Background: Fibromyalgia (FM) is one of the most common causes of chronic widespread pain. Although pain is the most distinctive feature of this syndrome, FM is characterized by a complex polysymptomatology that also comprises fatigue, sleep disturbances and other functional symptoms that negatively affect the overall quality of life. Since FM can negatively affect personal well-being, self-image and interpersonal relationship, it can also impact sexual functioning and pleasure. When interrogated regarding sexuality, female FM patients answer that it is important for their quality of life and, for the majority of them, it appears as a physical, psychological, emotional and relational need. For these reason, women require support and understanding from both their partners and health care professionals. In this context, the availability of a simple and rapidly administered questionnaire, such as the Qualisex, for the evaluation of sexual disfunction on these patients might be considered an acceptable method of communication of this sensitive issue. Objectives: The aim of this study was to evaluate sexual disfunctions in a large cohort of FM women through Qualisex questionnaire, which has been originally created for French patients with rheumatoid arthritis and recently adapted and validated to Italian language for FM patients. Methods: In this cross-sectional study, consecutive women with a diagnosis of FM (2016 ACR criteria) referring to our out-patients Fibromyalgia Clinic were asked to answer an anonymous online survey, including demographic characteristics, medical and pharmacological history, Hospital Anxiety and Depression Scale (HADS) and Qualisex questionnaire for sexual dysfunction. Results: The cohort enrolled in this study was composed by 489 FM women, median age 50. The results of the univariate analysis showed a worse sexual functioning in women with lower educational level, housekeepers and retired patients but also in women who referred a concomitant diagnosis of chronic pelvic pathology or a psychiatric disorder. Among women who were in an active relationship, the referred sexual understanding with the partner was inversely associated with sexual functioning. Finally, the consumption of drugs known to be associated with a reduction of sexual desire resulted significantly associated with a worse sexual functioning (Table 1). The multivariate linear model showed a significant influence of the presence of a partner in women’s life, the referred sexual understanding and the use of drugs associated with a reduction of sexual desire on women’s quality of life (Table 2). Conclusion: Qualisex questionnaire represents a good test to detect the impaired sexuality in FM female patients, to establish a more correct intervention, pharmacological, psychotherapeutic (single or couple) and supportive, reducing the destructive circle that FM and poor sexual quality determine. Different aspects contribute to sexual dysfunction, with an important impact of FM on sexual quality and consequently a worsening of FM symptoms. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.

OBJECTIVES:Fibromyalgia (FM) may have consequences on sexual life. The objective was to validate the Qualisex questionnaire in the assessment of sexual dysfunction in women affected by FM. METHODS:We consecutively enrolled FM women (American College of Rheumatology-ACR 2016) referring to our Fibromyalgia Clinic, from 2020 to 2022. Demographic, clinical data and evaluation of FM symptoms severity (Revised Fibromyalgia Impact Questionnaire (R-FIQ), Symptoms Severity Scale-SSS, Widespread Pain Index-WPI) were assessed. Hospital Anxiety and Depression Scale (HADS) and Qualisex questionnaire were anonymously administered. Qualisex includes 10 questions on different items of sexual life with higher scores suggestive of greater negative impact of the disease on sexuality. RESULTS:The cohort was composed by 373 FM women. Cronbach's alpha test was used to validate Qualisex questionnaire (0.878). Moreover, we observed higher values of Qualisex in married women (p<0.001), in women with lower grade of education (p=0.002) and with lower sexual feeling with partner (p<0.001). Higher values of Qualisex Total score showed a positive correlation with HADS-A/D (p<0.001 r=0.312; p<0.001 r=0.542 respectively), VAS pain, VAS fatigue, VAS dryness (p<0.001 r=0,438; p<0.001 r=0.375; p<0.001 r=0.370 respectively) and relationship duration (p<0.001 r=0.202). Multivariate analysis revealed a significant influence of relationship duration, VAS pain, fatigue, dryness, HADS-A/D, R-FIQ and all Qualisex items, on Qualisex Total score corrected for patients' age (p<0.001). CONCLUSIONS:This study validated Qualisex questionnaire as a good test for the sexual disorders' evaluation in FM women. Its use allows the assessment of different factors associated with sexual dysfunction, showing an impact of FM on sexuality. Moreover, due to demotivation feelings, sexual dysfunction contributes to worsen patients' quality of life.

