combination with standard treatment (ST) which includes AM and GC, using pooled data from past clinical trials in patients with SLE. Materials and Methods: This post hoc pooled Week 52 data for adults with active SLE from 5 Phase 3 trials (BLISS-52 [NCT00424476]; BLISS-76 [NCT00410384]; North East Asia [NCT01345253]; BLISS-SC [NCT01484496]; EMBRACE [NCT01632241]). In these studies, patients were randomised to receive BEL or placebo (PBO) in addition to ST. This summary grouped patients by study treatment: an IS cohort (receiving PBO and IS at baseline, defined as pre-treatment) and a BEL cohort (BEL 10 mg/kg IV or 200 mg SC, and no baseline IS); all patients received AM and GC at baseline. Efficacy endpoints included proportion of patients with SRI-4 response through 52 weeks, and cumulative GC dose (mg) between baseline and Week 52. Adverse events (AEs) and serious AEs (SAEs), also included data from an additional Phase 2 trial (LBSL02 [NCT00071487]). Results: Of the pooled population (N=3086), 552 patients were in the BEL cohort and 358 in the IS cohort. Baseline characteristics were similar between cohorts (Table 1). A higher proportion of BEL patients vs IS patients were SRI-4 responders at most time points, with a difference of 22% at Week 52 between BEL (61%) and IS (39%) cohorts (Figure 1A). The mean (SD) cumulative GC dose decreased by −192 (2510.8) mg atWeek 52 in the BEL cohort and increased by 339 (4725.5) mg in the IS cohort (Figure 1B). Fewer patients had AEs and SAEs in the BEL vs IS cohort (AEs: 79% vs 90%; SAEs: 11% vs 20%), with one death reported in the BEL cohort (pneumonia; treatment-unrelated). Fewer patients in the BEL vs IS cohort discontinued treatment due to AEs (6% vs 8%). Most common AEs were infections and infestations (53% vs 64%). The most frequent SAEs were infections and infestations (BEL: 4% vs IS: 8%). Conclusions: This post hoc summary adds cli…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Biological
  topic: keywords
subject: Clinical Trial
  topic: keywords
subject: Glucocorticoids
  topic: keywords
subject: Mariele Gatto
  topic: disciplines
subject: Karen H. Costenbader
  topic: disciplines
subject: Andreas Schwarting
  topic: disciplines
subject: Julia Hn Harris
  topic: disciplines
subject: Ciara O'Shea
  topic: disciplines
subject: Roger A. Levy
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2160

PO:15:218 | Evaluation of leukocyte expression of ecto-nucleotidase in patients with systemic lupus erythematosus
type: item
description: Background. Ecto-nucleotidases are membrane proteins that modulate the immune response through the extracellular conversion of pro-inflammatory mediators ATP and NAD into adenosine, a molecule with immunosuppressive functions. These enzymatic reactions are mediated by ectonucleotidases CD39 and CD73 and, to a lesser extent, by CD38, CD157, CD203a and CD203c. In systemic lupus erythematosus (SLE), alterations in serum ATP levels and adenosine receptors suggest a dysregulation of these pathways. Therefore, the aim of the study was to characterise the expression of ectonucleotidases in B and T lymphocytes, natural killer (NK) cells and dendritic cells (DCs) of patients with SLE, evaluating the association with disease activity status. Methods. Consecutive patients diagnosed with SLE according to the 2019 EULAR/ACR criteria and healthy controls matched for age and sex were enrolled. Clinical-demographic data were collected and peripheral blood mononuclear cell samples were collected and analysed by spectral flow cytometry for the detection of CD39, CD73, CD38, CD157, CD203a and CD203c. Patients were stratified according to disease remission status according to the DORIS definition. Results. The study included 57 SLE patients with a female-to-male ratio of 10:1 and a median age of 45 years (Table 1). Compared to controls, patients had reduced expression of CD73 in naïve B lymphocytes and cytotoxic T lymphocytes (Figure 1 A/B). Overall, there was increased expression of CD157, CD38, CD203a, and CD203c in mature B lymphocytes, T helper lymphocytes, DCs, and NK cells. In addition, there was an increase in CD39+ and CD73+ in NK cells, while the proportion of CD39+ was increased in DCs. In patients in remission according to the DORIS definition, an increase in CD39+ Treg cells was observed compared to those who did not achieve remission (Figure 1 C). Conclusions. This study is the first to conduct a comprehensive analysis of the expression of ecto-nucleotidases in different l…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Ectonucleotidase
  topic: keywords
subject: Adaptive immunity
  topic: keywords
subject: Biomarkers
  topic: keywords
subject: Luca Rapino
  topic: disciplines
subject: Simona Truglia
  topic: disciplines
subject: Fulvia Ceccarelli
  topic: disciplines
subject: Francesca Romana Spinelli
  topic: disciplines
subject: Silvia Mancuso
  topic: disciplines
subject: Giada La Spina
  topic: disciplines
subject: Hector Rincon Arvalo
  topic: disciplines
subject: Thomas Doerner
  topic: disciplines
subject: Ana Luisa Stefanski
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2038

PO:15:219 | Nailfold capillaroscopic abnormalities in systemic lupus erythematosus: comparison with healthy controls and clinical-immunological correlations. Preliminary data
type: item
description: Background. This study aims to evaluate capillaroscopic abnormalities in systemic lupus erythematosus (SLE) patients versus healthy controls and investigate correlations between microvascular changes and clinical or immunological features. It also seeks to support the diagnostic and prognostic value of nailfold videocapillaroscopy (NVC) in SLE, following prior evidence of heterogeneous microvascular involvement (1). Methods. This observational, case-control study included 105 patients diagnosed with SLE and 59 healthy controls, evaluated between January and June 2025. All participants underwent NVC performed by trained operators using standardized protocols. Capillaroscopic parameters assessed included average capillary density, presence of tortuous, dilated, and giant capillaries, neoangiogenesis, hemorrhages, and scleroderma or scleroderma-like pattern. Clinical data were collected through structured interviews and medical chart reviews, including vascular manifestations such as acrocyanosis, Raynaud’s phenomenon (RP), and digital ulcers, as well as smoking status, beta-blocker use, and autoantibody profiles. Statistical analyses included chi-square and t-tests for group comparisons, Fisher’s exact test for categorical variables, and calculation of odds ratios with 95% confidence intervals to explore associations between capillaroscopic findings and clinical-immunological variables. Results. Compared to controls, SLE patients more frequently presented with Raynaud’s phenomenon (p=0.001) and acrocyanosis (p=0.003), while no significant differences were observed in smoking habits. Capillaroscopy revealed a significantly lower capillary density in SLE patients (p<0.001), and a higher frequency of tortuous (p=0.043), dilated (p=0.001), and giant capillaries (p=0.014). Neoangiogenesis (p<0.001) and scleroderma-like patterns (p=0.027) were exclusively observed in SLE patients (Table 1). Within the SLE cohort, associations between capillaroscopic abnormalities and clinic…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Systemic Lupus Erythematosus
  topic: keywords
subject: Videocapillaroscopy of the nail bed
  topic: keywords
subject: Microvascular alterations
  topic: keywords
subject: Chiara Orlandi
  topic: disciplines
subject: Alessia Loda
  topic: disciplines
subject: Cesare Tomasi
  topic: disciplines
subject: Silvia Ebe Lucia Della Pina
  topic: disciplines
subject: Claudia Barison
  topic: disciplines
subject: Cecilia Nalli
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
subject: Micaela Fredi
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2039

PO:15:220 | Outcomes of extra renal flares in systemic lupus erythematosus: longitudinal analysis of a monocentric cohort
type: item
description: Background. Lupus low disease activity state (LLDAS) and remission are key therapeutic targets in systemic lupus erythematosus (SLE), associated with better long-term outcomes. This study aimed to evaluate the frequency of LLDAS achievement 12 months after an extra-renal flare and to identify clinical and serological predictors in a monocentric SLE cohort. Methods. This observational cohort study included SLE patients with an extra-renal disease flare between 2017 and 2024. Patients were assessed at the flare occurrence (T0) then at 3 (T3), 6 (T6), and 12 months (T12). Active organ involvement at flare was categorized based on BILAG domains, and disease activity at T0 and follow-up was evaluated by SLEDAI-2K score. At each time point, the attainment of clinical remission (based on the DORIS definition, excluding the physician global assessment [PGA]) and/or LLDAS-5 (according to modified criteria: excluding the PGA and requiring a prednisone dose < = 5 mg/day) was recorded. Univariate and multivariable logistic regression analysis of potential predictors were performed. Results. 98 patients were included. Demographic, clinical, and therapeutic characteristics are summarized in Table 1. During the follow-up, SLEDAI-2K score progressively declined from a median of 7 (4-10) to 2 (0-4); at 12 months, 67 (69.0%) patients were in LLDAS5 and 38 (38.7%) were in remission. As shown in figure 1, clinical outcomes assessed at 3, 6, and 12 months demonstrated a gradual increase in the proportion of patients achieving LLDAS5 and clinical remission. Comparison between those who reached LLDAS-5 at T12 and those who did not is detailed in Table 2. Patients not achieving LLDAS-T12 received significantly higher cumulative 6-methylprednisolone doses (2786.2 ± 349.6 mg vs 1740.3 ± 158.8 mg, p = 0.002) and higher daily doses at T12 (7.07 ± 1.38 mg/day vs 2.95 ± 0.24 mg/day, p < 0.001). In univariate analysis, variables associated with the achievement of LLDAS5 at 12 months resulted: SLE…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Extra-renal flares
  topic: keywords
subject: Low disease activity status
  topic: keywords
subject: Clinical outcomes
  topic: keywords
subject: Marco Oliva
  topic: disciplines
subject: Giorgia Capozzo
  topic: disciplines
subject: Giancarlo Cascarano
  topic: disciplines
subject: Chiara Cardelli
  topic: disciplines
subject: Dina Zucchi
  topic: disciplines
subject: Angela Elia
  topic: disciplines
subject: Elena Elefante
  topic: disciplines
subject: Viola Signorini
  topic: disciplines
subject: Chiara Stagnaro
  topic: disciplines
subject: Chiara Tani
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2040

PO:15:221 | Proteins upregulated in thrombotic antiphospholipid syndrome link to platelet function in contrast with non-antiphospholipid-related thrombosis: insights from two systematic reviews
type: item
description: Background. Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by thrombosis, pregnancy morbidity, and other clinical manifestations in the presence of antiphospholipid antibodies (aPL). Despite advances in research since its identification in 1983, no targeted therapies beyond anticoagulation have been developed, and the 10-year mortality rate remains at 9.3%. This study aims to inform future therapeutic strategies by exploring proteomic differences between thrombotic APS (tAPS) and non-aPL-related thrombosis. Methods. We conducted two systematic literature reviews (SLRs) following PRISMA guidelines to identify upregulated proteins in tAPS and in non-aPL-related thrombosis. Eligible studies were controlled observational studies focused on proteomic analysis. Upregulated proteins were used as input for gene cluster analysis, followed by gene enrichment analysis utilizing Gene Ontology (GO). Network analysis was conducted. Results. Out of 108 and 209 records screened, 7 studies on tAPS and 13 on non-aPL-related thrombosis met the inclusion criteria (Figure 1). A total of 118 proteins were found to be upregulated in tAPS, compared to 319 in non-aPL-related thrombosis. Cellular component enrichment revealed that the upregulated proteins in tAPS originate from blood microparticle, membrane attack complex and vesicle lumen. Similarly, the upregulated proteins in non-aPL-related thrombosis originate from blood microparticle, vesicle lumen and secretory granules. GO enrichment analysis highlighted distinct biological processes: in tAPS, the top terms were platelet aggregation, platelet activation, and blood coagulation. Conversely, in non-aPL thrombosis, the leading processes were hemostasis, blood coagulation, and wound healing, with platelet-related processes ranking only seventh. Notably, the upregulation of platelet-related proteins in tAPS patients was observed even outside the acute phase, suggesting a persistent alteration in platelet-re…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Antiphospholipid syndrome
  topic: keywords
subject: Proteomics
  topic: keywords
subject: Platelets
  topic: keywords
subject: Silvia Mancuso
  topic: disciplines
subject: Claudia Ciancarella
  topic: disciplines
subject: Luca Rapino
  topic: disciplines
subject: Simona Truglia
  topic: disciplines
subject: Cristiano Alessandri
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2041

PO:15:222 | Post-hoc analysis of the BeRLiSS-JS registry: efficacy of belimumab on thrombocytopenia
type: item
description: Background. We have seen clear evidence that belimumab is both effective and safe in treating systemic lupus erythematosus (SLE), showing good results across different disease domains. However, when it comes to hematologic manifestations, especially thrombocytopenia, the evidence remains limited. Aim. To assess the efficacy of belimumab in hematologic manifestations, in particular thrombocytopenia, in a nationwide cohort of patients with SLE. Methods. This study was based on a multicenter national cohort, involving 14 leading SLE referral centers across Italy. In particular, we enrolled 443 patients (n= 443) who met one of the following classification criteria for SLE: the ACR 1997 revised criteria, the SLICC 2012 criteria, or the EULAR/ACR 2019 criteria. In addition, all participants needed to be on either intravenous (10 mg/kg monthly) or subcutaneous treatment (200 mg weekly) with belimumab and have active disease at the time of enrollment. A positive serology was required, along with either joint or skin involvement. Among them we identified 44 patients with thrombocytopenia, defined as a platelet count <150,000/mm³ (Table 1). The efficacy of belimumab was assessed by evaluating the improvement in mean platelet count and the proportion of patients achieving platelet count normalization. The average daily dose of corticosteroids was also calculated at baseline and every 6 months. Univariate analyses were performed using paired t-tests and ANOVA for repeated measures, with SPSS version 29. Results. Among patients with thrombocytopenia at baseline, platelet values increased significantly from a mean ± SD baseline value of 110.2±38.1×109/l to 176.6 ± 88.7 ×109/L at 48 months (p=0.004) (Graph 1) and the rate of thrombocytopenic patients decreased to 45% at 48 months. Glucocorticoids users decreased numerically, but not significantly, from a baseline value of 93.2% to 80% at 48 months (Graph 2); specularly, the percentage of low-dose PDN users, defined as a daily dose…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Lupus
  topic: keywords
subject: Thrombocytopenia
  topic: keywords
subject: Belimumab
  topic: keywords
subject: Greta Hulej
  topic: disciplines
subject: Margherita Zen
  topic: disciplines
subject: Marisol Bracalenti
  topic: disciplines
subject: Francesca Bottazzi
  topic: disciplines
subject: Rossella De Angelis
  topic: disciplines
subject: Giacomo Emmi
  topic: disciplines
subject: Roberto Gerli
  topic: disciplines
subject: Marcello Govoni
  topic: disciplines
subject: Renato Lo Gullo
  topic: disciplines
subject: Simone Negrini
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
subject: Maurizio Rossini
  topic: disciplines
subject: Carlo Salvarani
  topic: disciplines
subject: Paola Tomietto
  topic: disciplines
subject: Angelo Vacca
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
subject: Luca Iaccarino
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2042

PO:16:231 | Differential clinical features of systemic lupus erythematosus patients on biological therapies: insights from a monocentric cohort
type: item
description: Background. to compare the clinical profile of patients prescribed with either BEL or ANI and assess preliminary efficacy of ANI in a monocentric cohort of systemic lupus erythematosus (SLE) patients. Methods. we performed an observational study on consecutive patients with active SLE prescribed with a biological drug at our clinic between July 2023 to July 2024, with a follow-up of at least 6 months from baseline (start of biologic). Clinical, demographic and serological data were collected at baseline, at 3 and 6 months. Disease activity was measured through the SLE-disease activity index 2000 (SLEDAI-2K) and the SLE-disease activity score (SLEDAS) including assessment of active serology. For skin involvement, ANI patients had their CLASIa (Cutaneous LE Disease Area and Severity Index) calculated. Comparisons between continuous and categorical variables were carried out using parametric or non parametric tests as appropriate. We used Friedman’s test to repeat measures and compare paired samples. Categorical variables were expressed as n (%) and continuous variables as mean±standard deviation (SD). Results. we included 15 SLE patients (Table 1) with a mean follow-up of 8.90 (6.10) months since start of biologic, receiving either BEL (7, 46.6%) or ANI (8, 53.4%). The main organ involvement encompassed skin rash and arthritis in the ANI group (both 62.5%), and skin rash (41%) and arthritis (71%) in the BEL group. BEL and ANI group did not differ in terms of baseline disease activity; more patients were serologically active (positive anti-dsDNA and/or low complement) in the BEL group while not reaching statistical significance. Organ damage was significantly lower at baseline in the BEL group. Out of 8 patients on ANI, 3 (37.5%) had to stop the drug after a mean time of 3.50±2.78 months due to inefficacy (1 case) or adverse events (2 cases: recurrent vaginal bleeding and pneumonia requiring ICU admission). No withdrawals were seen in the BEL group within the follow-up…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Anifrolumab
  topic: keywords
subject: Lupus
  topic: keywords
subject: bDMARDS
  topic: keywords
subject: Pietro Francesco Pilo
  topic: disciplines
subject: Elisa Bellis
  topic: disciplines
subject: Claudia Garulli
  topic: disciplines
subject: Claudio Cruciani
  topic: disciplines
subject: Marta Saracco
  topic: disciplines
subject: Claudia Lomater
  topic: disciplines
subject: Elena Marucco
  topic: disciplines
subject: Gloria Crepaldi
  topic: disciplines
subject: Valeria Data
  topic: disciplines
subject: Annamaria Iagnocco
  topic: disciplines
subject: Mariele Gatto
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2043

PO:16:232 | Belimumab step-down dose spacing in patients with systemic lupus erythematosus in persistent clinical remission: experience from a multicentric cohort
type: item
description: Background. To evaluate the feasibility and safety of belimumab (BEL) dose spacing and withdrawal in patients with systemic lupus erythematosus (SLE) who were in long-standing remission on BEL. Methods. Patients above 18 years of age with a diagnosis of SLE and persistent disease remission while on BEL were enrolled. Persistent remission was defined as >6 months on stable immunosuppressive therapy without experiencing a clinical flare of SLE (i.e. clinical SLE disease activity index [C-SLEDAI] less or equal to 2). All the patients started BEL spacing at enrolment. Patients were assessed by an experienced rheumatologist with physical examinations and laboratory tests every 12 weeks for 24 months for disease activity and damage accrual according to Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index. If the patient was in clinical remission (C-SLEDAI less or equal to 2 and absent [British Isles Lupus Assessment Group] BILAG A or B items), BEL was tapered as follows: - Step 1: BEL 200 mg subcutaneous (SC) every 10 days OR 10 mg/Kg intravenous (IV) every 6 weeks - Step 2: BEL 200 mg SC every 14 days OR 10 mg/Kg IV every 8 weeks - Step 3: BEL 200 mg SC every 21 days OR 10 mg/Kg IV every 12 weeks - Step 4: stop BEL Primary outcome: number of disease flares during follow-up. Secondary outcomes: progression of SLICC/ACR damage index, death. Results. Twenty-two patients were enrolled (Table 1), 21 were females (95.5%), with a mean age of 48±10 years. Mean disease duration was 21±11 years. Seven patients (31.8%) had a history of lupus nephritis. At the start of BEL spacing, 6 patients were on glucocorticoid (GC) therapy at a mean dose of 4.4±1.7 mg/day Prednisone equivalents), and 15 were taking Hydroxychloroquine (HCQ). Patients were treated with BEL for an average of 6±3 years before enrolment. Patients were observed for a median of 21 (Q1–Q3: 16–24) months. Five patients were stopped BEL during follow-up. One patient…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Systemic lupus erythematosus
  topic: keywords
subject: Belimumab
  topic: keywords
subject: Remission
  topic: keywords
subject: Alice Bartoletti
  topic: disciplines
subject: Laura Giudice
  topic: disciplines
subject: Lorenza Maria Argolini
  topic: disciplines
subject: Giuseppe Alvise Ramirez
  topic: disciplines
subject: Luca Moroni
  topic: disciplines
subject: Tommaso Schioppo
  topic: disciplines
subject: Chiara Bellocchi
  topic: disciplines
subject: Annalaura Fasiello
  topic: disciplines
subject: Lorenzo Beretta
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
subject: Roberto Caporali
  topic: disciplines
subject: Maria Gerosa
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2044

PO:16:233 | Efficacy of voclosporin on nephritis in patients with variable gain of function of TLR7 affected by lupus: clinical case
type: item
description: Background. We present the case of a 45-year-old woman diagnosed with systemic lupus erythematosus (SLE) in 2022, following the identification of a hemizygous gain-of-function variant in the TLR7 gene, detected during family screening for type I interferonopathy. The family history revealed that her eldest daughter died in 2023 from severe type I interferonopathy with neurological, vasculitic, and intestinal involvement; her younger son is currently under follow-up for the same condition. The patient’s medical history includes facial photodermatitis during adolescence and idiopathic thrombocytopenia at age 24, treated with steroids. In 2022, concomitant with the genetic finding, laboratory results showed hypocomplementemia, hypergammaglobulinemia, ANA 1:160 (speckled pattern), borderline anti-dsDNA, and negative antiphospholipid antibodies. Treatment with mycophenolate mofetil and hydroxychloroquine was initiated. In 2023, she developed thrombosis of the right femoroiliac axis and femoral tripod, treated with embolectomy and anticoagulant therapy. Subsequently, she experienced recurrent pleural and pericardial effusions. In November 2023, the first evidence of proteinuria up to 6 g/24 h led to a renal biopsy showing focal endocapillary proliferative glomerulonephritis (consistent with class III lupus nephritis). Treatment with mycophenolate mofetil 2 g/day was continued. In April 2024, due to persistent proteinuria in the absence of other laboratory or clinical signs of disease activity, a repeat renal biopsy revealed membranous glomerulonephritis (stage I), consistent with class V lupus nephritis. Based on the histological findings and the limited efficacy of previous therapies, voclosporin was added to the treatment regimen. A few weeks after introducing voclosporin, a progressive reduction in proteinuria was observed, reaching values of approximately 900 mg/24 h (as shown in Figure 1), without significant side effects or deterioration in renal function. Conclusio…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: lupus nephritis
  topic: keywords
subject: voclosporin
  topic: keywords
subject: TLR7
  topic: keywords
subject: Veronica Spedicato
  topic: disciplines
subject: Laura Coladonato
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Marlea Lavista
  topic: disciplines
subject: Daniele Sabella
  topic: disciplines
subject: Marco Capodiferro
  topic: disciplines
subject: Maria Morrone
  topic: disciplines
subject: Crescenzio Scioscia
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2161

PO:16:235 | Anifrolumab in systemic lupus erythematosus: real-life experience of a single-center cohort
type: item
description: Background. Anifrolumab (ANI) is a monoclonal antibody directed against type 1 interferon receptor. Its use in the treatment of patients with systemic lupus erythematosus (SLE) is becoming more frequent in clinical practice. The aim of this study is to evaluate the efficacy of ANI in SLE without active renal involvement. Methods. Data were prospectively collected from SLE patients (according to the ACR, SLICC, or EULAR/ACR classification criteria) undergoing treatment with ANI. Specifically, SLEDAI-2K, SLE Disease Activity Score (SLEDAS), painful/swollen joint count (SJT/TJC), and CLASI (Cutaneous LE Disease Area and Severity Index) were acquired before the start of therapy and subsequently every 3 months for the first year of therapy. Platelet count (PC) and lymphocyte count (LC), complement levels, anti-dsDNA antibody titers, and daily prednisone dose (PDN) were also collected at the same frequency. The SDI (SLICC/ACR damage index) was assessed at baseline and after 6 months. Finally, rates of remission (SLEDAI-2K=0 with PDN ≤5 mg/day), clinical remission (clinical SLEDAI-2K=0 with PDN ≤5 mg/day) and modified lupus low disease activity state (SLEDAI-2K ≤4 without major organ involvement and no new manifestations, with PDN≤7.5 mg/day) were obtained. The T-test and Wilcoxon test for paired data were used to compare the various timepoints. Results. Since September 2023, 22 patients with SLE have been treated with ANI: of these, 11 (50%) for skin involvement, 10 (45%) for joint involvement, while hematological and serosal involvement were present in 4 (18%) and 2 (9%) patients, respectively. In 8 patients (36%), ANI was administered before conventional immunosuppressants (IS). Reductions in the mean SLEDAI-2K (p = 0.016 at 6 months and p = 0.007 at 9 months), SLEDAS (p < 0.001 at 6 months), CLASI (p = 0.008 at 6 months and p = 0.043 at 9 months), TCJ (p = 0.009 at 6 months and p = 0.033 at 9 months), SJC (p = 0.023 at 6 months) and LC (p = 0.021 at 6 months and p = 0.…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Anifrolumab
  topic: keywords
subject: efficacy
  topic: keywords
subject: Real-life
  topic: keywords
subject: Filippo Vesentini
  topic: disciplines
subject: Luca Iaccarino
  topic: disciplines
subject: Federico Arru
  topic: disciplines
subject: Greta Hulej
  topic: disciplines
subject: Anna Giorgia Osele
  topic: disciplines
subject: Noemi Merra
  topic: disciplines
subject: Davide Ragno
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
subject: Margherita Zen
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2162

PO:16:236 | Achieving a low disease activity state with a corticosteroid dose of 5 mg or less: observational study with anifrolumab in patients with systemic lupus erythematosus in Italy
type: item
description: Background. Despite recent improvements in the management of systemic lupus erythematosus (SLE), patients still face a high risk of morbidity and mortality. Sustained remission is the goal of SLE management, although it is rarely achieved in clinical practice. When remission cannot be reached, the Lupus Low Disease Activity State (LLDAS) represents an alternative Treat-to-Target objective. In Italy, real-world data are lacking on the achievement and maintenance of LLDAS, remission, and corticosteroid tapering in patients treated with anifrolumab. Therefore, a study was designed with the primary objective of describing the proportion and characteristics of patients who achieve LLDAS5 and remission during treatment with anifrolumab in Italian clinical practice, and with the secondary objective of defining a glucocorticoid tapering scheme to inform clinical practice. Materials and Methods. DAHLIA is an Italian, multicenter, prospective, observational cohort study conducted in accordance with Good Clinical Practice (GCP). The study population will include 245 Italian adult patients of both sexes with SLE, according to EULAR/ACR criteria, who are prescribed initiation of anifrolumab therapy for the first time in the context of routine Italian clinical practice, in line with the approved and reimbursed label. The primary objective is to describe the proportion and characteristics of patients who achieve LLDAS with a corticosteroid (prednisone) dose equal to or less than 5 mg (LLDAS5) at week 52. Secondary objectives include assessment of the estimated cumulative probability of achieving LLDAS5 over the course of the study; the percentage of flares following glucocorticoid reduction to a dose equal to or less than 5 mg/day; the cumulative probability of achieving DORIS remission; the persistence of DORIS remission; and the description of a glucocorticoid tapering scheme used in routine clinical practice. The sample size was estimated based on results from analyses of LLDAS…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Anifrolumab
  topic: keywords
subject: LLDAS
  topic: keywords
subject: lupus
  topic: keywords
subject: Alessandra Bortoluzzi
  topic: disciplines
subject: Fulvia Ceccarelli
  topic: disciplines
subject: Fabio Leo
  topic: disciplines
subject: Paola Roccatagliata
  topic: disciplines
subject: Chiara Tani
  topic: disciplines
subject: Margherita Zen
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2163

PO:16:238 | Cardiovascular risk in systemic lupus erythematosus patients: comparison among Framingham Score, QRISK3, and SLECRE
type: item
description: Background. Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease associated with a high risk of developing cardiovascular (CV) events (1). The aim of this study is to analyse the performance of the main CV risk calculators, Framingham Score, QRISK3, and SLECRE (2), in predicting CV events at 10 years. Methods. We enrolled 82 SLE patients, with a minimum follow-up of 10 years and complete data on SLE features, disease activity (as SLEDAI-2K) and CV risk factors. Clinical and serological data were collected from clinical charts. CV risks were calculated at the CV event (at the last follow-up for controls) and 10 years before. A p-value lower than or equal to 0.05 was considered statistically significant. Results. Figure 1 shows demographic, CV risk data of the 82 patients (Table 1), and the distribution of 27 CV events (Graphic 1). CV events were associated with male sex (p: 0.01), longer SLE history (p: 0.014), and higher values of SLEDAI-2K at the event and 10 years before (p: 0.0023 and p: 0.0003, respectively). No differences in autoantibodies’ or clinical data were detected between groups. Considering risk factors, higher systolic pressure (p: 0.007) and chronic kidney disease (p<0.0001) were the only items associated with CV events, 10 years before. Stratifying patients in low (<10%), intermediate (11-20%), and high (>20%) CV risk, only SLECRE >20%, assessed 10 years before the CV event or before the last follow-up, was significantly associated with the CV event development at 10 years [OR: 5 (IC 95%: 1.8–13.6); p: 0.002]. FRS and QRISK3 stratification did not differ between CV event development and controls. Only anti-beta2glycoprotein-I, anti-dsDNA antibodies, lupus nephritis, and complement reduction were associated with SLECRE >10%, assessed 10 years before the last available, independently from CV event occurrence. Conclusion. SLECRE calculator demonstrated the best performance in identifying patients at risk to develop CV events at 10 y…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Systemic lupus erythematosus
  topic: keywords
subject: Cardiovascular risk
  topic: keywords
subject: SLECRE
  topic: keywords
subject: Francesca Vignoni
  topic: disciplines
subject: Serena Iodice
  topic: disciplines
subject: Cesare Tomasi
  topic: disciplines
subject: Chiara Orlandi
  topic: disciplines
subject: Eleonora Pedretti
  topic: disciplines
subject: Micaela Fredi
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2045

PO:16:241 | Prevalence and associated factors of premature ovarian insufficiency in women with systemic lupus erythematosus: the role of human herpesviruses HHV-7 and HHV-8
type: item
description: Background. Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that primarily affects women of reproductive age. Fertility may be impaired by intrinsic factors, such as disease activity, flares, and organ damage, as well as by extrinsic factors, including treatment-related effects. Premature ovarian insufficiency (POI), a condition characterized by reduced reproductive potential, represents a significant issue in SLE. Anti-Müllerian hormone (AMH), produced by ovarian follicles, is a reliable indicator of ovarian reserve, while elevated follicle-stimulating hormone (FSH) levels associated with 4–6 months of amenorrhea or oligomenorrhea remain the gold standard for POI diagnosis. The aim of this study was to assess the prevalence of POI in a monocentric cohort of women with SLE and to examine its association with clinical, immunological, therapeutic features, and viral serologies. Materials and Methods. We included women aged 18–45 years with a diagnosis of SLE according to the 1997 ACR, 2012 SLICC, and/or 2019 EULAR criteria, treated with hydroxychloroquine and/or conventional or biologic immunosuppressants, excluding cyclophosphamide (CYC), and enrolled between 2014 and 2023. Data collected through a secure electronic system included medical history, disease characteristics and activity (SLEDAI-2K, PGA), treatments, and hormonal profile (LH, FSH, prolactin, progesterone, and AMH). Viral serologies included HHV-6, -7, and -8. Categorical variables were expressed as frequencies and percentages, and continuous variables as mean ± standard deviation (SD). POI was defined as AMH <1 ng/mL or FSH >40 IU/L. Results. Seventy-nine women with SLE were enrolled (Table 1). POI defined by AMH <1 ng/mL was observed in 53.1% of patients, while 30.4% met the criteria based on FSH >40 IU/L. No statistically significant differences were found in disease activity, autoimmune serological profile, clinical manifestations, or treatments between patients with and withou…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: lupus erythematosus
  topic: keywords
subject: fertility
  topic: keywords
subject: human herpesviruses
  topic: keywords
subject: Margherita Rizzo
  topic: disciplines
subject: Francesca Ruffilli
  topic: disciplines
subject: Silvia Beltrami
  topic: disciplines
subject: Daria Bortolotti
  topic: disciplines
subject: Roberta Rizzo
  topic: disciplines
subject: Carlo Garaffoni
  topic: disciplines
subject: Ettore Silvagni
  topic: disciplines
subject: Marcello Govoni
  topic: disciplines
subject: Alessandra Bortoluzzi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2164

PO:17:248 | Prevention of human papillomavirus infection in women with systemic lupus erythematosus: a single-center cross-sectional study
type: item
description: Background. Women with systemic lupus erythematosus (SLE), especially those treated with immunosuppressants, have a greater risk of developing cervical cancer related to the human papilloma virus (HPV). Vaccination against HPV and screening for early detection of HPV are safe and effective prevention measures. The objectives of this study are to evaluate vaccine coverage and adherence to the HPV infection screening programs in women with LES, as well as investigate the incidence of infection in these patients. Methods. A cross-sectional study was conducted by administering an anonymous survey on vaccination and infection screening adherence to consecutive SLE patients attending our center's Lupus Clinic. Data on HPV infection and HPV vaccination in women were analyzed. Results. From March to June 2025, 45 women with SLE completed the survey (Table 1). Among these patients, 67% (30/45) expressed uncertainty regarding the safety of vaccines for patients with SLE, while 60% (27/45) reported not knowing which vaccinations are recommended. Regarding HPV vaccination coverage, only 3/45 (6.7%) reported having been vaccinated against HPV, while the majority (33/45, 73.3%) reported not having been vaccinated: 58% (19/33) of unvaccinated patients were in treatment with glucocorticoids (GCs), 82% (27/33) with conventional disease-modifying antirheumatic drugs (cDMARDs), and 27% (9/33) with biological disease-modifying antirheumatic drugs (bDMARDs). Figure 1 describes the reasons that led patients not to undergo vaccination. The main barriers were the lack of recommendation by the doctor (19/33, 56.7%) and lack of information about the vaccine (9/33, 27.3%). 27/45 patients (60%) reported regularly undergoing PAP tests or HPV DNA tests, while 12 (26.7%) declared they did not. Finally, 5/45 patients (11.1%) reported having been diagnosed with HPV infection. Conclusions. In our study, HPV vaccination coverage was suboptimal in patients with SLE, and the lack of promotion and infor…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: human papillomavirus
  topic: keywords
subject: women
  topic: keywords
subject: prevention
  topic: keywords
subject: Clizia Gagliardi
  topic: disciplines
subject: Maria Chiara Gerardi
  topic: disciplines
subject: Bianca Lucia Palermo
  topic: disciplines
subject: Giulia Carrea
  topic: disciplines
subject: Maria Di Cicco
  topic: disciplines
subject: Elena Manna
  topic: disciplines
subject: Giulia Segatto
  topic: disciplines
subject: Antonella Adinolfi
  topic: disciplines
subject: Laura Belloli
  topic: disciplines
subject: Cinzia Casu
  topic: disciplines
subject: Silvia Cavalli
  topic: disciplines
subject: Davide Antonio Filippini
  topic: disciplines
subject: Matteo Longhi
  topic: disciplines
subject: Gabriella Maioli
  topic: disciplines
subject: Martina Schettino
  topic: disciplines
subject: Nicola Ughi
  topic: disciplines
subject: Elisa Verduci
  topic: disciplines
subject: Arianna Bertolucci
  topic: disciplines
subject: Lara Buffa
  topic: disciplines
subject: Giulia Buonsante
  topic: disciplines
subject: Claudia Cordini
  topic: disciplines
subject: Eleonora Giacobbe
  topic: disciplines
subject: Francesco Molica Colella
  topic: disciplines
subject: Oscar Epis
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2165

PO:17:250 | Effectiveness and safety of the recombinant zoster vaccine in patients ≥18 years of age with systemic lupus
type: item
description: Background. The recombinant zoster vaccine (RZV) is FDA-approved for herpes zoster (HZ) prevention in adults ≥50, and immunocompromised adults ≥18 at increased HZ risk, which may include those with SLE or MS. This retrospective cohort study interim analysis assessed 2-dose RZV vaccine effectiveness (VE) in patients with SLE or MS, and severe SLE flare risk. Materials and Methods. Adults aged 18+ years with MS or SLE were identified within 7 insurers databases between 2018 or 2021-2023. In the analyses for determining VE, adults completing the 2-dose RZV series were matched 1:4 against unvaccinated controls, and patients with HZ one year prior to vaccination were excluded. The parameter for determining VE was the first episode of HZ ≥31 days after the administration of the second dose of RZV. For safety analyses, adults with SLE receiving RZV dose 1 or 2 were separately matched 1:4 to unvaccinated patients, excluding those with severe SLE flare 90 days prior to index. Safety outcome was the presence or absence of flare ≤90 days after index. Adjusted hazard ratios (HR) and VE were estimated using weighted Cox models to balance confounders. Results. Vaccinated patients had more immunosuppressive use and fewer comorbidities, emergency department visits and hospitalisations before weighting. VE cohorts included 1,308 and 6,025 commercially insured RZV-vaccinated patients with SLE and MS, respectively, and 2,284 and 8,705 Medicare patients. RZV 2-dose VE (95% confidence interval [CI]) in commercially insured patients was 54% (18-74) and 81% (70-88) in SLE and MS, respectively, and 70% (50-82) and 64% (51-74) in Medicare patients. SLE safety cohorts comprised 2,775 commercially insured patients receiving 4,196 RZV doses and 4,227 Medicare patients receiving 6,602 RZV doses. HR (95% CI) of severe SLE flare was 0.94 (0.72-1.24) in commercially insured patients, and 0.91 (0.75-1.11) in Medicare patients. Conclusions. RZV 2-dose VE ranged from 54-81% and RZV was not associated…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: lupus erythematosus
  topic: keywords
subject: multiple sclerosis
  topic: keywords
subject: antiherpes zoster vaccination
  topic: keywords
subject: Giulia Boschi
  topic: disciplines
subject: Sheryl A. Kluberg
  topic: disciplines
subject: Sophie E. Mayer
  topic: disciplines
subject: O'Mareen Spence
  topic: disciplines
subject: Driss Oraichi
  topic: disciplines
subject: Harry Seifert
  topic: disciplines
subject: Omar Ali
  topic: disciplines
subject: Huifeng Yun
  topic: disciplines
subject: Andrew L. Simon
  topic: disciplines
subject: Jenice S. Ko
  topic: disciplines
subject: Caroline Hugh
  topic: disciplines
subject: Meg Her
  topic: disciplines
subject: Kathleen Shattuck
  topic: disciplines
subject: Richard Platt
  topic: disciplines
subject: Aziza Jamal-Allial
  topic: disciplines
subject: Djeneba Audrey Djibo
  topic: disciplines
subject: Kimberly Daniels
  topic: disciplines
subject: Qianli Ma
  topic: disciplines
subject: Cheryl N. Mcmahill-Walraven
  topic: disciplines
subject: Rachel P. Ogilvie
  topic: disciplines
subject: Kristin Palmsten
  topic: disciplines
subject: Mano Selvan
  topic: disciplines
subject: Najat Ziyadeh
  topic: disciplines
subject: Alexis Ogdie
  topic: disciplines
subject: Michael George
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2166

PO:17:252 | The choice between belimumab and anifrolumab: analysis of a monocentric cohort
type: item
description: Background. Belimumab (BEL) and Anifrolumab (ANI) are currently the only biologic drugs authorized for the treatment of Systemic Lupus Erythematosus (SLE). The aim of the study is to analyze the factors associated with the therapeutic choice between BEL and ANI in a monocentric cohort of patients affected by SLE. Materials and Methods. We conducted a prospective observational study on consecutively enrolled patients affected by SLE and treated with BEL or ANI starting from June 2022, the date when the compassionate use of ANI began. Clinical, clinimetric, serological, and therapeutic data (prednisone, previous and concomitant therapy) were collected. Univariate analysis was performed using the chi-square or Fisher’s test for categorical variables and the Mann-Whitney or Student’s t test for continuous variables; for multivariate analysis, logistic regression models were created selecting variables with p<0.05. Results. The study included 22 patients treated with ANI (21 women, 95.5%) and 39 with BEL (35 women, 89.7%). The demographic, clinical, and therapeutic characteristics of the two groups at baseline are reported in the table, together with the results of the univariate analysis. In multivariate analysis, the use of ANI was preferentially associated with a chronic-active disease course (OR 17.8; 95% CI 3.5-91.7; p<0.001) and with active cutaneous manifestations (OR 9.9; 95% CI 1.5-66.5; p<0.017). In particular, the sub-analysis of cutaneous involvement showed an association between the preferential use of ANI compared with BEL in patients with subacute lupus (OR 12.7; 95% CI 2.0-79.4; p<0.006) and alopecia with lupus hair (OR 6.2; 95% CI 1.7-22.0; p<0.005). The use of BEL was significantly associated with a relapsing-remitting disease course (OR 10.7; 95% CI 2.3-50.1; p=0.002) and with the presence of active arthritis (OR 5.3; 95% CI 1.2-23.0; p<0.002). In particular, the sub-analysis of articular involvement showed a preferential association between the use of…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: anifrolumab
  topic: keywords
subject: belimumab
  topic: keywords
subject: therapeutic choice
  topic: keywords
subject: Fabio Congiu
  topic: disciplines
subject: Elisabetta Chessa
  topic: disciplines
subject: Giulia Rizzo
  topic: disciplines
subject: Elena Ragusa
  topic: disciplines
subject: Marta Paola Pireddu
  topic: disciplines
subject: Alessandra Oliva
  topic: disciplines
subject: Marianna Salis
  topic: disciplines
subject: Mattia Congia
  topic: disciplines
subject: Maria Maddalena Angioni
  topic: disciplines
subject: Micaela Rita Naitza
  topic: disciplines
subject: Alberto Floris
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2167

PO:17:253 | Unveiling the gap: a multicenter study on factors driving patient-physician discrepancies in assessing disease activity in systemic lupus erythematosus
type: item
description: Methods. Systemic lupus erythematosus (SLE) involves flares and remissions. This study explores discrepancies between physicians’ and patients’ reported disease activity and aims to identify key influencing factors. Methods. Data from SLE patients monitored consecutively between March and July 2024 at two Lupus Clinics were collected. Disease activity was assessed using a 0–3 visual analog scale for both Patient and Physician Global Assessment (PGA, PhGA). Results. The study included 280 adult SLE patients(92.5% women, 93% Caucasian). The median age at enrollment was 46 years(IQR 37–58), with a median age at diagnosis of 29 years(IQR 20–38.5). The median follow-up duration was 169 months(IQR 107–296). Twenty-nine percent had primary schooling, 36% completed high school, and 30% held a university degree. Most patients were employed, 10% students, 11% unemployed, 17% retired. Over the course of disease, ACLE was observed in 50% of patients, SCLE in 9% and 22% had CCLE. Mucosal, tumid, or hypertrophic SLE occurred in 1% of cases. Ulcers were present in 29% of patients, nonscarring alopecia in 24%, arthritis in 55%, pleuritis in 9% and pericarditis in 16%. Renal involvement occurred in 37% of patients(biopsy-confirmed glomerulonephritis class III/IV in 23% and class II/V in 10%). Neurological manifestations affected 9% of patients, hemolytic anemia 10%, leukopenia/lymphopenia 60% and thrombocytopenia 22%. Concomitant conditions included antiphospholipid syndrome(10%), overlap connectivitis(6%), fibromyalgia(11%) and depressive syndrome(14%). The last median SLEDAI was 2 (IQR 0–2) and the median SLEDAS was 0.37 (IQR 0.37–1.5). Steroid therapy was used by 45% of patients, DMARDs by 94%, biologic drugs by 22% and antidepressants/anxiolytics by 32%. The median SLICC Damage Index was 0 (range 0–8). The median PGA and PhGA scores were 0.58 and 0: 82% of patients achieved SLEDAS Low Disease Activity, while remission criteria were met by 73% (DORIS) and 77.5% (SLEDAS). PGA and …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Systemic Lupus Erythematosus
  topic: keywords
subject: Disease activity
  topic: keywords
subject: Patient-reported outcomes
  topic: keywords
subject: Giorgia Ingrid Gozzoli
  topic: disciplines
subject: Micaela Fredi
  topic: disciplines
subject: Federica Bonaso
  topic: disciplines
subject: Silvia Ebe Lucia Della Pina
  topic: disciplines
subject: Claudia Barison
  topic: disciplines
subject: Irene Lorenzini
  topic: disciplines
subject: Raffaele Pericotti
  topic: disciplines
subject: Anna Mattiuzzo
  topic: disciplines
subject: Marcelo Neto
  topic: disciplines
subject: Sofia Azevedo
  topic: disciplines
subject: Cláudia Oliveira
  topic: disciplines
subject: Cesare Tomasi
  topic: disciplines
subject: Luís Sousa Inês
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2046

