BV; has served as a consultant for AbbVie, Amgen, AstraZeneca,. BMS, Centocor ... and UCB; and has received grants/research support from AbbVie,. Merck ...
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also not significant (P > 0.05). Back pain was the main presenting symptom but this was similarly reported in both patient groups (15/24 vs 29/42), as were buttock (7/24 vs 9/42), neck (9/24 vs 11/42), knee (5/ 24 vs 8/42), shoulder (5/24 vs 11/42), and foot (6/24 vs 7/42) pain. Crucially, eye inflammation (later diagnosed as uveitis) was reported as a first symptom for 39% (9/24) of uveitis patients. Importantly, hip pain (10/24 vs 10/42; P < 0.025) was significantly more frequent, whereas headache (2/24 vs 8/42; P < 0.025) was less, in uveitis patients. Conclusion: Our study suggests that HLA-B27 positive SpA patients with uveitis are typically younger at diagnosis, and more often (40%) have hip pain as well as uveitis (with reduced reporting of headache) amongst their first presenting symptoms. Disclosure statement: The authors have declared no conflicts of interest. 228. EFFECTS OF SMOKING IN PATIENTS WITH ANKYLOSING SPONDYLITIS AND NONRADIOGRAPHIC AXIAL SPONDYLOARTHRITIS RECEIVING TNF INHIBITORS O¨zlem Pehlivan1, Yasemin Yalc¸|nkaya1, Nihat Hu¨seyinsinog˘lu1, Nilu¨fer Alpay Kan|tez1, Bahar Art|m Esen1, Burak Erer1, Sevil Kamal|1, Murat Inanc¸1, Ahmet Gu¨l1 and Lale Ocal1 1 Department of Internal Medicine, Division Rheumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TURKEY Background: The objective of this study is to identify the potential impacts of smoking on disease activity markers, physical examination and laboratory findings in severe AS and nr-axSpA receiving TNF inhibitors (TNFi). Methods: In this study, 211 patients treated with TNFi for severe disease activity and diagnosed as axSpA based on ASAS criteria (142 patients classified as AS according to modified New York criteria and 69 patients classified as nr-axSpA) between 2000 and 2013 were included. Patients were evaluated retrospectively. Smoking intensity has been evaluated as per pack-year. Patients were separated into groups according to smoking habits and intensity. Acute phase reactants- ESR, CRP- and functional indexes-BASMI, BASFI, BASDAI and AS Quality of Life (ASQoL)- were compared between groups. Physical examination including Schober’s test (ST), chest expansion (CE), fingertip-to-floor distance (FFD), tragus wall distance (TWD), lateral lumbar flexion (LLF), cervical rotation (CR), occiput-to-wall distance (OWD), inter-malleolar distance (IMD), chin-sternum distance (CSD) was performed. Independent sample t, paired t test, one-way Anova and Spearman correlation analysis were used to compare values. Results: Based on comparison between smokers (n:121) and nonsmokers (n:90), physical mobility indicators ST (p:0.03), FFD (P < 0.001) and LLF (p: 0.035) were found significantly more restricted in smokers and BASDAI (p: 0.011) values were significantly improved after TNFi in non-smokers. If smoking period was >20 years, LLF (p:0.004), CR (p:0.004), CE (p:0.005), OWD (p:0.021), TWD (p: 0.001), IMD (p: 0.015), BASFI (p: 0.019) and BASMI (P < 0.001) were significantly deteriorated. Significant correlation was found between smoking intensity with LLF (p:0.002), CR (p:0.01), TWD (p: 0.04), BASFI (p: 0.024) and BASMI (p:0.015). When effects of smoking were evaluated between AS (n:142) and nr-axSpA (n: 69) groups, significant restriction of ST (p:0.04) and FFD (P < 0.001) in AS group within smokers, restriction of FFD (p:0.02), CR(p:0.04), OWD (p:0.02), TWD (p:0.003), CSD (p: 0.02) and LLF (p:0.002) in AS group among smokers >10 years or more and significant restriction of ST (p: 0.04), FFD (P < 0.001), LLF (p: 0.01) in AS group who had quit smoking compared with non-smokers were found. Among currently smoking patients (n:46) comparison between who smoke >20 pack-year (n:23) and who smoke