OBJECTIVE:Fibromyalgia (FM) is a multifactorial disease characterized principally by chronic, widespread pain impairing a patient's quality of life. The management of FM requires a multidisciplinary approach that combines pharmacological and non-pharmacological strategies. Growing evidence suggests a potential beneficial role of micronutrients such as minerals and vitamins. Overall, the role of these supplements remains controversial, but clinical trials on vitamin D, vitamin B12, magnesium, and iron supplementation seem to provide promising results. The aim of this study was to investigate their role in an Italian female sample. SUBJECTS AND METHODS:An exploratory cross-sectional study was done to assess the association of selected micronutrients with symptoms of FM by using the Fibromyalgia Impact Questionnaire (FIQ) in twenty consecutive female patients with FM. A literature review was also conducted. RESULTS:FIQ results revealed that vitamin D and magnesium deficiency appear to play a role in FM symptoms, mainly in physical function and stiffness. From the literature review, only two studies investigating the role of micronutrients in FM were retrieved. CONCLUSIONS:Screening for micronutrient deficiencies in FM patients and supplementing them when levels are low might help counteract FM symptoms.

OBJECTIVES:Fibromyalgia (FM) is a chronic syndrome characterised by widespread musculoskeletal pain associated with symptoms such as fatigue, sleep disturbances and cognitive impairment. Prevalence is higher in females but the application of the 2010/2011 and 2016 revision of the American College of Rheumatology (ACR) criteria reduced prevalence differences and the actual female:male ratio is approximately 3:1. Even if lately some studies have been conducted regarding FM gender differences, disease severity is still assessed using questionnaires, such as the Revised Fibromyalgia Impact Questionnaire (FIQR), designed and validated through a predominantly female sample. The aim of this pilot study was to compare the 21 items of the FIQR among male and female patients in order to evaluate the possible existence of a gender bias.METHODS:In this case-control study, consecutive patients with a diagnosis of FM (2016 ACR criteria) were asked to answer an online survey, including demographic characteristics, disease variables and the Italian version of the FIQR. Among the 544 patients that compiled the questionnaire, 78 patients, 39 males and 39 females, matched for age and disease duration, were consecutively enrolled in order to compare their FIQR scores.RESULTS:The univariate analysis showed that total FIQR scores and physical function domain scores were significantly higher in females and, among the 21 items of the FIQR, the female group obtained significantly higher scores in 6 of them. Our results showed that female patients obtain significantly higher scores in the FIQR total score and physical function domain score, in particular in 5 out of the 9 sub-items of the FIQR physical function domain.CONCLUSIONS:These preliminary results indicate that the use of the FIQR as a severity index in male patients probably underestimates the disease impact in this group.

Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease and is extremely heterogeneous in terms of immunological features and clinical manifestations. This complexity could result in a delay in the diagnosis and treatment introduction, with impacts on long-term outcomes. In this view, the application of innovative tools, such as machine learning models (MLMs), could be useful. Thus, the purpose of the present review is to provide the reader with information about the possible application of artificial intelligence in SLE patients from a medical perspective. To summarize, several studies have applied MLMs in large cohorts in different disease-related fields. In particular, the majority of studies focused on diagnosis and pathogenesis, disease-related manifestations, in particular Lupus Nephritis, outcomes and treatment. Nonetheless, some studies focused on peculiar features, such as pregnancy and quality of life. The review of published data demonstrated the proposal of several models with good performance, suggesting the possible application of MLMs in the SLE scenario.