PO:17:254 | Systemic lupus erythematosus with pulmonary involvement: clinical insights from an Albanian cohort
type: item
description: Background. Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that can significantly affect the lungs leading to irreversible damage, resulting in reduced life quality and varied mortality rates. It can impact all parts of the lung although respiratory symptoms display later. Despite the high frequency, lung involvement in SLE remains understudied. Objectives. To evaluate the extent of pulmonary involvement in SLE patients and identify factors associated with its occurrence and severity. Materials and Methods. A retrospective cohort study from January 2024 to January 2025 was conducted at our hospital, including SLE patients >18 years old, fulfilling the ACR and/or SLICC diagnostic criteria. Data regarding demographics, disease, pulmonary involvement, and laboratory markers were extracted from the hospital records. R software version 4.2 was used to carry out statistical analysis. Results. 45 SLE patients were included; 44.4% (n = 20) were aged 41 years and older, 93.4% (n = 42) females. Around 17.7% had Kidney Disease (KD), 11.1% had hypertension, 4.4% had diabetes and 2.2% had hypothyroidism and deep vein thrombosis. Pulmonary involvement was present in 22 (48.8%) SLE patients, in the form of pleural effusion (45.5%), interstitial lung disease (13.6%), lupus pneumonitis (13.6%), pleuritic (13.6%), pulmonary embolism (9.3%) and pulmonary hemorrhage (4.5%). The most frequent respiratory symptoms reported by SLE patients were: dyspnea (25%), chest pain (20%), and cough (20%) while fever (16.7%), palpitation (13.8%), and hemoptysis (4.5%) were less frequent. KD and hypertension were significantly associated with pulmonary involvement; (χ2=3.307, p=0.026) and (χ2=7.762, p=0.02), respectively. Even the seropositivity for ANA, anti-DNA (ds), and low C4 were significantly associated with pulmonary involvement, (χ2=3.237, p=0.021), (χ2=4.672, p=0.023) and (χ2=8.2467, p=0.01), respectively. Conclusions. More than one-fifth of SLE patients develop pulmonary …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: lupus
  topic: keywords
subject: lung
  topic: keywords
subject: cohort
  topic: keywords
subject: Arbi Pecani
  topic: disciplines
subject: Arian Mezini
  topic: disciplines
subject: Loreta Karaulli
  topic: disciplines
subject: Laert Gjati
  topic: disciplines
subject: Silvana Bala
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2168

PO:17:255 | Efficacy and safety of voclosporin in the management of lupus nephritis: a case series
type: item
description: Background. Voclosporin (VOC) is a new drug approved for treating and managing lupus nephritis (LN) in patients with Systemic Lupus Erythematosus (SLE), according to EULAR recommendations. The aim of this study is to describe a case series of patients with long-standing SLE treated with VOC for active LN, refractory to multiple therapies, and persistent proteinuria. Materials and Methods. Demographic, clinical, histological, therapeutic and comorbidity data were recorded for patients with SLE (2019 EULAR/ACR criteria) treated with VOC, who were followed at our Lupus Clinic in collaboration with Nephrologists. A descriptive analysis of the cases was conducted. Results. Characteristics of 3 patients (2F, 1M), with a mean disease duration of 22.33±12.01 years at enrolment, are reported in the Table and Figures. Case 1 (F, 74 years old): patient with 34-year history of SLE with renal, articular, cutaneous and pulmonary involvement. In 2024, she developed nephrotic syndrome (proteinuria: 5 g/day). A renal biopsy was performed, revealing a class V LN. She was treated with mycophenolate mofetil (MM) 2 g/day and ramipril 5 mg/day with little benefit (proteinuria: 2.58 g/day after 6 months). Following discussion of the case with Nephrologists, she began therapy with VOC, leading to a rapid reduction in proteinuria (0.6 g/day after 1 month and 0.22 g/day after 6 months) and achievement of remission according to DORIS criteria (REM). Despite good subjective tolerance, the patient experienced an increase in serum creatinine (from 0.6 to 1.0 mg/dl) with a GFR of 58 ml/min, which required refinement of antihypertensive therapy. Case 2 (F, 57 years old): SLE onset with nephrotic syndrome in 2014; in 2021 she presented with a relapse, and renal biopsy showed mesangioproliferative LN (Class II). She started treatment with belimumab, suspended after 3 months due to intolerance (fever, arthralgia, and general malaise). She was then started on VOC, with a subsequent reduction in protei…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: lupus nephritis
  topic: keywords
subject: Voclosporin
  topic: keywords
subject: proteinuria
  topic: keywords
subject: Alessandra Oliva
  topic: disciplines
subject: Elisabetta Chessa
  topic: disciplines
subject: Marta Paola Pireddu
  topic: disciplines
subject: Marianna Salis
  topic: disciplines
subject: Giulia Rizzo
  topic: disciplines
subject: Fabio Congiu
  topic: disciplines
subject: Elena Ragusa
  topic: disciplines
subject: Antonello Pani
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
subject: Nicola Lepori
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2169

PO:18:271 | Managing concomitant sle and psoriasis: the role of anifrolumab in a clinical case
type: item
description: Background. Systemic Lupus Erythematosus (SLE) is a chronic systemic autoimmune disease characterized by the interaction of genetic, environmental, and immunological factors. The type I interferon (IFN-I) pathway, particularly IFN-alpha, represents a central element in its pathogenesis. IFN-I is produced by pDCs and other cells in response to exposure to immune complexes containing DNA or RNA, and it promotes the activation and differentiation of B and T cells, the maturation of DCs, and the expression of pro-inflammatory cytokines. Anifrolumab is a human monoclonal antibody that binds to the type I interferon receptor (IFNAR1), inhibiting the activity of all type I interferons. Interferons, particularly IFN-gamma and type I IFN, also play a crucial role in the pathogenesis of psoriasis: pDCs can be activated by nucleic acids released from damaged keratinocytes or by immune complexes, producing IFN and contributing to the inflammation. Methods and Results. A 57-year-old woman presented with a diagnosis of inverse psoriasis and undifferentiated connective tissue disease, previously treated with Hydroxychloroquine (discontinued due to an allergic reaction) and then with Methotrexate and Cyclosporine. Laboratory tests showed ANA positivity (1/640 speckled pattern), anti-dsDNA and anti-SSA/Ro60 positivity, ESR 44 mm/h, CRP 18.1 mg/L. On physical examination, she presented with erythematous, desquamative, and infiltrated lesions in the intergluteal fold, buttocks, submammary and retroauricular regions, alopecia and a malar rash. A diagnosis of Systemic Lupus Erythematosus was made, and initially treatment with Cyclosporine 300 mg/day was maintained. One year later, blood tests showed an increase in ESR and CRP, mild anemia, and 24-hour proteinuria of 884 mg/24h. The patient also presented with a painful swelling of the right sternoclavicular joint, and ultrasound documented inflammatory involvement (consistent with Tietze's syndrome). Cyclosporine therapy was suspended, …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Systemic Lupus Erythematosus
  topic: keywords
subject: Psoriasis
  topic: keywords
subject: Anifrolumab
  topic: keywords
subject: Angela Carenza
  topic: disciplines
subject: Liliana Dinoia
  topic: disciplines
subject: Sergio De Gioia
  topic: disciplines
subject: Federica Gatti
  topic: disciplines
subject: Teresa Caferri
  topic: disciplines
subject: Lucia Cristiana Colaprico
  topic: disciplines
subject: Angelica Napoletano
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2047

PO:18:276 | Use of anifrolumab in the treatment of difficult-to-treat manifestations in systemic lupus erythematosus
type: item
description: Background and Objective. To describe our experience with the use of anifrolumab (AFM) in a small single-center cohort of patients (pts) with systemic lupus erythematosus (SLE), with particular focus on the management of refractory manifestations. SLE is a systemic autoimmune disease that can affect virtually any organ or system. Refractory manifestations represent an unmet need in disease management, as they are associated with higher glucocorticoid (GC) exposure, increased risk of cumulative organ damage, and reduced quality of life (QoL). Type I interferons (IFN-I) play a key role in antiviral defense; however, in SLE patients, IFN-I signaling pathways are upregulated both in genetic predisposition and in epigenetic changes characteristic of the disease, contributing to disease onset and activity. Several clinical and laboratory features of SLE—including lymphopenia—are associated with the overexpression of IFN-I–regulated genes, providing a strong rationale for targeting this pathway. Anifrolumab, a monoclonal antibody that inhibits the type I interferon receptor, offers new therapeutic perspectives in this setting. Materials and Methods. We report on 5 female SLE patients aged 35–64 years, followed from September 2024 to the present. Four pts presented with cutaneous involvement: acute cutaneous lupus (n=2), subacute cutaneous lupus (SCLE)(n=1), and discoid lupus with scarring alopecia (DLE) (n=1). One pt exhibited predominant constitutional (persistent remittent fever up to 39.5°C for ~1 year, fatigue) and hematologic involvement (leukopenia–lymphopenia). These manifestations prompted initiation of AFM therapy. Previous manifestations (currently in remission) included articular (3 pts), serosal (pleural effusion, 1 pt), and renal involvement (class III glomerulonephritis, 1 pt). At the time of our observation, pts (previously followed in other Centers) were receiving hydroxychloroquine (except the pt with constitutional/hematologic involvement, due to intolera…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: SLE
  topic: keywords
subject: Anifrolumab
  topic: keywords
subject: difficult-to-treat
  topic: keywords
subject: Antonella Grimaldi
  topic: disciplines
subject: Giuseppe Alessandrini
  topic: disciplines
subject: Laura Quarta
  topic: disciplines
subject: Maria Rita Ricciardi
  topic: disciplines
subject: Daniela Costanza
  topic: disciplines
subject: Clara Minerba
  topic: disciplines
subject: Eugenio Quarta
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2170

PO:18:277 | Clinical case report of the management of a patient suffering from systemic lupus erythematosus and associated polyneuropathy
type: item
description: Background. The aim of this presentation is to show how a girl with systemic lupus erythematosus (SLE) was diagnosed with a rare complication, how her treatment was chosen based on her characteristics as a SLE patient with associated peripheral nervous system complications, and how her condition was successfully treated without causing any long-term effects. Methods. Clinical findings during the visit electromyography and nerve conduction tests for diagnosis blood test examinations to monitor the patient's condition The patient was visited several times with examinations and tests scheduled after diagnosis and their follow-up to monitor the effectiveness of therapy and to observe any clinical improvements indicating resolution of the complication and remission of the clinic related to SLE. Results. After the therapy and as a result of improvements attributable to the correct choice and management of the therapy, there was a remission of her pathology, a resolution of complications, and it was possible to reduce the dosage of the corticosteroid Conclusions. The management of SLE could be very difficult and related to a correct clinical approach in the first steps of the visits to know exactly the various complications associated to disease and to make the best choices of therapy for the patient
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: SYSTEMIC LUPUS ERYTHEMATOSUS
  topic: keywords
subject: RARE COMPLICATIONS
  topic: keywords
subject: TREATMENT
  topic: keywords
subject: Davide Murgia
  topic: disciplines
subject: Elena Marazzi
  topic: disciplines
subject: Rosetta Vitetta
  topic: disciplines
subject: Guido Rovera
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2048

PO:19:281 | Mitochondrial dysfunction in Still’s disease: a preliminary analysis of mtDNA copy number and TFAM expression
type: item
description: Background. Still’s disease (SD) is hypothesized to arise from the interaction between environmental and genetic factors that trigger an inappropriate activation of the innate immune system, leading to excessive production of proinflammatory cytokines. Oxidative stress—one of the main sources of DNA damage—plays a crucial role in several inflammatory disorders. Mitochondrial DNA (mtDNA) is particularly vulnerable to oxidative injury caused by reactive oxygen species (ROS), which are physiologically generated during mitochondrial respiration. The mitochondrial DNA copy number (mtDNA-CN) serves as a biomarker of mitochondrial function, and its maintenance depends on several nuclear-encoded genes, including the mitochondrial transcription factor A (TFAM). However, the role of oxidative stress and mitochondrial dysfunction in AOSD remains poorly understood. Objective: To compare mtDNA-CN and TFAM gene expression in patients with SD and healthy controls (CTRLs). Materials and Methods: Peripheral blood samples were collected for DNA and RNA extraction. mtDNA-CN and TFAM mRNA expression levels were quantified using quantitative PCR (qPCR). Statistical comparisons between groups were performed using ANOVA tests. Results: A total of 27 patients fulfilling Yamaguchi criteria for AOSD and 35 healthy CTRLs were enrolled. SD patients showed a significantly lower mtDNA-CN compared with CTRLs (p = 0.006). Conversely, TFAM mRNA expression was significantly higher in SD patients than in CTRLs (p = 0.02). A negative correlation between.....
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Stillճ disease (SD)
  topic: keywords
subject: genetic factors
  topic: keywords
subject: mtDNA-CN
  topic: keywords
subject: Ludovica Manisera
  topic: disciplines
subject: Francesca Giansanti
  topic: disciplines
subject: Andrea Latini
  topic: disciplines
subject: Francesca Lotito
  topic: disciplines
subject: Serena Colafrancesco
  topic: disciplines
subject: Angelica Gattamelata
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Cinzia Ciccacci
  topic: disciplines
subject: Roberta Priori
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2171

PO:19:283 | Hospitalization profile and complications in patients with adult-onset Still’s disease: results from a retrospective study of 74 cases
type: item
description: Background. Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disorder that may follow a severe course with potentially life-threatening complications. The aim of this study was to describe hospitalization patterns and major complications in a retrospective cohort of patients with AOSD. Materials and Methods. A retrospective study was conducted on patients with AOSD followed between January 2009 and May 2025 at a single tertiary center. Demographic, clinical, and laboratory data at disease onset were collected, along with information on hospitalizations (number, duration, causes, and timing) and therapies administered during admission. The incidence of macrophage activation syndrome (MAS), its temporal relationship with disease onset, and the treatments employed were also evaluated. Data were analyzed descriptively using medians, interquartile ranges (IQR), and absolute frequencies. Results. Seventy-four patients were included (median age at onset 35 years, IQR 25–47; 50% female), with a median follow-up of 54 months (IQR 31–147). Forty patients (54%) experienced a single hospitalization, and 20 (27%) had two or more. Forty-six patients (62%) were hospitalized at disease onset, among whom 9 presented with MAS. Of those with MAS, 3 (33%) had a second hospitalization within 3 years. Among patients hospitalized at onset, the median length of stay was 21.2 days (IQR 14.8–27.5), and treatment included glucocorticoids (98%), anakinra (22%), and cyclosporine A (15%). During follow-up, 26 additional hospitalizations were recorded at a median of 29 months after diagnosis (IQR 1.5–88). The main causes of hospitalization were AOSD relapse (n=16, 62%; associated with MAS in 6 cases), infections (n=5, 19%), cardiovascular events (n=3, 12%), and neurological events (n=3, 11.5%). Relapses occurred while patients were receiving systemic corticosteroids at a median prednisone dose of 20 mg (IQR 7.2–37.5); 8 patients were on anakinra and 12 on methotrexate. Managemen…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: Stillճ disease
  topic: keywords
subject: hospitalizations
  topic: keywords
subject: infections
  topic: keywords
subject: Chiara Calabrese
  topic: disciplines
subject: Alessandro Tomelleri
  topic: disciplines
subject: Corrado Campochiaro
  topic: disciplines
subject: Nicola Farina
  topic: disciplines
subject: Elena Baldissera
  topic: disciplines
subject: Marco Matucci-Cerinic
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2172

PO:19:286 | Genetic testing reveals an unexpected case of mevalonate kinase deficiency in a 37-year-old patient with AA renal amyloidosis and good response to colchicine
type: item
description: Mevalonate kinase deficiency (MKD) is a rare genetic autoinflammatory disease usually diagnosed in pediatric age. Case presentation. A 37-year-old male, born in Pakistan from consanguineous parents was first evaluated in March 2024 at the Nephrology Unit, where he was admitted for abdominal pain, peripheral and periorbital edema. Scrotal edema, peritoneal and pleural effusions were observed. Laboratory tests revealed: nephrotic syndrome (24h proteinuria max 12.4 g/day, albumin 1.8 g/dL); mild renal impairment (creatinine 1.5 mg/dL); hypogammaglobulinemia (IgG 1.37 g/L); raised levels of CRP (19 mg/L, normal value <5) and serum amyloid A (SAA; 286 mg/L, normal value <8). ANA, antiENA, antidsDNA, antiPLA2R, anti-phospholipid antibodies, cryoglobulins, C3, C4, serum and urine immunofixation, serum IgA were negative or in normal range. Renal biopsy showed amyloidosis (with glomerular, arteriolar and interstitial involvement) positively stained for AA. He reported hospital admission at the age of 2 with no clear diagnosis. Since infancy to 2007, he experienced periodic fever with abdominal pain, occurring approximately once a month and lasting 2-3 days. In the suspect of familial Mediterranean fever (FMF), colchicine was started (1 mg/day) and next generation sequencing (NGS) analysis of genes potentially linked to periodic fever was performed. Moreover, treatment with furosemide, canrenone, ramipril, statin, ezetimibe, dapaglifozin and warfarin (for catheter-associated deep vein thrombosis) was started. Two months after discharge, clinical condition improved (no more edema nor abdominal pain); SAA normalized; proteinuria decreased to 7 g/day. A clinical diagnosis of FMF was confirmed (Tel-Hashomer and Eurofever/Printo criteria). During the follow-up, due to creatinine and liver enzymes increase, a treatment adjustment was necessary, including colchicine reduction (0.5 mg/day). This resulted in an improvement of renal and hepatic function but a slight elevation of SAA. P…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: MKD
  topic: keywords
subject: RENAL AMYLOIDOSIS
  topic: keywords
subject: AUTOIMMUNE DISEASES
  topic: keywords
subject: Francesca Crisafulli
  topic: disciplines
subject: Paolo Airò
  topic: disciplines
subject: Federica Mescia
  topic: disciplines
subject: Gianmarco Lugli
  topic: disciplines
subject: Gianfranco Savoldi
  topic: disciplines
subject: Claudia Izzi
  topic: disciplines
subject: Federico Alberici
  topic: disciplines
subject: Marco Cattalini
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
subject: Micol Frassi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2049

PO:19:287 | Cardiac involvement in Still’s disease: a challenge in differential diagnosis
type: item
description: Background. To present and discuss a case of Still’s disease (SD) with significant cardiopulmonary involvement, underlining the importance of a comprehensive and multidisciplinary approach in achieving an accurate differential diagnosis. Materials and Methods. A 34-year-old man, previously healthy, presented with persistent high fever and pharyngodynia, followed by an evanescent erythematous rash, hepatosplenomegaly, polyarthralgia, and diffuse myalgia. Laboratory findings revealed elevated inflammatory markers (ESR 117 mm/h, CRP 143 mg/L) and hyperferritinemia (550 ng/mL). After exclusion of infectious, neoplastic, and autoimmune disorders, the diagnosis of SD was established (Yamaguchi’s criteria). Treatment with methylprednisolone (16 mg/day) led to only partial clinical improvement, while fever and arthromyalgic symptoms persisted. Upon admission to our unit, the patient started anakinra (100 mg subcutaneously daily). Within a few days, he developed urticarial lesions and cough. Suspecting an adverse reaction, Anakinra was discontinued and glucocorticoid increased. Despite withdrawal of the drug, clinical symptoms persisted and were soon associated with nocturia and exertional dyspnea. The patient was admitted to the emergency department, where a chest X-ray revealed increased bronchovascular markings, a congestive pattern, and blunting of the costophrenic angles. Chest high-resolution CT (HRCT) demonstrated bilateral pleural effusions and patchy ground-glass opacities. Transthoracic echocardiography showed reduced left ventricular ejection fraction (30–35%) and a moderate pericardial effusion without hemodynamic compromise. Cardiac cine-MRI confirmed pericardial effusion with myocardial wall thickening, in the absence of late gadolinium enhancement (LGE) within a non-ischemic dilated cardiomyopathy with hyopokinesia. The patient was transferred to the Cardiology Department, where, after thoracentesis, was treated for heath failure with dapaglifozin, dsacubritil…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 1
  topic: category
subject: cardiomyopathy
  topic: keywords
subject: Stillճ Disease
  topic: keywords
subject: differential diagnosis
  topic: keywords
subject: Ludovica Manisera
  topic: disciplines
subject: Martina Dodaro
  topic: disciplines
subject: Giuseppe Norcia
  topic: disciplines
subject: Angelica Gattamelata
  topic: disciplines
subject: Nicola Galea
  topic: disciplines
subject: Concetta Torromeo
  topic: disciplines
subject: Gaetano Tanzilli
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Roberta Priori
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2173

PO:20:002 | Respiratory function tests predict bone mineral density in autoimmune rheumatic disease patients
type: item
description: Background. Several studies suggest that pulmonary function, especially in terms of vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1), directly correlate with physical activity and in particular with the 6-minute walk test (6MWT). In this perspective pulmonary function may be associated with bone health. Moreover, this relationship between lung function and bone might be exacerbated in AIDs patients who develop interstitial lung disease or require glucocorticoid therapy. High-resolution peripheral quantitative computed tomography (HRpQCT) is a sensitive technique to measure bone mass and microarchitecture in humans. We therefore sought to investigate the relationship between lung function test and bone mineral density in patients with autoimmune rheumatic diseases. Methods. Patients affected by autoimmune rheumatic diseases were recruited from January to April 2025. Demographic data regarding age, gender, BMI, smoking habits, steroidal treatment, menopausal state, history of fracture and rheumatic disease were collected. HR-pQCT bone data from the distal radius and the tibia and pulmonary function test results were recorded. Pearson correlation test were performed between pulmonary function tests and HR-pQCT parameters of radius and tibia Results. 28 patients affected by AIDs were enrolled: 3 (10,71%) with rheumatoid arthritis, 9 (32,14%) with systemic lupus erythematosus, 15 (53,57%) with scleroderma and 1 (3,57%) with idiopathic inflammatory myopathy. 11(39,29 %) patients were male with an average age of 47,64±13,77 years and an average BMI 25,22 ± 11,29 kg/m2 . Among the patients, 14 (50%) had a history of smoking, 7 (29,17%) received glucocorticoid treatment and 8 (34.78%) had a history of fracture. Nine patients (32,14%) had confirmed interstitial lung disease. All the parameters calculated by HRpQCT in radius and tibia showed to positively correlate with the parameters of pulmonary function test [Table 1 a…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Pulmonary function test
  topic: keywords
subject: HR-pQCT
  topic: keywords
subject: Interstitial lung disease
  topic: keywords
subject: Andrea Zoli
  topic: disciplines
subject: Panagiotis Garantziotis
  topic: disciplines
subject: Sebastian Böltz
  topic: disciplines
subject: Janina Auth
  topic: disciplines
subject: Sara Bayat
  topic: disciplines
subject: Jule Taubmann
  topic: disciplines
subject: Anna-Maria Liphardt
  topic: disciplines
subject: Maria Antonietta D'Agostino
  topic: disciplines
subject: Christina Bergmann
  topic: disciplines
subject: Georg Schett
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2050

PO:20:003 | Romosozumab effect on neutrophil-to-lymphocyte ratio in post-menopausal women at high risk of fracture
type: item
description: Background. Romosozumab (ROMO) is a monoclonal antibody targeting sclerostin (SOST), a key regulator of bone metabolism. It has been demonstrated that changes in SOST levels can affect distinct niches within the bone marrow that support hematopoiesis. To date, no clinical studies have explored the changes in complete blood count (CBC) parameters in patients receiving ROMO. The objective of of the present study was to investigate the effects of Romosozumab on CBC parameters in post-menopausal women at high risk of fracture. Methods. We conducted a 12-month prospective observational study in post-menopausal women with severe osteoporosis treated with ROMO 210 mg/monthly during one year between October 2023 an April 2025. CBC values were assessed at baseline, 6 and 12 months. Inclusion criteria were: - Treatment with romosozumab as deemed necessary by the treating physician Exclusion criteria were: - Exposure to bisphosphonates within 12 months from romosozumab initiation - Prior treatment with other anti-osteoporosis medications - No diagnosis of anemia or lymphoma or leukemia - No active bleeding or recipients of plasma, red blood cells derivates and platelets in the last 12 months Absolute changes in CBC were assessed with a mixed model for repeated measures. Results. A total of 113 post-menopausal women (mean age of 73.4±9.7 years) were included. Neutrophils levels slightly decreased over time, with a significant decrease at 6 months (p=0.022), that was not sustained at 12 months (p=0.500). Haemoglobin and lymphocytes levels showed no significant differences over the period of the study. In the overall trend across time points, there was a statistically significant decrease in the neutrophil-to-lymphocyte ratio (NLR) over the 12 months (2.0 ± 1.1 at baseline, 1.8 ± 1.1 at month 6, and 1.8 ± 1.2 at month 12; p=0.034), with a small effect size (Cohen’s = 0.22). Figure 1 shows the NLR over the 12 month study period. Conclusion. In post-menopausal women with severe ost…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Romosozumab
  topic: keywords
subject: Neutrophils
  topic: keywords
subject: Sclerostin
  topic: keywords
subject: Giorgia Scagliosi
  topic: disciplines
subject: Mariana Diaz Lopez
  topic: disciplines
subject: Martina Teoni
  topic: disciplines
subject: Francesco Pollastri
  topic: disciplines
subject: Anna Piccinelli
  topic: disciplines
subject: Camilla Benini
  topic: disciplines
subject: Valeria Messina
  topic: disciplines
subject: Emma Pasetto
  topic: disciplines
subject: Davide Gatti
  topic: disciplines
subject: Ombretta Viapiana
  topic: disciplines
subject: Maurizio Rossini
  topic: disciplines
subject: Giovanni Adami
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2051

PO:20:004 | Increase in serum Dkk1 levels attenuates the anabolic response to romosozumab in postmenopausal osteoporosis
type: item
description: Background. Romosozumab is a monoclonal antibody against sclerostin that initially exhibits potent anabolic effects in treating osteoporosis. However, its efficacy diminishes after 6 months, with bone formation markers declining despite continued therapy. We hypothesized that increased levels of Dickkopf-1 (Dkk1), a Wnt pathway inhibitor, may contribute to this attenuation by suppressing osteoblast activity. Methods. We conducted a 12-month prospective observational study on post-menopausal osteoporosis naïve to anti-osteoporosis treatment, treated with romosozumab. Serum levels of Dkk1, Procollagen Type I N-Terminal Propeptide (P1NP), C-terminal telopeptide of type I collagen (CTX), and sclerostin were measured at baseline (M0) and at 3 (M3), 6 (M6), and 12 months (M12). Bone mineral density (BMD) at the lumbar spine, femoral neck, and total hip was assessed at M0, M6, and M12. Associations between Dkk1 and P1NP were analyzed using linear mixed-effects models. Results. Fifty-nine post-menopausal women were included in the study. Dkk1 levels increased significantly from 38.9 pmol/L at M0 to 44.2 pmol/L at M12 (p 0.003). P1NP increased from 89.4 ng/mL at M0 to 115.4 ng/mL at M3 (p 0.004) but decreased to 61.5 ng/mL by M12 (p 0.001). CTX decreased significantly throughout the study (p 0.001). BMD increased significantly at all sites by M12 (lumbar spine +13.8%, femoral neck +6.3%, total hip +4.7%; all p 0.01). An inverse association was found between Dkk1 increase and P1NP decrease between M3 and M12 (estimate -0.909; p 0.032). We also found a steep increase in sclerostin serum levels as soon as M3 (from 36.3 pmol/L, SD 15.6, to around 1500 pmol/L at all time points, p 0.001). This increase can probably be attributed to the sequestration of sclerostin from the bone to the bloodstream by romosozumab. Serum marker changes (least square changes from marginal means of the MMRM) are shown in Figure 1. Conclusion. Romosozumab treatment is associated with a significant rise …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Dkk1
  topic: keywords
subject: Romosozumab
  topic: keywords
subject: Osteoporosis
  topic: keywords
subject: Giovanni Adami
  topic: disciplines
subject: Filippo Montanari
  topic: disciplines
subject: Angelo Fassio
  topic: disciplines
subject: Francesco Pollastri
  topic: disciplines
subject: Anna Piccinelli
  topic: disciplines
subject: Davide Gatti
  topic: disciplines
subject: Ombretta Viapiana
  topic: disciplines
subject: Maurizio Rossini
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2052

PO:20:005 | Sarcopenia and fracture risk in rheumatoid arthritis: correlation between SACR-F and fragility score measured by radiofrequency echographic multi-spectrometry
type: item
description: Background. To evaluate the effectiveness of the Fragility Score (FS), measured by Radiofrequency Echographic Multi-Spectrometry (REMS), in predicting fracture risk and its correlation with the risk of sarcopenia in patients with rheumatoid arthritis (RA). Materials and methods. We examined a population of patients aged >50 years diagnosed with RA according to the 2010 ACR/EULAR criteria. All subjects underwent bone assessment using both REMS and DXA. The SARC-F questionnaire was administered and fracture risk was calculated using the DEFRA and FRAX algorithms. Correlations between FS, DEFRA, FRAX, and SARC-F were determined using Pearson’s correlation coefficient and its confidence interval (P<0.05). Results. A total of 67 patients were enrolled, with a mean age of 66.94 ± 9.66 years; 60 were female (89.55%) and 7 male (10.45%). Mean DXA T-scores were: lumbar spine –1.73 ± 1.17 and femoral neck –1.99 ± 0.77; mean REMS T-scores were: lumbar spine –2.05 ± 0.90 and femoral neck –2.11 ± 0.79. Mean FRAX values were: hip fracture 11.33 ± 12.16 and major osteoporotic fractures 24.64 ± 16.07; DEFRA (in females) 42.98 ± 29.27; FS lumbar spine 43.89 ± 20.21; FS femur 41.57 ± 21.40; SARC-F 1.69 ± 1.59. A strong correlation was observed between the Fragility Score of both the lumbar spine and femur with the DEFRA and FRAX (for both major and hip fractures) fracture risk algorithms, with P-values <0.0001 for all correlations. A moderate correlation was found between SARC-F and bone structure quality assessed by the Fragility Score at the lumbar spine (r = 0.44, P<0.0001) and femur (r = 0.42650, P = 0.0002). Moreover, SARC-F showed a moderate correlation with fracture risk estimates obtained from DEFRA (r = 0.47390, P<0.0001), FRAX hip fracture (r = 0.39578, P = 0.0007), and FRAX major fractures (r = 0.37185, P = 0.0016). Conclusions. REMS provides the qualitative parameter FS, which enables prediction of 5-year fracture risk. In our study, FS correlated significantly with both …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: osteoporosis
  topic: keywords
subject: REMS
  topic: keywords
subject: Sarcopenia
  topic: keywords
subject: Sara Torracchi
  topic: disciplines
subject: Pamela Bernardini
  topic: disciplines
subject: Daniela Melchiorre
  topic: disciplines
subject: Bianca Bossi
  topic: disciplines
subject: Dorilda Zeka
  topic: disciplines
subject: Francesca Nacci
  topic: disciplines
subject: Lorenzo Tofani
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2174

PO:20:010 | Coordinated outpatient pathway for osteoporosis: a new organizational model for osteoporosis management
type: item
description: Background. Osteoporosis requires a prompt diagnostic and therapeutic pathway to prevent fragility fractures. This study aimed to compare time required to complete the work-up and patient satisfaction levels between traditional outpatient model and a coordinated pathway. Materials and Methods: A retrospective study was conducted on 120 patients attending a dedicated setting. 55 patients were enrolled in coordinated pathway including specialist consultation, laboratory tests, vertebral morphometry, DEXA scan, and nutritional assessment. The remaining 65 followed a traditional diagnostic process with separate access to each service. Data were collected on waiting times for instrumental and laboratory tests, total time to complete the work-up, and perceived satisfaction (VAS scale 0–10). Statistical analyses were performed using independent t-tests and ANOVA. Results: The mean time to complete the diagnostic process was shorter in the coordinated pathway compared to the traditional group (7.8±1.3 days vs. 48.7±18.8 days;p < 0.01). Satisfaction scores were higher in the coordinated group (mean VAS 9.1/10vs7.2/10; p < 0.001). No significant differences were found in age, BMI, or comorbidities, confirming sample homogeneity. Discussion. Implementing a coordinated pathway for osteoporosis management reduces times and enhances patient satisfaction. This structured approach could serve as a replicable model for other chronic diseases.
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Osteoporosis
  topic: keywords
subject: Early Referral
  topic: keywords
subject: Organizational Model
  topic: keywords
subject: Domenico Birra
  topic: disciplines
subject: Ornella Romano
  topic: disciplines
subject: Vincenza Sara Suppa
  topic: disciplines
subject: Mariavittoria Guerra
  topic: disciplines
subject: Carmine Fierarossa
  topic: disciplines
subject: Benedetta Tartaglia
  topic: disciplines
subject: Antonietta De Sena
  topic: disciplines
subject: Fabio Granato Corigliano
  topic: disciplines
subject: Serena Ippolito
  topic: disciplines
subject: Vincenzo Nuzzo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2175

PO:20:011 | Suspected tumor-induced osteomalacia in a patient with polymyalgia rheumatica and persistent hyperphosphaturic hypophosphatemia
type: item
description: Background. To describe the case of a patient with polymyalgia rheumatica (PMR) and suboptimal response to steroid therapy with the incidental finding of hyperphosphaturic hypophosphatemia, suspected for tumor-induced osteomalacia (TIO), to highlight the importance of a multidisciplinary approach and targeted diagnostic laboratory and instrumental workup. Materials and Methods. Male patient, 76 years old, with a functionally single kidney following nephrectomy of an ectopic kidney at age 33, medical history of arterial hypertension, dyslipidemia, OSAS, subcritical stenosis of the supraaortic trunks, and polyglobulia (JAK2 mutation negative, endogenous EPO within normal limits); on chronic therapy with NSAIDs as needed, antihypertensives, ASA 100 mg/day, statins, and benzodiazepines for anxiety-depressive syndrome. Symptom onset approximately 3 months prior with arthralgias of the shoulder and pelvic girdles, prolonged morning stiffness >2 h, functional limitation, and elevation of inflammatory markers. Underwent initial treatment with prednisone 37.5 mg/day with tapering as indicated by the general practitioner. Subsequent relapse upon discontinuation and therefore referred for urgent rheumatology evaluation with reintroduction of PDN 18.75 mg/day and slow tapering and initiation of antiresorptive therapy with risedronate, calcium, and vitamin D supplementation. Results. At 3-month rheumatology follow-up visit, reported recurrence of arthralgias and morning stiffness upon reduction of prednisone below 7.5 mg/day. Laboratory tests revealed CRP 2.1 mg/dL; serum calcium 9.9 mg/dL; serum phosphorus 2.0 mg/dL (normal range 2.7-5.1); serum magnesium 2.1 mg/dL; spot urine phosphorus 49.9 mg/dL; plasma creatinine 1.01 mg/dL; TmPO4/GFR 1.42 mg/dL (normal range >2.7). Given suspicion of TIO, intact and C-terminal FGF23 assays were requested, with values resulting inappropriately normal in relation to serum phosphorus levels. Systematic monitoring of serum phosphorus was concu…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: tumor induced osteomalacia
  topic: keywords
subject: FGF23
  topic: keywords
subject: Hyperphosphaturic Hypophosphatemia
  topic: keywords
subject: Andrea Faggiano
  topic: disciplines
subject: Francesco Goatelli
  topic: disciplines
subject: Lucia Dardani
  topic: disciplines
subject: Carlo Salvarani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2176

PO:20:012 | Inflammatory markers and nutritional status in patients with osteoporotic fractures: preliminary analysis of a pilot study
type: item
description: Background. Chronic inflammation and malnutrition are emerging risk factors for bone fragility. This pilot study was designed to examine associations between inflammatory markers (ESR, CRP), nutritional status (albumin, total proteins), and metabolic parameters in patients with fragility fractures compared to non-fractured subjects. Materials and Methods. We enrolled 120 consecutive patients (12 men, 108 women), including 40 with fragility fractures. Data were collected on ESR, CRP, albumin, total proteins, liver, and hormonal profiles. Fractures were categorized as vertebral, femoral, and other sites. Non-parametric tests were used; significance was set at p<0.05. Results. Fracture patients had lower body weight (62±6 vs. 66±11 kg; p=0.017) and higher ESR and CRP (ESR 24±22 vs. 14±8; p=0.007; CRP 3.9±3 vs. 2.6±2.4; p=0.046). Vertebral fractures showed higher inflammation (ESR 25±21; CRP 4.5±3) and increased platelets (p=0.026). Other fractures had elevated CRP (4.9±2.7; p=0.016), liver enzymes (GammaGT 27.6±25; p=0.004), and calcitonin (1.8±1.5; p<0.001), with reduced albumin (4.1±0.3; p=0.04) and total proteins (6.2±0.67; p=0.013). Discussion. Systemic inflammation is associated with fragility fractures, especially vertebral. Fractures at other sites show nutritional and metabolic alterations, suggesting different mechanisms. These findings support multidimensional risk assessment and further studies in larger cohorts.
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Osteporosis
  topic: keywords
subject: inflammation
  topic: keywords
subject: Nutritional Status
  topic: keywords
subject: Domenico Birra
  topic: disciplines
subject: Manuela Maione
  topic: disciplines
subject: Carolina Bologna
  topic: disciplines
subject: Carmela Pierce
  topic: disciplines
subject: Paolo Tirelli
  topic: disciplines
subject: Gianluigi Cuomo
  topic: disciplines
subject: Carolina Sepe
  topic: disciplines
subject: Pasquale Madonna
  topic: disciplines
subject: Claudio De Luca
  topic: disciplines
subject: Federica Coretti
  topic: disciplines
subject: Vincenzo Nuzzo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2177

PO:20:014 | Post-partum osteoporosis: severe clinical presentation in absence of known risk factors
type: item
description: Background. Post-partum osteoporosis is a rare and under-recognized secondary osteoporosis that can manifest with multiple vertebral fractures in young women during the peripartum period. Early diagnosis and timely therapy improves outcomes. Materials and Methods. A 34-year-old woman in satisfactory health, without known osteoporosis risk factors, developed worsening low back pain two months after delivery during exclusive breastfeeding. Symptoms worsened, leading to bedridden status and functional impairment. A spine X-ray revealed L1 vertebral fracture; one month later, L4 fracture was detected. MRI confirmed recent L1, L2 and L4 fractures. DEXA scan showed severe osteoporosis with a lumbar T-score of -3.5 and a femoral of -2. Treatment with teriparatide 20 µg/day and cholecalciferol supplementation was started. Clinical and laboratory follow-up at 6 and 12 months were performed. Results. After 6 months, the patient reported clinical improvement with complete pain control, no new fractures, and resumption of physical activity. Laboratory tests were normal. Vitamin D was 27.6 ng/mL, PTH 64.4 pg/mL. At 12 months, bone density improved, and no further fractures occurred. Conclusions. This case underlines the importance of suspecting postpartum osteoporosis in persistent peripartum low back pain and demonstrates that early anabolic therapy with teriparatide can lead to rapid clinical and functional recovery, preventing further fractures.
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Postpartum osteoporosis
  topic: keywords
subject: Early diagnosis
  topic: keywords
subject: vertebral fracture
  topic: keywords
subject: Domenico Birra
  topic: disciplines
subject: Ludovica Frances Grasso
  topic: disciplines
subject: Vittoria Gammaldi
  topic: disciplines
subject: Antonietta De Sena
  topic: disciplines
subject: Carmine Pio Petrosino
  topic: disciplines
subject: Rosalia Boccia
  topic: disciplines
subject: Gabriella Oliva
  topic: disciplines
subject: Vincenzo Nuzzo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2178

PO:21:019 | Clinical phenotypes in IgG4-related disease: ACR/EULAR classification and practical limitations
type: item
description: Background. IgG4-related disease (IgG4-RD) is a rare, immune-mediated fibroinflammatory condition that can affect virtually any organ. Traditional diagnostic criteria (Umehara et al.) include clinical/radiological evidence of organ involvement, elevated serum IgG4, and specific histopathology. However, serum IgG4 elevation is inconsistent, and biopsy is not always feasible. The 2019 ACR/EULAR classification criteria introduced a point-based system (threshold ≥20) to improve disease classification. Materials and Methods. We retrospectively reviewed the clinical data of patients suspected to have IgG4-RD, which is defined by typical organ involvement, elevated serum IgG4 levels, and the exclusion of alternative diagnoses. Each patient was scored using ACR/EULAR criteria and assessed per diagnostic standards. Patients were grouped into four clinical phenotypes (head and neck, retroperitoneal/aortitis, systemic, pancreatobiliary) as described by Lanzillotta et al. Statistical analysis was performed using RStudio. Results. A total of 46 patients were included: 17 head and neck, 16 retroperitoneal/aortitis, 7 systemic, and 6 pancreatobiliary. Mean age was 57.9 years; 58.7% were male. The systemic phenotype showed the highest number of involved sites (mean 2.1). Serum IgG4 levels did not significantly differ among groups. Biopsy rates varied: 100% in systemic, 93.8% in head and neck, 83.3% in pancreatobiliary, and 31.2% in retroperitoneal/aortitis (p < 0.001). Definitive diagnosis was most frequent in systemic (85.7%), while retroperitoneal/aortitis was more often categorized as possible diagnosis (62.5%). Two patients (4.3%) failed to meet either diagnostic or classification criteria. All systemic cases scored ≥20 points. In the head and neck group, three scored below threshold, one of whom was not biopsied. Among retroperitoneal/aortitis patients, 66% scored <20, and none had undergone biopsy. One non-biopsied pancreatobiliary case also failed to meet the score threshold…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: IgG4-related disease (IgG4-RD)
  topic: keywords
subject: diagnostic criteria
  topic: keywords
subject: classification criteria
  topic: keywords
subject: Mattia Caliste
  topic: disciplines
subject: Flavia D'Auria
  topic: disciplines
subject: Linda Mastromanno
  topic: disciplines
subject: Francesca Carfora
  topic: disciplines
subject: Carla Giordano
  topic: disciplines
subject: Cristiano Alessandri
  topic: disciplines
subject: Marcella Visentini
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Roberta Priori
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2179