Introduction Objectives Fibromyalgia (FM) is a common rheumatic disorder characterized by chronic, widespread pain associated with several not painful symptoms. The contribution of gender to the manifestation of the disease may influence the higher prevalence of FM among women. In spite of this, how patients’ gender influences the clinical manifestation of FM is still not well understood. The frequent association with neuropsychiatric symptoms raised the attention on the role of neurotrophins, including the brain-derived neurotrophic factor (BDNF) as potential biomarkers of the condition. Aims of the study were to evaluate the influence of gender on clinical manifestations and to investigate BDNF serum levels as a potential biomarker of FM. Methods We consecutively enrolled 201 adult patients of both sexes diagnosed with FM. For each patient, we collected clinical and clinimetric data and, in a subgroup of 40 patients, we measured serum BDNF levels. BDNF levels have been measured also in 40 matched healthy controls (HC). Results Several symptoms were significantly higher in women compared with men, including pain, fatigue, memory problems, tenderness, balance problems and sensitivity to environmental stimuli. On the contrary, men reported a significant higher frequency of coexisting depressive symptoms. BDNF levels were significantly lower in FM patients compared with HC, discriminating with good accuracy the condition. Conclusion Gender influences FM clinical manifestations, with a higher prevalence of pain, fatigue and other common FM symptoms among women while higher frequency of neuropsychiatric symptoms among men. BDNF offers promises as a potential biomarker of the disease. Key Points • Gender-related differences in the clinical manifestations of FM may contribute to the higher prevalence of FM among females. Indeed, women show higher levels of pain and symptoms traditionally associated to FM, which are evaluated to establish the diagnosis according to the clinical criteria. • The new insights into the pathogenesis of the disease raised the attention on the role of brain mediators in FM. Among these, BNDF shows potential as a diagnostic biomarker.

OBJECTIVES:The COVID-19 pandemic severely increased the stress levels in the population. The aim of present study was to investigate the impact of the lockdown measures on emotional well-being and disease activity in patients with fibromyalgia (FM) and rheumatoid arthritis (RA) through a telemedicine approach.METHODS:An on-line survey, including demographic characteristics, disease-activity and psychometric scales (Stress-related Vulnerability Scale, Resiliency scale), Zung Anxiety and Depression Self-assessment Scale), was anonymously administered to FM, RA and healthy controls (HC). Disease activities were compared to the pre-lockdown cohort referring to our centre.RESULTS:Levels of anxiety and depression worthy of psychiatric attention were documented in 36.7% of FM, 14.6% of RA, 12.5% of HC and in 50% of FM, 17.1% of RA, 15% of HC, respectively. HC featured the highest stress scores, followed FM and then RA. RA showed higher resiliency than FM. Both anxiety and depression scores were significantly higher in FM than RA and HC. Disease severity was higher in RA patients and lower in FM patients when compared to the respective historical cohorts.CONCLUSIONS:Lockdown significantly affected emotional well-being and disease activity of patients suffering from rheumatic diseases. While HC showed a higher vulnerability to stress, RA patients showed a greater resilience compared to both HC and to FM patients, especially. Emotional disturbances are greater in patients with RDs and in particular with FM. The use of a telemedicine approach to screen for severe symptoms represents a useful addition to the overall management of rheumatic patients.

Background:By the beginning of March 2020, the pandemic of the novel coronavirus disease (COVID-19) imposed severe lockdown measures opposing the viral spread, limiting non-COVID patients’ access to hospitals. Previous reports suggest that Rheumatoid Arthritis (RA) patients may experience a worsening of self-reported disease activity following natural disasters. Moreover, RA patients are at increased risk of mood disorders, such as depression and anxiety. An increase of depressive symptoms, anxiety and suicidal rate has been recently reported as result of the lockdown in response to COVID-19.Objectives:Aims of this study were to investigate the impact of the lockdown measures on disease activity and emotional well-being among patients affected by RA, through a telemedicine approach.Methods:Patients followed in the “Early Arthritis Clinic” of our hospital were invited to participate to an online survey. They were asked also to invite their best friend (BF), matched for age and sex, to participate the survey, as control group. Moreover, clinical records from the same “Early Arthritis Clinic” cohort were used as pre-pandemic group. The online survey included demographic questions and, for RA patients, the evaluation of perceived pain (P-VAS) and disease activity (DA-VAS) on a scale of 1-10 as well as Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5), a validated self-reported disease activity measure. Both RA patients and BF responded also to validated, psychometric scales for stress vulnerability (Stress Vulnerability Scale-SVS), resilience (Resilience Scale-RS), depression (Zung’s depression questionnaire-Zung-D) and anxiety (Zung’s anxiety questionnaire-Zung-A) evaluation.Results:The cohort was composed by 76 RA patients who answered the survey, 32 BF and 170 RA patients from historical cohort. There were no differences in demographic characteristics, SVS, RS, Zung-D and Zung-A between RA patients and BF. RADAI-5 correlated positively with SVS (r=0,29;p=0,01), P-VAS (r=0,8;p<0,0001) and DA-VAS (r=0,8;p<0,0001) and negatively with RS (r=-0,23;p=0,04). Patients with higher disease activity showed higher classes of Zung-D (p=0,03) and SVS (p=0,006), and lower classes of RS(p=0,001). P-VAS was the only significant predictor of RADAI-5 (β=0,83;CI=0,53-0,76;p<0,001), and the concordance between RADAI-5, P-VAS and DA-VAS was high (K=0,94;p<0,001). Compared with the historical cohort, RA patients involved in the survey showed higher frequencies of moderate and elevated disease activity classes (p<0,001;Figure 1) despite there were no differences in P-VAS and DA-VAS.Conclusion:These results suggest that lockdown did not affect differently emotional well-being of RA patients compared to healthy subjects. RA patients with elevated disease activity report higher stress and depressive symptoms, and SVS and RS may be useful to identify patients at higher risk. The higher self-reported disease activity measured through RADAI-5 may be the result of an overestimation of disease severity by patients, which depends mostly from pain. This should be considered in the assessment of disease activity through telemedicine.Figure 1.Disclosure of Interests:None declared

Background Patients with Systemic Lupus Erythematosus (SLE) present an increased incidence of Cardio-Vascular Events (CVE) compared to general population, and the difference with healthy subjects is particularly evident in young SLE women. Objectives The aim of this study is to assess the predictive ability of established 10 years CV risk models in SLE Methods A retrospective analysis of two Italian SLE prospective cohorts was performed. SLE patients without previous CVE, with age ≥25 years, a minimum continuative follow-up of 10 years and sufficient data to calculate the 10 years risk scores were enrolled. The 10 years CVE risk scores were calculated at the first observation and all CVE were prospectively recorded in the following 10 years. We calculated the following scores: the QRisk3, the Framingham CV disease 10 years score, the HeartScore (Europe Low Risk) and the SLE CV Risk Score proposed by Petri et al. Discriminatory ability for CV risk prediction was estimated by the area under the receiver operating characteristic curve. Hosmer-Lemeshov (HL) tests was used to evaluate calibration comparing the observed versus expected number of events Results Analysis was performed on 131 SLE patients (mean baseline age of 37±11 years). We observed 10 CVE during the 10 years follow-up from baseline (3 acute coronary syndrome, 4 stroke, 1 transitory ischaemic attack and 2 peripheral artery disease). The AUC values were 0.75 (95% CI 0.55–0.94) for QRisk3, 0.66 (0.45–0.88) for Framingham score, 0.62 (0.41–0.82) for the HeartScore and 0.7 (95% CI 0.55–0.85) for the SLE CV risk score. The p values of HL test were 0.8 for Qrisk3 and SLE CV score and 0.4 for Framingham score and HeartScore, suggesting a good model fit for all the CV risk scores. Considering scores with better discriminative ability and calibration, 20% of CVE were observed with Qrisk3 score lower then 3.6% and with SLE CV risk score between 6% and 8%. Discriminative ability and calibration were not improved by multiplying by 2 the Framingham score and the HeartScore. Conclusions The available CV risk scores demonstrate a moderate predictive ability of 10 years CVE in SLE. We observed a better model fit for QRisk3 and SLE CV risk score. Nevertheless, a considerable proportion of patients, with very low predicted CV risk, developed CVE during follow-up. References [1] Petri MLS. Systemic lupus erythematosus Cardiovascular Risk Equation. [Abstract]. Arthritis Rheum2012;64. [2] Urowitz MB, Ibañez D, Su J, et al. Modified Framingham Risk factor score for systemic lupus erythematosus. J Rheumatol2016;43:875–9. Disclosure of Interest None declared