PO:21:021 | The eyes tell the story: a clinical case of Rosah syndrome
type: item
description: Background. ROSAH syndrome is a rare autoinflammatory disease with autosomal dominant inheritance caused by gain-of-function missense mutations in the ALPK1 gene on chromosome 4. This leads to hyperactivation of the NF-κB signaling pathway and chronic cytokine-mediated inflammation (IL-1, IL-6, and TNF-alpha). ROSAH is an acronym for the following clinical findings: retinal dystrophy, optic nerve edema, splenomegaly, anhidrosis, and headache. Reports have documented approximately 70 cases since the first description in 2012. Materials and Methods. We describe the case of a 22-year-old woman who presented in 2021 with bilateral progressive visual loss, dyschromatopsia, frontal headache, and severe fatigue. Ophthalmologic examination revealed bilateral papilledema, vitreous inflammation, macular edema, retinal dystrophy, retinal vascular inflammation, and neurodegeneration of outer retinal layers. Neuroimaging was unremarkable, but lumbar puncture showed elevated opening pressure (27 mmHg). Splenomegaly (13 cm) was detected on abdominal ultrasound. Laboratory tests are reported in the Table. An initial diagnosis of atypical systemic lupus erythematosus (SLE) was made, and high-dose corticosteroids were started (pulsed methylprednisolone followed by tapering oral prednisone). Additional treatments included low-dose aspirin (100 mg/day) and acetazolamide (1250 mg/day). The patient was treated subsequently with steroid-sparing drugs: azathioprine (2 mg/kg/day) and hydroxychloroquine (200 mg/day) later switched to mycophenolate mofetil (3 g/day), and then rituximab (1 g every two weeks, 2 doses). These treatments improved visual acuity and vitreous inflammation but had a limited effect on papilledema and retinal dystrophy. For these conditions, corticosteroids were the only effective treatment. In 2023, the patient was referred to our center: attempts to taper corticosteroids and acetazolamide resulted in the recurrence of headaches and ocular symptoms, along with worseni…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: ROSAH Syndrome
  topic: keywords
subject: Autoinflammatory diseases
  topic: keywords
subject: Tocilizumab
  topic: keywords
subject: Nicolò Sabbion
  topic: disciplines
subject: Sofia Vitale
  topic: disciplines
subject: Claudia Balicchia
  topic: disciplines
subject: Barbara Troise
  topic: disciplines
subject: Francesca Mascia
  topic: disciplines
subject: Eleonora Bassanello
  topic: disciplines
subject: Jacopo Croce
  topic: disciplines
subject: Federica Maiolini
  topic: disciplines
subject: Filippo Mazzi
  topic: disciplines
subject: Elisa Tinazzi
  topic: disciplines
subject: Francesca Bosello
  topic: disciplines
subject: Simonetta Friso
  topic: disciplines
subject: Lucia De Franceschi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2180

PO:21:028 | A difficult case of VEXAS syndrome: management of myelodysplastic syndrome associated with systemic inflammation and infectious complications
type: item
description: Background. This work describes a clinical case of VEXAS syndrome associated with myelodysplastic neoplasm, aiming to highlight the clinical and diagnostic features and the importance of a multidisciplinary approach to optimize treatment and improve the patient's prognosis. Materials and Methods. A 57-year-old male, with a medical history of type 2 diabetes and hypertension, presented between March and June 2024 with marked fatigue, migratory arthralgia in the lower limbs, subcutaneous nodules, an episode of left ear chondritis, and a 20 kg weight loss over 6 months, without fever or apparent infections. Laboratory findings included macrocytic anemia (Hb 6.8 g/dL, MCV 108 fl), without hemolysis, leukocytopenia (WBC 2270/mm³, PMN 1170/mm³), hyperferritinemia (842 µg/L), CRP 111 mg/L, and polyclonal hypergammaglobulinemia. Autoimmune markers (ANA, ENA, ANCA) and HCV/HBV serology were negative. CT scans of the head, chest, and abdomen (August 2024) revealed hepatosplenomegaly. In September, the patient developed a fever with chills, further weight loss, and petechiae at the base of all limbs. PET-CT showed increased lymph node, splenic, and skeletal uptake, while bone marrow biopsy identified myelodysplastic syndrome of the RAEB II subtype, with high IPSS and R-IPSS scores. Microscopic examination noted cytoplasmic vacuoles in granulocytes and blasts. VEXAS syndrome was confirmed by genetic testing identifying a mutation in the UBA1 gene (c.121A>G p.(Met41Val)). The treatment regimen included corticosteroids (methylprednisolone 1 mg/kg/day), with azacitidine as a bridge to transplant. Results. During follow-up, the patient showed a satisfactory clinical and laboratory response to steroid and antineoplastic drugs, with normalization of inflammatory markers, blood count, and regression of clinical manifestations. In January 2025, he was hospitalized for influenza A pneumonia during neutropenia and treated with antivirals, antibiotics, and corticosteroids. The steroid dos…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: VEXAS
  topic: keywords
subject: myelodysplastic
  topic: keywords
subject: autoinflammatory disorder
  topic: keywords
subject: Sandra Lombardi
  topic: disciplines
subject: Monica Regis
  topic: disciplines
subject: Stefano De Luca
  topic: disciplines
subject: Monica Poiani
  topic: disciplines
subject: Rossella Stella
  topic: disciplines
subject: Elisa Lucchini
  topic: disciplines
subject: Francesco Zaja
  topic: disciplines
subject: Fabio Fiammengo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2181

PO:22:029 | Impact of mepolizumab on idiopathic hypereosinophilic syndromes: analysis of a monocentric retrospective cohort
type: item
description: Background. Idiopathic hypereosinophilic syndromes (iHES) are characterized by persistent eosinophilia and eosinophil-mediated organ damage. Mepolizumab, an anti-interleukin-5 monoclonal antibody, has proven effective in reducing eosinophilic burden, controlling clinical manifestations, and decreasing the reliance on glucocorticoids (GCs). This study aims to evaluate the clinical and steroid-sparing efficacy of mepolizumab in a monocentric retrospective cohort of patients with iHES. Methods We enrolled patients with iHES, diagnosed at our Center according to the 2023 diagnostic criteria for HES (1), and treated with mepolizumab. Variables were analyzed immediately before mepolizumab initiation (t0) and at 1 (t1), 3 (t3), 6 (t6), 12 (t12), 18 (t18), and 24 (t24) months after treatment, using Wilcoxon test for paired data (significance: p < 0.05). Results. Eight patients were enrolled [M 50%, F 50%; median diagnostic delay: 6 (2-18) months]. Clinical features at onset are reported in Figure 1, Table 1. At iHES onset, median eosinophil count (EC) was 6,375 (4,570-12,282) cells/µl, 1 patient showed eosinophilia and 7 patients hypereosinophilia. The median time from diagnosis to mepolizumab initiation was 3 (0-14) months, with a median follow-up of 21 (5-24) months. Seven patients had received GCs before mepolizumab and were still on steroid therapy at the time of initiation. Furthermore, patient 2 had been treated with cyclosporine A for lichenified trunk eczema. At t0, 2 patients showed eosinophilia and 3 hypereosinophilia. A marked decrease in EC was observed as early as t1 [median t0: 980 (895-439) cells/µl; median t1: 116 (82-147) cells/µl; p: 0.0078], which was maintained at the last available follow-up [median at last follow-up: 70 (40-352) cells/µl; p: 0.0234]. At t6, 2 patients showed a significant rebound in ECs. In patient 1, hypereosinophilia persisted from t6 onward, and both GCs and dupilumab were introduced at t18. Patient 6 was hospitalized at t6 and late…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Hypereosinophilic syndrome
  topic: keywords
subject: Mepolizumab
  topic: keywords
subject: Cohort study
  topic: keywords
subject: Jacopo Mora
  topic: disciplines
subject: Francesca Regola
  topic: disciplines
subject: Paola Toniati
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2053

PO:22:033 | Unraveling VEXAS syndrome: when skin manifestations and monoclonal gammopathy precede hematological myeloid alterations
type: item
description: Background. VEXAS (Vacuoles, Enzyme E1, X-linked, Autoinflammatory, Somatic) syndrome is a rare adult disease caused by somatic mutations in the UBA1 gene within hematopoietic stem cells (1). These mutations compromise the ubiquitin-activating E1 enzyme and lead to a heterogeneous clinical presentation that includes autoinflammatory signs—such as fever and skin involvement in 80% of cases, primarily manifesting as neutrophilic dermatosis, chondritis, and serositis—as well as hematological alterations in myeloid lineage cells, including macrocytic anemia, myelodysplastic syndrome, and stem cell vacuolization in the bone marrow (1, 2). Case report: P.L., is a 80 years old man who developed fever, weight loss, fatigue, and urticarioid rash in the lower limbs and dorsum: exams showed an increase of inflammation markers (CRP 250 mg/L, ferritin 2,500 ng/mL) and a newly discovered seric IgG-lambda monoclonal component (MC), while complete blood count, LDH, autoimmunity, and liver and kidney function were within the normal range; the first skin biopsy suggested eczema. Steroid therapy was started, with a temporary benefit that was lost during tapering. Three months later the patient developed pericarditis and started colchicine. Total-body CT and PET scans ruled out possible occult malignancies. Given the need of prolonged steroid therapy to control the symptoms and the new MC, a bone marrow biopsy (BMB) was performed (no signs of disease) alongside a new skin biopsy, positive for neutrophilic dermatosis. The patient started dapsone, but there was no improvement. After a rheumatologic consult, according to Strasburg criteria (chronic urticaria, MC, high inflammation markers) (4), the patient was diagnosed with Schnitzler syndrome (SchS) and started anakinra. Eventually, given the lack of improvement and the development of injection-site reactions, therapy switched to canakinumab with partial improvement. The patient then developed macrocytic anemia. Considering the failure …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: VEXAS syndrome
  topic: keywords
subject: Rash
  topic: keywords
subject: monoclonal gammopathy
  topic: keywords
subject: Laura Di Centa
  topic: disciplines
subject: Simone Longhino
  topic: disciplines
subject: Valeria Manfrè
  topic: disciplines
subject: Stefania Sacco
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2182

PO:22:039 | A rare form of interstitial lung disease: granulomatous and lymphocytic interstitial lung disease
type: item
description: Background. In August 2024, a 48-year-old man presented to the emergency department with worsening dyspnea and oxygen desaturation. His medical history was remarkable only for IgA deficiency, but he reported recurrent episodes of pneumonia over the previous two months, treated with multiple antibiotics without improvement. He was admitted to the Department of Pulmonology at our hospital because his chest X-ray showed pulmonary infiltrates, his inflammatory markers were high, and he needed oxygen therapy. Chest CT performed during hospitalization showed diffuse nodular consolidations and ground-glass opacities predominantly in the middle and lower pulmonary lobes bilaterally. Autoimmune screening (ANA, ENA, ANCA, RF, anti-CCP, and myositis blot), serum precipitins, and microbiological tests (blood cultures, galactomannan, β-D-glucan, CMV DNA, and Borrelia serology) were all negative. Rheumatologic evaluation revealed no signs or symptoms suggestive of connective tissue disease. During hospitalization, treatment with iv methylprednisolone 80 mg led to oxygen therapy withdrawal and improvement of pulmonary consolidations on chest CT. The patient was discharged with a diagnosis of organizing pneumonia and prescribed prednisone 50 mg daily with gradual tapering. In January 2025, a new pulmonary consolidation was observed on CT scan. To further clarify the clinical picture, the patient underwent bronchoalveolar lavage (showing 50% lymphocytes, 30% macrophages) and transbronchial biopsy. Histopathological examination revealed foci of organizing pneumonia, lymphocytic inflammation, and nonnecrotizing granulomas, findings suggestive of Granulomatous and Lymphocytic Interstitial Lung Disease (GLILD). The case was discussed at the multidisciplinary interstitial lung disease meeting (including radiologists, pulmonologists, pathologists, rheumatologists), where a diagnosis of GLILD secondary to IgA deficiency was confirmed. The patient began treatment with Rituximab 1000 mg, whi…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: GLILD
  topic: keywords
subject: interstitial lung disease
  topic: keywords
subject: multidisciplinary
  topic: keywords
subject: Francesca Cozzini
  topic: disciplines
subject: Francesco Falco
  topic: disciplines
subject: Alberto Cavazza
  topic: disciplines
subject: Lucia Spaggiari
  topic: disciplines
subject: Chiara Marvisi
  topic: disciplines
subject: Francesca Petrillo
  topic: disciplines
subject: Caterina Ricordi
  topic: disciplines
subject: Francesco Muratore
  topic: disciplines
subject: Fabio Brandolino
  topic: disciplines
subject: Ilaria Chiapparoli
  topic: disciplines
subject: Carlo Salvarani
  topic: disciplines
subject: Andreina Manfredi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2183

PO:23:044 | Understanding fatigue through patients' eyes: development of a novel questionnaire capturing the complexity of real-life fatigue in Sjögren's disease
type: item
description: Background. Fatigue is one of the most frequent and impactful symptoms for patients with Sjögren's Disease (SjD), and one of the most challenging to measure. There are no PROs fully capturing fatigue as experienced by patients in their daily lives. The purpose of this study was to define a new PRO for assessing fatigue and its impact on the quality of life of patients with SjD, based on lived experiences and their own definitions of fatigue. Materials and Methods. A 15-item questionnaire was developed to capture different types of fatigue in SjD, based on a patient-authored essay published online. Items were formulated using patient-derived language and refined through expert review. Content validity was confirmed via CVI. A pilot phase with cognitive debriefing and patient feedback assessed clarity and relevance. Preliminary psychometric testing evaluated internal consistency. Items cover 15 distinct types of fatigue: basic fatigue, rebound fatigue, sudden fatigue, weather-related fatigue, molten lead phenomenon, tired-wired, flare-related fatigue, fatigue related to other physical causes, fatigue-related concentration impairment, stress/distress/anxiety/depression-related fatigue (SDAD), not sleeping well fatigue, normal aging fatigue, chronic illness fatigue, fatigue from trying to keep up with family and friends without a chronic illness, doctor fatigue. Results. 90 consecutive patients (female 93.4%) fulfilling SjD ACR/EULAR 2016 criteria, mean age 57.1 years (range 21–82), completed the questionnaire. The most frequently reported types of fatigue were SDAD (88.9%), basic (86.7%), and rebound (86.7%), while the least reported was weather-related (60%). The SDAD had the highest impact on quality of life (mean impact score 82.8%). Males more frequently reported SDAD (100%), doctor fatigue (100%), and not sleeping well (83.4%), while females reported rebound (89.3%), basic (88.1%), and SDAD (88.1%). Younger and older patients reported basic fatigue more frequently…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Questionnaires
  topic: keywords
subject: PRO
  topic: keywords
subject: New outcome measures
  topic: keywords
subject: Flavia Riccio
  topic: disciplines
subject: Mariachiara Visconti
  topic: disciplines
subject: Corrado Parlati
  topic: disciplines
subject: Nicola Della Rossa
  topic: disciplines
subject: Sabrina Marrone
  topic: disciplines
subject: Enrico Tirri
  topic: disciplines
subject: Francesco Ciccia
  topic: disciplines
subject: Saviana Gandolfo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2054

https://www.reumatismo.org/reuma/article/view/2184
type: item
title: PO:23:046 | Histopathological comparison between minor salivary gland biopsies from pediatric and adult patients with Sjögren’s disease: evidence of a more severe inflammatory profile in early-onset cases
description: Background. Pediatric-onset Sjögren’s disease (pSjD) presents distinct clinical and serological features compared with the adult form (SjD). While adults more frequently exhibit sicca symptoms such as xerophthalmia and xerostomia, parotid swelling and cutaneous involvement are the most common clinical manifestations in pSjD. From a serological perspective, pediatric patients less frequently test positive for ANA and anti-SSA/SSB antibodies but tend to show higher levels of rheumatoid factor (RF). The aim of this study was to compare the histopathological characteristics of minor salivary gland (MSG) biopsies between pediatric and adult patients with SjD. Materials and Methods. The study included 18 consecutive patients with pSjD followed at an Italian pediatric rheumatology center and 54 consecutively evaluated adult SjD patients from an adult rheumatology unit. All biopsy samples were examined by an expert pathologist at each site according to the EULAR recommendations for standardized histopathological assessment of minor salivary gland biopsies. Results. The surface area of biopsy specimens did not differ significantly between the two groups (p = 0.551). Pediatric patients displayed significantly higher focus scores (p = 0.0227) and a greater prevalence of ectopic germinal centers, as evidenced by increased CD21 (52.94% vs. 16.22%, p = 0.005) and Bcl6 expression (47.06% vs. 8.11%, p = 0.0011). Lymphoepithelial lesions were also more frequent in the pediatric cohort (55.56% vs. 18.92%, p = 0.0065), as was fibrosis (66.67% vs. 29.73%, p = 0.031). No significant differences were observed for glandular atrophy (p = 0.687) or ductal dilation (p = 0.128). When stratified by disease onset relative to menarche, prepubertal-onset patients exhibited a higher frequency of germinal centers and lymphoepithelial lesions than those with postpubertal-onset disease (p < 0.05). Conclusions. This study represents the first direct histopathological comparison of minor salivary gland…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: interdisciplinarity
  topic: keywords
subject: pediatric rheumatology
  topic: keywords
subject: prognostic markers
  topic: keywords
subject: Flavia Riccio
  topic: disciplines
subject: Mattia Neri
  topic: disciplines
subject: Martina Mellone
  topic: disciplines
subject: Immacolata Cozzolino
  topic: disciplines
subject: Jacopo Ferro
  topic: disciplines
subject: Valerio Gaetano Vellone
  topic: disciplines
subject: Ciro Emiliano Boschetti
  topic: disciplines
subject: Giuseppe Colella
  topic: disciplines
subject: Nicola Laffi
  topic: disciplines
subject: Pietro Buono
  topic: disciplines
subject: Enrico Tirri
  topic: disciplines
subject: Renato Franco
  topic: disciplines
subject: Marco Gattorno
  topic: disciplines
subject: Francesco Ciccia
  topic: disciplines
subject: Clara Malattia
  topic: disciplines
subject: Saviana Gandolfo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2184

PO:23:051 | Quantitative high-resolution computed tomography analysis in Sjögren’s disease-associated interstitial lung disease: CALIPER-derived imaging biomarkers for prognostic assessment
type: item
description: Background. Interstitial Lung Disease (ILD) is a frequent manifestation of Sjögren’s Disease (SjD), associated with significant morbidity and mortality. However, data on the prevalence of progressive-ILD in SjD remain scarce, and biomarkers for predicting progression are lacking. Computer-Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER) is a validated CT-based software that quantifies ILD patterns such as ground-glass opacities, reticulation, honeycombing, and low attenuation areas. CALIPER-derived parameters correlate with pulmonary function tests (PFT) and outcomes in IPF and other autoimmune ILDs, but their role in SjD-ILD is unexplored. Our aim was to assess the prognostic value of CALIPER-derived parameters in SjD-ILD patients Materials and Methods. SjD patients (2016 ACR/EULAR criteria) with HRCT-confirmed ILD followed from Jan-2018 to Sep-2023 were retrospectively included if >/=1 HRCT was suitable for CALIPER analysis. Clinical, laboratory and PFT data were collected at baseline and follow-up. Progressive-fibrosing ILD (PF-ILD) was defined (ATS criteria) by >/=2 of: worsening symptoms, FVC decline >/=5% or DLCO >/=10%, or radiological progression within 1 year. CALIPER-derived ILD% (sum of ground-glass, reticular, honeycombing) and VRS% (vascular-related structures) were calculated. Visual ILD extent (Warrick score) and pattern were assessed by a thoracic radiologist Results. Twenty-three patients (F:M=18:5, mean age 66.2±9.5 yrs, mean follow-up 6.1±5 yrs) were enrolled. ILD patterns included NSIP (n=14), UIP (n=6), and NSIP+OP (n=3). Dyspnea and cough occurred in 21 and 19 patients respectively. Median baseline FVC and DLCO were 83% and 64%. Seventeen patients received immunosuppressants; none received antifibrotics. Seven required long-term oxygen (LTO2) and 7 developed PF-ILD. Baseline ILD% and VRS% demonstrated a moderate-strong correlation with FCV% and DLCO%, visual ILD quantification (Warrick score) and between them (table 1). VRS%…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: ILD
  topic: keywords
subject: Radiomics
  topic: keywords
subject: Biomarkers
  topic: keywords
subject: Gaetano La Rocca
  topic: disciplines
subject: Francesco Ferro
  topic: disciplines
subject: Vincenzo Uggenti
  topic: disciplines
subject: Beatrice Dei
  topic: disciplines
subject: Giovanni Fulvio
  topic: disciplines
subject: Michele Moretti
  topic: disciplines
subject: Chiara Romei
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
subject: Chiara Baldini
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2055

PO:23:052 | Muscular and myocardial involvement in antisynthetase syndrome: a retrospective real-life study
type: item
description: Background. Antisynthetase syndrome (ASS) is a systemic autoimmune disease characterized by anti-aminoacyl-tRNA synthetase antibodies positivity and clinically manifested by interstitial lung disease (ILD), myositis, and arthritis. This retrospective real-life study, evaluates longitudinal changes in clinical and laboratory markers, as well as corticosteroid therapy, in muscular and myocardial involvement of ASS during the first two years after referral to our center. Materials and Methods. We retrospectively studied 39 patients with ASS at baseline (first evaluation at our centre) and at 12 and 24 months of follow-up. Myositis and myocardial involvement were assessed, and the following parameters were recorded: CRP(mg/L), ESR(mm/h), CPK(U/L), aldolase(U/L), Troponin T(mg/L), NT-proBNP(pg/mL), and ejection fraction(%EF). Corticosteroids and immunosuppressants were also evaluated. Predictors of steroid suspension at 12 and 24 months were evaluated. Results. In our cohort, 79% were females, median age 63 (52-70) years, median disease duration 7 (3-7.5) years. 64% were positive for anti-Jo1 antibodies. 32 (82%) patients had IIM-ILD, 26 patients (67%) had myositis, 12 (31%) had myocardial involvement. Baseline features are summarized in Table 1. Modifications in immunosuppressive therapies over time in Figure 1. Among patients with myositis, CRP levels declined at 12 months (p=0.042), and stabilized at month 24 (p=0.092). ESR levels significantly decreased at both timepoints (p=0.021, p=0.021); CPK levels dropped at both 12 and 24 months; aldolase levels remained stable (see Table 2). The % of patients on oral corticosteroids decreased from 96% at baseline, to 73% at 12 months (p=0.077) and 62% at 24 months (p=0.016), with a significant dose reduction in both timepoints (p<0.001, p=0.027). In addition, the % of patients receiving corticosteroid boluses significantly dropped from 27% at baseline, to 4% at 12 months and 0% at 24 months (p=0.002). Among patients with myoca…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Real-life
  topic: keywords
subject: Antisynthetase syndrome
  topic: keywords
subject: Myocardial
  topic: keywords
subject: Giulia Buonsante
  topic: disciplines
subject: Giacomo De Luca
  topic: disciplines
subject: Veronica Batani
  topic: disciplines
subject: Daniele Scaramuzzi
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
subject: Marco Matucci-Cerinic
  topic: disciplines
subject: Corrado Campochiaro
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2056

PO:23:055 | Overlap of systemic sclerosis and Sjögren’s disease: insights from an Italian case-control study
type: item
description: Background. Patients with systemic sclerosis (SSc) may refer sicca symptoms, mainly due to glandular fibrosis but also in the setting of coexisting Sjögren’s disease (SjD)[1,2]. This overlap was first described in 1965[3], but available data on the characteristics of patients with concurrent SSc and SjD remain limited and outdated. Materials and Methods. This case-control study aimed to characterize a large cohort of Italian patients with overlapping SSc and SjD (SSc/SjD), and to identify significant clinical and immunological differences compared to patients with isolated SSc or SjD. METHODS Patients included in the SSc/SjD cohort fulfilled both the 2013 ACR/EULAR classification criteria for SSc[4] and the 2016 ACR/EULAR criteria for SjD[5]. The control groups (1:2 ratio) consisted of patients with a diagnosis of SSc or SjD only, without further rheumatological overlap, consecutively seen between January and December 2024. The clinical data of the studied groups were extracted from the medical records and analysed with appropriate statistical tests using GraphPad Prism v9. Results. A total of 50 patients with SSc/SjD (98% women, mean age ± SD: 67±11 years) were included, compared to 100 patients with SSc alone and 100 patients with SjD alone. Patients with SSc/SjD were significantly older than those with isolated SSc (p<0.01) or SjD (p<0.001) and had a longer disease duration than patients with SSc (p<0.001). In terms of autoimmunity, SSc/SjD patients presented more frequently positive ANA (p<0.01), anti-CENP (p<0.0001), and anti-TopoI (p<0.0001) antibodies than those with SjD alone. Anti-SSA antibodies were more common in SSc/SjD than in SSc (p<0.0001), whereas anti-SSB antibodies were less common in SSc/SjD than in SjD (p<0.0001). Clinical features of the SSc/SjD group are detailed in Table. Sicca symptoms were more prevalent in SSc/SjD compared to SSc (p<0.0001). Interstitial lung disease (ILD) was more frequent in SSc/SjD than in SjD (p<0.0001), and comparable …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic Sclerosis
  topic: keywords
subject: Sjögren's syndrome
  topic: keywords
subject: Overlap
  topic: keywords
subject: Stefano Stano
  topic: disciplines
subject: Fabio Cacciapaglia
  topic: disciplines
subject: Maria Morrone
  topic: disciplines
subject: Simone Perniola
  topic: disciplines
subject: Marco Capodiferro
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Laura Coladonato
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2057

PO:24:056 | Major salivary gland ultrasonographic features of lymphoma and high lymphoproliferative risk lesions in Sjögren’s disease: a systematic review
type: item
description: Background. Sjögren's disease (SjD) is burdened by significant lymphoproliferative risk. Up to date there is no established consensus on the salivary gland ultrasonographic (SGUS) features of lymphoma or of high lymphoproliferative risk (HLR) lesions (e.g., LELs, GCs, MESA/LESA). The aim is to systematically review existing literature on SGUS features of SjD patients complicated by SG Lymphoma or HLR lesions. Materials and Methods: a systematic review of existing literature (SLR) (January 1988 – January 2025) was conducted according to PRISMA 2020 guidelines (Prospero registration: CRD420251008467). Results: 15 studies (13 full text articles, 2 international conference abstracts) were included, with a predominantly moderate-low risk of bias (Figure 1). 13/15 described SGUS features of lymphoma, considering 121 total cases. 11/13 described the presence of focal lesions in lymphomas (8/11 quantitatively), identifying 45 focal lesions on 117 cases. These lesions were described with variable features, but commonly presented as a dominant glandular hypo- to anechoic mass on SGUS (Table 1). In 3/11 studies, the parenchyma surrounding the focal lesion was also assessed, with quantitative or inferable SGUS scores indicating moderate to severe involvement in all cases (Table 1). 10/13 studies described a diffuse glandular involvement (presence of SGUS abnormalities) in lymphoma cases (7/10 quantitatively), identifying 32 cases on 105 lymphomas. 4/10 studies quantitatively reported SGUS scores, with moderate-severe involvement in most cases (Table 2). 9/15 studies described HLR lesions, with a total of 161 quantifiable cases. In 4/9 a focal lesion in HLR cases was described, resulting in 11 focal lesions on 16 HLR cases considered, with descriptions and features as heterogeneous as lymphomas. Only 1/4 studies addressed SGUS features of the surrounding parenchyma, reporting a severe grade (Tab.2). 5/9 studies reported a diffuse involvement in the absence of mention of focal le…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Sjogren
  topic: keywords
subject: Ultrasound
  topic: keywords
subject: Lymphoma
  topic: keywords
subject: Alessia Nano
  topic: disciplines
subject: Valeria Manfrè
  topic: disciplines
subject: Maria Teresa Rizzo
  topic: disciplines
subject: Garifallia Sakellariou
  topic: disciplines
subject: Alen Zabotti
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2058

PO:24:057 | Qualitative and quantitative analysis of nailfold videocapillaroscopy in patients with idiopathic inflammatory myopathies: focus on muscle histology
type: item
description: Background. Idiopathic inflammatory myopathies (IIM) are a group of autoimmune diseases characterized by inflammation of the muscle with clinical manifestations such as skin rash, interstitial lung disease, heart involvement or arthritis. Within IIM, we distinguish dermatomyositis (DM), immune-mediated necrotizing myopathy (IMNM), anti-synthetase syndrome (ASyS), inclusion body myositis (IBM), and Polymyositis (PM). Nailfold video-capillaroscopy (NVC) is a useful technique to study microvascular abnormalities in autoimmune diseases and a scleroderma-like (SL) pattern has been reported in about 70% of DM patients and in 35% of those with ASyS. Histologically, muscular findings are shared across IIM subgroups, such as sarcolemmal expression of MHC I and inflammatory infiltrates. Others are more specific: perifascicular atrophy (PFA) in DM or perifascicular necrosis (PFN) in ASyS. The aim of our study was to evaluate qualitatively and quantitatively the capillaroscopic alterations in IIM patients, for their possible associations with histological data. Materials and Methods. Patients with IIM who underwent muscle biopsy and NVC were prospectively enrolled. Morphological parameters were assessed qualitatively (number, length, distribution, and size of capillary loops, as well as microhemorrhages and neoangiogenesis). We also assigned a semiquantitative score (0–3) and other quantitative scores (total megacapillary count, mean of megacapillaries apex width, mean capillary density, number of hemorrhages, and mean of avascular areas). Results. We enrolled 20 patients including 9 with DM, 4 with ASyS, and 7 with PM. Table 1 presents the main clinical, histological, and capillaroscopic features of our cohort. Regarding capillaroscopic findings, we observed a significant association between the presence of a SL pattern and DM diagnosis (p=0.0098). Comparing the biopsies regardless of the type of idiopathic inflammatory myopathy (IIM), we observed a higher mean semiquantitativ…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: capillaroscopy
  topic: keywords
subject: Myositis
  topic: keywords
subject: Histology
  topic: keywords
subject: Jacopo Landro
  topic: disciplines
subject: Marius Cadar
  topic: disciplines
subject: Davide Mohammad Reza Beigi
  topic: disciplines
subject: Ilaria Bisconti
  topic: disciplines
subject: Francesca Romana Di Ciommo
  topic: disciplines
subject: Elena Platania
  topic: disciplines
subject: Martina Salerno
  topic: disciplines
subject: Beatrice De Girolamo
  topic: disciplines
subject: Annalisa Villa
  topic: disciplines
subject: Angelica Gattamelata
  topic: disciplines
subject: Simona Truglia
  topic: disciplines
subject: Cristiano Alessandri
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Valeria Riccieri
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2059

PO:24:058 | Serum ferritin as a biomarker in idiopathic inflammatory myopathies with interstitial lung disease: baseline levels and longitudinal trends
type: item
description: Background. Serum ferritin has been proposed as a biomarker of interstitial lung disease (ILD) in anti-MDA5 dermatomyositis (DM), but data on its role in other idiopathic inflammatory myopathies (IIM) with or without ILD are limited. This multicenter retrospective study aimed to evaluate serum ferritin as a specific and sensitive biomarker for IIM-ILD and to assess its correlation with clinical and immunological features, including a subanalysis on longitudinal ferritin changes in anti-MDA5 DM and antisynthetase syndrome (ASS) patients. Materials and Methods. We retrospectively included 139 adult patients with a definite diagnosis of IIM according to 2017 ACR/EULAR criteria, followed at referral centers in Siena, Palermo, Bari (Italy) and Lucknow (India). All had available baseline data on serum ferritin, muscle enzymes, inflammatory markers, lung function and myositis-specific antibodies: patients were grouped by ILD status and clinical phenotype. In a subgroup of 23 ILD patients (11 anti-MDA5 DM, 12 anti-Jo1 ASS), longitudinal data were analysed. Results. We enrolled 139 IIM patients (mean age 44.3±17.75 years), including 70 DM and 50 ASS , with 69 affected by ILD. Baseline ferritin was significantly higher in DM-MDA5 compared to DM-non-MDA5 (p=0.0073) and ASS (p=0.0006), and also differed between patients with and without ILD (p=0.0013) (figure 1). A ferritin cut-off of 303.5 ng/mL effectively excluded MDA5-DM at initial assessment, independently of CPK and CRP, suggesting ferritin’s specificity beyond systemic inflammation. A longitudinal subanalysis of 23 ILD patients (11 anti-MDA5 DM, 12 anti-Jo1 ASS) evaluated ferritin, disease activity, CRP, ESR, at baseline and up to 18 months. Despite ASS patients showing more extensive organ involvement (> 4 domains in 66%), baseline ferritin was higher in DM (median 312 vs 82 ng/mL, p=0.007), whereas CPK was elevated in ASS (median 336 vs 101 U/L, p=0.05). Over follow-up, DM patients demonstrated a progressive ferritin d…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Ferritin
  topic: keywords
subject: Dermatomyositis
  topic: keywords
subject: Interstitial lung disease
  topic: keywords
subject: Silvia Grazzini
  topic: disciplines
subject: Edoardo Conticini
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Chiara Rizzo
  topic: disciplines
subject: Federica Camarda
  topic: disciplines
subject: Paolo Cameli
  topic: disciplines
subject: Miriana D'Alessandro
  topic: disciplines
subject: Lidia La Barbera
  topic: disciplines
subject: Stefano Stano
  topic: disciplines
subject: Maria Rosa Pellico
  topic: disciplines
subject: Latika Gupta
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Giuliana Guggino
  topic: disciplines
subject: Elena Bargagli
  topic: disciplines
subject: Nicoletta Del Papa
  topic: disciplines
subject: Luca Cantarini
  topic: disciplines
subject: Bruno Frediani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2060

PO:24:061 | Allodynia is highly prevalent in patients with Sjögren’s disease and correlates with immunobiological disease markers: preliminary results from the sjnapse project
type: item
description: Background. Neurological involvement in Sjögren’s disease (SjD) is frequently underdiagnosed due to the extreme variability and heterogeneity of clinical manifestations, the lack of standardized diagnostic criteria, and the absence of anti-SSA/anti-SSB autoantibodies in a substantial proportion of patients. The SjNAPSE Project (Sjögren’s Neuroinflammation Assessment, Pain, and Symptoms Evaluation) is a prospective, multicenter study designed to investigate neurological involvement in patients with SjD without a previous diagnosis of neuro-Sjögren and in the absence of comorbidities that could account for neurological manifestations. Materials and Methods. A total of 100 patients (95 females, 95%) fulfilling the 2016 ACR/EULAR classification criteria for SjD were consecutively enrolled. All participants completed the following questionnaires: Neuropathic Pain Symptom Inventory (NPSI), Patient Health Questionnaire-9 (PHQ-9), PainDetect Questionnaire (PD-Q), VAS pain, VAS fatigue, and VAS sicca. Sensory assessments for allodynia were performed according to the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), administered by the same examiner in each participating center. Patients who did not report pain or presented neurological involvement attributable to other known conditions were excluded. Results. Sixty-five patients (63 females, 96.92%) met the inclusion criteria. Among these, 40 patients (61.53%) tested positive for allodynia. The presence of allodynia showed a positive correlation with the scores of all administered questionnaires. Moreover, significant correlations were found between allodynia and rheumatoid factor (r = 0.85; p = 0.032), focus score (r = 0.47; p = 0.02), VAS pain (r = 0.64; p < 0.001), VAS fatigue (r = 0.55; p < 0.001), and ESSPRI (r = 0.50; p < 0.001). No significant correlation was observed with ESSDAI, although a positive trend was noted. An inverse trend was also observed between the presence of allodynia and anti-SSA antibody p…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: OUTCOME MEASURES
  topic: keywords
subject: neurological involvement
  topic: keywords
subject: Clinical questionnaires
  topic: keywords
subject: Flavia Riccio
  topic: disciplines
subject: Maria Chiara Visconti
  topic: disciplines
subject: Corrado Parlati
  topic: disciplines
subject: Nicola Della Rossa
  topic: disciplines
subject: Sabrina Marrone
  topic: disciplines
subject: Enrico Tirri
  topic: disciplines
subject: Francesco Ciccia
  topic: disciplines
subject: Saviana Gandolfo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2185

PO:24:062 | Transcriptomic profile of salivary glands in patients with primary Sjögren’s syndrome and interstitial lung disease: implications for pathogenesis and risk stratification
type: item
description: Background. Primary Sjögren’s syndrome (pSS) is a chronic autoimmune inflammatory disease that typically develops in the absence of another systemic autoimmune disorder. Interstitial lung disease (ILD) represents the most frequent pulmonary manifestation of pSS and is associated with impaired lung function and potentially severe complications. Stratifying patients according to their risk of developing pSS-associated ILD (pSS-ILD) and identifying those at increased risk at an early stage may enable timely therapeutic intervention. Therefore, transcriptomic studies aimed at identifying differentially expressed genes across the three study groups may prove useful for the characterization of predictive disease factors. Materials and Methods. Transcriptomic analyses of inflammatory and immune-related gene panels were performed on patients with ILD, pSS, and pSS-ILD using the NanoString nCounter platform. RNA was extracted from FFPE-embedded minor salivary gland samples obtained from eight patients in each group. Only RNA samples with the highest DV200 values, as assessed by Bioanalyzer, were used for further analysis. Data were processed using the nSolver software, and genes showing significant up- or down-regulation with p < 0.05 were considered differentially expressed. Results. Gene expression analysis in patients with ILD revealed significant differences in immune and inflammatory responses compared to patients with isolated pSS. The up-regulation of TSLP, IL1RN, MAP2K6, JUN, IL1RL1, TNFRSF14, CXCL10, and IL7, along with the down-regulation of PIGR and ITGA6, signifies modified immunologic activity that may aid in clarifying the pathophysiology associated with ILD. Moreover, substantial gene expression variations were observed between pSS-ILD and isolated ILD. Elevated expression of HIF1A, NFATC3, FLT1, APP, and CD14, alongside diminished expression of transcription factors like MYC and FOS, indicates significant modifications in intracellular signaling pathways that…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: interstitial lung disease
  topic: keywords
subject: Transcriptomic
  topic: keywords
subject: comorbidity
  topic: keywords
subject: Elisa Pignatti
  topic: disciplines
subject: Monia Maccaferri
  topic: disciplines
subject: Alessandra Bisagni
  topic: disciplines
subject: Alberto Cavazza
  topic: disciplines
subject: Marco Sebastiani
  topic: disciplines
subject: Luca Keller
  topic: disciplines
subject: Luca Magnani
  topic: disciplines
subject: Claudio Galluzzo
  topic: disciplines
subject: Tommaso Fasano
  topic: disciplines
subject: Lucia Nota
  topic: disciplines
subject: Giulia Canu
  topic: disciplines
subject: Andreina Manfredi
  topic: disciplines
subject: Carlo Salvarani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2186

PO:24:066 | Antibody profile in myositis and early risk of interstitial lung disease: clinical and laboratory correlations in patients with suspected rheumatologic disease
type: item
description: Background. Interstitial lung disease (ILD) is a frequent comorbidity not only in idiopathic inflammatory myopathies (IIM) but also in other rheumatologic disorders such as Sjögren’s syndrome, systemic sclerosis, and rheumatoid arthritis. Since ILD can represent a potentially life-threatening complication of these conditions, several recent studies have investigated possible risk factors useful for early diagnosis. The aim of this study was to assess the correlation between positivity for an antibody associated with IIM, together with clinical and laboratory data, and the risk of ILD at the time of diagnosis of a rheumatologic disease. Materials and Methods. In this single-center, cross-sectional study, patients were enrolled according to the following inclusion criteria: a) suspected rheumatologic disease with myositic involvement; b) evaluation between January 2022 and May 2025 at a tertiary care center; c) diagnostic work-up including a line immunoassay for myositis autoantibodies (Euroimmun blot) with at least one positive result; d) chest CT scan performed. Data were collected on age, sex, clinical manifestations, creatine kinase (CPK) levels, and antibody positivity (from 1+ to 3+). A multivariate logistic regression model was applied to analyze the relationship between these variables and the presence of ILD at the time of diagnosis. Results. A total of sixty-three patients were included (45 females, 18 males). Sixteen had ILD (documented by chest CT) at the time of rheumatologic disease diagnosis (polymyositis, dermatomyositis, Sjögren’s syndrome, undifferentiated connective tissue disease, antisynthetase syndrome, or systemic sclerosis). After adjusting for clinical and laboratory variables, the strongest risk factor for ILD at diagnosis was a strong positivity for anti-Ro52 antibodies (≥2–3+). Older age at diagnosis and CPK levels <300 U/L were also identified as independent risk factors associated with ILD at disease onset (FIG 1). Raynaud’s phenomenon an…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Myositis
  topic: keywords
subject: anti-Ro52
  topic: keywords
subject: interstitial lung disease
  topic: keywords
subject: Lindsay Brooke Boling
  topic: disciplines
subject: Gaia Deleonardi
  topic: disciplines
subject: Alarico Ariani
  topic: disciplines
subject: Tania Silvestri
  topic: disciplines
subject: Ana Gabriela Grondona
  topic: disciplines
subject: Marica Trevisani
  topic: disciplines
subject: Rita Mulè
  topic: disciplines
subject: Enrica Vandelli
  topic: disciplines
subject: Gentiana Vukatana
  topic: disciplines
subject: Elisa Rossi
  topic: disciplines
subject: Olga Addimanda
  topic: disciplines
subject: Francesca Bergossi
  topic: disciplines
subject: Angela Buffa
  topic: disciplines
subject: Giovanni B. Canestrari
  topic: disciplines
subject: Francesco Cianci
  topic: disciplines
subject: Daniela Chiarini
  topic: disciplines
subject: Laura Gigante
  topic: disciplines
subject: Nicolò Girolimetto
  topic: disciplines
subject: Daniele Lini
  topic: disciplines
subject: Luca Magnani
  topic: disciplines
subject: Mirco Magnani
  topic: disciplines
subject: Erika Meleddu
  topic: disciplines
subject: Francesca Pignataro
  topic: disciplines
subject: Sofia Testoni
  topic: disciplines
subject: Massimo Reta
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2187

PO:24:070 | Preliminary descriptive data from a single-centre cohort of patients with idiopathic inflammatory myopathy: focus on paraneoplastic and non-paraneoplastic patients
type: item
description: Background. Idiopathic inflammatory myopathies (IIMs) are a group of autoimmune disorders with heterogeneous clinical manifestations. The discovery of myositis specific autoantibodies (MSAs) brought great advances, because they are strongly associated with distinct clinical phenotypes and different prognosis. Among MSAs, anti-TIF1(a-TIF1) antibodies are considered a strong serologic marker for cancer-associated myositis (CAM, defined as myositis arising ± 3 years from cancer diagnosis). Approximately 70% of DM patients a-TIF1+ are diagnosed as having concominant cancer. The aim of this study is to describe our cohort of IIMs patients, focusing on CAM patients and IIM cases with a history of cancer. Materials and Methods. Medical records of 213 IIM patients followed up at our Myositis Clinic were reviewed. The demographic data, diagnosis, autoantibodies, laboratory profile, instrumental and clinical features at onset were collected.Patients with a history of cancer were then considered and divided into 2 groups: the first one, named “Concomitant” (CC), composed by CAM cases, and group 2, named “Not concomitant” (NCC), consisting of IIM patients with neoplasia onset outside the 3-year period.Normality of the distributions was assessed using the Kolmogorov-Smirnov test. Continuous variables were presented as means ±SD and compared with Student’s T-test. Categorical variables were presented as frequencies or percentages and compared with Chi-Square test and the Fisher’s exact test, as appropriate; associations of the crosstabs were verified using standardized adjusted residuals. A two-sided alpha level of 0.05 was used for all tests. Results. Data from the entire cohort were showed in Table 1. Within the cohort 28,6% (N=61) of patients developed a malignancy: 30 patients defined as CC group (49.2%) and 31 patients as NCC one (50.8%). DM was the IIM most frequent in CC group (p=0,025) and ASS in NCC one (p=0,043). As shown in Table 3, no clinical features are significant…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: IIM
  topic: keywords
subject: Cancer-associated myositis
  topic: keywords
subject: Anti-TIF1 gamma autoantibodies
  topic: keywords
subject: Silvia Ebe Lucia Della Pina
  topic: disciplines
subject: Paola Bizioli
  topic: disciplines
subject: Samantha Mazza
  topic: disciplines
subject: Caproli Alessia
  topic: disciplines
subject: Cesare Tomasi
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2061

PO:25:071 | Gender differences in Sjögren’s disease: clinical activity, illness perception, and emotional impact
type: item
description: Background. Sjögren’s Disease (SjD) is a systemic autoimmune disorder with a marked female predominance, characterized by a broad spectrum of clinical manifestations and a substantial impact on quality of life. Yet, gender-related differences in disease perception and emotional experience remain poorly investigated. This multicenter study, promoted by GRISS, aimed to explore these aspects. Materials and Methods. Eighty-six patients (30 men and 56 women) with primary SjD (ACR–EULAR criteria) were enrolled. Disease activity was assessed using the ESSDAI, while subjective symptom intensity was measured with the ESSPRI. Illness perception was evaluated through the Brief Illness Perception Questionnaire (BIPQ), which includes eight items addressing cognitive (consequences, timeline, personal control, treatment control, perceived symptoms), emotional (concern, emotional impact), and understanding dimensions. Emotional status was assessed using the Hospital Anxiety and Depression Scale (HADS), comprising the anxiety (HADS-A) and depression (HADS-D) subscales. Statistical analyses were performed with Student’s t-test or Mann–Whitney test for group comparisons, and Pearson or Spearman correlations to explore associations between variables. General characteristics are shown in Table 1; significant findings are summarized in Table 2. Results. Compared with women, men displayed significantly higher systemic disease activity (ESSDAI, p = 0.0102) but lower symptom intensity (ESSPRI, p = 0.0107). Women reported higher levels of anxiety (p = 0.0054) and depression (p = 0.0033) and perceived a greater emotional impact of the disease (BIPQ item 8, p = 0.0153). Correlations between illness perception and psychological distress revealed gender-specific patterns. In women, both HADS-A and HADS-D correlated with the disease’s impact on daily life (item 1), symptom intensity (item 5), and emotional burden (item 8); only HADS-A was associated with disease-related concern (item 6). In men, …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: gender differences
  topic: keywords
subject: Perception
  topic: keywords
subject: emotional impact
  topic: keywords
subject: Ilenia Fischetti
  topic: disciplines
subject: Martina Salerno
  topic: disciplines
subject: Linda Mastromanno
  topic: disciplines
subject: Angelica Gattamelata
  topic: disciplines
subject: Martina Villa
  topic: disciplines
subject: Ludovica Manisera
  topic: disciplines
subject: Emanuele Grilli
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
subject: Valeria Manfrè2
  topic: disciplines
subject: Francesco Carubbi
  topic: disciplines
subject: Evy Di Ruscio
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Roberta Priori
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2188

PO:25:073 | Pulmonary involvement and progressive interstitial lung disease in anti-synthetase syndrome: a single-center retrospective study
type: item
description: Background. Anti-synthetase syndrome (ASS) is a systemic autoimmune disease frequently associated with lung involvement. This single-center retrospective study aimed to longitudinally assess the clinical and instrumental evolution of patients with ASS and Interstitial Lung Disease (ILD) and to evaluate the rate of disease progression. Materials and Methods. Clinical and instrumental data, including spirometric parameters (%pFVC and %pDLCO), radiological patterns, and fibrotic extent according to HRCT visual scoring, were collected at three time points: baseline (first visit at our center), 12 ± 3 months, and 24 ± 3 months. Progressive ILD at 12 and 24 months was defined according to the ATS/ERS/JRS/ALAT 2022 guidelines (presence of at least two among worsening respiratory symptoms, decline in %pFVC ≥ 5% or in %pDLCO ≥ 10%, or radiological progression) and the INBUILD trial criteria (at least one among %pFVC decline ≥ 10%, 5–10% decline in %pFVC with worsening symptoms or radiological progression, or worsening of symptoms and radiological progression). Predictors of progression were analyzed. Results. Thirty-three patients with ASS-ILD were included. Patients and disease characteristics are summarized in Table 1. Twenty-five patients (76%) presented pulmonary involvement at disease onset. The most frequent radiological pattern was NSIP, observed in 23 patients (70%), followed by UIP in 6 patients (18%), OP in 2 patients (6%), and mixed NSIP-OP in 2 patients (6%). Fibrotic extent on HRCT was ≤10% in 15 patients (46%), 10–20% in 10 patients (30%), and >20% in 8 patients (24%). The distribution of NYHA functional class for dyspnea across the three time points is shown in Graphic 1. We observed an improvement from baseline in NYHA functional class for dyspnea (2, 4, and 2 patients moved from class IV, III, and II to class I, respectively, at both 12 and 24 months), as well as an improvement in exertional dyspnea at 24 months [24 (73%) vs 15 (45%); p = 0.0242], together w…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Antisynthetase Syndrome
  topic: keywords
subject: Interstitial Lung Disease
  topic: keywords
subject: Progression
  topic: keywords
subject: Daniele Scaramuzzi
  topic: disciplines
subject: Giacomo De Luca
  topic: disciplines
subject: Veronica Batani
  topic: disciplines
subject: Giulia Buonsante
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
subject: Marco Matucci-Cerinic
  topic: disciplines
subject: Corrado Campochiaro
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2189

https://www.reumatismo.org/reuma/article/view/2062
type: item
title: PO:25:074 | Capillaroscopic assessment in interstitial lung disease: a comparative study between connective tissue disease-associated interstitial lung disease, interstitial pneumonia with autoimmune features, and idiopathic pulmonary fibrosis
description: Background. Nailfold videocapillaroscopy (NVC) is a validated, non-invasive tool for evaluating microvascular ab-normalities, increasingly explored in interstitial lung diseases (ILDs) with suspected autoimmune fea-tures. However, data on capillaroscopic patterns across ILD subtypes, especially in Caucasian popu-lations, are limited. Objectives: To compare NVC findings in patients with idiopathic pulmonary fibrosis (IPF), interstitial pneumonia with autoimmune features (IPAF), and connective tissue disease-associated ILD (CTD-ILD), and to assess correlations with autoantibody status—particularly myositis-specific antibodies (MSA – Jo-1, KS, PL7/PL12, NXP-2, MDA-5). Materials and Methods. Fifty-nine Caucasian ILD patients underwent NVC during routine evaluation. Based on multidiscipli-nary diagnosis, they were classified as IPF (n=9), IPAF (n=10), or CTD-ILD (n=40), further subdivided into systemic sclerosis (SSc, n=20) and non-SSc CTD-ILD (n=20). A validated 6-item semiquantitative scoring system (range 0–3 per item, max 18) was used; individual items are listed in Table 1. Clinical data included demographics and autoimmune serology (ANA, ENA, MSA). Statistical comparisons employed ANOVA and Student’s t-test. Results. Total capillaroscopic scores differed significantly across diagnostic groups: CTD-ILD (6.1±3.09), IPAF (4.6±3.31), and IPF (3.4±1.74) (p=0.0042). Within CTD-ILD, SSc patients showed higher scores than non-SSc (7.4±2.87 vs 4.8±3.22; p=0.0105). A four-group comparison confirmed this trend (p=0.0042). Among individual items, only “loss of capillaries” differed significantly across groups (p<0.0001), with highest scores in SSc. Subsequently, the total capillaroscopic score was analyzed in relation to autoimmune serology: it was not significantly different between MSA+ and MSA- pati-ents (5.21±3.51 vs 5.51±3.17; p=0.7805). After excluding the 9 patients with IPF, the comparison between MSA+ and MSA- subjects still revealed no significant difference in total…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Capillaroscopy
  topic: keywords
subject: Pulmonary interstitial disease
  topic: keywords
subject: Inflammatory myopathies
  topic: keywords
subject: Daniele Vito And Sabella
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Laura Coladonato
  topic: disciplines
subject: Marlea Lavista
  topic: disciplines
subject: Veronica Spedicato
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2062

PO:25:075 | Cancer occurence in patients with idiopathic inflammatory myopathies: new insights from the analysis of a monocentric cohort
type: item
description: Background. Idiopathic inflammatory myopathies (IIMs) are rare systemic autoimmune disorders, associated with an increased risk of cancer. Data from International Guideline for IIMs-Associated Cancer Screening identified the following conditions as a risk factor for cancer development: Dermatomyositis (DM), Anti-TIF1-gamma and Anti-NXP2 positivity, age >40 years at onset, persistent high disease activity despite therapy, dysphagia and cutaneous necrosis. The objective of the study was to assess the prevalence of cancer in a single-centre cohort of patients with IIMs, exploring possible correlations among cancer development, demographic and clinical parameters. Materials and Methods. We retrospectively analysed the medical records of consecutive patients diagnosed with IIMs according to the 2017 EULAR classification criteria and followed at our Unit. Data about demography, autoantibody profile, organ involvement and comorbidities were collected. Intergroups comparisons were assessed by using Chi- square, t-test and ANOVA. P values <0.05 were considered significant. Results. A total of 220 IIMs patients [mean age 66.5±14.3, 77 men (35%)] were enrolled. Among them, 30 (15.8%) had a diagnosis of cancer: 5 prostate, 5 breast, 3 endometrium, 3 lung, 3 larynx, 2 melanoma, 2 colon, 1 nasopharyngeal, 1 thyroid, 1 liver, 1 basal cell carcinoma, 1 squamous cell carcinoma, 1 MALT and 1 osteosarcoma. In this subgroup of patients, the mean age was 74.5± 9.4 years and 16 patients were men (53.3%). An older age and male sex were risk factors for neoplasms (respectively p <0.001 and p=0.03). No IIM phenotype appeared to significantly influence tumor risk, however, some differences emerged. Indeed,no patients with Clinically Amyopathic DM (CADM) and Immune-Mediated Necrotizing Myositis (IMNM) developed cancer. On the contrary, in the subgroup of Anti-synthetase syndrome (ASS) we found that 7 on 30 patients (23%) developed a cancer. Autoantibodies positivity for anti-Ro52 and anti-TIF…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Cancer
  topic: keywords
subject: Comorbidity
  topic: keywords
subject: Quality of life
  topic: keywords
subject: Michele Diomedi
  topic: disciplines
subject: Federico Fattorini
  topic: disciplines
subject: Simone Barsotti
  topic: disciplines
subject: Chiara Cardelli
  topic: disciplines
subject: Elenia Laurino
  topic: disciplines
subject: Alessandra Tripoli
  topic: disciplines
subject: Linda Carli
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2063

PO:25:079 | Anifrolumab in refractory dermatomyositis: a case report
type: item
description: Background. Dermatomyositis is a rare autoimmune disease characterized by multisystem involvement. Treatment can be challenging, particularly in refractory cases unresponsive to conventional therapies, for which standardized management protocols are lacking. An increased activation of the type I interferon (IFN-I) pathway has been demonstrated in patients with dermatomyositis, providing a rationale for the use of anifrolumab, a monoclonal antibody targeting the IFN-I receptor, already approved for systemic lupus erythematosus and particularly effective on cutaneous manifestations. Materials and Methods We report the case of a 57-year-old woman with anti–TIF-1γ–positive dermatomyositis, diagnosed in May 2024, with a history of high-grade serous ovarian carcinoma treated with surgery and chemotherapy (August 2024–February 2025). At rheumatologic evaluation in March 2025, the disease was clinically active with extensive cutaneous involvement, including heliotrope rash, malar rash without sparing of the nasolabial folds, diffuse erythema of the limbs, back, and décolleté, palmar and facial telangiectasias, and distal ulcers on the hands and right ear (Cutaneous Dermatomyositis Disease Area and Severity Index – CDASI: Activity 29, Damage 5). The patient also reported disabling myalgia and progressive gait impairment (Medical Research Council scale – MRC 45/60). Previous treatments (steroids, hydroxychloroquine, mycophenolate mofetil, intravenous immunoglobulins, and anakinra) were ineffective or discontinued due to adverse events, while rituximab was considered inappropriate because of her oncologic history. Therefore, monthly intravenous anifrolumab therapy was initiated. Results. After two months of anifrolumab treatment, marked clinical improvement was observed in both cutaneous (CDASI Activity 12; Damage 4) (Figure 1A–C, Figure 2A–B) and muscular domains (MRC 50/60), with no adverse events reported, including serious infections. The improvement allowed progressive co…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: dermatomyositis
  topic: keywords
subject: anifrolumab
  topic: keywords
subject: type I interferon
  topic: keywords
subject: Chiara Calabrese
  topic: disciplines
subject: Corrado Campochiaro
  topic: disciplines
subject: Giacomo De Luca
  topic: disciplines
subject: Veronica Batani
  topic: disciplines
subject: Marco Matucci-Cerinic
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2190

PO:25:081 | Atypical onset of anti-SAE-1 positive dermatomyositis: paraneoplastic flame hemorrhages in urothelial carcinoma
type: item
description: Background. Flame hemorrhages are a manifestation of infectious endocarditis, as well as autoimmune or neoplastic diseases. Anti-SAE-1 antibodies (small ubiquitin-like modifier-activating enzyme, against enzymes involved in gene transcription mechanisms and apoptosis control) are specific for a form of dermatomyositis with mild skin and muscle involvement that can be associated with neoplasms. Materials and Methods. We describe the case of a 50-year-old patient who developed flame hemorrhages and acrocyanosis with positivity for anti-SAE-1 antibodies. Results. Following a urinary tract infection, treated with levofloxacin, she developed Raynaud's phenomenon, flame hemorrhages, and acrocyanosis (Figure 1). Increased PCR and ESR (1.42 mg/dL and 45 mm/h), blood count and biochemistry within normal limits. An upper limb Doppler ultrasound and a chest CT scan ruled out vascular pathologies of the upper extremities, and a transesophageal echocardiogram ruled out infectious endocarditis. Video capillaroscopy showed the absence of a frank scleroderma pattern but the presence of multiple flame hemorrhages and thrombosed capillaries (Figure 2). Regarding autoimmunity: ANA positive, fine dense speckled cytoplasmic (AC-19), anti-ENA, ANCA, APL, and LAC absent. Anti-SAE-1 tested positive on the rare myositis antibody panel. Acrocyanosis was treated with an iloprost infusion, with partial benefit. During the first-level paraneoplastic screening, a third-degree hydronephrosis of the left kidney and dilation of the ureter at its opening into the bladder were detected by abdominal ultrasound. Further investigation with an abdominal CT scan with contrast revealed a lymph node mass responsible for the ureteral dilation, and endoluminal vegetations were present in the bladder (Figure 3). A radical cystectomy was performed, with histological confirmation of high-grade urothelial carcinoma, with positive lymph nodes. Conclusions. The reported case is peculiar, as there are no similar cas…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Anti-SAE-1 antibodies
  topic: keywords
subject: Flame-shaped haemorrhages
  topic: keywords
subject: Urothelial carcinoma
  topic: keywords
subject: Valentina Morandi
  topic: disciplines
subject: Alessandro Biglia
  topic: disciplines
subject: Francesco Maggiore
  topic: disciplines
subject: Sofia Chiricolo
  topic: disciplines
subject: Silvia Sammorì
  topic: disciplines
subject: Maria Cristina Sacchi
  topic: disciplines
subject: Edoardo Cammarata
  topic: disciplines
subject: Maria Rosa Pellico
  topic: disciplines
subject: Luigi Mario Castello
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2064

https://www.reumatismo.org/reuma/article/view/2191
type: item
title: PO:25:082 | Progressive interstitial lung disease secondary to Sjögren's disease in a patient with inclusion body myositis complicated by dysphagia: a multidisciplinary approach and therapeutic challenges
description: Background. Inclusion Body Myositis (IBM) is a rare idiopathic inflammatory myopathy, characterized by an insidious onset with progressive muscle weakness and dysphagia. While its association with Sjögren’s syndrome (pSS) has been reported, this overlap is uncommon and often challenging to manage. We present the case of a patient affected by this dual condition, treated at our center. Case report. A 70-year-old man, a former smoker, with a medical history of hypertension, hypothyroidism, transient ischemic attack, and prior intestinal obstruction surgery, presented to rheumatologic evaluation in 2017 with progressive dysphagia and muscle weakness. A diagnosis of IBM was established and confirmed by muscle biopsy. The patient was subsequently treated with intravenous immunoglobulins and pyridostigmine, achieving clinical improvement. In 2023, the patient developed new-onset xerophthalmia, xerostomia, and progressive exertional dyspnea. The comprehensive diagnostic work-up included a chest CT scan showing subpleural reticular thickening, mainly in the posterior-basal segments of the lower lobes, in the lateral segments of the middle lobe, and in the superior segments of the lingula. Pulmonary function testing showed a restrictive ventilatory defect and a moderate drop in DLCO. Serological analysis showed anti-Ro52 antibody positivity, and minor salivary gland biopsy demonstrated a focus score of 1. The overall findings were consistent with pSS. In 2024, due to worsening dyspnea, a new chest CT was performed, showing disease progression with the appearance of pulmonary fibrosis (radiologic UIP pattern). The case was discussed during a multidisciplinary meeting involving radiologists, pulmonologists, and rheumatologists. Due to the clinical and radiological deterioration of pSS-associated interstitial lung disease, treatment with nintedanib 150 mg twice daily, prednisone 50 mg with gradual tapering, and cyclophosphamide according to the NIH protocol was initiated. Maint…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: inclusion body myositis
  topic: keywords
subject: interstitial lung disease
  topic: keywords
subject: Sjogren's syndrome
  topic: keywords
subject: Emanule Cocchiara
  topic: disciplines
subject: Francesco Falco
  topic: disciplines
subject: Luca Spaggiari
  topic: disciplines
subject: Francesca Cozzini
  topic: disciplines
subject: Lucia Dardani
  topic: disciplines
subject: Gianluigi Bajocchi
  topic: disciplines
subject: Andreina Manfredi
  topic: disciplines
subject: Carlo Salvarani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2191

PO:25:083 | Overlap between Sjögren’s syndrome and lichen sclerosus: beyond coincidence?
type: item
description: Background. Lichen sclerosus (LS) is a chronic, immune-mediated inflammatory condition that predominantly affects mucocutaneous areas, particularly the anogenital region. Although the etiopathogenesis of LS remains poorly understood, autoimmune, genetic, infectious, and traumatic mechanisms have been hypothesized.¹ Large-scale epidemiological studies are limited, but the estimated prevalence in the general population ranges from 0.05% to 0.3%. ²,³ In Italy, LS is classified among rare diseases (prevalence 5/10,000; exemption code RL0060). LS has been associated with several dermatological and immune-mediated conditions, including Hashimoto’s thyroiditis, psoriasis, vitiligo, alopecia areata, ulcerative colitis, systemic lupus erythematosus (SLE), and systemic sclerosis. However, the relationship between LS and systemic autoimmune diseases warrants further investigation. Although some case reports have described overlap between LS and Sjögren’s disease (SjD), this potential association remains poorly explored. Outcome: To further investigate the possible overlap between LS and SjD. Materials and Methods: Medical records of patients with SjD and non-Sjögren sicca syndrome consecutively evaluated at the Sjögren Clinic of our Rheumatology Unit over the past 12 months were reviewed. During each visit, patients were specifically asked whether they had ever received a diagnosis of LS. Those reporting a prior diagnosis of LS were subsequently re-evaluated to confirm the diagnosis. Results. A total of 378 patients with SjD (13 males, 365 females; mean age 55 years, range 24–79; mean disease duration since diagnosis 3.7 years) and 99 subjects with non-Sjögren sicca (6 males, 93 females; mean age 56.3 years, range 34–72; mean symptom duration 3.12 years) were included. Among patients with SD, 7/378 (1.8%) female patients had a confirmed diagnosis of LS (mean age 46.8 years, range 37–55). None of the subjects with non-Sjögren sicca had LS. Conclusions. Although no statistically…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Sjogren
  topic: keywords
subject: LIchen Sclerosus
  topic: keywords
subject: autoimmune
  topic: keywords
subject: Emanuele Giovann Grilli
  topic: disciplines
subject: Ludovica Manisera
  topic: disciplines
subject: Ilenia Fischetti
  topic: disciplines
subject: Linda Mastromanno
  topic: disciplines
subject: Martina Villa
  topic: disciplines
subject: Angelica Gattamelata
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Roberta Priori
  topic: disciplines
subject: Serena ColaFrancesco
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2192

PO:26:088 | Rheumatologic immune-related adverse events from immune checkpoint inhibitors: a monocentric retrospective study
type: item
description: Background. Since their introduction into oncological practice, immune checkpoint inhibitors (ICIs) have revolutionized the treatment of several malignancies. However, their use is associated with the development of immune-related adverse events (irAEs), which can occur at any time during therapy and represent one of the main challenges in clinical management. Among irAEs, rheumatologic manifestations constitute a relevant subgroup, whose complexity requires a multidisciplinary approach capable of balancing disease control without compromising oncological prognosis. The aim of this study is to evaluate the clinical features of a monocentric cohort of patients who developed rheumatologic irAEs. Materials and Methods. Among the patients followed at the outpatient clinic in our Center dedicated to irAEs, those with rheumatic symptoms were retrospectively identified. For each patient, demographic data, type of malignancy, administered ICI(s), characteristics of the rheumatologic irAEs, possible concomitant irAEs, administered immunosuppressive therapies, and oncologic and rheumatologic outcomes (defined through disease score based on the specific type of irAE) were collected. Results. Ninety-one patients met the inclusion criteria, and the demographic and oncological characteristics are reported in Table 1. The most frequently observed oncological histotype was pulmonary adenocarcinoma (n=34, 37%), while the most commonly administered ICI was pembrolizumab (n=52, 51%). In 12 (13%) cases, a combination of multiple ICIs was administered. Patients were also treated with another oncological therapy in 76 (84%) cases. The median interval between the start of ICI therapy and the onset of the rheumatologic irAE was 3 (IQR 1–8) months. As shown in Figure 1a, the most frequent form was arthritis (n=53, 45%). In 5 (5%) patients, an ICI-induced relapse of pre-existing rheumatologic disease was observed (rheumatoid arthritis 3 [60%], psoriatic arthritis 1 [20%], systemic lupus eryt…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: immune-related adverse events
  topic: keywords
subject: Immune checkpoint inhibitors
  topic: keywords
subject: Retrospective study
  topic: keywords
subject: Giulio Fraticelli
  topic: disciplines
subject: Nicola Farina
  topic: disciplines
subject: Alessandro Tomelleri
  topic: disciplines
subject: Marco Matucci Cerinic
  topic: disciplines
subject: Corrado Campochiaro
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2065

https://www.reumatismo.org/reuma/article/view/2066
type: item
title: PO:26:095 | Educational online webinars of European Reference Network on rare and complex connective tissue and musculoskeletal diseases for patients, caregivers and healthcare professionals: six years' experience
description: Background. The European Reference Network on Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET), founded in 2017 by the European Union (EU) Commission, aimed to improve the management of rare connective tissue diseases (CTDs) across the EU. ReCONNET includes rare (Ehlers-Danlos Syndromes, IgG4-Related Diseases, Mixed Connective Tissue Disease, Relapsing Polychondritis) and complex with low prevalence (Antiphospholipid Syndrome, Idiopathic Inflammatory Myopathies, Sjögren’s Syndrome, Systemic Lupus Erythematosus, Systemic Sclerosis, and Undifferentiated Connective Tissue Disease) CTDs. Since 2019, ReCONNET Educational Committee organized free online webinars accessible live on Zoom platform and recorded on ReCONNET YouTube (YT) page. Aim of the study was to assess the interest and size of webinar viewers (wv) and views from patients/caregivers, HCPs, or both, for the different CTDs. Materials and Methods. Zoom live view data (available from October 2023) and YT views (available from 2019) were collected as of 2nd May 2025. Results. From 2019 up to 2025, ERN ReCONNET organized 73 webinars, totaling 147,030 YT views. Webinars on rare CTDs (n=20) collected 70,307 YT views (average 3,515±4,271 per webinar) and webinars on complex CTDs (n=53) totalized 76,723 YT views (average of 1,447±1,838 per webinar), the former with a significantly higher number of YT views per webinar (p<0.01). By considering Zoom data available from October 2023, live webinars targeted at patients/caregivers got 158 wv (6 webinars, average 26±18 per webinar); those for HCPs got 265 wv (11 webinars, average 24±9 per webinar) and those for both classes got 132 wv (6 webinars, average 22±15 per webinar) without statistically significant differences interclasses. The YT recording of the above webinars for patients/caregivers averaged 541±507 views (total of 3,244), those for HCPs 902±816 views (total of 9,925), and those for both classes 581±598 views (total of 3,486), without statistically…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Connective tissue diseases
  topic: keywords
subject: Rare diseases
  topic: keywords
subject: Education and training
  topic: keywords
subject: Emanuele Gotelli
  topic: disciplines
subject: Rosanna Campitiello
  topic: disciplines
subject: Eric Hachulla
  topic: disciplines
subject: Vanessa Smith
  topic: disciplines
subject: Joao Eurico Fonseca
  topic: disciplines
subject: Tadej Avcin
  topic: disciplines
subject: Gabriele Simonini
  topic: disciplines
subject: Silvia Aguilera
  topic: disciplines
subject: Lisa Matthews
  topic: disciplines
subject: Charissa Frank
  topic: disciplines
subject: Wiebke Lautré
  topic: disciplines
subject: Monica Testoni
  topic: disciplines
subject: Diana Marinello
  topic: disciplines
subject: Rosaria Talarico
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
subject: Maurizio Cutolo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2066

PO:26:097 | Ultrasound evaluation of temporomandibular disorders: comparative analysis between inflammatory and degenerative patterns in patients with and without rheumatological pathologies
type: item
description: Background. Temporomandibular disorders (TMD) encompass a heterogeneous group of conditions with varying etiologies, either inflammatory or degenerative, that affect the temporomandibular joint (TMJ). Differentiating these mechanisms is crucial for targeted treatment, especially in patients with underlying rheumatologic diseases, where TMJ involvement may reflect systemic activity. The aim of this prospective, cross-sectional study is to evaluate the usefulness of ultrasound (US) in identifying inflammatory or degenerative alterations of the TMJ, comparing the results between patients with known inflammatory rheumatic diseases (arthritis, connective tissue diseases, and vasculitis), primary fibromyalgia, and symptomatic individuals without known rheumatologic conditions. Materials and Methods. A total of 312 subjects (272 patients + 40 healthy controls) were subjected to standardized TMJ clinical and ultrasound evaluation between 2018 and February 2025. The sample was divided into two groups: Group A, consisting of patients without inflammatory rheumatic disease + healthy controls (asymptomatic for TMD) + primary fibromyalgia (n = 110); and Group B, consisting of patients with inflammatory arthropathy or connective tissue disease (n = 202). Clinical signs and symptoms related to TMD were recorded for each subject included in the study. The ultrasound parameters analyzed included more specifically inflammatory characteristics (joint effusion, synovial hypertrophy, and Doppler signal -PD-), and degenerative-mechanical features (condylar surface irregularities, enthesophytes, erosions, joint space narrowing, calcifications, and disc dislocations). Results. Inflammatory ultrasound findings—such as synovitis, joint effusion, and PD signal—were significantly more frequent in Group B (p < 0.05). Physical examination alone did not reliably differentiate inflammatory involvement from mechanical involvement in the TMJ (66.4% vs. 33.6%, p = 0.634) (Figure 4). Degenerative find…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Temporomandibular disorders
  topic: keywords
subject: either inflammatory
  topic: keywords
subject: Joint ultrasound
  topic: keywords
subject: Beatrice Maranini
  topic: disciplines
subject: Stefano Mandrioli
  topic: disciplines
subject: Fabio Fabbian
  topic: disciplines
subject: Tommaso Bianchi
  topic: disciplines
subject: Manlio Galiè
  topic: disciplines
subject: Marcello Govoni
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2193

PO:27:105 | Sleep disturbances in patients with polymyalgia rheumatica: correlations with disease activity, fatigue, and glucocorticoid dosage
type: item
description: Background. The aim of this study was to investigate the prevalence of sleep disturbances in patients with polymyalgia rheumatica (PMR) and to assess their possible correlation with disease activity, fatigue, and glucocorticoid (GC) dosage. Materials and Methods. Consecutive patients with PMR classified according to the 2012 ACR/EULAR provisional criteria and age- and sex-matched non-rheumatologic controls were enrolled. Demographic, clinical, and serological data, disease activity (PMR-activity score, PMR-AS, calculated using CRP); and current GC dose were recorded for all PMR patients. Both PMR patients and controls filled out questionnaires about their sleep quality and fatigue. These included the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), and the Fatigue Severity Scale (FSS). Patients taking GC for conditions apart from PMR were excluded. Results are expressed as median/interquartile range (IQR). The χ² test, or Fisher’s exact test, was used for the comparison of categorical variables, as appropriate. Correlations were assessed using Spearman’s rank correlation coefficient. A p-value <0.05 was considered statistically significant. Results. A total of 42 PMR patients (M/F 13/29, age 74.5 years [IQR 12.75], disease duration 6 months [IQR 8], ESR 18 mm/h [IQR 23.75], CRP 0.49 mg/dL [IQR 0.94], PMR-AS 1.085 [IQR 3.09], GC dose 5 mg/day prednisone equivalent [IQR 2.5]) and 42 controls (M/F 20/22, age 67 years [IQR 9.75]) were included (Table 1). Questionnaire adherence was 84% among PMR patients (42/50 respondents) and 100% among controls. Six PMR patients (14.2%) were taking hypnotic medications. The prevalence of sleep disturbances assessed by PSQI was 45% in PMR patients vs. 21% in controls (p<0.05). The prevalence of insomnia, evaluated by ISI, was 38% in PMR patients vs. 28% in controls (p=ns). Daytime sleepiness assessed by ESS was 0% in PMR patients vs. 7% in controls (p=ns). Fatigue prevalence…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: polymyalgia rheumatica
  topic: keywords
subject: sleep disturbance
  topic: keywords
subject: glucocorticoids
  topic: keywords
subject: Ilaria Franch
  topic: disciplines
subject: Lorenzo Di Sanzo
  topic: disciplines
subject: Chiara Castellani
  topic: disciplines
subject: Giulia Bevignani
  topic: disciplines
subject: Lucia Colella
  topic: disciplines
subject: Veronica Alò
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Rossana Scrivo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2194

PO:27:108 | Delphi consensus on the shared management of patients with rheumatologic and oncologic diseases
type: item
description: Background. The intersection between rheumatologic and oncologic diseases, especially concerning the use of immunostimulatory cancer therapies, poses relevant clinical challenges. Immunotherapy may induce rheumatologic or autoimmune manifestations, while csDMARDs or bDMARDs can affect the efficacy and course of oncologic treatment. The aim of this project was to develop expert-based recommendations, through consensus between the Italian Society of Rheumatology and the Italian Association of Medical Oncology, to support the shared management of patients with concomitant rheumatologic disease and malignancy, as well as immune-mediated adverse events from cancer therapies. Materials and Methods. A modified Delphi process was conducted according to principles of anonymity, iterative feedback, and multidisciplinary involvement (18 clinicians including rheumatologists, oncologists, and methodologists). After a narrative literature review (54 articles, 1988–2024), three key assumptions and 11 consensus statements were defined. Each statement was rated (0–10) via Google Forms. Critical or low-consensus feedback was revised and re-voted. Consensus was achieved when at least 75% of respondents scored >7.5. Results. Three key assumptions and 11 statements were submitted to voting in two separate sessions. The three main assumptions were: (1) tumor development may result directly or indirectly from rheumatologic disease or its therapies; (2) clinical evaluation must consider both oncologic stage and rheumatologic activity; (3) clinical management should be shared between oncologist and rheumatologist. The first assumption did not reach consensus. Statements in Sections A and B achieved consensus (Figure 1). Section A addressed the onset of malignancy in rheumatologic patients. Experts agreed on shared management, individualized evaluation of therapeutic continuation, relevance of cancer history, possible DMARD withdrawal in remission, and joint management in severe or active ca…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Oncology
  topic: keywords
subject: tumors
  topic: keywords
subject: Delphi
  topic: keywords
subject: Luigi De Marco
  topic: disciplines
subject: Augusta Ortolan
  topic: disciplines
subject: Antonio Carletto
  topic: disciplines
subject: Fulvia Ceccarelli
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
subject: Ginevra De Marchi
  topic: disciplines
subject: Ennio Giulio Favalli
  topic: disciplines
subject: Alessandro Inno
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Francesco Ciccia
  topic: disciplines
subject: Ennio Lubrano
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
subject: Immacolata Prevete
  topic: disciplines
subject: Roberta Ramonda
  topic: disciplines
subject: Nicola Silvestris
  topic: disciplines
subject: Marcello Tiseo
  topic: disciplines
subject: Michelina Turri
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2195

PO:27:112 | The impact of rurality in chronic inflammatory rheumatic diseases in the province of Udine (2014-2023): analysis of clinical outcomes and potential complications
type: item
description: Background. Chronic inflammatory rheumatic diseases (IRDs) are immune-mediated disorders that may be affected by geographical barriers, such as rurality and distance from specialized centers, potentially limiting access to care. Evidence regarding the impact of these factors on clinical outcomes remains scarce and mostly derived from non-European settings. This study investigates, within an Italian hub-and-spoke healthcare model, the influence of rurality, distance from the referral center, and other factors, such as comorbidities, sex, age, and type of IRD, on clinical outcomes among patients residing in the province of Udine. Materials and Methods. The study conducted a retrospective cohort analysis using administrative healthcare data, encompassing all incident diagnoses of IRDs (chronic arthritis, connective tissue diseases, and systemic vasculitis) from 2014 to 2023. Rurality was defined as residence in areas with a population density <150 inhabitants/km²; distance from the specialized center was measured in kilometers, with a threshold of 27 km (75th percentile). Comorbidities were classified according to the Charlson Comorbidity Index (CCI): mild (CCI=1), moderate (CCI=2), severe (CCI≥3). Outcomes analyzed included first hospitalizations and emergency department (ED) visits for avoidable IRD-related complications (infections, cardiovascular events, osteoporotic complications) and all-cause mortality. Statistical analysis: multivariable Cox regression. Results. A total of 3,044 patients were included, 66.33% female, with a median follow-up of 4.9 (2.4–7.3) years. Median age at diagnosis was 57 (47–67) years. The distribution of IRDs was as follows: chronic arthritis (73.95%), connective tissue diseases (17.53%), and vasculitis (8.51%). Overall, 32.95% of patients lived in rural areas, and 24.31% resided more than 27 km from the center. Rurality and distance did not correlate with an elevated risk of hospitalization, emergency department visits, or mortality (p…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: rurality
  topic: keywords
subject: comorbidities
  topic: keywords
subject: rheumatic diseases
  topic: keywords
subject: Simone Longhino
  topic: disciplines
subject: Luigi Castrista
  topic: disciplines
subject: Yvonne Beorchia
  topic: disciplines
subject: Marco Driutti
  topic: disciplines
subject: Elena Treppo
  topic: disciplines
subject: Silvio Brusaferro
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2196

PO:28:116 | Glandular involvement in autoimmune diseases: a spectrum of differential diagnosis
type: item
description: Background. Sarcoidosis is a multisystem disease of unknown etiology, characterized by the presence of non-necrotizing granulomas in multiple organs. It is a clinical condition capable of mimicking several disorders. For an accurate differential diagnosis, histopathological examination of the affected organ is crucial, in addition to clinical, radiological, and laboratory findings. Case Report. We report the case of a patient with a suspected IgG4-related disease in a differential diagnosis of sarcoidosis. A 25-year-old Pakistani male, smoker, and stable worker was referred to rheumatologic evaluation in January 2025 for progressive, painless, bilateral periorbital and parotid swelling that had developed since November 2024. Ophthalmologic examination and subsequent orbital MRI confirmed the presence of bilateral glandular hypertrophy. The patient denied any infectious episodes preceding symptom onset. His past medical history included only a left-sided Bell’s palsy with lagophthalmos in 2021, occurring after the first dose of the SARS-CoV-2 vaccine, which resolved after a short course of corticosteroids. At the presentation, he denied dry cough, dyspnea, fever or low-grade fever, arthritis/arthralgia, visual impairment, erythema nodosum, cutaneous lesions, or gastrointestinal symptoms. Physical examination revealed painless swelling of the parotid, submandibular, and lacrimal glands, associated with conjunctival hyperemia and lagophthalmos. Palpable, non-tender, mobile lymph nodes were noted in the right retroauricular and left laterocervical regions; no joint inflammation was detected. Given the suspicion of an IgG4-related disease, hospital admission was planned. During hospitalization, the patient underwent • Laboratory tests: ESR 45 mm/h, CRP 0.5 mg/dL, ACE 66 U/L, severe vitamin D deficiency (<4 ng/mL), PTH 36.3 pg/mL; normal serum calcium, phosphate, and 24-hour urinary calcium (145.2 mg). The patient's IgG subclasses were within normal limits, and both autoi…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: glands
  topic: keywords
subject: IgG4
  topic: keywords
subject: Sarcoidosis
  topic: keywords
subject: Francesca Petrillo
  topic: disciplines
subject: Caterina Ricordi
  topic: disciplines
subject: Caterina Tomassini
  topic: disciplines
subject: Luca Cimino
  topic: disciplines
subject: Giorgia Citriniti
  topic: disciplines
subject: Fabio Brandolino
  topic: disciplines
subject: Chiara Marvisi
  topic: disciplines
subject: Carlo Salvarani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2197

PO:28:126 | Effectiveness of the new AMEL system in the treatment of simple painful shoulder syndrome
type: item
description: Background. The term "shoulder periarthritis" refers to a group of conditions with a mixed degenerative-inflammatory pathogenesis and predominantly microtraumatic etiology, affecting the periarticular tendon structures (rotator cuff and long head of the biceps) and the subacromial bursa. Depending on the anatomical-pathological characteristics and anatomical location of lesions, different clinical pictures can occur. These syndromes are typically unilateral, with symptoms dominated by pain and restricted mobility. Among the various types of shoulder periarthritis, simple painful shoulder (SDs) is the expression of a small tendon lesion affecting the rotator cuff and characterized by the prevalence of the painful component over the limitation of joint motion. The analgesic-therapeutic efficacy and tolerability of Extremely Low Frequency (ELF) electromagnetic fields—modulated at a frequency of 100 Hz with a sinusoidal waveform and average induction of a few gauss—have been demonstrated in numerous studies conducted on various hyperalgesic pathologies, particularly of the musculoskeletal system. Materials and Methods. In this research, the authors evaluated a new type of pulsed magnetic field (PEMF) developed by AMEL, with frequency variation, whose frequency changes over time so that all permitted codes can be used during a single application. They compared it with a ELF field, a low-frequency magnetic field. For the purposes of comparison, 60 patients (28 females and 32 males), aged 37-66 years and diagnosed with simple shoulder pain, were enrolled. They were randomly divided into three groups of 20 subjects each and underwent treatment for 30 minutes per day for 20 days. One group was exposed to the AMEL PEMF, another to the ELF field, and a third to sham treatment. The sham field was included to rule out a placebo effect. Pain intensity and shoulder joint function were assessed before treatment, immediately after treatment, and at 30-day follow-up. Results. Patient…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Simple painful shoulder
  topic: keywords
subject: PEMF
  topic: keywords
subject: Therapy
  topic: keywords
subject: Antonietta Albanese
  topic: disciplines
subject: Emilio Battisti
  topic: disciplines
subject: Federico Filippi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2198

PO:28:127 | Efficacy of b/ts-DMARDS therapy on depressive and anxiety symptoms in patients with chronic inflammatory joint diseases: preliminary results of a prospective study
type: item
description: Background. Depression and anxiety frequently co-occur in chronic inflammatory diseases, with a prevalence of up to 20% in psoriatic arthritis. These patients may experience an increased risk of depression due to the influence of chronic pain and limitations in daily activities. In addition to the psychological effects of chronic illness, new research shows that systemic inflammation may directly cause anxiety and depression through neuroinflammatory pathways involving pro-inflammatory cytokines like TNF-alpha, IL-1beta, IL-6, IL-8, IL-17, and IL-23. The aim of the study is to evaluate the effect of b/ts-DMARDs therapies on anxiety-depressive symptoms and their relationship with disease activity. Materials and Methods. We present a prospective single-center longitudinal study on a cohort of patients with psoriatic arthritis, rheumatoid arthritis, or axial spondyloarthritis starting b/ts-DMARDs therapy, either as first-line or subsequent treatment. Patients were assessed at baseline (T0) and at 3 months (T3) using HAQ, SF-36, SAS, and BDI, self-report questionnaires for functional disability, quality of life, and anxious and depressive symptoms. We will integrate the currently available data, which represent preliminary 3-month results, with ongoing follow-up. Statistical analyses included comparisons between T0 and T3, correlations between changes in psychometric scores and clinical and functional parameters, as well as analysis of the influence of sex, antidepressant use, and drug class administered. Results. A total of 37 patients were included (mean age 54.9 ± 15.1 years; 75.7% women). At 3 months, patients experienced a mean worsening in BDI score (+3.22, SD 8.01) and SAS score (+1.94, SD 5.83), while their HAQ score improved (-0.24, SD 0.43). No significant differences were found in BDI, SAS, or HAQ score changes based on sex or antidepressant therapy. However, patients treated with antidepressants showed a mean reduction in SAS (-2.33) compared to an increase …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: arthritis
  topic: keywords
subject: depression
  topic: keywords
subject: b/ts-DMARDs
  topic: keywords
subject: Nikita Pecani
  topic: disciplines
subject: Christian D'Elia
  topic: disciplines
subject: Francesca Bartoli
  topic: disciplines
subject: Sabrina Aliberti
  topic: disciplines
subject: Francesco Rotella
  topic: disciplines
subject: Arianna Ida Altomare
  topic: disciplines
subject: Francesco Vinci
  topic: disciplines
subject: Lorenzo Cortoni
  topic: disciplines
subject: Davide Benedetti
  topic: disciplines
subject: Camilla Ferrari
  topic: disciplines
subject: Gemma Lepri
  topic: disciplines
subject: Silvia Bellando Randone
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2199