To assess clinical and psychosocial factors related to alexithymia in systemic sclerosis (SSc). We enrolled 40 consecutive SSc patients in a cross-sectional study evaluating alexithymia with Toronto Alexithymia scale (TAS-20). We measured Beck Depression inventory (BDI), Hamilton Anxiety rating scale (HAM-H), 36-Items Short-Form Healthy Survey (SF-36), Functional Assessment of Chronic Illness Therapy (FACIT)—Fatigue, Visual Analog Scale (VAS) pain, Pittsburgh Sleep Quality Index (PSQI), Satisfaction with Appearance Scale (SWAP), and Mouth Handicap in Systemic Sclerosis (MHISS). The prevalence of alexithymia was 42%. Alexithymic patients presented increased depressive (p = ≤ 0.001) and anxiety symptoms (p = ≤ 0.001), sleep disorders (p = 0.03), pain (p = 0.02), esthetic concerns (p = 0.03), disability in activities (p = 0.03) and reduced scores of SF-36 in mental components summary (MCS) (p = ≤ 0.001) and physical components summary (PCS) (p = 0.01). We found significant correlations with sleep disorders (r = 0.41, p = ≤ 0.001), BID (r = 0.35, p = 0.04), facial image dissatisfaction (r = 0.35, p = 0.04), mouth disability (r = 0.51, p = 0.005), depressive (r = 0.6, p = ≤ 0.001), and anxiety symptoms (r = 0.48, p = ≤ 0.001), fatigue (r = − 0.45 p = 0.005), SF-36 PCS (r = − 0.51, p = ≤ 0.001) and MCS (r = − 0.65, p = ≤ 0.001). In multiple linear regression analysis, SWAP facial was the only variable associated with TAS-20 [0.99 (0.48) p = 0.05]. Alexithymia correlates with several psychosocial factors but seems strongly related to facial image dissatisfaction.

Introduction The aim of this study was to evaluate the proportion of patients with Systemic Lupus Erythematosus (SLE) who did not met the WHO recommendations for physical activity and to evaluate the amount of time spent in sedentary behavior. Methods SLE patients were consecutively enrolled in a cross sectional study. The type and the time spent in physical activity and sedentary behavior were evaluated using the IPAQ short form questionnaire. The adequate physical activity was defined according to the 2010 WHO recommendations for health and the sedentary behavior according to the 2017 SBRN consensus. We also assessed quality of life using SF-36, mood disorders using BDI and HAM-H, fatigue using Facit-Fatigue and sleep disorders using PSQI scores. Results Physical activity was not sufficient to meet WHO recommendations in 56 of 93 SLE patients (60%). SLE patients spent a median (95% range) of 180 (0 +/- 600) minutes everyday in sedentary activities. The length of daily sedentary time was more than 6 hours in 25% of SLE patients. In multivariable analysis, the factors associated to the probability of not meeting WHO criteria was only the time of exposure to antimalarials (OR 0.88, p 0.03) and the factors related to the probability of being in the upper tertile of sedentary time (more than 270 minutes) were age (OR 1.04, p 0.02), disease activity expressed by SELENA-SLEDAI score (OR 1.2, p 0.01) and Facit-fatigue score (OR 0.94, p 0.04). Conclusion A relevant proportion of SLE patients were inadequately physically active. It is essential to improve the awareness of the importance of increase physical activity and reduce sedentary time. A better control of disease activity and fatigue and a prolonged use of antimalarials could help to reach this notable goal.

Background Alexithymia describes the difficults of people in identifying, differentiating and articulating emotions of others and themselves and in discriminating those from bodily sensations, with a limited fantasy and a concrete, externally oriented cognitive style.1 A high prevalence of alexithymia has been found in patients with a variety of health conditions, including SLE.2 Previous authors identified mood states2 and quality of life3 as the main factors related to alexithymia in Systemic Lupus Erythematosus (SLE). Objectives Aim of our study was to assess the impact of clinical, immunological, psycho-social factors on the presence of alexithymia in Systemic Lupus Erythematosus (SLE). Methods We consecutively enrolled 104 patients in a cross-sectional study. Alexithymia was assessed using the Toronto Alexithymia scale (TAS-20). We also evaluated symptoms of mood disorders using BDI and HAM-H, quality of life using MOS-SF36, sleep disorders with PSQI and physical activity using IPAQ. Results The mean (standard deviation) TAS-20 score was 49.5 (15.6). The prevalence of alexithymia (TAS-20 ≥61) was 28%. Alexithymic patients (TAS-20 ≥61) were significantly older (p 0.0005), presented more severe depressive and anxiety symptoms (p<0.0001), a higher score of sleep disorders (p<0.0001), a reduced Facit-Fatigue score (p 0.0007), reduced SF-36 mental and physical component summary scores (p 0.0001 and 0.004) and increased daily sedentary time (p 0.002). In the multiple logistic regression analysis the variables associated to the presence of alexithymia were age (OR 1.07, p 0.02) and the score of depressive symptoms (OR 1.15, p 0.02). Conclusions About a third of SLE patients presented a dysfunctional processing of emotion. It is necessary to carefully consider the symptoms of mood disorders to optimise SLE patient management. References [1] Taylor GJ, Bagby RM. Measurement of alexithymia. Recommendations for clinical practice and future research. Psychiatr Clin North Am. 1988Sep;11(3):351–66 [2] Vadacca M, Bruni R, Terminio N, Sambataro G, Margiotta D, Serino FM, Afeltra A. Alexithymia, mood states and pain experience in systemic lupus erythematosus and rheumatoid arthritis. Clin Rheumatol. 2014;33(10):1443–50.3. [3] Barbosa F, Mota C, Alves M, Alcântara C, Rossiñol B, Patrício P, Barbosa A, Ferreira C. Alexithymia in systemic lupus erythematosus patients. Ann N Y Acad Sci. 2009Sep;1173:227–34 Disclosure of Interest None declared

Introduction Systemic Lupus Erythematosus (SLE) is associated to an increased prevalence of Metabolic Syndrome (MeS) and to a reduction of Quality of Life (QoL). The aim of this study is to evaluate the association between MeS and QoL in SLE. Methods SLE patients were consecutively enrolled in a cross sectional study. MeS was defined according to IFD definition. Therapy with glucocorticoids (GC) and antimalarial was analyzed as cumulative years of exposure. We used a cut off of 7.5 mg of prednisone to define high daily dose of GC. QoL was quantified using SF-36. We used BDI and HAM-H to assess symptoms of mood disorders. Fatigue was evaluated using Facit-Fatigue, physical activity using IPAQ, sleep quality using PSQI and alexithymia using TAS-20. Results We enrolled 100 SLE patients. MeS prevalence was 34%. Patients with MeS presented reduced scores in SF-36 MCS and PCS compared to patients without MeS (p 0.03 and p 0.004). BDI and HAM-H score were significantly higher in patients meeting MeS criteria compared to subjects without MeS (p 0.004, p 0.02). These results were confirmed after adjustment for confounders. Compared to patients without MeS, those with MeS presented higher age, lower education level, higher recent SELENA-SLEDAI, higher number of flares, increased SDI, longer cumulative exposure to high dose GC and shorter duration of antimalarial therapy. In the multiple logistic regression model, the variable associated to the Odds Ratio of having MeS were: the average of recent SELENA-SLEDAI (OR 1.15 p 0.04), the years of exposure to high dose of GC (OR 1.18 p 0.004), the years of exposure to antimalarials (OR 0.82 p 0.03) and the BDI score (OR 1.1 p 0.005). Conclusion A modern management of SLE should not miss to take all the possible measures to ensure an adequate QoL to SLE patients, with particular attention to those affected by MeS.

Background Several evidences described a considerable prevalence of alexithymia among patients with chronic diseases, such as systemic autoimmune diseases. In patients affected by Systemic Lupus Erythematosus (SLE), alexithymia seems to be related to mood disorders and personality. Objectives In this study we evaluated alexithymia in relation to HR-QoL (Health related Quality of Life) and to factor associated to HR-QoL, such as mood disorders, fatigue, work ability, sleep quality and physical activity. Methods We consecutively enrolled SLE patients and healthy controls in a cross sectional study with a retrospective design. We wvaluated alexithymia by the Toronto Alexithymia Scale 20 (TAS-20). AHR-QoL was expressed by MOS-SF-36. Mood disorders was assessed by BDI and HAM-H. Fatigue was evaluated by Facit-Fatigue. Physical activity was quantified using International Physical Activity Questionnaire (IPAQ) and the sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Work ability was assessed by Work Productivity and Activity Impairment (WPAI). Cognitive impairment was defined according to MOCA screening test. Results Fifty-two SLE patients and 50 age-matched healthy subjects were enrolled in the study. Mean TAS-20 score was significantly higher in SLE compared to controls (p<0.01). Alexithymic patients presented increased values of BDI score and HAM-H score (p<0.01 and p<0.05) and reduced Facit-Fatigue score (p<0.05). We found increased values of Work missed due to health problems and Activity impairment in alexithymic SLE subjects (p<0.05). SF-36 summary components PCS and MCS and SF-36 individual components did not significantly differ between alexithymic and non-alexithymic SLE. A greater proportion of alexithymic SLE patients presented fibromyalgia (p<0.05), low scholastic education (p<0.01), cognitive impairment according to MOCA test (p<0.01) and mild-to-severe depression according to BDI (p<0.01). We did not find differences among alexithymic and non alexithymic in MeS, obesity and physical inactivity prevalence. TAS-20 values positively correlated with BDI score (p<0.001), HAM-H score (p<0.01) and activity impairment score (p<0.01) and negatively with Facit-Fatigue score (p<0.01). In multiple linear regression, predictors of TAS-20 values were to be fibromyalgic and to have mild-to-severe depression according to BDI. In multiple logistic regression, alexithymia was significantly associated to BDI score (OR 1.2, 95% CI 1.0–1.4) and inversely associated to cognitive impairment (OR 0.1, 95% CI 0.02–0.8). Conclusions SLE patients frequently present alexithymic tract. Alexithymia seems to be associated neither to disease feature, to disease course (activity and damage) and to SLE therapy, nor to HR-QoL expressed by SF-36. Nevertheless, alexithymia could be tightly related to QoL-associated factors as depression and fibromyalgia Disclosure of Interest None declared