PO:29:138 | Cetylated fatty acids and fibromyalgia: efficacy and tolerability in a prospective study
type: item
description: Background. Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain, fatigue, sleep disturbances, and cognitive impairment, in the absence of organic lesions. It is often associated with comorbidities such as headache, anxiety, irritable bowel syndrome, hypothyroidism, and endometriosis. (1) Currently classified among central sensitization syndromes, FM is thought to be sustained by dysfunction in nociceptive processing within the central nervous system. (2) Given the lack of a universally effective therapy and the limited tolerability of conventional pharmacological agents in many patients, there is growing interest in the use of nutraceutical supplements as adjunctive treatment. Among these, cetylated fatty acids (CFAs)—natural lipophilic esters of fatty acids and cetyl alcohol—have been reported to exhibit excellent tolerability and potential analgesic properties. (3)(4) It has been further hypothesized that such effects may, at least in part, be mediated through modulation of the endocannabinoid system, specifically via inhibition of monoacylglycerol lipase (MAGL), resulting in increased levels of 2-arachidonoylglycerol (2-AG) and subsequent activation of CB1 and CB2 receptors. (5) Materials and Methods. The study enrolled a total of 45 patients with fibromyalgia (FM), diagnosed according to the 2016 ACR/EULAR criteria (14 males, 31 females; mean age: 54 years). All participants received one stick per day of cetylated fatty acids (Lipocet®) for a duration of 60 days. The following outcome measures were evaluated: – Visual Analog Scale (VAS) for pain; – Fatigue Severity Scale (FSS); – Health Assessment Questionnaire (HAQ). Assessments were conducted at baseline (T0), after 40 days of treatment (T1), after 60 days of treatment (T2), and 30 days following treatment discontinuation (T3). Results. The analysis revealed a significant reduction in VAS and FSS scores between T0 and T1, as well as between T1 and T2. HAQ scores showed a significant improv…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Cetylated fatty acids
  topic: keywords
subject: Fibromyalgia
  topic: keywords
subject: Fatigue
  topic: keywords
subject: Anna Capogna
  topic: disciplines
subject: Marco Bardelli
  topic: disciplines
subject: Luca Cantarini
  topic: disciplines
subject: Bruno Frediani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2200

PO:29:139 | Modulation of autonomic dysfunction in fibromyalgia through auricular vagal nerve stimulation: preliminary results
type: item
description: Background. Fibromyalgia is frequently associated with dysautonomia, including orthostatic intolerance and impaired vascular tone, contributing to symptom chronicity and poor therapeutic response. Transcutaneous auricular vagus nerve stimulation (tVNS) has emerged as a novel strategy to modulate autonomic pathways and restore vagal balance. This pilot study explored the short-term effects of tVNS on autonomic function in fibromyalgia using the Nurosym® device. Materials and Methods. Twenty-five women (mean age 48.6 ± 7.3 years) with fibromyalgia (ACR 2016 criteria) underwent 56 self-administered tVNS sessions over 28 days. The intervention consisted of 30-minute stimulations twice daily via electrodes on the auricular tragus. Autonomic function was assessed using the COMPASS31 questionnaire; symptom severity was measured by the FIQR. Paired comparisons (T0 vs T1) were conducted using t-tests or Wilcoxon tests, with effect sizes reported as Cohen’s d. Results. tVNS significantly improved the overall COMPASS31 score (49.5 ± 9.2 vs 43.1 ± 8.8; p = 0.019, d = 0.68). The orthostatic domain showed the strongest improvement (p = 0.016), and a favorable trend emerged in the vasomotor domain (p = 0.05). These changes suggest enhanced autonomic regulation, particularly of cardiovascular homeostasis. Changes in COMPASS31 did not significantly correlate with FIQR scores (r = 0.21), possibly due to the short treatment duration or the dissociation between autonomic and subjective symptom modulation. Conclusions. These preliminary findings support the role of tVNS as a promising non-pharmacologic intervention to target dysautonomia in fibromyalgia. The rapid improvement in objective autonomic parameters—particularly orthostatic function—highlights the potential of vagal modulation in addressing one of the disorder’s core pathophysiological components. Further studies with larger samples and longer follow-up are warranted.
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Fibromyalgia
  topic: keywords
subject: Disautonomia
  topic: keywords
subject: Vagus nerve
  topic: keywords
subject: Sonia Farah
  topic: disciplines
subject: Marco Di Carlo
  topic: disciplines
subject: Maria Giovanna Lommano
  topic: disciplines
subject: Benedetta Bianchi
  topic: disciplines
subject: Piercarlo Sarzi Puttini
  topic: disciplines
subject: Fausto Salaffi
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2067

PO:29:141 | Assessing psychosomatic diagnoses and psychological distress in patients with fibromyalgia. The clinical utility of a multidisciplinary approach
type: item
description: Background. Fibromyalgia is a central sensitization syndrome characterized by chronic widespread musculoskeletal pain associated with fatigue, sleep disturbances, cognitive impairment, psychological difficulties, and somatic and neurovegetative symptoms. It affects approximately 2–8% of the general population, with a higher prevalence among females. It is a functional disorder, given the lack of biological markers for diagnosis. The aim of the present study was to evaluate whether a multidisciplinary assessment which includes tools to evaluate mental disorders and psychological distress in fibromyalgia might be associated with psychosomatic syndromes and whether the occurrence of psychosomatic syndromes may influence patients’ psychological distress and functioning. Methods. We assessed 151 patients with fibromyalgia who were attending the Rheumatology Unit of the Academic Hospital Careggi in Florence, Italy. A clinical psychologist evaluated psychosomatic syndromes by administering the Revised Semi-Structured Interview for Diagnostic Criteria for Psychosomatic Research (DCPR-R-SSI). Psychological distress, psychological well-being, mental pain and perceived loneliness were evaluated via self-report questionnaires: Symptom Questionnaire (SQ), PsychoSocial Index (PSI), World Health Organization-Five Well-Being Index (WHO-5), Mental Pain Questionnaire (MPQ), and UCLA Loneliness Scale (UCLA). Results. The sample included 143 females and 7 males, with a mean age of 54.23 ± 12.63 years. Most participants had a partner (62.7%) and were employed (58.6%). Nearly all patients (94%) presented at least one psychosomatic syndrome. Patients with three or more psychosomatic syndromes showed significantly higher levels of anxiety, somatization, depression, anger–hostility, psychological distress, abnormal illness, mental pain, and perceived loneliness (p < 0.05), along with lower levels of psychological well-being (p < 0.05). Conclusions. Psychosomatic syndromes in patients with f…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Fibromyalgia
  topic: keywords
subject: assessment
  topic: keywords
subject: multidisciplinary
  topic: keywords
subject: Sara Ceccatelli
  topic: disciplines
subject: Francesca Nacci
  topic: disciplines
subject: Ginevra Fiori
  topic: disciplines
subject: Gemma Lepri
  topic: disciplines
subject: Fiammetta Cosci
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2201

PO:29:144 | Refractory localized pain in fibromyalgia and the importance of differential diagnosis: two cases of Bertolotti’s syndrome and avascular necrosis successfully treated with targeted therapy
type: item
description: Background. Fibromyalgia (FM) is a chronic widespread pain condition associated with multiple and heterogeneous systemic manifestations. It is currently regarded as a paradigmatic example of nociplastic pain, specifically a pain not attributable to direct nociceptive stimuli or neuropathic mechanisms, but rather to altered pain modulation processes due to peripheral and central sensitization (hyperalgesia and allodynia). FM may therefore present as a primary condition or coexist with other disorders that can influence its onset, course, and activity. We report two clinical cases of patients with refractory FM in whom an comprehensive diagnostic assessment revealed underlying osteoarticular disorders that responded to targeted treatment, leading to overall symptomatic improvement. Materials and Methods. The first patient, a 27-year-old woman diagnosed with FM two years earlier (according to the 2016 ACR/EULAR criteria: WPI 9, SSS 11) and with concomitant endometriosis and spasmophilia, complained of mixed low back pain poorly responsive to conservative therapy (amitriptyline, NSAIDs, neurotrophic supplements) and rehabilitation. Lumbosacral MRI revealed a left-sided L5 hemisacralization with hypertrophic transverse process articulating with the sacral ala (Castellvi type IIa), associated with subchondral bone marrow edema—findings consistent with Bertolotti’s syndrome (a lumbosacral transitional anomaly causing chronic low back pain). Intravenous neridronate treatment was initiated (100 mg per infusion, 4 infusions over 12 days). The second patient, a 73-year-old woman with a five-year history of FM (2016 ACR/EULAR criteria: WPI 8, SSS 10) under duloxetine therapy, presented with right hip pain initially attributed to myofascial iliopsoas syndrome in an osteoarthritic context. After failure of local infiltrative therapy, MRI demonstrated early avascular necrosis of the femoral head with subchondral bone edema. Combined treatment was started with intravenous neridrona…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: fibromyalgia
  topic: keywords
subject: Bertolotti syndrome
  topic: keywords
subject: avascular necrosis
  topic: keywords
subject: Andrea Lacarpia
  topic: disciplines
subject: Riccardo Terribili
  topic: disciplines
subject: Silvia Valentini
  topic: disciplines
subject: Marta Fabbroni
  topic: disciplines
subject: Stefano Barbagli
  topic: disciplines
subject: Stefano Gentileschi
  topic: disciplines
subject: Caterina Baldi
  topic: disciplines
subject: Luca Cantarini
  topic: disciplines
subject: Bruno Frediani
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2202

PO:29:145 | Fibromyalgia in idiopathic inflammatory myopathies: is it time for rheumatologists to investigate it?
type: item
description: Background. Fibromyalgia (FM) is a complex syndrome characterised by chronic pain, fatigue and functional symptoms; it is often accompained by mood disorders. FM affects, on average, 2.3% of the European population with a profound impact on both physical and social aspects of quality of life (QoL). FM is known to be a frequent comorbidity in Connective Tissue Diseases (CTDs). Few data are available at present about the prevalence of FM in Idiopathic Inflammatory Myopathies (IIMs) and about the profile of IIM patients with FM. The objective of the study was to determine the prevalence of FM in a monocentric cohort of IIMs patients, evaluating possible correlations with clinical features, disease activity and parameters of QoL. Materials and Methods. We retrospectively analyzed medical records of consecutive patients diagnosed with IIM according to the EULAR/ACR 2017 criteria and regularly followed at our specialistic outpatient Myositis Clinic. We collected data about demography, subset and disease duration, organ involvement, autoantibody profile and comorbidities. Patients’ QoL was investigated through the following Patient Reported Outcomes (PROs): Short Form 36 (SF36), Hospital Anxiety and Depression Scale (HADS), Health Assessment Questionnaire (HAQ). The diagnosis of FM was confirmed following the 2016 American College of Rheumatology Fibromyalgia Diagnostic Criteria. Intergroups comparisons were assessed by using Chi-square, t-test and ANOVA. P values <0.05 were considered significant. Results. A total of 184 patients were enrolled, 119 (64,7%) female, with a mean age of 66,5±11.2 years and a mean disease duration of 9.9±5.2 years. Twenty-three patients (12,5%) had FM, all of them were female. Taking into account epidemiological and clinical characteristics of patients, a diagnosis of FM was significantly associated with female sex (p<0.001), muscular involvement (p=0.015), lung involvement (p=0.036), sicca syndrome (p=0.004). Regarding comorbidities, a signif…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Quality of Life
  topic: keywords
subject: Fibromyalgia
  topic: keywords
subject: Myositis
  topic: keywords
subject: Federico Fattorini
  topic: disciplines
subject: Michele Diomedi
  topic: disciplines
subject: Simone Barsotti
  topic: disciplines
subject: Elenia Laurino
  topic: disciplines
subject: Chiara Cardelli
  topic: disciplines
subject: Alessandra Tripoli
  topic: disciplines
subject: Linda Carli
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2068

PO:30:151 | Clinical characteristics and evolution of juvenile undifferentiated connective tissue diseases: results of a single-center study
type: item
description: Background. Juvenile undifferentiated connective tissue diseases (UCTD) represent a heterogeneous clinical entity characterized by symptoms suggestive of connective tissue disease without meeting the classification criteria. Currently, epidemiological and prognostic knowledge about the pediatric population is limited, with implications for clinical and therapeutic management. The aim of our work is to describe the clinical and serological characteristics of a single-center cohort of patients with juvenile UCTD, evaluating the clinical course and potential evolution toward defined connective tissue diseases. Materials and Methods. We conducted a retrospective study on 33 patients diagnosed with juvenile UCTD who were followed at our center from 2006 to 2025. Inclusion criteria: age 16 years or less at onset, disease duration of at least 12 months, at least one clinical sign suggestive of connective tissue disease, and positivity in at least two ANA or ENA tests. Demographic, clinical, serological, capillaroscopic, and therapeutic data were collected. Results. The demographic and clinical characteristics are shown in Table 1. All patients tested positive for ANA. In 7 patients, ANA negativity was observed at a mean follow-up of 12 months, associated with lower ESR values (p<0.01) and a reduced presence of other antibodies (ENA, aPL, anti-dsDNA) (p=0.003). 3 of these patients had a scleroderma pattern at baseline; In one case, the pattern remained stable, in another it regressed to a borderline pattern, and in the third to non-specific abnormalities. During a median follow-up of 36 months (18-49 months), 5 patients (15.2%) progressed to defined connective tissue disease: 2 cases of SS, 1 case of SLE, 1 case of Sjögren's syndrome, and 1 case of anti-Jo1+ myositis. These patients had an earlier onset age (12 years vs 14.5 years), were positive for ENA, anti-dsDNA, or aPL in 4 out of 5 cases, and showed capillaroscopy alterations in 3 cases (2 scleroderma patterns and 1 n…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: UCTD
  topic: keywords
subject: Connective tissue diseases
  topic: keywords
subject: Juvenile
  topic: keywords
subject: Nicoletta D'Angelo
  topic: disciplines
subject: Stefania Costi
  topic: disciplines
subject: Achille Marino
  topic: disciplines
subject: Francesco Baldo
  topic: disciplines
subject: Cecilia Beatrice Chighizola
  topic: disciplines
subject: Roberto Felice Caporali
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2069

PO:30:160 | A rare case of juvenile systemic sclerosis
type: item
description: Juvenile Systemic Sclerosis (jSSc) is a rare, autoimmune connective tissue disease with onset in the pediatric age; the pathogenesis appears to be mediated by adaptive immunity, with autoantibody production, endothelial dysfunction, proliferative vasculopathy leading to ischemia and tissue fibrosis with variable involvement of the skin and internal organs.1,2 The average age at diagnosis in the pediatric age is between 8 and 12 years, with a clear female prevalence. Compared to the adult-onset form, pulmonary involvement is more common and severe in juveniles, while renal involvement is less frequent.3,4 We present the rare case of a 16-year-old female patient with rapidly progressive diffuse cutaneous jSSc. The disease began in 2019 at the age of 11 with Raynaud’s phenomenon leading to digital ulcers. Physical examination revealed puffy hands and cutaneous fibrosis (J4S equal to 12.5/40). Thoracic auscultation showed normal vesicular breath sounds, no crackles. Serological tests showed ANA positivity at a titer of 1:1280 and anti-Scl70 antibodies. Capillaroscopy in 2023 showed a scleroderma pattern; the punch skin biopsy in 2022 showed dermal and hypodermal sclero-hyalinosis (score 2), mild perivascular and periannexal inflammatory infiltrate (score 1), and annexal atrophy (score 1), compatible with scleroderma. Pulmonary Function Tests (PFTs) in 2024 revealed moderate-to-severe restrictive syndrome (FVC 65%, FEV1 68%, DLCO/Va 94%.) and initial signs of fibrosis on 2024 thoracic HRCT (interlobular septal thickening <5%, ground-glass areas, emphysema, bronchiectasis not present on HRCT in 2021). Due to the relapsing nature of the digital ulcers, therapy was started with intravenous prostanoids and bosentan, with good control of the lesions. The patient was treated with rituximab every six months (2019–2023) then suspended due to recurrent infections, then with methotrexate (2019–2020 suspended due to ineffectiveness, resumed in 2023 and suspended in 2024 due to hype…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: SCL70
  topic: keywords
subject: progressive
  topic: keywords
subject: scleroderma.
  topic: keywords
subject: Marta Arese
  topic: disciplines
subject: Francesco Baldo
  topic: disciplines
subject: Stefania Costi
  topic: disciplines
subject: Achille Marino
  topic: disciplines
subject: Cecilia Chighizola
  topic: disciplines
subject: Roberto Felice Caporali
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2203

PO:31:163 | Safety and tolerability of home-based prostacyclin analogue therapy in vascular manifestations of the scleroderma spectrum: results of a monocentric study
type: item
description: Background. To evaluate the safety and perceived efficacy of home-based prostacyclin analogue infusions compared with hospital administration in patients with vascular manifestations of the Scleroderma Spectrum. Methods: In 2019, a pilot program for home-based Iloprost infusions was launched at the Local Health Authority (ASL) of Pescara. We performed a retrospective 6-year analysis including patients receiving home therapy for at least 6 months. Patients completed a structured questionnaire assessing: • frequency of vascular manifestations, • comparison between home (EL) and hospital (DH) administration in terms of side effects, • acceptability and overall impact of home treatment. Blood pressure values were collected before, during, and after each home infusion. Results. Thirty-four patients were included. Most reported subjective improvement of Raynaud’s phenomenon. A moderate positive correlation (ρ ≈ 0.47) was observed between the duration of home treatment and perceived benefit. Among the 5 patients with active digital ulcers, 4 reported improvement. Only two patients had pulmonary arterial hypertension; therefore, no conclusions were drawn for this subgroup. Eight side effects were evaluated on a 0–3 scale. Nausea, flushing, and headache were significantly reduced during home treatment (p < 0.05), while hypotension and diarrhea showed no significant differences. Elastomer pump acceptability was high: 100% of patients judged it easy to handle, 97% felt safe using it, and 88% reported improved quality of life. Regarding hemodynamic effects, systolic blood pressure showed a significant reduction during infusion (−4.6 mmHg; p = 0.0015) followed by recovery afterwards (+3.1 mmHg; p = 0.011). Diastolic pressure changes were milder, with a slight decline during infusion (−1.5 mmHg; p = 0.083) and a significant increase at the end (+2.8 mmHg; p = 0.026). Mean arterial pressure varied transiently and was well tolerated. Only one patient showed marked variability, sugg…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: systemic sclerosis
  topic: keywords
subject: Home-based
  topic: keywords
subject: ILOPROST
  topic: keywords
subject: Alice Dionisi
  topic: disciplines
subject: Lucrezia Verardi
  topic: disciplines
subject: Annacarla Finucci
  topic: disciplines
subject: Paola Volpe
  topic: disciplines
subject: Anna Cinzia Raspa
  topic: disciplines
subject: Paola Cipriani
  topic: disciplines
subject: Raffaele Zicolella
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2204

PO:31:165 | Prevalence and incidence of skin telangectasia and their association with clinical features: analysis of the European Scleroderma Trials and Research cohort
type: item
description: Background. Skin telangiectasias (TAs) are common in systemic sclerosis (SSc) and suggested to be associated with a more severe vascular phenotype. The aim of our work was to analyse prevalence and incidence of TAs in a SSc multicentric cohort and their clinical correlations. Materials and Methods. SSc patients from the European Scleroderma Trials and Research (EUSTAR) database with baseline data on TAs were enrolled to analyse the prevalence and TAs and their clinical correlations (project CP156). During the follow-up we evaluated the incidence of TAs and compared disease features between patients with TAs from baseline, those developing TAs during the follow-up and those without. Results. A total of 8.088 patients with baseline data on TAs, of whom 4.050 presented TAs with a prevalence of 50.1% (IC 0.49-0.51). At baseline patients with TAs showed significant differences in disease phenotype compared to those without (Fig 1): a greater skin involvement (8.3±8.6 vs 7.0±7.8, p:<0.0001) and higher mean NT-proBNP values (456.4±1833.7 vs 304.4±2114.0, p:<0.0001) were observed in patients with TAs that also presented higher frequency of anticentromere antibodies (ACA) and lower prevalence of anti-topoisomerase I (Topo I) (p<0.0001 and 0.0278 respectively). Puffy fingers were more frequent in patients with TAs (1747 vs 1573, p:0.0147) and a significantly higher prevalence of digital ulcers (DUs) and digital pitting scars (DPS) (current or previous) was observed in TAs patients. The mean values of DLCO and DLCO/VA were lower in SSc patients with TAs (67.8±20.3 vs 73.8±20.5 and 76.3±18.3 vs 82.2±17.8 respectively, p<0.001) that also presented a higher frequency of ILD at HRCT (1293 vs 1017, p:<0.001). Echocardiographic abnormalities were more prevalent in TAs patients. The incidence of TAs was of 32.6% (IC 0.31-0.34) in a median observation time of 1.61 years (1.50-1.74) (Figure 2). The median follow-up time was of 1.02 years (0.701-1.56) for patients with TAs from baseline…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Telangiectasia
  topic: keywords
subject: Organ involvement
  topic: keywords
subject: Clinical association
  topic: keywords
subject: Gemma Lepri
  topic: disciplines
subject: Lorenzo Tofani
  topic: disciplines
subject: Silvia Bellando Randone
  topic: disciplines
subject: Veronica Batani
  topic: disciplines
subject: Paolo Airò
  topic: disciplines
subject: Patricia Carreira
  topic: disciplines
subject: Joerg Henes
  topic: disciplines
subject: Alexandra Balbir Gurman
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Antonella Marcoccia
  topic: disciplines
subject: Luc Mouthon
  topic: disciplines
subject: Branimir Anic
  topic: disciplines
subject: Carolina De Souza Müller
  topic: disciplines
subject: Armine Haroyan
  topic: disciplines
subject: Ana Cristina Cordeiro
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Eustar Coll
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2070

PO:31:166 | S'/PAPs ratio in systemic sclerosis: a promising non-invasive index for early detection and prognosis of pulmonary hypertension. A step toward more accurate screening?
type: item
description: Background. Pulmonary hypertension (PH) is a severe and multifactorial complication in systemic sclerosis (SSc), with right ventricular (RV) involvement playing a pivotal prognostic role. Echocardiography remains the cornerstone for PH screening and monitoring. However, traditional indices such as TAPSE are limited by geometric assumptions, angle dependency, and operator variability. The systolic velocity of the tricuspid annulus measured by tissue Doppler imaging (TDI S') has emerged as a more accurate and reproducible parameter. Based on this, the S'/PAPs ratio—reflecting RV-arterial coupling—has been proposed as a valuable non-invasive tool for early detection and risk stratification in SSc-related PH. Nevertheless, clinical data in this specific setting are still scarce. Materials and Methods. A retrospective/prospective analysis was conducted on 200 SSc patients followed at the Scleroderma Unit of the University Hospital of Modena between 2020 and 2025. Among them, 19 had a confirmed diagnosis of PH based on hemodynamic criteria. Collected data included clinical, echocardiographic, respiratory, serological variables and outcomes. The main objective was to evaluate the diagnostic performance of the S'/PAPs ratio, identifying a reliable cut-off and comparing it with the established TAPSE/PAPs <0.55 threshold. Associations between S'/PAPs and patient characteristics were also explored. Results. ROC curve analysis identified five S'/PAPs cut-offs (0.328, 0.34, 0.36, 0.38, 0.40). For each, sensitivity, specificity, positive/negative predictive values, accuracy, likelihood ratios (LR positive/LR negative), and Youden index were calculated. The 0.40 cut-off demonstrated the best diagnostic performance, outperforming TAPSE/PAPs <0.55 in sensitivity (89% vs 74%), NPV (98% vs 97%) and LR negative (0.14 vs 0.26). Patients with S'/PAPs <0.40 showed worse clinical and echocardiographic profiles: older age (p=0.001), older age at diagnosis (p=0.038), higher prevalence of lim…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic sclerosis
  topic: keywords
subject: Pulmonary hypertension
  topic: keywords
subject: Screening
  topic: keywords
subject: Marco De Pinto
  topic: disciplines
subject: Amelia Spinella
  topic: disciplines
subject: Pierluca Macripò
  topic: disciplines
subject: Alessia Laneri
  topic: disciplines
subject: Benedetta Bongiovanni
  topic: disciplines
subject: Maria Grazia Malandra
  topic: disciplines
subject: Martina Orlandi
  topic: disciplines
subject: Gianluca Pagnoni
  topic: disciplines
subject: Arianna Maini
  topic: disciplines
subject: Rosario Rossi
  topic: disciplines
subject: Clodoveo Ferri
  topic: disciplines
subject: Francesca Coppi
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2071

PO:31:167 | Increased M2 pro-fibrotic marker expression in circulating monocytes and cultured monocyte-derived macrophages in systemic sclerosis patients with progressive interstitial lung disease
type: item
description: Background. Systemic sclerosis (SSc) is a complex disease in which macrophages play a key role in driving progressive fibrosis of the skin and internal organs, especially the lungs1,2. Alternatively activated macrophages (M2) seem to promote fibrosis by releasing pro-fibrotic mediators3. Previous studies have identified M2 macrophages expressing pro-fibrotic markers, including hybrid M1/M2 cells expressing toll-like receptor 4 (TLR4), in lung tissues from SSc patients with interstitial lung disease (ILD)3. The aim of the study is to evaluate the phenotype and functional M2 markers in circulating monocytes and cultured monocyte-derived macrophages (MDMs) obtained from SSc patients (pts) with progressive ILD (prog-ILD), versus non-progressive ILD (no-prog-ILD), and without ILD (no-ILD). Materials and Methods. A total of 56 SSc pts, diagnosed per 2013 ACR/EULAR criteria, and 20 age-matched healthy controls (HC) were recruited with informed consent. Circulating monocytes from a subset of 37 SSc patients (10 prog-ILD, 14 no-prog-ILD, 13 no-ILD; mean age 65±13) and 20 HC were analyzed by flow cytometry for expression of M2 markers (CD204, CD163, CD206) and the M1 marker (TLR4). MDMs were generated from 29 SSc patients (13 prog-ILD, 10 no-prog-ILD, 6 no-ILD; mean age 64±14) and 5 HC, and evaluated for gene and protein expression of the same markers using RT-PCR, Western blotting, and ELISA for TGF-beta1 and Mer tyrosine kinase (MerTK). Statistical analyses employed non-parametric tests. Results. Prog-ILD SSc pts showed a higher percentage of hybrid (M1/M2) circulating TLR4+CD204+CD206+CD163+monocytes compared to no-prog-ILD and significantly higher compared to no-ILD SSc pts (p<0.05). Cultured MDMs from prog-ILD pts had significantly increased gene and protein expression of TGF-beta1 (p<0.05), and a trend toward elevated MerTK and CD206 levels compared to no-prog-ILD pts. When compared to no-ILD patients, prog-ILD MDMs showed significantly elevated expression of TGF-beta1,…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic sclerosis
  topic: keywords
subject: Macrophages
  topic: keywords
subject: Immunology
  topic: keywords
subject: Vanessa Smith
  topic: disciplines
subject: Stefano Soldano
  topic: disciplines
subject: Rosanna Campitiello
  topic: disciplines
subject: Emanuele Gotelli
  topic: disciplines
subject: Paola Montagna
  topic: disciplines
subject: Elvis Hysa
  topic: disciplines
subject: Tamara Vojinovic
  topic: disciplines
subject: Carmen Pizzorni
  topic: disciplines
subject: Sabrina Paolino
  topic: disciplines
subject: Alberto Sulli
  topic: disciplines
subject: Maurizio Cutolo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2072

https://www.reumatismo.org/reuma/article/view/2073
type: item
title: PO:31:172 | Age and timing of onset of Raynaud's phenomenon and first non-Raynaud sign/symptom as prognostic factors in systemic sclerosis: a retrospective analysis from the systemic sclerosis progression investigation registry of the Italian Society for Rheumatology
description: Background. To investigate whether age and timing of Raynaud’s phenomenon (RP) and non-Raynaud’s phenomenon (NRP) onset influence systemic sclerosis (SSc) endotype and prognosis. Materials and Methods. We performed a cross-sectional study including patients from the SPRING Registry, fulfilling the SSc 2013 ACR/EULAR criteria(1). Patients were categorized into 4 groups based on age at RP (age-RP) and age at NRP (age-NRP) onset, according to quartiles’ distribution. Additionally, patients were divided into 3 groups based on RP onset timing:1) RP >1 year after NRP onset (NRP group); 2) RP and NRP within the same year (Simultaneous group, SG), 3) RP >1 year before NRP onset (RP group). Comparisons were performed using Chi-square, ANOVA, logistic, linear, and multinomial regression models. Kaplan-Meier and Cox regression were used to evaluate survival. Results. 1748 SSc patients were eligible for the study: 682 (39%) in the RP group, 1026 (58.8%) in the SG, and 39 (2.2%) in the NRP group. The RP group had a higher prevalence of anti-centromere antibodies (ACA, 41.5%), whereas the SG presented more anti-topoisomerase I antibodies (ATA, 41.1%), diffuse cutaneous SSc (dcSSc, 25.2%), and higher modified Rodnan Skin Score (mRSS) (5, IQR 2–10). The NRP group showed more pulmonary arterial hypertension (PAH, 15.8%) and less dcSSc (5.1%), without a distinct autoantibody profile. Dividing patients by age-RP quartiles, those in the youngest group (18–34 years) had more ATA (42.2%), dcSSc (23.4%), digital ulcers (DU, 29.2%) and digital pitting scars (DPS, 58.2%) while the oldest group (>56 years) had more cardiopulmonary involvement (35.3%) with higher systolic pulmonary arterial pressure (sPAP, 25±18 mmHg). Similar trends emerged with age-NRP stratification. Logistic regression showed that SG was associated with higher dcSSc prevalence vs RP (OR 1.491, 95% CI 1.032–2.154), independently of ATA and sex. Earlier age-RP predicted lower sPAP (beta -0.149, 95%CI: -0,297, -0,001) and mR…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic Sclerosis
  topic: keywords
subject: Raynaud's phenomenon
  topic: keywords
subject: Endotype
  topic: keywords
subject: Silvia Peretti
  topic: disciplines
subject: Cosimo Bruni
  topic: disciplines
subject: Silvia Laura Bosello
  topic: disciplines
subject: Fabio Cacciapaglia
  topic: disciplines
subject: Corrado Campochiaro
  topic: disciplines
subject: Veronica Codullo
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
subject: Rossella De Angelis
  topic: disciplines
subject: Giacomo De Luca
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Francesca Ingegnoli
  topic: disciplines
subject: Valeria Riccieri
  topic: disciplines
subject: Marco Matucci Cerinic
  topic: disciplines
subject: Clodoveo Ferri
  topic: disciplines
subject: Silvia Bellando Randone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2073

PO:31:173 | Methotrexate monotherapy in early systemic sclerosis: a real-life monocentric Italian experience
type: item
description: Background. Systemic sclerosis (SSc) is a complex autoimmune disease with significant morbidity and mortality. Methotrexate (MTX) is one of the most prescribed immunosuppressants for SSc, particularly in patients with early diffuse cutaneous disease, with prescription rates of 30-50%. However, supporting scientific evidence remains limited. The objective of this study is to evaluate the efficacy of MTX monotherapy on the cutaneous component of SSc using the modified Rodnan Skin Score (mRSS) as the primary parameter. Materials and Methods. A retrospective monocentric study was conducted on patients with SSc treated with MTX monotherapy within the first two years of disease onset. The mRSS, MTX dosage, and prednisone equivalent were collected at baseline and at 3, 6, 12, and 24 months. Cutaneous improvement was defined as a reduction of > or = 5 points or > or = 25% from baseline mRSS. Disease activity was assessed using the EUSTAR Activity Index. Temporal variation was evaluated through analysis of variance (ANOVA) corrected for independent variables. Kaplan-Meier analysis was applied to estimate MTX therapy persistence, and survival curves were censored at MTX monotherapy discontinuation (intolerance, disease progression, combination with an additional drug, pregnancy). Results. The cohort included 92 patients, predominantly female (85%), with a median age of 50.75 years and a median disease duration of 1.08 years at MTX initiation. 77% had diffuse cutaneous SSc (dcSSc), and 72% were Scl70 positive (Table). Linear mixed-model analysis revealed a statistically significant variation in mRSS over time (p < 0.001). Estimated marginal means showed a progressive decline from baseline (9.745) to 24 months (6.603), with the most substantial improvement occurring after 3 months (-1.886), reaching the improvement criterion of > or = 25% (Figure 1). The EUSTAR Activity Index remained stable during follow-up (p = 0.213), consistently staying below the active disease threshold (…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Real-world evidence
  topic: keywords
subject: Outcome measures
  topic: keywords
subject: Skin
  topic: keywords
subject: Claudia Iannone
  topic: disciplines
subject: Ilaria Magi
  topic: disciplines
subject: Antonina Minniti
  topic: disciplines
subject: Giuseppe Armentaro
  topic: disciplines
subject: Silvia Cavalli
  topic: disciplines
subject: Manuel Sette
  topic: disciplines
subject: Laura Giudice
  topic: disciplines
subject: Maria Rosa Pellico
  topic: disciplines
subject: Cristina Bochicchio
  topic: disciplines
subject: Roberto Felice Caporali
  topic: disciplines
subject: Nicoletta Del Papa
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2074

https://www.reumatismo.org/reuma/article/view/2075
type: item
title: PO:31:174 | Increased frequency of anti-RNA polymerase 3 antibodies in patients with systemic sclerosis and silicone breast implants: a multicentre study from the international European Scleroderma Trials and Research cohort
description: Background. Systemic Sclerosis (SSc) is a heterogeneous systemic autoimmune disease, in which distinct disease subsets can be identified with autoantibodies. In a large EUSTAR study including >4,000 SSc patients, anti-RNA polymerase III (anti-RNAP3) was positive in 4.5% and their clinical phenotype included malignancies synchronous to disease onset and specifically breast cancer. Noteworthy, one study from Italy and one from Japan reported a specific association of silicone breast implants (SBI) with anti-RNAP3 positivity in SSc females, raising the possibility of a new clinical association of this autoantibody. The study aims to analyse the characteristics of female SSc patients with SBI implanted before the disease onset, and to compare them with female SSc patients without SBI. Materials and Methods. International case-control study within the EUSTAR network (CP-117), including SSc females with SBI implanted before SSc onset (cases) and 2-3 SSc female patients without SBI (controls) matched for cutaneous subset, age at onset (±5 years) and disease duration (±2 years). Data regarding indication for SBI implantation and rupture (cases) and on breast cancer (cases and controls) were recorded. Results. 41 SSc patients with SBI (cases) and 119 matched controls were collected from 12 centres. Among 41 cases, the majority had SBI implanted for cosmetic reasons (82.9%) and had diffuse cutaneous involvement (dcSSc,58.5%), with anti-RNAP3 positivity in 31.7%. Anti-RNAP3+ patients, as compared to anti-RNAP3- had a tendency toward higher frequency of documented SBI rupture (p:0.089). As compared to 119 matched controls, patients with SBI had higher frequency of anti-RNAP3 positivity (31.7% vs 14.3%, p:0.020, [OR 2.78, 95% CI 1.20-6.42]). No difference in the rate of breast cancer was observed, with no cases of breast cancer synchronous in both groups. Clinical characteristics were similar in cases and controls, except for lower prevalence of clinically relevant arrythmias an…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic sclerosis
  topic: keywords
subject: silicone
  topic: keywords
subject: breast
  topic: keywords
subject: Maria Grazia Lazzaroni
  topic: disciplines
subject: Yolanda Braun-Moscovici
  topic: disciplines
subject: Elda Piovani
  topic: disciplines
subject: Claudia Barison
  topic: disciplines
subject: Liala Moschetti
  topic: disciplines
subject: Veronica Batani
  topic: disciplines
subject: Corrado Campochiaro
  topic: disciplines
subject: Michal Tomcik
  topic: disciplines
subject: Francesca Motta
  topic: disciplines
subject: Maria De Santis
  topic: disciplines
subject: Petros P. Sfikaki
  topic: disciplines
subject: Masataka Kuwana
  topic: disciplines
subject: Brigitte Granel
  topic: disciplines
subject: Roberta Foti
  topic: disciplines
subject: Virginia Berlingiero
  topic: disciplines
subject: Joana Caetano
  topic: disciplines
subject: Yannick Allanore
  topic: disciplines
subject: Alexandra Balbir-Gurman
  topic: disciplines
subject: Marco Matucci Cerinic
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
subject: Paolo Airò
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2075

PO:31:175 | Characterizing gastrointestinal involvement in systemic sclerosis: insights from the national systemic sclerosis progression investigation registry of the Italian Society of Rheumatology
type: item
description: Background. Gastrointestinal (GI) involvement affects over 80% of patients with systemic sclerosis (SSc), contributing significantly to morbidity and representing the third leading cause of disease-related mortality. Symptoms can affect any GI tract segment and often appear early in the disease course. To date, no disease-specific treatment exists, and management remains symptomatic. The underlying mechanisms are not fully understood, and the clinical course is highly variable. This study aimed to identify SSc endotypes associated with GI involvement, determine clinical predictors of GI symptoms, and explore the relationship between disease duration and GI manifestations using data from the SSc Progression INvestiGation (SPRING) registry of the Italian Society of Rheumatology. Materials and Methods. Patients fulfilling the 2013 ACR/EULAR classification criteria and with available GI symptom data were included. GI involvement was defined by the presence of symptoms in at least one of the esophageal, gastric, or intestinal tracts. GI manifestations were classified as “upper GI involvement” (esophageal/gastric symptoms only) or “lower GI involvement” (intestinal symptoms regardless of upper GI symptoms). Chi-square and Student’s t-test were used for descriptive comparisons. Logistic regression was used to identify predictors of GI involvement; ordinal regression assessed predictors of increasing GI disease extent. Results. Among 2178 patients, 1917 met inclusion criteria. Of these, 1073 (56%) reported GI symptoms. Patients with GI involvement had longer disease duration (p<0.001) and more severe disease features, including diffuse cutaneous SSc (dcSSc), interstitial lung disease (ILD), and digital ulcers (DU) (all p<0.001). Autoantibody status, sex, and age were similar across groups. GI involvement increased with longer disease duration, peaking in those with >12 years of disease (62.3%, Figure 1). Logistic regression identified telangiectasias, tobacco exposure, dcSS…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic sclerosis
  topic: keywords
subject: Gastrointestinal
  topic: keywords
subject: Risk factors
  topic: keywords
subject: Francesco Bonomi
  topic: disciplines
subject: Cosimo Bruni
  topic: disciplines
subject: Silvia Laura Bosello
  topic: disciplines
subject: Fabio Cacciapaglia
  topic: disciplines
subject: Corrado Campochiaro
  topic: disciplines
subject: Roberto Caporali
  topic: disciplines
subject: Veronica Codullo
  topic: disciplines
subject: Maria Antonietta D'Agostino
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
subject: Rossella De Angelis
  topic: disciplines
subject: Giacomo De Luca
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
subject: Francesca Ingegnoli
  topic: disciplines
subject: Carlomaurizio Montecucco
  topic: disciplines
subject: Valeria Riccieri
  topic: disciplines
subject: Clodoveo Ferri
  topic: disciplines
subject: Marco Matucci Cerinic
  topic: disciplines
subject: Silvia Bellando Randone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2076

https://www.reumatismo.org/reuma/article/view/2077
type: item
title: PO:32:176 | Outcomes of upfront combination vs monotherapy with rituximab or mycophenolate mofetil for systemic sclerosis interstitial lung disease: results from a European Scleroderma Trials and Research cohort study
description: Background. Interstitial lung disease (ILD) is a major complication in systemic sclerosis (SSc) patients as it is associated with increased mortality and significant morbidity. Since combination therapies are foreseen as the future of SSc-ILD management, in this study we aimed to compare the outcomes at 12 months in patients with SSc-ILD treated with RTX alone, MMF alone, or upfront combination therapy (MMF + RTX). Materials and Methods. SSc patients meeting the 2013 ACR/EULAR criteria, with ILD confirmed by chest HRCT and available % predicted FVC (%pFVC) at baseline and 12 ± 3 months, were eligible for inclusion. Patients were grouped based on treatment initiated at baseline: (a) MMF alone, (b) RTX alone, or (c) upfront combination therapy (MMF + RTX). Patients on nintedanib or tocilizumab at baseline were excluded. Inverse probability of treatment weighting (IPTW) was used to adjust for confounding and treatment imbalances, following multiple imputation for missing data. Propensity score models incorporated the following variables: age, gender, disease subset (diffuse vs. limited), autoantibody status (ATA positivity), baseline FVC, and disease duration. Linear mixed-effects models were used to compare the change in %pFVC and DLCO% at 12 ± 3 months across groups. The proportion of patients with ILD progression (FVC decline >5%) was also estimated. Results. A total of 425 patients were included in the final analysis (250 MMF, 154 RTX and 21 combination therapy). At 12 months, FVC remained stable in all treatment groups. In model 1 (MMF vs. combination), the mean change in FVC was 2.28% (95%CI 0.10 — 4.40) for MMF vs 1.83% (95%CI -2.8 — 6.5) for the combination group (mean difference -0.44, 95%CI -5.70 — 4.80, p = 0.867). The mean change in DLCO was -1.35% (95%CI -3.92 — 1.21) for MMF vs -2.05% (95%CI -11.2 — 7.14) for the combination group (mean difference -0.7, 95%CI -10.0 — 8.61, p = 0.882). In model 2 (RTX vs. combination), the mean change in FVC was -0.93% (95…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic sclerosis
  topic: keywords
subject: Interstitial lung disease
  topic: keywords
subject: Combination therapy
  topic: keywords
subject: Devis Benfaremo
  topic: disciplines
subject: Corrado Campochiaro
  topic: disciplines
subject: Gábor Kumánovics
  topic: disciplines
subject: Christina Bergmann
  topic: disciplines
subject: Elisabetta Zanatta
  topic: disciplines
subject: David Launay
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Mickael Martin
  topic: disciplines
subject: Carolina De Souza Müller
  topic: disciplines
subject: Carlomaurizio Montecucco
  topic: disciplines
subject: Luc Mouthon
  topic: disciplines
subject: Gabriella Szucs
  topic: disciplines
subject: Kastriot Kastrati
  topic: disciplines
subject: Marie-Elise Truchetet
  topic: disciplines
subject: Madelon Vonk
  topic: disciplines
subject: Francesco Del Galdo
  topic: disciplines
subject: Marco Matucci-Cerinic
  topic: disciplines
subject: Gianluca Moroncini
  topic: disciplines
subject: Yannick Allanore
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2077

PO:32:180 | Clinical and hemodynamic profile of patients with SSC-PAH with and without pulmonary veno-occlusive disease: a single-center study
type: item
description: Introduction. Signs of pulmonary veno-occlusive disease (PVOD) may be found in patients with pulmonary arterial hypertension (PAH), particularly in systemic sclerosis (SSc)¹. This association (PVOD/PAH) remains poorly characterized in SSc. We aimed to compare the clinical, echocardiographic and hemodynamic profile of patients with SSc-PAH with and without a concomitant diagnosis of PVOD, and their potential response to vasodilators. Materials and Methods. We retrospectively analyzed 23 patients with SSc-PAH diagnosed by right heart catheterization, followed at our center between 2017 and 2023. Data collected at diagnosis and after 12 months included clinical, laboratory, functional and imaging parameters. Multidisciplinary assessment allowed the identification of cases with clinical and radiological features suggestive of PVOD/PAH¹. Patients were divided into two groups (PVOD/PAH and non-PVOD/PAH) and data were compared at baseline and 12-month follow-up. Results. Twenty-three patients with SSc-PAH were enrolled in the study, of whom 6 (26%) had signs of PVOD/PAH. At PAH diagnosis, PVOD/PAH patients had higher values of mean pulmonary arterial pressure compared to non-PVOD/PAH (47.5±5.3 vs. 36.7±8.8 mmHg, p=0.011), but similar pulmonary vascular resistance. Age, sex, cardiovascular risk factors, SSc features, echo findings as well as cardiac biomarker values were similar between the two groups (Table 1). At follow-up, most PVOD/PAH patients (67%) were on monotherapy with endothelin receptor antagonists (ERA), and 33% on dual therapy (ERA + phosphodiesterase inhibitors). Only one case of pulmonary edema was recorded. In the non-PVOD/PAH group, most patients (53%) were on dual vasodilator therapy. On echocardiography, PVOD/PAH patients showed higher tricuspid regurgitation velocity (4.10±0.68 vs. 3.07±0.91 m/s; p=0.035) and worse right ventricular function (FAC 25.6±8.4% vs. 33.9±6.8%; p=0.046). Changes in NT-proBNP levels from baseline differed between groups (p=0.01…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: PVOD
  topic: keywords
subject: PAH
  topic: keywords
subject: echocardiography
  topic: keywords
subject: Anna Cuberli
  topic: disciplines
subject: Michele Strosio
  topic: disciplines
subject: Alessandro Magi
  topic: disciplines
subject: Beatrice Moccaldi
  topic: disciplines
subject: Marco Binda
  topic: disciplines
subject: Andrea Benini
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
subject: Martina Perazzolo Marra
  topic: disciplines
subject: Giulia Famoso
  topic: disciplines
subject: Laura De Michieli
  topic: disciplines
subject: Elisabetta Zanatta
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2205