Background Systemic Lupus Erythematosus (SLE) is associated to a huge prevalence and incidence of cardiovascular diseases (CVDs) due to accelerated atherosclerosis. Several evidences demonstrated that metabolic syndrome (MeS) could contribute to CVDs burden in SLE. In general population, MeS components and, according to some reports, MeS itself are associated to worsened Health related Quality of Life (HR-QoL). In SLE patients, a severe decline of HR-QoL has been widely demonstrated. Objectives In the study, we evaluated the association between MeS, HR-QoL and QoL-related factors, such as depression, fatigue and physical activity. Methods We conducted a cross-sectional study with retrospective evaluation of disease activity, damage and therapies cumulative dosage. MeS was defined according to International Federation of Diabetes (IFD) criteria. All patients were evaluated to explore MeS IFD criteria and other CVD risk factors (familiar history, lifestyle, smoking). SLE disease activity and damage were evaluated using SELENA-SLEDAI and SDI indices, respectively. Disease flares were retrospectively assessed by SFI index. HR-QoL was quantified by SF-36 instrument. We used Beck Depression Inventory (BDI) to assess depression and Facit-Fatigue to evaluate fatigue. Physical activity was quantified using International Physical Activity Questionnaire (IPAQ) and expressed according to categorical IPAQ total score. Patients also completed Pittsburgh Sleep Quality Index (PSQI) exploring sleep pathology. Results We enrolled 55 SLE patients (2 male and 53 female). Mean age was 45±12.5. MeS prevalence was 23.6% and obesity (according to IFD definition) was recorded in 36.4% of patients. SLE patients with MeS presented reduced scores in SF-36 summary components MCS and PCS compared to patients without MeS (p 0.002 and p 0.04, respectively). The SF-36 individual components significantly decreased in MeS were the Mental Health, the Physical Rose and the Social Role (p 0.003, p 0.03, p 0.05, respectively). In multiple linear regression the values of MCS was significantly associated only to obesity (p 0.01), while neither MeS it self nor any MeS components were associated to PCS values. BDI score was significantly higher and Facit-Fatigue score was reduced in SLE patients meeting MeS criteria compared to subjects without MeS (p<0.0001, p 0.005, respectively). A greater proportion of SLE patients with MeS presented almost mild depression (p 0.03). We found to be physically inactive, according to IPAQ score, the majority of SLE patients with MeS compared to patients without MeS (p<0.0001). In multiple logistic regression, factors related to MeS were the Number of flares in the previous one year [OR (95% CI) 13.7 (1.7–107.8)], to have a BDI>13 (to have almost mild depression) [OR 0.05 (0.004–0.87)] and to be physically inactive (IPAQ=1) [OR 33.5 (2.3–496.4)]. Conclusions HR-QoL seems to be compromised in SLE patients with MeS, especially in mental components. Moreover, SLE patients with MeS often presented depression, are burdened by more severe fatigue and frequently are physically inactive. The presence of MeS in SLE was associated to the number of flare and, above all, to the physical inactivity, while not having depression seems exert a protective effect on MeS. Disclosure of Interest None declared