PO:32:183 | Innovative use of integra dermal regeneration template on systemic sclerosis digital ulcers: a case report
type: item
description: Introduction. Digital ulcers (DU) are among the most frequent debilitating manifestations of systemic sclerosis (SSc), causing pain, disability, and impaired quality of life. In refractory cases, surgical procedures, including amputations, may be required. Integra® dermal regeneration template is a bilayer acellular dermal substitute composed of a porous collagen–glycosaminoglycan matrix and a temporary silicone layer. Although originally developed for burns and complex wounds, it has been increasingly used in reconstructive surgery. We report the first case of combined use of Integra and autologous fat grafting (AFG) for the treatment of refractory DUs in a patient with SSc. Case Report. A 45-year-old woman with diffuse cutaneous SSc (anti-Scl70 positive, mRSS 22), severe skin involvement, Raynaud’s phenomenon with digital resorption, esophageal and pulmonary disease, presented with refractory DUs despite maximal vasodilatory therapy (Iloprost, Selexipag, Bosentan) and immunosuppressants (MTX, RTX, MMF). She had previously undergone partial digital amputations and one AFG. In March 2025, due to progression of disease with multiple hard-to-heal DUs (Figure 1), a combined surgical approach was planned, consisting of debridement, Integra application to three digits of the right hand (I, II, IV), and bilateral AFG. The procedure, performed under local anesthesia, consisted of two phases: 1. Integra application: after surgical debridement, the matrix was hydrated, positioned, and sutured to wound margins with absorbable stitches (Figure 2). 2. AFG: adipose tissue was harvested by liposuction, purified by centrifugation, and injected into the hands at subcutaneous and perilesional levels. The fat, rich in mesenchymal stem cells (MSC), was distributed to dorsal and palmar aspects of all fingers and interdigital spaces. The postoperative course was uneventful. The silicone layer was removed after 10 days, revealing correct matrix integration and well-formed granulation tis…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: systemic sclerosis
  topic: keywords
subject: digital ulcers
  topic: keywords
subject: Integra
  topic: keywords
subject: Elena Vanni
  topic: disciplines
subject: Martina Orlandi
  topic: disciplines
subject: Amelia Spinella
  topic: disciplines
subject: Valentina Pinto
  topic: disciplines
subject: Massimo Pinelli
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2206

https://www.reumatismo.org/reuma/article/view/2078
type: item
title: PO:32:184 | Assessing the burden of Sars-Cov2 in systemic sclerosis-related interstitial lung disease patients: functional, clinical and therapeutic outcomes from an Italian cohort, a retrospective study
description: Background. Systemic sclerosis (SSc) is a rare immune condition mainly affecting connective tissues with interstitial lung disease (ILD) being a common feature of its clinical milieau. Among others, suffering from autoimmune systemic diseases (ASD) emerged as one of COVID-19 predisposing factors. Objective: the purpose of the present work was to assess the clinical, therapeutic and functional outcomes of a cohort of patients affected by SSc-related ILD (SSc-rILD). Materials and Methods. We retrospectively analysed data from medical charts of 64 SSc-rILD patients from our Rheumatology Unit of Bari clustered into two groups depending on whether they experienced COVID-19 (35 patients) or not (29 patients). Baseline characteristic intended as the ones acquired at the very last visit before COVID infection or, in the other group, before SARS-CoV2 outbreak, included skin pattern, autoimmune features, ongoing medications, clinical manifestations, respiratory function as assessed through spirometry and radiographic appearance evaluated as TC-scans of the lungs. This information was then newly investigated at the latest available follow-up date as long as COVID-19 outcomes. Standard descriptive statistics were employed to evaluate demographic, clinical and functional characteristics. SPSS IBM was the software of choice in our work. Results. The mean follow-up period was 46.3 (SD ±10.9) months for the non-COVID and 38.7 (±12.7) months for the COVID cohort. Diffuse cutaneous subset was found to be statistically more frequent in the COVID group (p=0.007) at baseline. The cohort resulted homogeneous when investigated for other demographical characteristics. The main highlight of our work comes from the evaluation of pulmonary functional index variations (Table 1): FVC and FEV1 showed a greater reduction in patients who experienced COVID, respectively -15.7% ±31.4% (vs -0.9%±14.8%, p=0.02) and -15.5% ±30.5% vs -1.7% ±13.9%, p=0.03. A similar trend was observed for DLCOc, -6.1% ±1…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic sclerosis
  topic: keywords
subject: ILD
  topic: keywords
subject: COVID-19
  topic: keywords
subject: Andrea Cito
  topic: disciplines
subject: Greta Giulia Dipietrangelo
  topic: disciplines
subject: Daniele V. A. Sabella
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Fabio Cacciapaglia
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2078

PO:32:185 | Deep-learning analysis of high-resolution computed tomography images predicts progression and mortality in systemic sclerosis related interstitial lung disease
type: item
description: Background. Interstitial lung disease (ILD) is a major complication in systemic sclerosis (SSc) patients, associated with substantial morbidity and mortality. Functional, imaging, and clinical measures of lung involvement could be biased in SSc due to its multiorgan nature and extra-articular involvement (e.g., cardiac, musculoskeletal). Artificial intelligence (AI) reading of high-resolution computed tomography (HRCT) has emerged as a novel tool for the objective and reliable assessment of pulmonary diseases. The aim of this study is to correlate AVIEW measures, an Deep learning based software for HRCT image assessment, with ILD-progression and disease-related mortality in SSc patients. Materials and Methods. The AVIEW software (Coreline Soft, South Korea) was employed to analyze HRCT images from a cohort of consecutive SSc-ILD patients at baseline and after 24±3 months. Quantitative analyses included lung volume, texture, airways, and vascular anatomy. Baseline metrics were assessed for their association with ILD progression, defined by clinical, functional, and imaging criteria based on the INBUILD study parameters over 24 months. Furthermore, changes in AVIEW-derived measurements between consecutive HRCT evaluations over the 24-month period were analyzed for their association with SSc-related mortality during the subsequent 36 months. All absolute measurements were normalized to body surface area. Results. A total of 146 HRCT scans from 73 SSc-ILD patients were assessed (mean age 58.4±14.3 years; male 16.4%; diffuse skin variant 49.3%). Thirty-one patients (42.4%) experienced ILD progression, which was predicted at baseline by higher percentages of ground glass opacities (GGO) (p=0.05) and reticulation (p=0.05), higher subpleural vessel volumes (p=0.017), and a tendency toward larger distal airways (p=0.066). Serial evaluations demonstrated that INBUILD progression was associated with a reduction in the percentage of normal lung (p=0.044) and absolute volumes (p…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic sclerosis
  topic: keywords
subject: Interstitial lung disease
  topic: keywords
subject: Valentina Boni
  topic: disciplines
subject: Rosa D'Abronzo
  topic: disciplines
subject: Piergiacomo Cerasuolo
  topic: disciplines
subject: Lucio Calandriello
  topic: disciplines
subject: Giuseppe Cicchetti
  topic: disciplines
subject: Gerlando Natalello
  topic: disciplines
subject: Bruno Iovene
  topic: disciplines
subject: Francesco Varone
  topic: disciplines
subject: Giacomo Sgalla
  topic: disciplines
subject: Luca Richeldi
  topic: disciplines
subject: Anna Rita Larici
  topic: disciplines
subject: Maria Antonietta D'Agostino
  topic: disciplines
subject: Silvia Laura Bosello
  topic: disciplines
subject: Enrico De Lorenzis
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2079

PO:32:189 | Salivary gland alterations in systemic sclerosis: a comprehensive ultrasound study and autoantibody correlation
type: item
description: Background. Salivary gland involvement in systemic sclerosis (SSc) is often underrecognized, despite the potential clinical burden of sicca syndrome in affected patients. This study investigates the association between autoantibody profiles and salivary gland (SG) ultrasonographic findings in individuals with SSc. Materials and Methods. In this monocentric cross-sectional study, patients with SSc, classified according to the 2013 ACR/EULAR criteria, underwent clinical evaluation, immunoblot testing, and SG ultrasonography. Imaging assessments included grey-scale (GS) scoring based on the OMERACT scoring system; power Doppler ultrasound (PDUS), graded as 0 (normal) or 1 (pathological) for each SG; and shear wave elastography (SWE), with stiffness values measured in meters per second (m/s). Patients were stratified by autoantibody profile into the following groups: anti-centromere antibody (ACA) only, anti-topoisomerase I antibody (ATA) only, anti-Sjögren syndrome type A antibody (SSA) with or without additional antibodies, and other autoantibody positivity. Sicca syndrome was defined clinically as objective and/or subjective evidence of ocular (xerophthalmia) and/or oral (xerostomia) dryness, in the absence of Sjögren’s syndrome (SS) based on the 2016 ACR/EULAR criteria or other identifiable causes. Results. A total of 123 patients with SSc were included (median age 61 years [IQR 55–71], 89.4% female), distributed as follows: ACA+ 32.5%, ATA+ 26.0%, SSA+ 16.3%, and other autoantibody profiles 25.2%. Patients in the SSA+ group showed significantly higher GS scores compared to other groups (p < 0.001), indicating more severe salivary gland involvement. No significant differences were observed in PDUS scores (p = 0.872) or in SWE measurements (parotid glands: p = 0.422; minor salivary glands: p = 0.873), as reported in Table 1. Regarding GS alterations, the SSA+ group had the highest proportions of Grade 2 (36.8%) and Grade 3 (15.8%) lesions, while the ATA+ group had th…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic Sclerosis
  topic: keywords
subject: Ultrasound
  topic: keywords
subject: Salivary glands
  topic: keywords
subject: Riccardo Bixio
  topic: disciplines
subject: Francesca Pistillo
  topic: disciplines
subject: Luca Idolazzi
  topic: disciplines
subject: Francesca Nava
  topic: disciplines
subject: Beatrice Gabrielli
  topic: disciplines
subject: Emanuela Perrucchini
  topic: disciplines
subject: Ombretta Viapiana
  topic: disciplines
subject: Maurizio Rossini
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2080

https://www.reumatismo.org/reuma/article/view/2081
type: item
title: PO:33:190 | Travel distance to tertiary healthcare reflects disease severity and medication access in systemic sclerosis patients: insights from the Italian systemic sclerosis progression investigation registry of the Italian Society of Rheumatology
description: Background. Commuting poses a considerable burden and costs for patients with rare rheumatic diseases such as systemic sclerosis (SSc), who require care from tertiary medical centres. In a universal healthcare system, the selection of healthcare services is possibly influenced by geographical distribution, referral networks from primary care, and patient preferences. This study aims to evaluate whether longer commuting distances are associated with clinical variables and differences in medication access among Italian SSc patients receiving follow-up care at tertiary centres. Materials and Methods. The driving distance from the city of residence to the care centre was calculated using the Google Maps Distance Matrix API for anonymized patients with SSc from the Systemic Sclerosis Progression INvestiGation (SPRING) Italian registry. This distance was then correlated with clinical and drug history in an ordinal logistic regression analysis. Results. The characteristics of 1,782 patients were obtained from 38 centres across the country (Figure 1 and Table 1): 74.2% were categorized as short-distance commuters (traveling less than 100 km), 20.1% as intermediate-distance commuters (traveling 100-500 km), and 5.6% as long-distance commuters (traveling more than 500 km). Notably, 24.6% of the patients received care outside their residential administrative region. Patients with interstitial lung disease (ILD), pulmonary arterial hypertension, lower Forced Vital Capacity (FVC), reduced Diffusion Capacity for Carbon Monoxide (DLCO), anti-Scl70 positivity, and anti-centromere negativity had higher probability of traveling longer distances. Similarly, access to multiple immunosuppressants (cyclophosphamide, azathioprine, methotrexate, tocilizumab) and vasoactive/vasodilator drugs (Endothelin Receptor Antagonists (ERA), Phosphodiesterase Type 5 Inhibitors (PDE5i), iloprost) was associated with increased probability of long travel distances (Table 1). No significant differences we…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: systemic sclerosis
  topic: keywords
subject: Travel distance
  topic: keywords
subject: Tertiary healthcare
  topic: keywords
subject: Camilla Teresa Magnanimi
  topic: disciplines
subject: Enrico De Lorenzis
  topic: disciplines
subject: Gerlando Natalello
  topic: disciplines
subject: Fabio Cacciapaglia
  topic: disciplines
subject: Rossella De Angelis
  topic: disciplines
subject: Edoardo Cipolletta
  topic: disciplines
subject: Maria Antonietta D'Agostino
  topic: disciplines
subject: Veronica Cudullo
  topic: disciplines
subject: Giacomo De Luca
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
subject: Francesca Ingegnoli
  topic: disciplines
subject: Valeria Riccieri
  topic: disciplines
subject: Lorenzo Dagna
  topic: disciplines
subject: Fiorenzo Iannone
  topic: disciplines
subject: Clodoveo Ferri
  topic: disciplines
subject: Marco Matucci Cerinic
  topic: disciplines
subject: Silvia Laura Bosello
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2081

PO:33:191 | Evaluation of the living with pulmonary fibrosis questionnaire in patients with systemic sclerosis associated interstitial lung disease: monocentric results
type: item
description: Background. Purpose Interstitial lung disease (ILD) is a common manifestation of Systemic Sclerosis (SSc) and a leading cause of death. The assessment of respiratory symptoms, with lung physical examination and pulmonary function tests, represents a useful approach to monitoring pulmonary disease progression. However, there is currently no consensus on the optimal monitoring strategies for these patients. A specific patient-reported outcome measure (PROM), the Living with Idiopathic Pulmonary Fibrosis Questionnaire (L-IPF), has been validated for patients with idiopathic pulmonary fibrosis and has shown correlation with FVC% predicted and DLCO% values [1]. Its adapted version, the Living with Pulmonary Fibrosis Questionnaire (L-PF), is designed for patients with any fibrosing interstitial lung disease and was also used in the INBUILD study [2]. The aim of this study is to evaluate the L-PF in our patients with SSc-ILD. Materials and Methods. L-PF consists of 44 items, divided into two modules: Symptoms (subdivided into dyspnea, cough, and energy) and Impact. Scores for both modules range from 0 (no symptoms and/or impact) to 100 (maximum symptoms and/or impact). The correlation between L-PF and the Systemic Sclerosis Impact of Disease (ScleroID), a comprehensive PROM developed for SSc, was analysed. Data are presented as medians (interquartile range). SSc subgroups were compared using the Mann–Whitney U test and correlation analysis using the Spearman coefficient (rs). Results. L-PF was administered to 55 consecutive patients with SSc-ILD. Their demographic and clinical features are detailed in Table 1. A negative correlation was found between DLCO% and all L-PF domains: Cough (rs= -0.454, p=0.001), Total Symptoms (rs= -0.386, p=0.007), Impact (rs= -0.335, p=0.037), Dyspnea (rs= -0.285, p=0.047) and Energy (rs = -0.299, p=0.039). In addition, ScleroID correlated positively with all L-PF domains except Cough: Total Symptoms (rs=0.612, p<0.0001) (Figure 1), Impact (rs…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Interstitial lung disease
  topic: keywords
subject: L-PF
  topic: keywords
subject: PROM
  topic: keywords
subject: Claudia Barison
  topic: disciplines
subject: Elda Piovani
  topic: disciplines
subject: Eleonora Pedretti
  topic: disciplines
subject: Eleonora Pazzi
  topic: disciplines
subject: Liala Moschetti
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
subject: Maria Grazia Lazzaroni
  topic: disciplines
subject: Paolo Airò
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2082

PO:33:194 | The role of anti-g protein-coupled receptors antibodies in the assessment of systemic sclerosis-primary heart involvement
type: item
description: Background. Primary heart involvement (pHI) is a major organ complication of systemic sclerosis (SSc), accounting for a significant share of SSc-related deaths. Since pHI is often asymptomatic and its presentation is highly variable, a multiparametric assessment is mandatory. Echocardiography is essential in pHI screening; coronary flow velocity reserve (CFR) assessed by echocardiography has been demonstrated to identify SSc patients with coronary microvascular dysfunction (CMD), which appears to be involved in the pathogenesis of SSc-pHI. Autoantibodies targeting G protein-coupled receptors (GPCRs) – specifically, anti-endothelin type A and anti-angiotensin 1 receptors antibodies (anti-ETAR and anti-AT1R) – have been associated with the microvascular manifestations of SSc, namely digital ulcers and pulmonary arterial hypertension. Our study aims to evaluate a possible association between anti-GPCRs antibodies and CMD in SSc patients. Materials and Methods. Adult patients fulfilling the 2013 ACR/EULAR classification criteria for SSc were enrolled; patients with pulmonary arterial hypertension, coronary artery disease or other cardiomyopathies were excluded. Demographic and clinical data were recorded, as well as the presence of pHI(1). Echocardiography with CFR assessment was performed on all patients by an experienced cardiologist: according to the literature, CFR < 2.5 was considered marker of CMD, while CFR values < 2 defined severe CMD. Serum levels of anti-ETAR and anti-AT1R antibodies were assessed by ELISA for each patient up to 3 months prior or following the echocardiographic assessment. The seropositive threshold was provided by the manufacturer (>10 U/ml). Results. Thirty-one patients were enrolled. The median disease duration was 1 year (IQR 1-4), the median age at enrolment was 58 (48-63) years, the majority of patients were females (71%), had diffuse cutaneous SSc (61%) and positive anti-topoisomerase I antibodies (55%). Clinically overt pHI was diagno…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic sclerosis
  topic: keywords
subject: Primary myocardial involvement
  topic: keywords
subject: Functional autoantibodies
  topic: keywords
subject: Beatrice Moccaldi
  topic: disciplines
subject: Giovanni Civieri
  topic: disciplines
subject: Annagrazia Cecere
  topic: disciplines
subject: Marco Binda
  topic: disciplines
subject: Marta Vadori
  topic: disciplines
subject: Laura Iop
  topic: disciplines
subject: Marta Tonello
  topic: disciplines
subject: Anna Cuberli
  topic: disciplines
subject: Andrea Benini
  topic: disciplines
subject: Emanuele Cozzi
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
subject: Francesco Tona
  topic: disciplines
subject: Elisabetta Zanatta
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2083

PO:33:195 | Evaluation of prevalence and role of anti-endothelin type a-receptor and anti-angiotensin ii type 1-receptor antibodies in a cohort of systemic sclerosis patients
type: item
description: Background. Systemic sclerosis (SSc) is a systemic, autoimmune, heterogeneous disease, characterized by fibrosis and vasculopathy of skin and internal organs. Disease prognosis is mainly driven by autoantibody profile and specific organs involvement. The renin-angiotensin and endothelin systems have been implicated in the pathogenesis of vascular dysfunction. Antibodies (abs) against the angiotensin II type 1-receptor (AT1R) and the endothelin type A-receptor (ETAR) have been hypothesized to play a pathogenetic role in SSc, although their role in SSc remains unclear. Severe vascular disease manifestations have been associated with higher titers of anti-AT1R and anti-ETAR abs, which also appear to predict SSc-related mortality. Aim of the study was to estimate the prevalence of these autoabs in an SSc cohort and to evaluate their possible correlation with clinical and laboratory characteristics. Materials and Methods. A cross-sectional monocentric study enrolling SSc patients was conducted. Demographic, clinical and laboratory data were collected and nailfold capillaroscopy was performed. Sera were tested by enzyme-linked immunosorbent assay for anti-AT1R and anti-ETAR abs, indirect immunofluorescence on Hep2 cells for anti-nuclear (ANA) abs, immunoblotting, fluorescent enzyme and chemiluminescence immunoassays for exctractable nuclear antigens (ENA) abs. Patients under anti-endothelin receptor antagonists were excluded. Categorical variables were compared using the chi-squared test, continuous variables were compared using t-test or Mann Whitney U test. Variables with statistical significance were tested in a multivariate regression model, corrected for selected confounders. Results. A population of 80 SSc patients was enrolled. 6 patients resulted to be positive for both anti-ETAR and anti-AT1R abs, 8 patients only for anti-ETAR abs. Table 1 shows demographic and clinical data of the study population. Characteristics of patients anti-ETAR/AT1R abs positive were com…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Systemic Sclerosis
  topic: keywords
subject: Anti-ETAR/AT1R autoantibodies
  topic: keywords
subject: Vascular manifestations of SSc
  topic: keywords
subject: Clara Minerba
  topic: disciplines
subject: Sara Ferrigno
  topic: disciplines
subject: Antonella Grimaldi
  topic: disciplines
subject: Noemi Aprile
  topic: disciplines
subject: Daniela Costanza
  topic: disciplines
subject: Laura Quarta
  topic: disciplines
subject: Maria Rita Ricciardi
  topic: disciplines
subject: Daniela Stasi
  topic: disciplines
subject: Paola Conigliaro
  topic: disciplines
subject: Alberto Bergamini
  topic: disciplines
subject: Eugenio Quarta
  topic: disciplines
subject: Maria Sole Chimenti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2084

PO:33:197 | Systemic sclerosis and endothelial dysfunction: the passive leg movement technique in the assessment of no-mediated vascular impairment
type: item
description: Objectives: To evaluate nitric oxide (NO)-mediated vascular dysfunction in patients with Systemic Sclerosis (SSc) compared to age- and sex-matched healthy controls through passive leg movement (PLM). Materials and Methods: Twenty-one patients and twenty-one controls were enrolled. PLM was performed in a seated position, and blood flow (BF) was measured at the right common femoral artery (CFA), distal to the inguinal ligament and approximately 2 cm from the femoral bifurcation, by assessing flow velocity and vessel diameter. Baseline BF, peak flow (hyperaemia) during PLM, and the area under the curve (AUC) of BF over time were calculated. Patients were stratified according to phenotype (limited: lcSSc; diffuse: dcSSc), disease complications, and ongoing therapies. Results: The mean disease duration was 16.2 years (SD ±9.78). Fifteen patients (71%) had lcSSc. The most frequent autoantibodies were anti-centromere (47%) and anti-Scl70 (43%). Nine patients (43%) had a history of digital ulcers (DU), eight (38%) had pulmonary arterial hypertension (PAH), and eleven (52%) had interstitial lung disease (ILD). Seventeen patients (81%) were on vasoactive therapy and eight were taking immunosuppressive treatment (Table 1). At rest, CFA diameter and baseline BF were not significantly different between groups (p=0.14 and p=0.56, respectively). Both groups exhibited a PLM-induced response. Peak BF was significantly reduced in SSc patients (467.7 vs 552.5; p=0.038), as well as change from baseline (p=0.005). The AUC was also significantly lower in patients (p=0.01) (Figure 1). No differences were observed between lcSSc and dcSSc in terms of peak flow (p=0.34) or AUC (p=0.3). A higher modified Rodnan skin score (mRSS) correlated with a smaller CFA diameter (p=0.001). The presence of DU history did not affect the hyperaemic response (p=0.65). Patients with PAH showed a slightly higher peak flow (p=0.05), likely related to vasoactive therapies. No correlation was found between PLM-in…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: endothelial dysfunction
  topic: keywords
subject: Passive Leg Movement
  topic: keywords
subject: (NO)-mediated vascular dysfunction
  topic: keywords
subject: Silvia Guella
  topic: disciplines
subject: Giovanni Baldassarre
  topic: disciplines
subject: Alessandro Gratton
  topic: disciplines
subject: Lucrezia Zuccarelli
  topic: disciplines
subject: Elena Treppo
  topic: disciplines
subject: Emma Di Poi
  topic: disciplines
subject: Bruno Grassi
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2207

PO:33:200 | Analysis of risk factors associated with vertebral fractures in systemic sclerosis: evidence from the "Sclero-RER" study group
type: item
description: Background. Systemic sclerosis (SSc) is a rare disease characterised by fibrosis of the skin and internal organs, as well as vascular involvement. Recent evidence indicates that osteoporosis (OP) is a frequent comorbidity in patients with SSc, with an estimated prevalence of 27%. However, specific risk factors for vertebral fractures in these patients remain unclear. This study aims to identify both general risk factors (age, BMI, age at menopause, family history of fragility fractures, smoking, steroid therapy, and femoral and vertebral T-score) and SSc-related factors (disease duration, autoimmune profile, visceral involvement) associated with the presence of vertebral fractures in patients with SSc and suspected osteoporosis. Materials and Methods. A cross-sectional multicenter study conducted by the "Sclero-RER" group in Emilia-Romagna. Consecutive patients diagnosed with SSc (2013 ACR/EULAR criteria) were included, assessed with bone densitometry (DXA) and vertebral imaging. Collected data included: demographic parameters, disease duration, autoantibody profile, osteometabolic tests, organ involvement, and therapies. Statistical analysis used a stepwise logistic regression model to evaluate the association between risk factors and vertebral fractures (significance: p ≤ 0.05). Results. 103 patients were enrolled (97.1% women, all postmenopausal). Osteoporosis was present in 52.4%, 38.8% had at least one vertebral fracture, and 28.1% had osteopenia. In the model with general factors, a family history of major fragility fractures and the vertebral T-score were significant predictors. When integrating SSc-specific factors, only family history and gastrointestinal (GI) involvement remained associated with the occurrence of vertebral fractures (OR 13.8 p=0.03 and OR 1.6 p=0.05, respectively). Pulmonary involvement and diffuse cutaneous SSc (DcSSc) showed a non-significant trend. Conclusions. This study highlights that both general risk factors (family history of frag…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: systemic sclerosis
  topic: keywords
subject: osteoporosis
  topic: keywords
subject: fractures
  topic: keywords
subject: Alessandra Bezzi
  topic: disciplines
subject: Federica Lumetti
  topic: disciplines
subject: Martina Orlandi
  topic: disciplines
subject: Fabio Mascella
  topic: disciplines
subject: Maria Cristina Focherini
  topic: disciplines
subject: Eugenio Arrigoni
  topic: disciplines
subject: Elena Bravi
  topic: disciplines
subject: Andrea Lo Monaco
  topic: disciplines
subject: Amelia Spinella
  topic: disciplines
subject: Ottavio Secchi
  topic: disciplines
subject: Gianluigi Bajocchi
  topic: disciplines
subject: Francesco Girelli
  topic: disciplines
subject: Francesco Ursini
  topic: disciplines
subject: Pierluigi Cataleta
  topic: disciplines
subject: Massimo Reta
  topic: disciplines
subject: Alarico Ariani
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2208

PO:33:201 | Metabolic and functional state of circulating platelets in patients with systemic sclerosis
type: item
description: Background. Systemic Sclerosis (SSc) is a systemic autoimmune disease characterized by vasculopathy, inflammation and fibrosis. Microangiopathy manifests with Raynaud’s phenomenon and digital ulcers, but also visceral involvement. Endothelial dysfunction represents an early event, associated with imbalance in vasoconstriction–vasodilation, chronic hypoxia and altered angiogenesis. Platelets, besides their known role in hemostasis, recruit immune cells and release pro-fibrotic mediators. Recent studies show increased levels of platelet-derived products in SSc, suggesting higher platelet activity, although the use of antiplatelet therapy in this field remains controversial. Evidence on a complete phenotypic analysis of platelets in SSc is still limited. This preliminary study aims to investigate platelet functionality in SSc. Materials and Methods. This single-center study involved patients diagnosed with SSc according to the 2013 ACR/EULAR criteria, adults, not on antiplatelet therapy, in outpatient follow-up. As healthy controls, age- and sex-matched subjects without autoimmune diseases and not on antiplatelet therapy were enrolled. Blood samples were analyzed within 30 minutes after collection. Platelet activation and reactivity were evaluated by labeling diluted blood with Tyrode buffer, CD62P-PE and PAC1-FITC, in the absence or presence of agonists (ADP, convulxin, TRAP-6). To identify procoagulant platelets, staining with CD41-APC and Annexin V-PE was used, in buffer with Ca² and fibrin inhibitor. Mitochondrial functionality was studied with MitoTracker Green FM and MitoTracker CMXRos on washed platelets, with or without stimulation with agonists. Analysis was performed using BD Accuri C6 Plus flow cytometer and FlowJo™ and GraphPad Prism software version 10.4.2. Results. Eleven patients with SSc (mean age 58.4 ±11.7, F 11) and six healthy controls (age 54.7 ±13.6, F 6) were enrolled. Circulating platelets showed greater mass and mitochondrial membrane potential…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: systemic sclerosis
  topic: keywords
subject: microangiopathy
  topic: keywords
subject: platelets
  topic: keywords
subject: Annalisa Villa
  topic: disciplines
subject: Simona Truglia
  topic: disciplines
subject: Francesca Maiorca
  topic: disciplines
subject: Annamaria Sabetta
  topic: disciplines
subject: Ludovica Lombardi
  topic: disciplines
subject: Silvia D'Orso
  topic: disciplines
subject: Lucia Stefanini
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Marcella Visentini
  topic: disciplines
subject: Valeria Riccieri
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2209

PO:33:203 | Efficacy and safety of rituximab in eosinophilic fasciitis: report of three cases and systematic literature review
type: item
description: Background. Eosinophilic fasciitis (EF) is a rare inflammatory condition classified among scleroderma-like syndromes. Corticosteroids represent the first-line treatment, followed by conventional immunosuppressants. In refractory cases, other agents have been used, including rituximab (RTX), although it is not currently included in EF guidelines (1). Our study aimed to evaluate the efficacy and safety of RTX by describing three cases from our centre and conducting a systematic review of the literature. Methods. We included patients with a clinical and histological diagnosis of EF1 who were treated with RTX at our centre between 2010 and 2025. Demographic, clinical, laboratory, and instrumental data, as well as previous and concomitant therapies, were collected. Disease severity was assessed according to the Jinnin et al. score. A systematic review of the literature (01/2010–05/2025) was conducted in accordance with PRISMA guidelines using the Medline (PubMed) database, including studies published in English on adult patients with EF (population) treated with RTX (exposure), with the aim of evaluating efficacy and safety (outcomes). Results. Three patients with EF who were treated with RTX were identified. Demographic and clinical features are summarized in Table 1. All patients had typical skin involvement confirmed by histology. Physical triggers, infections, drugs, autoimmune diseases, oncological and hematological diseases were excluded. At the time of diagnosis, all patients presented with peripheral eosinophilia and were initially treated with corticosteroids and methotrexate. RTX was added due to progressive skin involvement and a worsening disease severity score. A rapid clinical improvement was observed in all cases, with a reduction in skin thickening, extent of involvement, and disease severity score. The mean daily corticosteroid dose at the last follow-up was 71% lower compared to the pre-RTX dose. In terms of safety, two non-serious adverse events were r…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Eosinophilic fasciitis
  topic: keywords
subject: Rituximab
  topic: keywords
subject: efficacy
  topic: keywords
subject: Andrea Benini
  topic: disciplines
subject: Beatrice Moccaldi
  topic: disciplines
subject: Marco Binda
  topic: disciplines
subject: Anna Cuberli
  topic: disciplines
subject: Mariangela Favaro
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
subject: Elisabetta Zanatta
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2210

PO:34:204 | Impact of anti-centromere antibodies on immunosuppressive therapy persistence in systemic sclerosis: a single-center case-control study
type: item
description: Background. Although in Systemic Sclerosis (SSc) the autoantibody profile is associated with different clinical and therapeutic phenotypes, it remains unclear whether it also affects patients’ persistence in immunosuppressive (IS) therapy. Through a case-control study, we aimed to evaluate whether the presence of specific autoantibodies is associated with a greater tendency to discontinue IS therapy in SSc patients. Materials and Methods. We conducted a retrospective analysis on a single-center cohort of 90 patients (M/F 4/86) affected by SSc, classified according to the 2013 ACR/EULAR criteria and treated with immunosuppressive drugs (IS). Thirty ACA-positive (ACA+) patients were identified and compared with 60 ACA-negative (ACA–) patients, including anti-Scl-70+, anti-RNAP III+, and non-specific ANA+ subjects, matched 1:2 for sex and age. A descriptive analysis of clinical, demographic, and instrumental characteristics was performed at the time of IS initiation (T0). Data regarding the first IS introduced and its clinical indications were also collected. During follow-up, conducted for up to 10 years or until the last documented visit, tolerability and causes of therapy discontinuation were evaluated. Persistence was analyzed using Kaplan–Meier curves, log-rank test, and Cox regression. Results. Table 1 reports the clinical, demographic, and instrumental characteristics of the 90 patients at T0. Table 2 describes, at baseline, IS use and clinical indications in the two groups. During follow-up, 8 ACA+ patients (27%) discontinued therapy compared to 7 ACA– patients (12%). Among ACA+ patients, the main reasons were clinical stability (25%) and gastrointestinal intolerance (25%) (Figure 1). In the ACA– group, discontinuation mainly occurred due to malignancy (28.5%), with no cases related to clinical stability. Persistence was significantly lower in ACA+ patients compared to ACA– (log-rank test, p = 0.0163), with a marked divergence between the 2nd and 6th year (Figu…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: ANTI-CENTROMERE
  topic: keywords
subject: immunosuppressive therapy
  topic: keywords
subject: systemic sclerosis
  topic: keywords
subject: Martina Salerno
  topic: disciplines
subject: Marius Cadar
  topic: disciplines
subject: Ilaria Bisconti
  topic: disciplines
subject: Francesca Romana Di Ciommo
  topic: disciplines
subject: Elena Platania
  topic: disciplines
subject: Jacopo Landro
  topic: disciplines
subject: Beatrice De Girolamo
  topic: disciplines
subject: Davide Mohammad Reza Beigi
  topic: disciplines
subject: Simona Truglia
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Valeria Riccieri
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2211

PO:34:205 | Optical coherence tomography angiography: a window on systemic sclerosis microangiopathy
type: item
description: Background. Vasculopathy represents the primum movens in Systemic sclerosis (SSc) pathogenesis and the determining cause of many of the clinical manifestations of the disease. Optical coherence tomography angiography (OCTA) is a non-invasive imaging technique that allows visualization of retinal blood vessels, providing information on their structure and blood flow. Some studies have documented the presence of retinal vascular alterations in patients with SSc, even in early stages of the disease. The aim of the study is to evaluate the microangiopathic alterations in the retina of SSc patients and to evaluate their correlation with the clinical manifestations of the disease and the alterations at the capillaroscopy. Materials and Methods. This is a case-control study comparing SSc patients with matched healthy controls (HC). The inclusion criteria for patients were: diagnosis of SSc or Very early SSc (VEDOSS), absence of maculopathy, no therapy with Hydroxychloroquine. The OCTA acquisition consisted of 3 x 3 mm scans of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of both the macula and the optic nerve, performed using Canon OCT HS100 with dilated pupils. The vascular density (VD) and the vascular length density (VLD) as long as foveal avascular zone (FAZ) were then calculated using dedicated software (OCT-HS100 Angio Expert AX®). Retinal thickness in the fovea and in the perifoveal region was also measured. Results. 82 eyes of 41 SSc patients (of which 11 were VEDOSS) were compared with 40 eyes of 20 HC. Patients showed significantly reduced VD values in all areas evaluated both at the SCP level (p<0.001) and at the DCP level (p<0.001). VLD values were also significantly reduced in patients compared to HC, both at the SCP (p<0.001) and DCP (p<0.001). Also at the optic nerve level, both VD and VLD values were significantly reduced at the SCP (p<0.001 for both) and at the DCP level (p=0.009 and p<0.001, respectively). Differently, FAZ values…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: systemic sclerosis
  topic: keywords
subject: Optical coherence tomography
  topic: keywords
subject: vasculopathy
  topic: keywords
subject: Martina Orlandi
  topic: disciplines
subject: Tommaso Verdina
  topic: disciplines
subject: Filippo Santoro
  topic: disciplines
subject: Alessandra Carobbio
  topic: disciplines
subject: Amelia Spinella
  topic: disciplines
subject: Marco De Pinto
  topic: disciplines
subject: Giorgia Roveta1
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2212

PO:34:209 | Increased liver stiffness and fibrosis in systemic sclerosis: a single-center transient elastography cohort study.
type: item
description: Background. This study aims to evaluate and compare the liver stiffness (LS) and the prevalence of liver fibrosis in patients with systemic sclerosis (SSc) versus healthy controls (HCs). Additionally, within the SSc cohort, it sought to identify demographic, clinical, or serological factors having a potential role as predictors of increased LS and overt liver fibrosis. Materials and Methods. Data from a monocentric cohort of 94 SSc patients, diagnosed according to the ACR/EULAR 2013 classification criteria, and 50 gender - and age - matched HCs were analyzed. All SSc patients and HCs were screened for concomitant infective, metabolic or autoimmune hepatic disorders and excluded if positive. The LS was measured in all patients and HCs by the Transient Elastography (FibroScan®) performed by a trained gastroenterology clinician. A cut-offs of > = 5.4 kPa and > = 7.5 kPa were applied to define, respectively, increased LS and overt fibrosis. Demographic, clinical, treatment and laboratory data, including autoantibodies profile, were recorded in all SSc patients and analyzed as potential predictors of LS and overt liver fibrosis in uni-and multivariate analysis. Results. Out of the 94 SSc patients, 79 (84%) were female. The mean (SD) age at enrollment and disease duration were 58.4 (12.9) and 9.4 (7.6) years, respectively. SSc patients exhibited a significantly higher mean (SD) LS compared to HCs (5.12 ± 1.95 kPa vs 4.18 ± 0.98 kPa; p = 0.002). Similarly, SSc patients showed a significantly higher prevalence of increased LS (40.4% vs 10.0%, p < 0.001) and overt liver fibrosis (11.7% vs 0, p = 0.009). In univariate analysis anti-centromere antibody (ACA) positivity (40.9% vs 24%, p = 0.028.), and increased serum GOT levels (23.9 ± 9,4 vs 19.9 ± 5.9, p = 0.008) were significantly associated with increased LS. However, in multivariate analysis only telangiectasias (p= 0.010 ) and elevated GOT (p= 0.009) levels were confirmed to be independently associated with increased LS. …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: SYSTEMIC SCLEROSIS
  topic: keywords
subject: HEPATIC RIGIDITY
  topic: keywords
subject: TRANSITORY ELASTOGRAPHY
  topic: keywords
subject: Nicola Ortalli
  topic: disciplines
subject: Simone Aldo Lari
  topic: disciplines
subject: Alessandra Vacca
  topic: disciplines
subject: Erika Meleddu
  topic: disciplines
subject: Alberto Civolani
  topic: disciplines
subject: Emanuela Vargiu
  topic: disciplines
subject: Alberto Floris
  topic: disciplines
subject: Massimo Claudio Fantini
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2085

PO:34:212 | Orofacial manifestations in systemic sclerosis: preliminary observational study and update of a single-center experience
type: item
description: Background: Systemic sclerosis (SSc) is a rare autoimmune disease characterized by endothelial dysfunction, tissue fibrosis, and immune dysregulation, leading to increased morbidity and mortality. Orofacial involvement—often underestimated—includes reduced mouth opening, periodontal alterations, hyposalivation, and masticatory difficulties, with a potential negative impact on quality of life. The aim of this study, conducted in collaboration between rheumatologists and dentists, was to investigate the correlations between systemic disease features and oral health parameters in a preliminary SSc cohort. Materials and Methods: An observational study was conducted on 13 SSc patients (F/M 12/1) attending the Scleroderma Unit of the University Hospital of Modena. All patients fulfilled the 2013 ACR/EULAR classification criteria and were referred to the Dental Service for comprehensive evaluation. Demographic, clinical, serological, rheumatological, and dental parameters were assessed, including DMFT index, periodontal indices, mouth opening, salivary flow rate, and quality of life (SSc-HAQ). Statistical analyses included Spearman/Pearson correlations and non-parametric tests. Results: The 13 enrolled patients presented a cutaneous subset distribution of dcSSc/lcSSc = 6/7, with a mean age of 56.5 ± 23.6 years. Older age was significantly associated with poorer oral health (r=0.79, p=0.002) and greater functional disability (r=0.83, p=0.0008). Patients with interstitial lung disease (ILD) exhibited a significant reduction in mouth opening (p=0.019). A strong positive correlation was also observed between plaque accumulation and disability index (r=0.72, p=0.006). Other non-significant trends suggested a possible association between limited cutaneous subset and reduced salivary flow. Conclusions: In our experience, orofacial involvement in SSc—particularly in older patients and those with ILD—adversely affects oral function and quality of life. Regular oral health monitorin…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: systemic sclerosis
  topic: keywords
subject: Orofacial manifestations
  topic: keywords
subject: multidisciplinarity
  topic: keywords
subject: Amelia Spinella
  topic: disciplines
subject: Marco De Pinto
  topic: disciplines
subject: Giacomo Setti
  topic: disciplines
subject: Martina Orlandi
  topic: disciplines
subject: Samuele Veronesi
  topic: disciplines
subject: Federica Lumetti
  topic: disciplines
subject: Alessia Laneri
  topic: disciplines
subject: Luca Keller Sarmiento
  topic: disciplines
subject: Giorgia Roveta
  topic: disciplines
subject: Gilda Sandri
  topic: disciplines
subject: Pierantonio Bellini
  topic: disciplines
subject: Ugo Consolo
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2213

PO:34:217 | Possible role of phosphodiesterase type 5 inhibitors in the prevention of digital ulcers and videocapillaroscopic changes in patients with systemic sclerosis
type: item
description: Background. In systemic sclerosis (SSc), phosphodiesterase type 5 inhibitors (PDE5i) are currently used in the treatment of pulmonary hypertension and in the management of refractory Raynaud’s phenomenon, and they appear to play a role in the healing of digital ulcers. However, the impact of these drugs on ulcer prevention and on nailfold videocapillaroscopy (NVC) findings remains poorly investigated. Materials and Methods. In this single-center retrospective study, 17 patients diagnosed with SSc according to the 2013 ACR/EULAR criteria and treated with PDE5i for at least 12 months were enrolled. Clinical, serological, and capillaroscopic data were collected. Based on the occurrence of new digital ulcers (DU) after starting therapy, patients were divided into two groups (DU+ and DU–). NVC images before and after treatment were analyzed qualitatively and quantitatively. Capillaroscopic data were unavailable for five patients. Results. Of the 17 patients enrolled, 14 (82%) were female, with a median age of 60 years (IQR 50–68). Twelve (70%) had a history of digital ulcers. Based on the occurrence of new DU during therapy, two groups were identified: DU+ (n=7, 41%) and DU– (n=10, 59%), as shown in Table 1. The groups were comparable in terms of age, disease duration, and duration of PDE5i exposure. Patients with recurrent DU more frequently had diffuse cutaneous disease, a history of previous DU, positivity for anti-Scl70 antibodies, and greater use of prostanoid therapy. Regarding capillaroscopy performed at a median interval of 3 years (IQR 2–5), no statistically significant differences were found between groups in terms of NVC pattern. Quantitative analysis of NVC showed that, although not statistically significant, in the DU+ group the absolute number of capillaries/mm decreased during therapy, while in the DU– group it remained stable. Conversely, the number of megacapillaries/mm remained stable in the DU+ group but decreased in the DU– group. The overall results …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: phosphodiesterase
  topic: keywords
subject: ulcers
  topic: keywords
subject: videocapillaroscopy
  topic: keywords
subject: Elena Platania
  topic: disciplines
subject: Marius Cadar
  topic: disciplines
subject: Ilaria Bisconti
  topic: disciplines
subject: Davide Mohammad Reza Beigi
  topic: disciplines
subject: Francesca Romana Di Ciommo
  topic: disciplines
subject: Jacopo Landro
  topic: disciplines
subject: Martina Salerno
  topic: disciplines
subject: Beatrice De Girolamo
  topic: disciplines
subject: Simona Truglia
  topic: disciplines
subject: Fabrizio Conti
  topic: disciplines
subject: Valeria Riccieri
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2214

PO:35:219 | Real-world effectiveness of mepolizumab on gastrointestinal involvement in eosinophilic granulomatosis with polyangiitis and hypereosinophilic syndrome: a multicentre retrospective study
type: item
description: Background. Eosinophilic gastrointestinal disorders are characterized by marked eosinophilic infiltration of the gastrointestinal (GI) tract causing organ dysfunction and the onset of GI symptoms. They may present in isolation or as part of systemic diseases including eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndrome (HES). Mepolizumab (MEPO), an anti-interleukin-5 monoclonal antibody, is approved for both conditions; however, data are limited regarding its effectiveness in managing GI involvement. This study aims to evaluate MEPO’s effectiveness on EGPA and HES-related GI involvement. Materials and Methods. This was a retrospective cohort study conducted among centres referring to the European EGPA Study Group. Inclusion criteria: age >18 years; EGPA or HES diagnosis; GI manifestations confirmed by histology or imaging; start of MEPO any dosage (100 or 300 mg/month sc, 750 mg/month iv) for uncontrolled GI manifestations. Data were collected from disease onset until MEPO start (t0), at 1 (t1), 3 (t3), 6 (t6), 12 (t12), 24 (t24) months, and during flares (exacerbations of GI symptoms requiring therapeutic escalation). Outcomes included symptom improvement, absolute eosinophil count (AEC) reduction, flare occurrence, and corticosteroid (CS)-sparing effect. Data are presented as n (%) or median (IQR). Wilcoxon or McNemar tests were used as appropriate. Flare rates (flares/patient-month) pre- and post-MEPO were compared using incidence rate ratio (IRR) with 95% CI (p<.05). Results. Forty-eight patients were included. At baseline, all the patients had active GI involvement, with median peak AEC 3857 (1593-9743) cells/mm3. Forty-six patients (96%) had a history of CS use prior to MEPO. Median time from diagnosis to MEPO start was 5 (1-49) months (Table 1). Median AEC decreased by t1 [t0: 805 (482-1805) cells/mm3; t1: 115 (60–223); p<.001] and remained low through t24 [70 (23–108) cells/mm3; p<.001]. By t24, active GI symptoms decreased fr…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Mepolizumab
  topic: keywords
subject: Gastrointestinal disorders
  topic: keywords
subject: Eosinophils
  topic: keywords
subject: Alessia Gatti
  topic: disciplines
subject: Francesca Regola
  topic: disciplines
subject: Giulia Fontana
  topic: disciplines
subject: Mario Addrea Piga
  topic: disciplines
subject: Gianluca Moroncini
  topic: disciplines
subject: Palma Carlucci
  topic: disciplines
subject: Angelo Vacca
  topic: disciplines
subject: Paolo Delvino
  topic: disciplines
subject: Enrico Heffler
  topic: disciplines
subject: Emanuele Nappi
  topic: disciplines
subject: Jakub Moll
  topic: disciplines
subject: Laura Losappio
  topic: disciplines
subject: Jan Schroeder
  topic: disciplines
subject: Federica Davanzo
  topic: disciplines
subject: Roberto Padoan
  topic: disciplines
subject: Edoardo Conticini
  topic: disciplines
subject: Paolo Cameli
  topic: disciplines
subject: Greta Pacini
  topic: disciplines
subject: Alvise Berti
  topic: disciplines
subject: Lorenzo Vrola
  topic: disciplines
subject: Paola Tomietto
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
subject: Jan Willem Cohen Tervaert
  topic: disciplines
subject: Sabrina Arnold
  topic: disciplines
subject: Peter Lamprecht
  topic: disciplines
subject: Florence Roufosse
  topic: disciplines
subject: Ilaria Cavazzana
  topic: disciplines
subject: Franco Franceschini
  topic: disciplines
subject: Giacomo Emmi
  topic: disciplines
subject: Paola Toniati
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2086

PO:35:220 | IgG anti-pentraxin 3 autoantibodies distinguish eosinophilic granulomatosis with polyangiitis from severe eosinophilic asthma and chronic rhinosinusitis with nasal polyps
type: item
description: Background. Eosinophilic granulomatosis with polyangiitis (EGPA) typically presents with severe eosinophilic asthma (SEA) and chronic rhinosinusitis with nasal polyps (CRSwNP), often preceding systemic vasculitis by years. Early identification of patients likely to develop EGPA among those with asthma and sinusitis is therefore crucial. Circulating IgG autoantibodies against Pentraxin-3 (PTX3) have recently been reported in EGPA, raising the possibility that they could help distinguish EGPA from related airway disorders. The objective of the study was to determine the prevalence of anti-PTX3 autoantibodies in patients with EGPA, SEA and CRSwNP, and to evaluate their utility as a biomarker for differentiating EGPA from these conditions. Materials and Methods. We performed a single-center study including consecutive patients diagnosed with EGPA, and patients with SEA or CRSwNP. Serum anti-PTX3 IgG levels were measured using a standardized, in-house ELISA (positivity cut-off: optical density > 0.234 at 405 nm), as previously described. Liquid-phase inhibition assays were performed to evaluate potential assay interferences. Categorical variables were compared with ² tests; continuous variables with the Mann–Whitney U test. Results. We included 120 patients diagnosed with EGPA (56.7% female, median age 61), 60 with SEA (68.3% female, median age 59), and 63 with CRSwNP (44.4% female, median age 58). Anti-PTX3 autoantibodies were detected in 35% EGPA patients, compared to 8.3% in asthma and 7.9% in CRSwNP (p<0.001 for EGPA vs each comparator). Median OD values were higher in EGPA (0.175) than in asthma (0.11, p=0.014) and CRSwNP patients (0.07, p=0.001). PTX3 inhibited anti-PTX3 binding in a dose-dependent manner. No associations were found with ANCA status or clinical features at diagnosis. At the time of sample collection, 10% (12/120) of patients were characterized by active disease, while 90% (108/120) experienced remission. No statistically significant differences in …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: ANCA-associated vasculitis
  topic: keywords
subject: EGPA
  topic: keywords
subject: Diagnostic biomarkers
  topic: keywords
subject: Eleonora Fiorin
  topic: disciplines
subject: Anna Ghirardello
  topic: disciplines
subject: Federica Davanzo
  topic: disciplines
subject: Luca Iorio
  topic: disciplines
subject: Marta Codirenzi
  topic: disciplines
subject: Roberta Prevedello
  topic: disciplines
subject: Roberto Padoan
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2087

PO:35:221 | Cryofibrinogen: a cold case. Characteristics and clinical outcomes from a cryofibrinogen positive cohort
type: item
description: Background. Cryofibrinogen (CF) is a protein tangle mainly made of fibrinogen, fibrin and fibronectin that precipitates when exposed to cold temperatures. Unlike cryoglobulins (CG), CF significance is still poorly understood. Objective: to characterize patient with CF positivity and to define its clinical impact and therapeutic outcomes. Materials and Methods. We retrospectively collected data focusing on 46 CF positive patients. Demographic, clinical and therapeutic features were assessed at baseline (To), after the first determination (T1) and at each CF finding. Standard descriptive statistics were employed for our analysis. Results. 20 patients (43.5%) presented with CF alone, whilst 26 (56.5%) showed CF + CG. Female sex was prevalent (76.1%) with an average age of 54.1 (±14.6) years. 41.3% of patients were diagnosed with vasculitis, 14 of which cryoglobulinaemic, 13% arthritis, 23.9% connectivitis, 21.7% had no defined diagnosis. Clinical involvement ranged from neurological (58.2%), to cutaneous (purpuric rash 48.9%, skin ulcers 20%), inflammatory arthralgias (34.8%), cardiovascular (13%) and renal (6.5%). We then provided a statistical analysis dividing patients into two subgroups depending on CF positivity alone or CF + CG positivity. Groups were homogeneous for demographic, therapeutic, clinical features and outcomes (Figura 1.a). We then performed a comparison between patients who experienced a resolution of the symptomatology (responders) and those who haven’t (non-responders). Non-responders showed a significantly more frequent CG positivity (72.7% vs 41.7%, p=0.04) and a similar trend for ANA positivity (57.1 vs 29.2, p=0.07). On the other hand, a significant lower baseline employment rate of csDMARD was observed among responders 12.5% vs 36.4%, p=0.05), being hydroxychloroquine the most frequent among non-responders (55.1% vs 0%). More responders were administered corticosteroids at T1 (83.3% vs 59.1) even if statistical significance wasn’t achieved, w…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Cryofibrinogen
  topic: keywords
subject: Cryoglobulins
  topic: keywords
subject: Vasculitis
  topic: keywords
subject: Daniele Catameró
  topic: disciplines
subject: Andrea Cito
  topic: disciplines
subject: Cristiana Colaprico
  topic: disciplines
subject: Teresa Caferri
  topic: disciplines
subject: Teresa Troiano
  topic: disciplines
subject: Anna Marinaccio
  topic: disciplines
subject: Marco Fornaro
  topic: disciplines
subject: Giuseppe Lopalco
  topic: disciplines
subject: Florenzo Iannone
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2088

PO:35:227 | Long-term renal and survival outcomes in microscopic polyangiitis: data from an observational monocentric cohort
type: item
description: Background. Microscopic polyangiitis (MPA) is an ANCA-associated small-vessel vasculitis, often causing severe renal involvement that may lead to dialysis or transplantation. While ANCA-associated vasculitides have been extensively studied, data focusing specifically on MPA remain limited. Materials and Methods. MPA patients fulfilling the 2022 ACR/EULAR criteria, who were followed at our centre between May 2004 and May 2025, were analysed retrospectively. Clinical and laboratory data as well as information regarding induction and maintenance therapy, were collected at diagnosis, during relapses, and at last follow-up. Furthermore, variables potentially associated with death, renal outcomes and relapse were investigated. Results. Of the 71 MPA patients included (median age 66 years; 54.5% female), 98.6% were ANCA-positive, mostly MPO-ANCA (91.5%). At diagnosis 94.4% had renal involvement. Induction therapy consisted of glucocorticoids alone (16.9%) or with immunosuppressants (83.1%), mainly cyclophosphamide (31%) and rituximab (19.7%), while mycophenolate mofetil (21.4%) was the most used for maintenance. Over a median follow-up of 55 months, 90% achieved remission, 18.3% died, 26.8% experienced at least one relapse and 26.8% progressed to end-stage kidney disease (ESKD). Among those, 18.3% required dialysis and 7% underwent kidney transplantation. Baseline characteristics are summarized in Table 1. Survival, based on Kaplan-Meier curves, was significantly lower in patients aged >65 years (p=0.0019), with rapidly progressive nephritis (p=0.0263), arterial hypertension (p=0.0251), or dialysis at onset (p=0.0445). No significant differences in survival were observed based on induction with rituximab (p=0.5597), cyclophosphamide (p=0.227), or maintenance immunosuppressants (p=0.058). Neither VDI >5 nor ANCA Renal Risk Score (ARRS) >8 were associated with increased mortality. In multivariate analysis, faster ANCA negativity was independently associated with better survi…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Microscopic Polyangiitis
  topic: keywords
subject: ANCA-associated vasculitis
  topic: keywords
subject: Vasculitis
  topic: keywords
subject: Roberta Prevedello
  topic: disciplines
subject: Federica Davanzo
  topic: disciplines
subject: Luca Iorio
  topic: disciplines
subject: Eleonora Fiorin
  topic: disciplines
subject: Marta Codirenzi
  topic: disciplines
subject: Roberto Padoan
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2089

https://www.reumatismo.org/reuma/article/view/2090
type: item
title: PO:35:228 | Polymyalgia rheumatica and giant cell arteritis induced by immune checkpoint inhibitors for cancer treatment: a systematic review and meta-analysis highlighting differences from the idiopathic forms
description: Background. Immune checkpoint inhibitors (ICIs), widely used in cancer immunotherapy, can trigger immune-related adverse events, including polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), likely through mechanisms involving altered immune tolerance. We conducted a systematic review (SLR) and meta-analysis to characterize these conditions and explore potential differences from the idiopathic forms. Materials and Methods. The SLR analyzed Medline and EMBASE databases up to July 2024, comparing ICI-induced PMR and GCA to their primary forms. Where direct comparisons with idiopathic forms were unavailable, we referred to data from prior meta-analyses and large observational cohorts to qualitatively explore potential differences. Results. From 1,237 abstracts, 46 were included, yielding 358 patients (314 with ICI-PMR and 44 with ICI-GCA). ICI-PMR had a pooled prevalence of 0.3% [95% CI: 0.1%–1.2%] among ICI recipients. Patients were predominantly males (64% [95% CI: 54%–73%]), with a mean age of 71 years [95% CI: 68–74]. PD1/PDL1 blockers were used in 85% [95% CI: 80%–89%] of cases. Inflammatory pain in the girdles was universal (100%), however pelvic girdle involvement was explicitly reported in only 3 studies. Peripheral arthritis in ICI-PMR was present in 26% [95% CI: 9%–54%], and normal inflammatory markers were detected in 26% [95% CI: 15%–40%]. Glucocorticoids (GCs) completely improved symptoms in 83% of patients [95% CI: 66%–92%], with 13% [95% CI: 12%–34%] requiring DMARDs and 18% [95% CI: 9%–33%] experiencing relapses (Figure 1). Two comparative case-control studies showed significant differences between ICI-induced and primary PMR. ICI-PMR patients had milder symptoms, lower C-reactive protein levels, and required lower median prednisone dosages. ICI-GCA prevalence was 0.06% among ICI recipients. Male patients comprised 51% [95% CI: 36%–66%], with a mean age of 71 years [95% CI: 68–74]. About 50% [95% CI: 23%–77%] received anti-CTLA4 blockers (alone…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Polymyalgia rheumatica
  topic: keywords
subject: Giant cell arteritis
  topic: keywords
subject: Immune checkpoint inhibitors
  topic: keywords
subject: Elvis Hysa
  topic: disciplines
subject: Andrea Casabella
  topic: disciplines
subject: Emanuele Gotelli
  topic: disciplines
subject: Rosanna Campitiello
  topic: disciplines
subject: Carlo Genova
  topic: disciplines
subject: Enrica Teresa Tanda
  topic: disciplines
subject: Carmen Pizzorni
  topic: disciplines
subject: Alberto Sulli
  topic: disciplines
subject: Vanessa Smith
  topic: disciplines
subject: Marco Amedeo Cimmino
  topic: disciplines
subject: Sabrina Paolino
  topic: disciplines
subject: Maurizio Cutolo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2090

PO:36:238 | Clinical, functional, and radiological similarities between interstitial lung disease–anti–myeloperoxidase and idiopathic pulmonary fibrosis
type: item
description: Background. An association between interstitial lung disease (ILD) and anti–myeloperoxidase (MPO) antibody positivity is well established. This condition does not necessarily overlap with ANCA-associated vasculitis but in 60–70% of cases presents as an isolated pulmonary disease. Previous observations suggested that this fibrosing disorder (MPO-ILD) shares several clinical features with idiopathic pulmonary fibrosis (IPF). Radiologically, small case series reported the presence of honeycomb-like lesions in the anterior segment of the upper lobe and a possible larger size of honeycombing cysts, as suggested by expert radiologists. Based on these findings, we conducted an exploratory comparative study between MPO-ILD and IPF aimed at identifying potential clinical, functional, and radiological differences. Materials and Methods. We retrospectively enrolled patients followed at the tertiary referral clinics for interstitial lung disease and rheumatology, diagnosed with IPF or MPO-ILD. Clinical data (demographics, comorbidities, treatments, environmental exposures), laboratory findings (autoantibody profiles, CRP, baseline neutrophil count, creatinine), and pulmonary function parameters (FVC, TLC, DLCO) were collected. High-resolution CT (HRCT) scans at diagnosis and after 24 months were reviewed by an expert thoracic radiologist using a structured evaluation grid. A specific index was developed to assess honeycombing cyst size, based on the mean diameter of three cysts per lung side. Results. A total of 27 IPF and 5 MPO-ILD patients were included; two MPO-ILD patients developed vasculitis after the ILD diagnosis. Demographic, exposure, and comorbidity profiles were comparable between groups. Compared to IPF, MPO-ILD patients more frequently reported arthralgia and ENT symptoms (p = 0.009 and 0.008, respectively). At baseline, MPO-ILD patients had higher serum creatinine (p = 0.012) and neutrophil counts (p = 0.012). Low-titer ANA positivity was more frequent in MPO-ILD…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: interstitial lung disease
  topic: keywords
subject: anti-MPO
  topic: keywords
subject: ANCA associated vasculitis
  topic: keywords
subject: Enrico Colombo
  topic: disciplines
subject: Jessica Gozzi
  topic: disciplines
subject: Paolo Francia
  topic: disciplines
subject: Giulia Cervi
  topic: disciplines
subject: Marilena Frigato
  topic: disciplines
subject: Martina Garuti
  topic: disciplines
subject: Francesca Bartoli
  topic: disciplines
subject: Irene Gavioli
  topic: disciplines
subject: Caterina Cerbone
  topic: disciplines
subject: Massimiliano Beccaria
  topic: disciplines
subject: Maria Teresa Costantino
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2215

PO:36:242 | Bilateral central retinal artery occlusion as the first manifestation of eosinophilic granulomatosis with polyangiitis during benralizumab therapy
type: item
description: Background. Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis characterized by an initial prodromal phase with eosinophil-driven manifestations such as asthma, nasal polyposis, and rhinitis, followed by an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitic phase. Ocular involvement is possible but uncommon (approximately 15% of cases), and central retinal artery occlusion (CRAO) represents an exceedingly rare event. Although benralizumab, a monoclonal antibody targeting the IL-5 receptor, has proven effective in managing eosinophilic manifestations such as asthma and nasal polyposis, its ability to prevent vasculitic damage remains uncertain. We report a case of EGPA complicated by bilateral CRAO occurring during benralizumab therapy. Case report. A 61-year-old man with a history of adult-onset chronic rhinosinusitis and severe asthma, treated with benralizumab since 2022, presented to the emergency department in June 2024 with sudden bilateral blindness preceded by transient amaurosis episodes, without systemic symptoms or ocular pain. Ophthalmologic examination revealed markedly reduced visual acuity in both eyes (hand motion only) and a relative afferent pupillary defect. Fundus examination showed pale optic discs with central cherry-red spots. Optical coherence tomography (OCT) demonstrated inner retinal layer edema and hyperreflectivity (Figure 1a–c), while fluorescein angiography confirmed delayed retinal arteriolar filling (Figure 1d), findings consistent with CRAO. Laboratory tests revealed elevated inflammatory markers and high-titer myeloperoxidase (MPO)-ANCA positivity (134 IU/mL; positive >3 IU/mL) in the absence of peripheral eosinophilia, likely due to benralizumab therapy. Based on clinical and serological findings, a diagnosis of EGPA was established. High-dose corticosteroids and combined rituximab–cyclophosphamide therapy were initiated according to KDIGO and PEXIVAS recommendations. After an initial i…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Eosinophilic
  topic: keywords
subject: vasculitic
  topic: keywords
subject: benralizumab
  topic: keywords
subject: Benedetta Fazzi
  topic: disciplines
subject: Elena Treppo
  topic: disciplines
subject: Lucia Finocchio
  topic: disciplines
subject: Maria Pillon
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2216

PO:36:243 | Drug survival, discontinuation reasons and disease activity in patients with Behçet's disease treated with infliximab - a real-life study
type: item
description: Background. Behçet's Disease (BD) is a rare multisystemic vasculitis that can result in life-threatening manifestations when involving the central nervous system or vascular system. Infliximab (IFX) is an immunosuppressive drug widely used for the treatment of BD with major organ involvement or refractory to therapies. The objective of the study was to evaluate the drug survival, discontinuation reasons, safety profile and disease activity of a cohort of patients diagnosed with BD receiving IFX. Materials and Methods. We conducted a retrospective observational study examining all the patients affected by BD according to ISG criteria treated with Infliximab. Patient demographics and background data were collected. Disease activity was assessed using the BDCAF (Behçet’s Disease Current Activity Form 2006) index, and clinical remission was evaluated with a score <= 2 points; the safety outcomes were the incidence of adverse drug reactions (ADRs). IFX 5 mg/kg was administered as an intravenous infusion at weeks 0, 2, and 6, and at 6-8 week intervals thereafter. We performed statistical analysis using descriptive statistics (mean ± standard deviation), median (interquartile range IQR), Odds Ratio, Chi-square test, Student’s t-test or Mann Whitney test, statistical significance was assessed for p < 0.05. Results. A total of 60 BD patients (56.7% female, 43.3% male) were treated with IFX from 2003 to 2025. Their mean age of disease onset was 30.9 years (range 8-63), with a mean age at the introduction of Infliximab of 41.6 years. The main cumulative reasons for starting therapy were: oral and genital recurrent aphthae (71.7% and 35%), cutaneous manifestations (35%), articular involvement (inflammatory arthralgias in 23.3% and arthritis in 23.3%), ocular involvement was found in 28% and SNC involvement in 15%. Analyzing the duration of treatment, it was observed that therapy is currently being followed by 27 patients (drug survival 45%) with a median treatment duration of 3…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Behcet's Syndrome
  topic: keywords
subject: Infliximab
  topic: keywords
subject: Real-life observational study
  topic: keywords
subject: Antonello Sulis
  topic: disciplines
subject: Federica Di Cianni
  topic: disciplines
subject: Maria Laura Manca
  topic: disciplines
subject: Rosaria Talarico
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2091

PO:36:244 | Early diagnosis in eosinophilic granulomatosis with polyangiitis: a multidisciplinary approach
type: item
description: Background. Early diagnosis of Eosinophilic Granulomatosis with Polyangiitis (EGPA) remains one of the major unmet needs in clinical practice due to the non-specific nature of prodromal symptoms and the lack of specific biomarkers, particularly in patients who are anti-neutrophil cytoplasmic antibody (ANCA)-negative. The involvement of a multidisciplinary team may improve clinical management and the diagnostic-therapeutic process. The study objectives were: 1. To identify factors that may suggest an early diagnosis of EGPA by comparing patients referred to the rheumatologist through a multidisciplinary team, who do or do not receive an EGPA diagnosis. 2. To evaluate whether clinical features differ between EGPA patients referred through a multidisciplinary team and those referred through conventional pathways. Materials and Methods. A retrospective study was conducted on consecutive patients between December 2023 and May 2025, categorized into three groups: 1. Patients with suspected EGPA evaluated through the multidisciplinary eosinophilic diseases pathway at our university hospital, who received a confirmed diagnosis (EGPA-MDT); 2. Patients evaluated through the same pathway who did not receive an EGPA diagnosis (nEGPA); 3. Patients referred through conventional channels who were diagnosed with EGPA (EGPA-CR). Demographic, clinical, laboratory, and instrumental data were compared. Non-parametric tests (Kruskal-Wallis, Mann-Whitney, and Chi-square) were used for statistical analysis. A p-value < 0.05 was considered statistically significant. Results. A total of 85 patients were enrolled: 21 EGPA-MDT, 26 nEGPA, and 38 EGPA-CR. Demographic data are shown in Table 1. Compared to nEGPA patients, EGPA-MDT patients had a higher prevalence of systemic manifestations (81% vs 26.9%; p = 0.001) and more severe nasal disease (Nasal Polyp Score 4.0±2.3 vs 2.6±2.3; p = 0.05), as well as higher mean eosinophil counts (absolute mean values 4283.6±6131.6 cells/µL vs 644.4±537.4 ce…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: EGPA
  topic: keywords
subject: Multidisciplinary
  topic: keywords
subject: Hyper eosinophilia
  topic: keywords
subject: Federico Giuseppe Lazzaro
  topic: disciplines
subject: Elena Chiaradia
  topic: disciplines
subject: Chiara Lombardi
  topic: disciplines
subject: Flavia Leone
  topic: disciplines
subject: Massimo Nucci
  topic: disciplines
subject: Roberta Masnata
  topic: disciplines
subject: Flora Niedda
  topic: disciplines
subject: Maria Rita Gigante
  topic: disciplines
subject: Pietro Rubortone
  topic: disciplines
subject: Silvia Laura Bosello
  topic: disciplines
subject: Maria Antonietta D'Agostino
  topic: disciplines
subject: Augusta Ortolan
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2092

PO:36:245 | Uncovering clinical and demographic differences in major organ involvement versus benign Behçet’s disease: insights from a single-centre study
type: item
description: Background. Behçet’s disease (BD) is a rare chronic inflammatory disease with a multi-systemic clinical presentation. Mucosal ulcerations and skin lesions are the most common features, typically indicating a benign disease course. In contrast, major organ involvement (MOI) defines a severe disease due to the organ-threatening potential. Patients with MOI often require immunosuppressive treatment to achieve sustained remission and prevent organ damage. Identifying factors associated with the development of a MOI subset is crucial for understanding disease progression and guiding therapeutic strategies. The aim of this analysis was to describe and compare the clinical and demographic characteristics of patients with MOI BD and benign subset. Materials and Methods. We retrospectively analyzed 186 BD patients with a minimum of 5 -year follow-up. Patients were classified into the MOI subset if they had a history of ocular, vascular or neurological involvement; those without MOI were classified as having benign disease. Descriptive statistics was performed (mean ± standard deviation, median with interquartile range). Categorical variables were compared using Chi-square test or Fisher's exact test when appropriate. Continuous variables were compared using Student's t-test for normally distributed data or Mann-Whitney U test for non-parametric data. Statistical significance was set at p < 0.05. Results. The benign group included 80 patients (43.2%) while the MOI group consisted of 105 patients (56.8%). In both groups patients were mainly females (67.5% in benign group versus 64.8% in MOI group). The mean age at disease onset was 31.2 years (median:35) for benign group and 28.1 years (median:30) for MOI group, whereas the mean age at diagnosis was 38.1 years (median: 39) and 37.3 years (median: 38), respectively. The median diagnostic delay amounted to 3 years in benign group and 5 years in MOI group. However, no statistically significant differences were found regarding gen…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Behçet's disease
  topic: keywords
subject: Disease subgroup
  topic: keywords
subject: Major organ involvement
  topic: keywords
subject: Federica Di Cianni
  topic: disciplines
subject: Antonello Sulis
  topic: disciplines
subject: Maria Laura Manca
  topic: disciplines
subject: Rosaria Talarico
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2093

PO:36:246 | Early real-world outcomes with benralizumab in eosinophilic granulomatosis with polyangiitis: a monocentric retrospective
type: item
description: Background. Eosinophilic Granulomatosis with Polyangiitis (EGPA) is a rare small-vessel vasculitis driven by eosinophilic inflammation. Benralizumab, an IL-5 receptor antagonist, has recently been introduced for EGPA treatment, although data from real-life clinical practice following its European approval remain limited. This study aimed to assess the early effectiveness and safety of Benralizumab in patients with EGPA during the first 6 months of therapy. Materials and Methods. Patients with EGPA were enrolled according to the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology Classification Criteria. Blood eosinophil counts and clinical manifestations were recorded at baseline, after three months (T3), and at six months (T6). Changes in continuous variables were analyzed using the Wilcoxon signed-rank test. Results. Thirteen patients (F: 66.7%) were included. No relapses were observed during the 6-month follow-up (mean relapse count: 0.0). The mean blood eosinophil count significantly decreased from baseline to T3 and T6 (mean reduction: 984.2 cells/mm³; p < 0.001; figure 1). Clinical improvement was observed across several domains. ENT symptoms, present at baseline, resolved in all affected patients. Renal involvement showed improvement (p = 0.0316), while neurological involvement remained unchanged (p = 0.157). No adverse events or treatment discontinuations were reported. Conclusions. In this early monocentric real-world experience, Benralizumab was associated with a favorable safety profile, significant eosinophil depletion, and clinical improvement—particularly in ENT and renal involvement. Although limited by small sample size and short follow-up, these preliminary findings support the potential role of Benralizumab as a therapeutic option in EGPA, especially in patients with prominent eosinophilic or upper airway manifestations.
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: EGPA
  topic: keywords
subject: Benralizumab
  topic: keywords
subject: Vasculitis
  topic: keywords
subject: Richard Borrelli
  topic: disciplines
subject: Stefania Nicola
  topic: disciplines
subject: Federica Corradi
  topic: disciplines
subject: Iuliana Badiu
  topic: disciplines
subject: Marzia Boem
  topic: disciplines
subject: Valentina Marmora
  topic: disciplines
subject: Simone Negrini
  topic: disciplines
subject: Luisa Brussino
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2094

PO:36:251 | Rheumatoid factor predicts vasculitis relapse in eosinophilic granulomatosis with polyangiitis: a machine learning approach
type: item
description: Background. The present study was conducted with the objective of evaluating the frequency and prognostic significance of rheumatoid factor (RF) in patients diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA). A particular emphasis was placed on the potential role of RF in predicting vasculitis relapses. Materials and Methods. A retrospective cohort study was conducted, encompassing patients diagnosed with EGPA who underwent RF testing (immunoturbidimetric assay/nephelometric assay/enzyme-linked immunosorbent assay) at the time of diagnosis. Clinical and laboratory data were prospectively collected starting from diagnosis and throughout the following 60 months. Relapse was defined as the new onset, recurrence, or worsening of systemic signs or symptoms (excluding asthma and nasal polyps exacerbations) associated with a BVASv3 > 0, requiring the modification of systemic therapy. Kaplan-Meier curves were used to assess relapse-free survival. A Random Forest machine learning model was developed to identify relapse predictors, with support from SHAP analysis. Results. A total of 83 patients diagnosed with EGPA were included in the present study, 45.8% of whom (38/83) were found to have positive RF. During follow-up, 19.3% (16/83) of patients experienced at least one relapse. Patients with a positive RF test had a significantly higher relapse rate than those with a negative RF test (39.5% vs. 2.2%, p=0.003). The median time to relapse was 29 [11.8-71.8] months. The overall relapse rate at 12, 24 and 60 months were 4.8%, 9.1% and 26.2%, respectively. As illustrated in Figure, the Kaplan-Meier analysis demonstrated a significant lower 5-year relapse-free survival in RF-positive patients compared to RF-negative patients (log-rank test, p < 0.001). Furthermore, patients with a positive RF test had a higher frequency of mononeuritis multiplex (52.6% vs. 13.3%, p = 0.011) and elevated C-reactive protein levels (49.1 mg/L vs. 11.0 mg/L, p = 0.007) compared to RF…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: EGPA
  topic: keywords
subject: Rheumatoid factor
  topic: keywords
subject: Prognosis
  topic: keywords
subject: Luca Iorio
  topic: disciplines
subject: Federica Davanzo
  topic: disciplines
subject: Giulia Lorenzoni
  topic: disciplines
subject: Eleonora Fiorin
  topic: disciplines
subject: Marta Codirenzi
  topic: disciplines
subject: Roberta Prevedello
  topic: disciplines
subject: Debora Campaniello
  topic: disciplines
subject: Dario Gregori
  topic: disciplines
subject: Roberto Padoan
  topic: disciplines
subject: Andrea Doria
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2095

PO:36:253 | Lifestyle and Behçet's syndrome: a preliminary study on gender differences
type: item
description: Background. Behçet’s syndrome (BS) is a chronic, relapsing autoinflammatory disease characterised by various clinical manifestations, including oral and genital ulcers, skin lesions, ocular inflammation, and neurological, vascular, and gastrointestinal involvement. Both genetic and environmental factors contribute to susceptibility and disease phenotype. A previous study investigating the clinical phenotype across gender differences revealed that the disease is more frequent and more severe in male subjects [1]. Emerging literature evidences support the role of a healthy lifestyle as an environmental factor able to modulate disease activity, disease severity, and quality of life [2, 3]. The purpose of this preliminary study is to evaluate gender differences in the main lifestyle-related aspects within a cohort of patients with BS. Materials and Methods. An anonymous questionnaire was administered to a cohort of consecutive patients with BS, who provided information on the following items: age, sex, dietary habits, physical activity, smoking habits, alcohol consumption, impact of the disease on work, and sleep habits/hygiene. Results. Table 1 reports the results of the survey related to the 39 recruited patients (24M:15F). Statistically significant differences were found in case of: 1) fruit consumption: women consumed more abundant weekly portions compared to men (16-29 weekly portions in 8.3% of males vs 33.3% of females); 2) consumption of sugary drinks: the weekly frequency was zero in a significantly higher number of females compared to males (73.3% F vs 16.7% M); 3) the impact on work, which was reported as null for 10.7% of males compared to 46.7% of females. Conclusions. Our study highlights a greater consumption of pro-inflammatory dietary components (sugars) and a lower consumption of anti-inflammatory foods (fruit) in men. Among the modifiable lifestyle factors, nutrition plays an essential role for human health: a diet rich in anti-inflammatory foods, suc…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Behetճ syndrome
  topic: keywords
subject: life style
  topic: keywords
subject: diet
  topic: keywords
subject: Pietro Leccese
  topic: disciplines
subject: Angela Anna Padula
  topic: disciplines
subject: Nancy Lascaro
  topic: disciplines
subject: Salvatore D'Angelo
  topic: disciplines
subject: Maria Carmela Padula
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2217

PO:37:256 | Spontaneous renal artery dissection: a subtle presentation of a “vasculitis-mimicker”
type: item
description: Background. Medium- and large-vessel vasculitides represent a diagnostic challenge. The case described here highlights the importance of an accurate differential diagnosis, as non-inflammatory vascular diseases can mimic vasculitic patterns, with significant therapeutic implications. Materials and Methods. A 42-year-old man presented to the emergency department with subacute onset of temporal headache, low-grade fever, left flank pain, and hypertension (BP 170/100 mmHg). Rheumatologic history was unremarkable and physical examination was normal. Abdominal CT, performed for suspected ureterolithiasis, showed a hypodense area in the mid and upper third of the left kidney compatible with parenchymal ischemia, and a sleeve-like thickening with filiform stenosis of the ipsilateral renal artery, initially suggestive of vasculitis (renal arteritis). The patient was admitted to the Rheumatology Unit. Laboratory tests revealed inflammatory activity (CRP 3.7 mg/dL, ESR 51 mm/h). Intravenous methylprednisolone pulses (250 mg for 3 days) were started, followed by oral prednisone (1 mg/kg) and antihypertensive therapy. Given the suspicion of vasculitis, PET imaging was performed, showing no evidence of vascular inflammation, as well as duplex ultrasound of the four limbs and supra-aortic trunks, which revealed no stenotic or occlusive lesions. Considering the abrupt onset of symptoms, negative autoimmunity, negative PET findings, and absence of additional clinical or instrumental abnormalities, a renal arteriography was performed. It revealed a dissection of the left renal artery with thrombosis of the false lumen and parenchymal ischemia, allowing a final diagnosis of spontaneous left renal artery dissection complicated by renal infarction and renovascular hypertension. Results. The case was discussed with the Radiologist and Vascular Surgeon. Given the complete thrombosis of the false lumen, endovascular revascularization was excluded, and a conservative approach was adopted w…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Dissecazione arteria renale
  topic: keywords
subject: Vasculite-mimicker
  topic: keywords
subject: Diagnosi differenziale
  topic: keywords
subject: Federdo Nogarin
  topic: disciplines
subject: Alfonso Valerio Massara
  topic: disciplines
subject: Zairo Ferrante
  topic: disciplines
subject: Filippo Furicchia
  topic: disciplines
subject: Riccardo Bertola
  topic: disciplines
subject: Elena Pollicelli
  topic: disciplines
subject: Ilaria Calciolari
  topic: disciplines
subject: Sopie Secka
  topic: disciplines
subject: Andrea Lo Monaco
  topic: disciplines
subject: Marcello Govoni
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2218

PO:37:257 | Giant cell arteritis debuting with aortic involvement: the importance of integrated diagnostics in fever of unknown origin
type: item
description: Background: giant cell arteritis (GCA) is the most frequent large vessel vasculitis, affecting both male and female patients older than 50 years old. Opposite to the cranic involvement (common carotid arteries and their branches) that may debut with headache and visus loss, the extra-cranic involvement (aorta and its branches) is more subtle, leading to a delayed diagnosis, causing the development of aneurisms and dissections [1-3]. Usually, these are late disease complications (after 10 years) but can be found even at diagnosis [1-3]. Case report: a 68-year-old woman, ex-smoker, comes to visit because of a 4-month history of daily fever (up to 38.5°C) with shivers and night sweats, myalgias, fatigue and weight loss. Blood tests showed high neutrophil and platelet count, with persistent inflammation (CRP 35 mg/L). To rule out an occult infection, the patient had been thoroughly screened with blood cultures, urine cultures, treponemic tests, which all came back negative. Being affected by a fever of unknown origin (FUO), the patient was admitted to our Clinic to undergo further testing from which no sign of autoimmunity emerged. Given the development of a persistent frontal headache, even though no other arteritis symptoms were present, an ultrasonographic study of the temporal, axillary, and carotid arteries was performed, showing no halo sign. Because of the persistence of fever and inflammation without explanation, a PET-CT and an echocardiography (to rule out infective endocarditis) were performed and, since GCA was still highly suspected, a temporal artery biopsy was scheduled. PET-CT (Figure 1) showed an intense FDG avidity along the full length of the aortic wall and the carotid and axillary arteries while the echocardiography found a dilation of the aortic root with valve insufficiency and no sign of endocarditis. Granulomatous inflammation suggesting GCA was found in the biopsy specimen of the temporal artery. The aortic dilation was studied performing a CT …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Giant cell arteritis
  topic: keywords
subject: aortic dissection
  topic: keywords
subject: fever of unknown origin
  topic: keywords
subject: Alessandro Gratton
  topic: disciplines
subject: Giovanni Striani
  topic: disciplines
subject: Luisa Occhipinti
  topic: disciplines
subject: Stefania Sacco
  topic: disciplines
subject: Enrico Pegolo
  topic: disciplines
subject: Luca Quartuccio
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2219

PO:37:258 | Neutrophil and eosinophil extracellular traps in eosinophilic granulomatosis with polyangiitis: phenotype-based characterization and response to mepolizumab
type: item
description: Background. EGPA presents eosinophil (EOS)-related and vasculitic features. Introduction of mepolizumab (MEP) revolutionized the treatment of EOS manifestations. However, efficacy of MEP also in vasculitic phenotypes suggests direct interactions between EOS and neutrophilic inflammation in EGPA. Neutrophil extracellular traps (NETs) are an important innate immune response involved in ANCA-associated vasculitis pathogenesis. Similarly, EOS produce extracellular traps (EETs), recently detected in EGPA patients. Our study aims to analyse NETs and EETs in different disease phenotypes and in response to MEP therapy. Materials and Methods. EGPA patients classified according to MIRRA trial and/or ACR/EULAR 2022 criteria and eligible for MEP therapy were consecutively enrolled. Clinical and routine blood chemistry data were collected before (T0) and after 6 (T1) and 12 (T2) months of treatment with MEP 300mg/4weeks. Oral steroid was tapered according to clinical judgement. Therapy with immunosuppressant, if taken, was unchanged during the study. In parallel, we evaluated NETs and EETs on peripheral blood by immunofluorescence staining (Petretto et al.,2019). NETs and EETs were expressed as percentage of total area of cells in the fields. Patients were stratified by disease phenotype according to presence/absence of MPO-ANCA, asthma, nasal polyposis (CRSwNP) and organ involvement. Results. 17 patients were enrolled (53% female (9/17)). MPO-ANCA were detected in 29.4% of patients (5/17). 88% (15/17) were asthmatic, 60% had severe asthma. 53% (9/17) were atopic and 82% had CRSwNP. At T0 94% (16/17) were administered oral prednisone (5.83±4.18mg, mean dose). Figure 1 reports distribution of organ involvement. Following MEP introduction, EOS blood count reduced from T0 to T1 (p=0.036) but not from T1 to T2, while neutrophils did not vary in any period. Steroid dosage was reduced to 1.04±2.59mg at T2 (p=0.003). 10 patients (58.8%) were steroid-free. No relapse was observed. At T0…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: EGPA
  topic: keywords
subject: Mepolizumab
  topic: keywords
subject: Extracellular traps
  topic: keywords
subject: Michele Moretti
  topic: disciplines
subject: Francesco Ferro
  topic: disciplines
subject: Francesco Pisani
  topic: disciplines
subject: Elisa Ferrigno
  topic: disciplines
subject: Gaetano La Rocca
  topic: disciplines
subject: Federica Di Cianni
  topic: disciplines
subject: Rosaria Talarico
  topic: disciplines
subject: Marta Mosca
  topic: disciplines
subject: Chiara Baldini
  topic: disciplines
subject: Ilaria Puxeddu
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2096

PO:37:259 | Is there a seasonal pattern in giant cell arteritis? Revisiting the evidence in a large monocentric cohort of 1203 patients
type: item
description: Background. Whether the disease onset in giant cell arteritis (GCA) exhibits a seasonal pattern remains unclear. Previous studies have yielded conflicting evidence: some report no seasonality, while others suggest seasonal variation, though findings are inconsistent and difficult to compare, especially due to methodological limitations, including small cohort sizes and reliance on diagnosis or biopsy dates rather than symptoms onset. We aimed to clarify whether a seasonal pattern exists by analyzing a large cohort using the date of symptom onset as the temporal reference. Materials and Methods. Consecutive patients from a large monocentric GCA (1994–2024) with a documented date of symptom onset were included. To ensure balanced seasonal representation, patients with symptom onset outside the period of December 1, 1994, to November 30, 2023, were excluded. Meteorological seasons were used for the analysis (spring: Mar–May; summer: Jun–Aug; autumn: Sep–Nov; winter: Dec–Feb). To assess whether symptom onsets were equally distributed across seasons (25% per season), we applied an exact multinomial test using the “ExactMultinom” package in R. Sensitivity analyses were performed for subgroups by sex and clinical phenotype (cranial vs extracranial involvement), with Bonferroni-Holm correction for multiple testing. Results. Of 1203 patients in the full cohort, 1149 fulfilled the inclusion criteria and were included in the main analysis (population’s characteristics are reported in Table 1). The overall seasonal distribution of symptom onset was: spring 292 (25.4%), summer 276 (24.0%), autumn 271 (23.6%), winter 310 (27.0%) (p = 0.36). Figure 1 illustrates the seasonal distribution of symptom onset stratified by years across the study period. Subgroup analyses revealed no overall significant seasonal variation as shown in Table 2. Conclusions. This large, single-center cohort study using symptom onset data found no evidence of a significant seasonal pattern in the disease on…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Giant cell arteritis
  topic: keywords
subject: Epidemiology
  topic: keywords
subject: Vasculitis
  topic: keywords
subject: Milena Bond
  topic: disciplines
subject: Philipp Bosch
  topic: disciplines
subject: Aaron Juche
  topic: disciplines
subject: Hans Bastian
  topic: disciplines
subject: Wolfgang Schmidt
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2097

PO:37:260 | Mepolizumab in the treatment of patients with eosinophilic granulomatosis with polyangiitis: real-life experience from a single-center cohort
type: item
description: Background. Mepolizumab is an anti-interleukin-5 (IL-5) monoclonal antibody approved for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA) at a dose of 300 mg every 4 weeks, with the goal of both achieving and maintaining disease remission besides reducing the dose of glucocorticoids (GCs). The objective of this study is to evaluate the characteristics of patients with EGPA treated with mepolizumab at our center, their response to treatment, and the steroid-sparing effect. Materials and methods. Twenty-one patients (12 men) were enrolled, mean age 64.5 ± 9 years, median disease duration 4 years (IQR 1.6-7.25). Nine patients (43%) were positive for MPO (myeloperoxidase) antibodies, 2 (10%) for PR3 (proteinase 3). The mean duration of treatment with mepolizumab was 2.3 ± 1.7 years. In 6 patients (29%) mepolizumab was used as first-line, one patient had previously been treated with rituximab, 5 patients with cyclophosphamide, 9 patients with methotrexate/azathioprine or both. Results. The clinical description of patients with disease manifestations before starting mepolizumab therapy is reported in Table 1. All patients had an excellent response, with a reduction in the number of asthma flares, normalization of eosinophil counts, resolution of cutaneous vasculitis, improvement in nasal polyps, neuropathy, gastrointestinal and myocardial involvement. During follow-up, 13 patients (62%) were able to discontinue GCs, and in the remaining 8 cases, a dose of ≤5 mg/day was achieved. No adverse events leading to drug discontinuation occurred. Conclusions. In our cohort of patients with EGPA, mepolizumab confirmed its efficacy in reducing disease activity, its excellent safety profile and its steroid-sparing effect, allowing us to interrupt GCs in more than 60% of patients, and to reduce the daily dosage below 5 mg in the rest of the case series.
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: EGPA
  topic: keywords
subject: Mepolizumab
  topic: keywords
subject: steroid
  topic: keywords
subject: Eleonora Bruschi
  topic: disciplines
subject: Fabrizio Angeli
  topic: disciplines
subject: Alessandro Belotti Masserini
  topic: disciplines
subject: Stefania Bertocchi
  topic: disciplines
subject: Silvia Breda
  topic: disciplines
subject: Elide Lupi
  topic: disciplines
subject: Valeria Rossi
  topic: disciplines
subject: Tania Ubiali
  topic: disciplines
subject: Massimiliano Limonta
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2220

PO:37:263 | First non invasive visualization of vasculitis in the retinal arteries by high resolution optical coherence tomography in a patient with giant cell arteritis
type: item
description: Background. Giant cell arteritis (GCA) is an idiopathic vasculitis affecting the large- and medium-sized arteries of the elderly. GCA is characterized by systemic inflammation and patchy arterial inflammation resulting in arterial wall thickening and potential remodelling with stenosis/occlusion or aneurysms. Accordingly, GCA may be complicated by end-organ ischemia, especially in the eye, due to arteritic ischemic optic neuropathy, occlusion of central retinal artery (CRAO) or of one of its branches. Optical coherence tomography (OCT) is an imaging technique that exploits interferometry with short-coherence-length light to characterize the tissues on the micron scale, allowing to visualize retinal features and thickness. High resolution OCT (HR-OCT) is an evolution of OCT not yet available on the market. It has a higher spatial resolution tha traditional OCT. Being potentially able to characterize the arterial walls of the branches of the central retinal artery, HR-OCT is being developed to study retinal vasculopathies. Here we present the first case of GCA with visual involvement (specifically CRAO), evaluated with HR-OCT. Case Report. An 80 year old woman with history of hypertension, dyslipidemia, diverticolitis, and crhonic headache, present to the emergency room in March 2024 for visual loss. She refers that her chronic headhace had changed since the spring of 2023, affecting the temporal area bilaterally and being more prevalent in the morning. The patient also reported astenia for 6-12 months, worsening exertional dyspnea for 5-6 months and blurred vision for 2-3 months, for which she had a diagnosis of cataract. On the 21st of February 2024 the patient experienced loss of vision from the left eye for which she went to the ER of another hospital, and was diagnosed with CRAO. The patient was discharged with prescription of blood test which showed an ESR of 39 mm/h and a CRP of 76 mg/L. On the 4th of March 2024 GCA was suspected and the patient was referred to…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Giant Cell Arteritis
  topic: keywords
subject: High-resolution OCT
  topic: keywords
subject: Ocular involvement
  topic: keywords
subject: Ruggiero Mascolo
  topic: disciplines
subject: Chiara Facoetti
  topic: disciplines
subject: Claudia Nardi
  topic: disciplines
subject: Stefano Erba
  topic: disciplines
subject: Martina Martelli
  topic: disciplines
subject: Gabriella Marinaro
  topic: disciplines
subject: Giulia Dieguez
  topic: disciplines
subject: Giacomo Iacomelli
  topic: disciplines
subject: Chiara Carollo
  topic: disciplines
subject: Michel Chevallard
  topic: disciplines
subject: Bruno Lucchino
  topic: disciplines
subject: Mariaeva Romano
  topic: disciplines
subject: Andrea Locatelli
  topic: disciplines
subject: Donatella Ventura
  topic: disciplines
subject: Giovanna Randisi
  topic: disciplines
subject: Giuliana La Paglia
  topic: disciplines
subject: Alessandra Mutti
  topic: disciplines
subject: Alessandro Invernizzi
  topic: disciplines
subject: Stefano De Angelis
  topic: disciplines
subject: Giovanni Staurenghi
  topic: disciplines
subject: Antonio Brucato
  topic: disciplines
subject: Enrico Tombetti
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2098

PO:37:267 | Mimickers of polyarteritis nodosa: a case of segmental arteriolar mediolysis
type: item
description: Background. The diagnosis of medium-vessel vasculitis often requires a thorough differential diagnosis to exclude non-inflammatory vasculopathies. We describe a case of Segmental Arteriolar Mediolysis (SAM), a non-inflammatory arteriopathy that can mimic medium-vessel vasculitis. Materials and Methods. A 54-year-old woman presented to the Emergency Department with acute abdominal pain radiating posteriorly. Laboratory tests showed CRP 21.7 mg/dl and ESR 106 mm/h. Abdominal CT angiography revealed dissection of the superior mesenteric artery and partial occlusion of the inferior mesenteric artery at the proximal and mid-distal segments. A positive urine culture for Klebsiella pneumoniae confirmed a urinary tract infection, treated with targeted antibiotics. A week later, a second abdominal CT angiography showed celiac trunk ectasia, circumferential thickening of the inferior mesenteric artery (reported by the radiologist to be suggestive of vasculitis, see Figure 1), and reduced caliber of the left hypogastric artery, with thrombotic appositions in the right internal mammary, inferior mesenteric, and segmental renal arteries. Further investigations revealed negative ANA and ANCA, equivocal lupus anticoagulant (not confirmed on repeat testing), and negative anticardiolipin and anti-beta2-glycoprotein antibodies. CRP measured approximately 10 days after antibiotic therapy was 0.9 mg/dL. Given the suspicion of medium-vessel vasculitis, high-dose corticosteroids were started, later combined with methotrexate. At the 4-month follow-up, methotrexate had been discontinued due to elevated liver enzymes, and the patient was on low-dose prednisone (5 mg/day). She was asymptomatic, with persistently normal inflammatory markers. The normalization of CRP before corticosteroid initiation, the absence of vascular lesions typical of polyarteritis nodosa, and full clinical and laboratory remission without maintenance therapy raised suspicion for SAM. A new abdominal CT angiography sh…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: vasculitis
  topic: keywords
subject: polyarteritis nodosa
  topic: keywords
subject: mimickers
  topic: keywords
subject: Filippo Santoro
  topic: disciplines
subject: Caterina Vacchi
  topic: disciplines
subject: Giulia Cassone
  topic: disciplines
subject: Maria Grazia Malandra
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2221

PO:37:268 | Antineutrophil cytoplasmic antibodies-associated vasculitis mimicking giant cell arteritis: a diagnostic dilemma
type: item
description: Background. Here we present a diagnostically challenging case of ANCA-associated vasculitis (AAV) that initially presented with clinical features highly suggestive of giant cell arteritis (GCA). Case Report. An 80-year-old woman, with a medical history notable only for prior COVID-19 pneumonitis and a diagnosis of polymyalgia rheumatica (PMR) in 2024, presented to the emergency department in February 2025 with a three-week history of worsening pelvic and scapular girdle pain. Routine laboratory tests revealed elevated inflammatory markers (ESR 76 mm/h, CRP 16.8 mg/dL) and findings consistent with a urinary tract infection (UTI), with preserved renal function (GFR >60 mL/min). A presumptive diagnosis of a PMR flare triggered by the UTI was made, and antibiotic therapy was initiated. Due to the persistence of symptoms, she was referred to the rheumatology unit. A positive history of recent unintentional weight loss and new-onset jaw claudication emerged. Given the high clinical suspicion of giant cell arteritis (GCA), corticosteroid therapy was promptly initiated. Subsequent vascular ultrasound revealed intima-media complex thickening and a positive compression sign in the left frontal artery, along with moderate intima-media thickening of the right facial artery. While suggestive of GCA, these findings were insufficient for a definitive diagnosis. Following an initial symptom remission, corticosteroid tapering led to a relapse of jaw claudication and the new onset of widespread livedo reticularis. Additionally, previously absent signs of acute kidney injury (AKI) emerged, prompting hospital admission for further diagnostic workup. Laboratory testing revealed persistently elevated ESR and CRP levels, significant renal impairment (creatinine 1.67 mg/dL, GFR 29 mL/min), and positive anti-MPO antibodies (37.0 UI/mL). Over the following days, renal function deteriorated rapidly (creatinine rising to 2.2 mg/dL). Given the progressive AKI and ANCA-MPO positivity, a diagnosi…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Large vessel vasculitis
  topic: keywords
subject: ANCA-associated vasculitis
  topic: keywords
subject: Overlap syndrome
  topic: keywords
subject: Bruno Biasi
  topic: disciplines
subject: Elena Vanni
  topic: disciplines
subject: Marco De Pinto
  topic: disciplines
subject: Giulia Cassone
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2099

PO:37:269 | Intensive therapeutic plasma exchange in life-threatening ANCA-associated vasculitis
type: item
description: Background. In ANCA-associated vasculitis (AAV), despite the findings of the PEXIVAS trial, the usefulness of plasma exchange (PLEX) remains debated in selected clinical settings, such as diffuse alveolar hemorrhage (DAH). Methods. We report a case of life-threatening AAV successfully treated with an intensive, high-volume, and individualized PLEX protocol. Results. We describe a 40-year-old man with newly diagnosed AAV (c-ANCA/anti-PR3, high titer) who presented with rapidly progressive glomerulonephritis and severe respiratory failure (PaO2/FiO2 ratio < 200) secondary to DAH, requiring mechanical ventilation. In addition to induction therapy with methylprednisolone pulses (total 3000 mg) and weekly rituximab (375 mg/m²), we initiated an intensive PLEX regimen consisting of 20 sessions over 52 days (three consecutive at onset), with a mean plasma exchange volume of 1.0–1.5 times the plasma volume (mean exchanged volume per session: 4450 ± 705 mL; total exchanged volume: 89 L). From the third PLEX session, we observed a marked reduction in ANCA titer and inflammatory markers, followed by significant respiratory improvement after the sixth session (Figure 1). The last four sessions were performed after extubation. At 48 months of follow-up, under maintenance therapy with mycophenolate mofetil, no vasculitis flares were observed, although renal recovery was not achieved. This case highlights the potential benefit of an intensive, high-volume PLEX protocol in life-threatening AAV with DAH, supporting several considerations: the PEXIVAS trial, cornerstone of current guidelines, adopted a limited PLEX schedule (7 sessions) without escalation in refractory cases—possibly underestimating efficacy in severe disease phenotypes (our patient achieved pulmonary recovery after the 6th session). Moreover, only 61 patients (8.7%) in PEXIVAS had DAH, and subgroup analysis showed lower one-year mortality in PLEX-treated patients (19.4% vs. 33.3%). A post-hoc analysis of PLEXIVAS dem…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: ANCA-associated vasculitis
  topic: keywords
subject: Diffuse alveolar haemorrhage
  topic: keywords
subject: Plasma exchange
  topic: keywords
subject: Davide Bertelle
  topic: disciplines
subject: Riccardo Bixio
  topic: disciplines
subject: Francesco Pollastri
  topic: disciplines
subject: Maurizio Rossini
  topic: disciplines
subject: Angelo Fassio
  topic: disciplines
subject: Alessandro Giollo
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2222

PO:37:270 | Efficacy of iloprost as a therapy for skin ulcers in cryofibrinogenemia and cryoglobulinemia: a complex case in a fragile patient
type: item
description: Background. We present the case of a 75-year-old patient with a past medical history of melanoma removed in 2020, type 2 diabetes mellitus, cognitive decline evolving into Lewy body dementia, and IgG-lambda MGUS (0.5 g/dL) under hematological follow-up. Case Report. Starting in 2020, the patient reported the recurrent appearance of small, subcentimeter ulcers on the fingers, which resolved spontaneously within a few weeks, and an isolated episode of frank purpura on the lower limbs, which subsequently evolved into dyschromic scars. In the rheumatological field, immunological and instrumental tests were performed (capillaroscopy, echocardiogram, ANA, ENA, ANCA, ACPA, antiphospholipids, RF, C3/C4, PCR, serologies for HBV and HCV, Bence Jones proteinuria), all of which were within normal limits. In this context, the presence of a 6% cryocrit was documented, composed of monoclonal IgM-lambda cryoglobulin (2%) and cryofibrinogen (4%). Subsequent hematological investigation with flow cytometry documented a circulating T-LGL population (30%), with no evidence of clonality on bone marrow biopsy, nor signs of myelodysplasia. In the absence of criteria for overt lymphoproliferative disease, there was no indication for specific treatment. In the following years, subcentimeter digital lesions continued to appear episodically, always self-limiting, without deep ulcerations or purpuric recurrences. However, in early 2025, following reported exposure to low temperatures, a sudden worsening was observed, with the appearance of crusted ulcers on the lower limbs, not consistent with vascular distribution. The major lesions were located on the lateral surface of both legs (up to 4 cm in diameter), on the heels, and on some toes. The patient initially reported home management without benefit. A lower extremity ECD was negative for occlusive changes. A skin biopsy of a lesion on the right heel showed partial epidermal ulcerative necrosis, hyperkeratosis, epidermal hyperplasia, and in th…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Cryofibrinogenemia
  topic: keywords
subject: Skin ulcers
  topic: keywords
subject: Iloprost
  topic: keywords
subject: Luca Keller Sarmiento
  topic: disciplines
subject: Amelia Spinella
  topic: disciplines
subject: Marco De Pinto
  topic: disciplines
subject: Giorgia Roveta
  topic: disciplines
subject: Dilia Giuggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2100

PO:38:278 | Cognitive behavioural therapy vs. physical therapy for chronic primary low back pain: a systematic review with meta-analysis of randomised controlled trials
type: item
description: Background. Over recent decades, chronic primary low back pain (CPLBP) has shown a consistent epidemiological increase worldwide. Although cognitive behavioural therapy (CBT) is not among the most commonly used interventions for this condition, several recent systematic reviews h ave demonstrated its efficacy. Given its limited implementation in clinical practice, this review aimed to assess the therapeutic validity of CBT by comparing it with physiotherapy (PT) interventions, designed according to the most recent clinical guidelin es for CPLBP. Materials and Methods: Randomised controlled trials (RCTs) comparing CBT and PT in adults with CPLBP were included. The databases PubMed, Cochrane CENTRAL, Embase, CINAHL, Scopus, and PEDro were searched from inception to March 3, 2025. Risk of bias was independently assessed by two reviewers using the Cochrane Risk of Bias 2.0 (RoB 2.0) tool. Based on extracted data, several meta analyses were conducted, grouping outcomes into early phase, acute phase, and late phase follow ups. The certainty of evidence was evaluated according to the GRADE approach. Results: Twelve RCTs were included, comprising a total of 1,762 participants. Meta analyses indicated very low certainty evidence that CBT is more effective than PT in reducing pain in the early p hase (n = 650, MD = −1.29, 95% CI = −2.00 to −0.59, p = 0.0003, I² = 83%), acute phase (n = 337, SMD = −0.16, 95% CI = −0.38 to +0.05, p = 0.14, I² = 0%), and late phase (n = 1108, SMD = −0.45, 95% CI = −0.87 to −0.03, p = 0.03, I² = 91%), as well as in de creasing disability in the early phase (n = 650, SMD = −1.00, 95% CI = −1.55 to −0.44, p = 0.0004, I² = 90%), acute phase (n = 337, MD = −0.27, 95% CI = −2.43 to +1.88, p = 0.80, I² = 75%), and late phase (n = 1108, SMD = −0.97, 95% CI = −1.52 to −0.41, p = 0.0007, I² = 95%). The results for early phase and late phase outcomes, for both pain and disability, were statistically significant. Conclusions: Although supported by very low …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: physiotherapy
  topic: keywords
subject: CBT
  topic: keywords
subject: chronic low back pain
  topic: keywords
subject: Luca Castioni
  topic: disciplines
subject: Stefano Salvioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2223

PO:38:280 | Accuracy of generative artificial intelligence in risk of bias assessment using RoB 2.0 tool and extracting data in exercise therapy for chronic low back pain randomised controlled trials
type: item
description: Background. Systematic reviews are essential tools for evidence-based practice but are often time-consuming. Recent developments in artificial intelligence, including large language models such as ChatGPT-4o, offer potential to support and partially automate some processes. This study aimed to evaluate the performance of ChatGPT-4o in assessing Risk of Bias (RoB) using RoB 2.0 tool and in extracting data from randomised controlled trials (RCTs) on exercise therapy for chronic low back pain. Materials and Methods. This cross-sectional comparative study included 150 RCTs previously assessed by human reviewers. ChatGPT-4o was tested in two tasks: (1) RoB assessment using a single structured prompt, compared with expert ratings across five domains and overall judgement; (2) data extraction across 34 predefined variables using both simplified and detailed prompts. Human reviewers served as the reference standard. Statistical analysis focused on Cohen’s kappa and overall accuracy, alongside sensitivity, specificity, PPV, NPV, and F1-score. Results. Agreement between ChatGPT-4o and human reviewers for RoB assessment was low (Cohen’s κ = 0.14), with a tendency to underestimate bias. Sensitivity was 40%, while specificity and PPV were higher for low-risk classifications. For data extraction, ChatGPT-4o showed strong performance, with accuracy above 84% and F1-scores over 90% using both prompt types. Hallucinations were rare (<0.02%). Task duration was reduced from 30-50 minutes (human reviewers) to under 5 minutes with ChatGPT-4o. Conclusions. While ChatGPT-4o showed limited reliability for RoB assessment, likely due to the interpretative complexity of the task, it performed robustly in data extraction, particularly when guided by well-structured prompts. Its high precision, speed, and low hallucination rate suggest strong potential as a secondary reviewer in systematic review workflows. Nonetheless, its application to evaluative tasks requiring critical judgement remains pr…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: Artificial Intelligence
  topic: keywords
subject: Risk of Bias
  topic: keywords
subject: Data Extraction
  topic: keywords
subject: Luca Carrer
  topic: disciplines
subject: Marco Pozzati
  topic: disciplines
subject: Dario Taborelli
  topic: disciplines
subject: Niccolò Maschi
  topic: disciplines
subject: Tiziano Innocenti
  topic: disciplines
subject: Stefano Salvioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2224

PO:38:281 | Therapeutic exercise in temporomandibular disorders: a scoping review of the literature
type: item
description: Background. Temporomandibular disorders (TMD) are musculoskeletal dysfunctions affecting the temporomandibular joint and related structures, leading to pain and functional limitations. The aim of this review is to map the available studies on therapeutic exercise for temporomandibular disorders in the adult population, analyzing rehabilitation strategies, their dosage, and clinical implications. Materials and Methods. A scoping review was conducted through a literature search in five databases: MEDLINE, EMBASE, CINAHL, PEDro and Cochrane. Primary studies (RCTs, prospective and retrospective studies, case series and case reports) conducted on adults diagnosed with TMD of non-traumatic, non-infectious, non-neoplastic or non-post-surgical origin who underwent therapeutic exercise interventions were included. Study selection and data extraction processes were carried out independently by two reviewers. Results. A total of 57 studies were included in the review, from which 267 exercises were extracted and organized into functionally homogeneous categories. 76% (204/267) of the identified exercises targeted the orofacial region, particularly mouth opening (50%), lateral movements (13%), and protrusion movements (7%). Motor-control strategies accounted for 20% of the interventions analyzed. Only 19% of the studies provided explicit instructions for pain management during exercise execution. The overall duration of rehabilitation protocols varied across studies, with 68% recommending daily exercises and 89% adopting a multi-session frequency. Conclusions. The analyzed data indicate that mouth-opening exercises and motor-control exercises are the most commonly used strategies for the rehabilitation of TMD. However, the lack of standardization in terminology and exercise prescription limits the clinical applicability of the findings, particularly regarding their impact on pain management. Future research should focus on developing shared therapeutic strategies to optimize reh…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: therapeutic exercise
  topic: keywords
subject: Temporomandibular disorders
  topic: keywords
subject: Scoping review
  topic: keywords
subject: Federico Amateis
  topic: disciplines
subject: Gabriele Aimini
  topic: disciplines
subject: Paolo Mastromarchi
  topic: disciplines
subject: Lorenzo Lo Russo
  topic: disciplines
subject: Marco Chiodini
  topic: disciplines
subject: Roberta Giova Bazzacchi
  topic: disciplines
subject: Noemi Corbetta
  topic: disciplines
subject: Stefano Salvioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2225

PO:38:283 | Accuracy of chatgpt 4 omni in providing clinical recommendations in musculoskeletal care: a valuable support for clinicians and patients?
type: item
description: Background. Generative artificial intelligence models, such as ChatGPT-4 omni, is gaining popularity in healthcare and could provide valuable support for the clinical management of widespread diseases in the population, such as osteoarthritis. However, its accuracy in providing up-to-date clinical recommendations remains underexplored, particularly in the context of osteoarthritis (OA), one of the most common conditions with a high socio-economic impact, where it is critical that recommendations are up-to-date, clear and consistent with scientific evidence. Objective: to evaluate the accuracy and consistency of the clinical recommendations generated by ChatGPT-4 omni in relation to the most recent international guidelines for osteoarthritis (NICE, EULAR, OARSI) and to compare them with the responses given by Italian physiotherapists. Materials and methods: cross-sectional study based on 24 clinical questions derived from OARSI, NICE and EULAR guidelines. The questions were presented to ChatGPT-4o in the form of ‘classic’ and ‘medical’ prompts, in Italian and English, for a total of nine administrations each. A complex clinical case was also evaluated. Accuracy, internal reliability (SD, CV%) and concordance (Cohen's K) were calculated. Results: ChatGPT-4o showed good internal consistency (CV < 25%) and moderate to high agreement between Italian and English (K up to 0.902). Accuracy ranged from 66.7% to 79.2%, higher in classical and English prompts. Agreement with Italian physiotherapist was low (K = 0.106). In the clinical case, the mean accuracy was 81.4%, but answers were only 38.2% complete. Conclusion: ChatGPT-4o proved to be potentially useful to support clinical practice in the musculoskeletal field. However, its efficacy in daily practice is contingent on its integration with human clinical reasoning and critical practitioner supervision. Keywords: Artificial Intelligence (AI), Deep Learning (DL), Large Language Model (LLM), Large Multimodal Model (LMM), Cli…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: artificial intelligence
  topic: keywords
subject: Guidelines
  topic: keywords
subject: Osteoarthritis
  topic: keywords
subject: Dario Taborelli
  topic: disciplines
subject: Silvia Negro
  topic: disciplines
subject: Federico Padovani
  topic: disciplines
subject: Tiziano Innocenti
  topic: disciplines
subject: Stefano Salvioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2226

PO:38:285 | Cross-sectional analysis: interpretation of nonstatistically significant results in randomised controlled clinical trials in rehabilitation
type: item
description: Objectives: to assess the prevalence of misinterpretation of non-statistically significant results, both in the abstract and in the article conclusions, in a sample of randomised controlled trials with nonstatistically significant primary outcomes published in rehabilitation journals and reporting of primary outcomes according to CONSORT guidelines. Methods: a cross-sectional analysis of all randomised controlled trials with non- statistically significant primary outcomes in 5 general rehabilitation journals with the highest Impact Factor published between 2019 and 2023 to determine the prevalence of trials in which non-significance was interpreted as absence of evidence, evidence of absence, or advice to use the intervention in clinical practice in the abstract and article conclusions, and the prevalence of trials that adhered to CONSORT guidelines for reporting the primary outcome. Results: at the end of the selection process, 31 trials were included. The most common interpretation of non-statistically significant results is the evidence of absence, both in the abstract (74.2%) and in the article (58.1%). Only 4 (12.9%) studies in the abstract and 5 (16.1%) in the article conclusions suggest the correct interpretation as absence of evidence. Adherence to CONSORT guidelines for reporting primary outcomes was moderate, with only 61.3% of trials reporting summaries of results for each arm, effect size and confidence interval. Conclusions: There is the need for increased rigor in reporting and interpreting non statistically significant results in rehabilitation trials. Evidence misinterpretations can adversely impact clinical decision-making and future research directions. Efforts should be made to promote accurate interpretation of statistical results, emphasize the importance of reporting and analysing effect sizes and confidence intervals, and develop educational interventions to improve statistical literacy.
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Posters - Day 2
  topic: category
subject: absence of evidence
  topic: keywords
subject: randomized controlled trials
  topic: keywords
subject: rehabilitation
  topic: keywords
subject: Caterina Mugnai
  topic: disciplines
subject: Luca Falsiroli Maistrello
  topic: disciplines
subject: Giacomo Fiacca
  topic: disciplines
subject: Michele Perrucchini
  topic: disciplines
subject: Noemi Corbetta
  topic: disciplines
subject: Federico Amateis
  topic: disciplines
subject: Stefano Salvioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2227

S02:5 | Combined anti-IL-5/IL-5r and dupilumab therapy in eosinophilic granulomatosis with polyangiitis: a European retrospective study
type: item
description: Background. Eosinophilic granulomatosis with polyangiitis (EGPA) is a small-vessel vasculitis characterized by asthma, ear, nose, and throat (ENT) symptoms, eosinophilia, and systemic involvement. Despite the use of anti-interleukin (IL)-5/IL-5R therapies, asthma or primarily ENT symptoms may persist. Dupilumab (anti-IL-4R) is approved for severe asthma and chronic rhinosinusitis but has been associated with drug-induced eosinophilia and EGPA flares. Given their complementary mechanisms, the combination of anti-IL-5/IL-5R and dupilumab may improve disease control in patients with EGPA. We report the safety and efficacy of this off-label combination in relapsing/refractory EGPA. Materials and Methods. This European, multicenter, retrospective study included EGPA patients fulfilling 2022 ACR/EULAR classification criteria treated with anti-IL-5/IL-5R in combination with dupilumab for relapsed or refractory disease. Complete response (CR) was defined as BVAS=0 and prednisone dose (PDN) not exceeding 4 mg/day, partial response (PR) as BVAS=0 and PDN >4 mg/day. Failure was defined as inability to reduce PDN <7.5 mg/day due to persistently active disease, vasculitis relapse and/or worsening of asthma or ENT symptoms requiring treatment escalation. Results. Sixteen patients received the combination therapy, with mepolizumab or benralizumab in 8 cases each. Twelve patients (75%) received the addition of dupilumab to ongoing anti-IL-5/IL-5R, 6 for uncontrolled ENT symptoms, 5 for both uncontrolled ENT and asthma symptoms, and 1 for uncontrolled asthma. The remaining 4 patients (25%) received the addition of anti-IL-5/IL-5R to dupilumab for drug-induced eosinophilia associated with vasculitis relapse in 3 patients and for uncontrolled ENT symptoms/asthma in 3 cases. Thirteen patients [Figure 1] with at least 3 months of follow-up were analyzed for efficacy (median follow-up 6 (3-12) months). At the start of combination therapy, the median PDN dose was 5 mg/day (0-10), decreasi…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: ANCA-associated vasculitis
  topic: keywords
subject: Biologics
  topic: keywords
subject: EGPA
  topic: keywords
subject: Miriam Guerini
  topic: disciplines
subject: Pavel Novikov
  topic: disciplines
subject: Roberto Padoan3
  topic: disciplines
subject: Georgina Espigol Frigolé
  topic: disciplines
subject: Jan Willem Cohen Tervaert
  topic: disciplines
subject: Vincent Grobost
  topic: disciplines
subject: Laurent Guilleminault
  topic: disciplines
subject: Jan Walter Schroeder
  topic: disciplines
subject: Bernhard Hellmich
  topic: disciplines
subject: Joana Martins Martinho
  topic: disciplines
subject: Camillo Ribi
  topic: disciplines
subject: Matthieu Groh
  topic: disciplines
subject: Benjamin Terrier
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2101

https://www.reumatismo.org/reuma/article/view/2228
type: item
title: S05:6 | Prevalence of osteoporosis and bone mineral metabolism disorders in an Italian cohort of patients with microcrystalline arthritis: results from the PREMIA observational study of the Italian Society of Rheumatology
description: Background. Rheumatologic diseases are frequently associated with osteoporosis (OP) and bone mineral metabolism disorders. Crystal-induced arthropathies, in particular, may involve alterations in calcium, phosphate and parathyroid hormone (PTH) that act as both pathogenic and predisposing factors. This study aimed to evaluate the prevalence of OP and related metabolic disturbances in patients enrolled in the PREMIA study, promoted by the Italian Society of Rheumatology’s Microcrystalline Arthritis Study Group (AMC). Methods. A total of 1,003 patients from Italian rheumatology centers participating in the PREMIA project were included. Each patient underwent a specialist rheumatologic evaluation, clinical data collection, and basic laboratory testing. Suspected OP or bone metabolism disorder was defined by at least one of the following: (a) history of fragility fracture, (b) pharmacologic treatment for OP, or (c) abnormal serum levels of calcium, phosphate, alkaline phosphatase, or PTH. Patients were stratified according to rheumatologic diagnosis and comorbidities. Results. Overall, 244 patients (24.3%; 95% CI: 21.7%–27.1%) met criteria for OP or bone metabolism disorder, with a predominance of women (62.3%) and a mean age of 69.4 years. Altered serum calcium was detected in 21.5% of cases, and 10.3% were receiving OP treatment (Fig. 1). Among rheumatologic comorbidities, rheumatoid arthritis (42.4%), osteoarthritis (36.7%), connective tissue diseases (34.5%), and systemic vasculitis (33.3%) showed the highest association with OP (Tab. 1). Notably, 32.6% of patients with chronic gout presented evidence of altered bone mineral metabolism. Discussion. Approximately one in four patients with microcrystalline arthritis exhibits osteoporosis or bone metabolism disturbances, with prevalence increasing to one in three among those with rheumatoid arthritis, osteoarthritis, or connective tissue disease. These findings indicate that bone fragility extends beyond traditional ri…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Microcrystalline Arthritis
  topic: keywords
subject: osteoporosis
  topic: keywords
subject: metabolic disturbances
  topic: keywords
subject: Silvia Grignaschi
  topic: disciplines
subject: Sonia Farah
  topic: disciplines
subject: Silvia Balduzzi
  topic: disciplines
subject: Bernd Raffeiner
  topic: disciplines
subject: Carlomaurizio Montecucco
  topic: disciplines
subject: Fausto Salaffi
  topic: disciplines
subject: Enrico Selvi
  topic: disciplines
subject: Annamaria Iagnocco
  topic: disciplines
subject: Fabiola Atzeni
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: Rosario Foti
  topic: disciplines
subject: Maria Manara
  topic: disciplines
subject: Marcello Govoni
  topic: disciplines
subject: Carlo Selmi
  topic: disciplines
subject: Francesca Oliviero
  topic: disciplines
subject: Roberta Ramonda
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2228

S07:5 | Ankle ultrasound patterns may in the identification of Löfgren’s syndrome in patients with acute-onset erythema nodosum
type: item
description: Background. In this study, we performed ultrasound (US) evaluation of the ankles in patients with acute-onset erythema nodosum (EN) and joint symptoms to characterize the US features of this common manifestation and to assess whether these findings could help differentiate Löfgren’s syndrome (LS) from other conditions. Materials and Methods. Thirteen consecutive patients with acute onset of EN and mono- or bilateral ankle involvement (arthralgia/arthritis/swelling) were recruited at a single rheumatologic centre. All patients underwent specific diagnostic investigations aimed at identifying the cause of EN, separating those cases in which it was a manifestation of LS from those in which it was secondary to other causes (OC). An experienced operator in musculoskeletal US, blinded to the course of the diagnostic work-up, performed US examination of ankles bilaterally, investigating the presence of the following parameters: (a) Joint effusion/synovitis at tibiotalar joint (TT JEP); (b) Tenosynovitis (TS) at anterior (AC), lateral (LC) and medial compartment (MC) level; (c) Soft cutaneous tissue inflammation (SCTI) around the ankle. All parameters were initially scored according to OMERACT definition, both for grey scale (GS) and Power Doppler (PD), except for SCTI which were scored according to GLOUDAS definition. US features were classified as positive if their OMERACT parameters were GS>=2 and PD>=1 and if GLOUDAS GS and PD SCTI were >=1. Chi-square test was performed to assess the association between patients diagnosed with LS and US findings. Results. At the end of the diagnostic workup, 8 patients were diagnosed with LS; whereas the remaining patients received diagnosis of mediastinal lymphoma, Sweet's syndrome during pregnancy, EN secondary to Chron's disease, reactive manifestation during M. homini infectiction and one case remained idiopathic. Demographic and clinical details of the recruited cohort are reported in table 1. Mean time of the US examination was 5…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Löfgren syndrome
  topic: keywords
subject: Musculoskeletal ultrasound
  topic: keywords
subject: Erythema nodosum
  topic: keywords
subject: Davide Corradini
  topic: disciplines
subject: Alberto Floris
  topic: disciplines
subject: Andrea Carta
  topic: disciplines
subject: Mattia Congia
  topic: disciplines
subject: Elisabetta Chessa
  topic: disciplines
subject: Matteo Piga
  topic: disciplines
subject: Alberto Cauli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2102

https://www.reumatismo.org/reuma/article/view/2103
type: item
title: S13:5 | Association between vasoactive-vasodilating therapy and reduced detection of pulmonary arterial hypertension in systemic sclerosis: evidence from a European Scleroderma Trials and Research study
description: Background. Vasoactive-vasodilating drugs (VVD) are the cornerstone of the treatment of pulmonary arterial hypertension (PAH), a form of precapillary pulmonary hypertension (pPH) that represents a complication of systemic sclerosis (SSc). VVD categories include endothelin receptor antagonists (ERAs), phosphodiesterase type 5 inhibitors (PDE5i) and prostanoids, which are commonly used to treat digital ulcers (DU) and Raynaud’s phenomenon. As protective effects remain unclear, we investigated the effectiveness of VVD on the primary prevention of pPH. Materials and Methods. SSc patients from the EUSTAR cohort who underwent right heart catheterization (RHC) were included; postcapillary PH cases (pulmonary wedge pressure – PWP >15 mmHg) were excluded. Multivariable logistic regression assessed the association between exposure to VVD and detection of pPH (mPAP>20 mmHg, PVR>2 WU and PWP<15 mmHg) and of PAH (pPH, ILD extent <20% and FVC >70%). Models 1 and 2 tested the exposure at the time of RHC ever and ongoing to VVD categories, models 3 and 4 tested the same for specific VVD molecules. The primary outcome was the diagnosis of precapillary PH; PAH was analyzed as sensitivity analyses. All models were adjusted for known confounders. Interaction terms between VVDs and current DU were also tested. Results. Among 944 eligible patients, 498 (53%) were diagnosed with pPH, of whom 367 (74%) had PAH (Table 1). For VVD classes, a statistically significant association was detected for the interaction of ERAs and current DU with the detection of pPH, in both logistic regression models 1 and 2 (Figure 1a and 1b). However, this finally resulted in a non-significant association between ERAs exposure in patients with current DU and PH detection when calculating marginal effects estimates (ERAs ongoing: OR 0.435, 95%CI 0.193-1.064; ERAs ever: OR 0.636, 95%CI 0.349-1.158). Additionally, both models showed lack of effectiveness of ERAs in patients without current DU, as well as for PDE5i …
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Systemic sclerosis
  topic: keywords
subject: Vasodilators
  topic: keywords
subject: Pulmonary hypertension
  topic: keywords
subject: Nicola Farina
  topic: disciplines
subject: Silvia Bellando-Randone
  topic: disciplines
subject: Sebastien Sanges
  topic: disciplines
subject: Hilde Jenssen Bjørkekjær
  topic: disciplines
subject: Lorenzo Tofani
  topic: disciplines
subject: Marie-Elise Truchetet
  topic: disciplines
subject: Vanessa Smith
  topic: disciplines
subject: Andra Balanescu
  topic: disciplines
subject: Christina Bergmann
  topic: disciplines
subject: Yannick Allanore
  topic: disciplines
subject: Philipp Klemm
  topic: disciplines
subject: Simona Truglia
  topic: disciplines
subject: Luca Idolazzi
  topic: disciplines
subject: Christopher Denton
  topic: disciplines
subject: Roberta Foti
  topic: disciplines
subject: Anna Wojteczek
  topic: disciplines
subject: Emmanuel Chatelus
  topic: disciplines
subject: Madelon Vonk
  topic: disciplines
subject: Serena Guiducci
  topic: disciplines
subject: David Launay
  topic: disciplines
subject: Eric Hachulla
  topic: disciplines
subject: Jeska De Vries-Bouwstra
  topic: disciplines
subject: Anna-Maria Hoffmann-Vold
  topic: disciplines
subject: Oliver Distler
  topic: disciplines
subject: Marco Matucci-Cerinic
  topic: disciplines
subject: Cosimo Bruni
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2103

S13:6 | Investigating the intricate interplay between pulmonary functionality and advanced microangiopathy in very early diagnosis of systemic sclerosis
type: item
description: Background. Diffusing capacity of the lungs for carbon monoxide (DLCO) may correlate with major organ involvement, including Pulmonary Artery Hypertension (PAH), Interstitial lung Disease (ILD) and Left Ventricular Diastolic impairment in Systemic Sclerosis (SSc). Recently, the 2011 Very Early Diagnosis of Systemic Sclerosis (VEDOSS) preliminary classification criteria have been validated. Major features of VEDOSS that could predict progression toward definite SSc are represented by microvascular damage and SSc specific autoantibodies. However, Data concerning pulmonary function is still lacking in this population. The aim of our study was to detect differences between reduced versus normal values of DLCO% predicted (using a cut-off of DLCO of 80%), along with identifying several clinical predictors and to analyze the persistence of DLCO>80% in several intergroups. Materials and Methods. A cross-sectional retrospective study was conducted by analyzing Pulmonary function tests results across a cohort of VEDOSS. Patients were enrolled due to their fulfillment of 2021 VEDOSS validated criteria, while not meeting 2013 ACR/EULAR Classification Criteria for SSc. Enrollment period spanned from September to December 2024. Clinical and demographic data were obtained from medical records. DLCO values were collected from the last available assessment, as well as nail-fold videocapillaroscopic (NVC) patterns. Tricuspid Annular Plane Systolic Excursion (TAPSE) and systolic Pulmonary Arterial Pressure (sPAP) estimates were extracted from the last echocardiographic assessment. Chi-square or Fischer exact tests and T-student were used for intergroup analysis. General univariate regression model was used to define several clinically selected determinants of reduced DLCO, by including age, body mass index, late NVC pattern, SSc specific autoantibodies positivity. Kaplan-Meyer curves and long rank test were assessed using Raynaud’s phoenomenon duration as time interval to evaluate the…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: VEDOSS
  topic: keywords
subject: LUNG FUNCTION
  topic: keywords
subject: ADVANCED MICROVASCULAR DAMAGE
  topic: keywords
subject: Eugenio Capparelli
  topic: disciplines
subject: Eleonora Zaccara
  topic: disciplines
subject: Daniela Bompane
  topic: disciplines
subject: Elisabetta Ricchiuto
  topic: disciplines
subject: Giorgio Bonardi
  topic: disciplines
subject: Laura Castelnovo
  topic: disciplines
subject: Antonio Tamburello
  topic: disciplines
subject: Antonino Mazzone
  topic: disciplines
subject: Paola Faggioli
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2104

S14:5 | Erosive hand osteoarthritis: premenopausal onset and more severe disease progression
type: item
description: Background. Erosive hand osteoarthritis (EHOA) is a particularly aggressive and inflammatory subset of hand osteoarthritis (OA). It predominantly affects women and typically manifests after the age of 50, coinciding with the menopausal transition. However, recent evidence suggests that patients with EHOA, compared with those affected by non-erosive forms, may experience an earlier onset and a more severe clinical course with greater functional and radiographic impairment. The main objectives of our study were to: 1. Assess the prevalence of premenopausal onset among patients with EHOA; 2. Compare clinical, functional, and radiographic characteristics between patients with premenopausal and postmenopausal onset. Materials and Methods. A retrospective study was conducted on a cohort of 87 patients diagnosed with EHOA, followed at the Joint Pathology Outpatient Clinic of our Rheumatology Unit between January 2015 and February 2025. EHOA was diagnosed based on the presence of at least one central radiographic erosion involving a proximal or distal interphalangeal joint. Demographic, clinical, and laboratory data were collected, with particular attention to the age of symptom onset, menopausal status, and use of hormone replacement therapy (HRT). Joint function was assessed using validated AUSCAN and DREISER indices. Radiographic damage was evaluated using the Altman scoring system on bilateral hand radiographs. A total composite radiographic score was calculated by summing the individual joint scores for all assessed hand joints. Statistical analyses included Student’s t-test, and linear and logistic regression models, with statistical significance set at p < 0.05. Results. Eighty-seven patients with EHOA were retrospectively enrolled, with a mean age of 63.17 ± 8.85 years; 77 were women (88.5%). Among female patients, 71 (92.21%) were postmenopausal, and 17 (22.08%) had previously used or were currently using HRT. The mean disease duration was 13.75 ± 9 years. In 42.9%…
subject: 62nd National Congress of the Italian Society of Rheumatology
  topic: section
subject: Abstract Book
  topic: category
subject: Erosive arthrosis of the hand
  topic: keywords
subject: menopause
  topic: keywords
subject: Radiographic damage
  topic: keywords
subject: Marta Favero
  topic: disciplines
subject: Giacomo Cozzi
  topic: disciplines
subject: Clarissa Benvoluti
  topic: disciplines
subject: Laura Scagnellato
  topic: disciplines
subject: Gianluca Poncina
  topic: disciplines
subject: Stefano Rizzetto
  topic: disciplines
subject: Mariagrazia Lorenzin
  topic: disciplines
subject: Roberta Ramonda
  topic: disciplines
creator: Società Italiana di Reumatologia
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by-nc/4.0
date: 2025-11-26
publication date: 2025-11-26
doi: 10.4081/reumatismo.2025.2229