POS1487-HPR WHAT PATIENTS THINK OF SYNOVIAL BIOPSIES: OUR EXPERIENCE FROM THE GSYNC STUDY
Authors: K. Straiton
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Glasgow Synovial Tissue Cohort (G-SYNC) is an ongoing prospective interventional study aiming at discovering biological markers for personalized medicine for patients who have a clinical diagnosis of the following rheumatic diseases groups, rheumatoid arthritis, psoriatic arthritis, peripheral spondyloarthritis, seronegative arthritis, axial spondyloarthritis, osteoarthritis, Infectious arthritis, reactive arthritis, immunotherapy-related arthritis, enteropathic-associated arthritis, undifferentiated arthritis, crystal arthropathies, connective tissue disease-related arthritis. Hopefully leading to improved clinical outcomes for patients. Each patient has a mini-invasive ultrasound guided synovial biopsies of one joint at baseline visit along with bloods and questionnaires, a phone call is made at 4 weeks to assess tolerance and a follow visit at 3-6 months with optional biopsy. <h3>Objectives:</h3> Using the patient reported outcomes and adverse events gathered through G-SYNC, we hope to highlight the positive experiences and opinions of patients about their biopsy procedure as well as tolerance and safety. <h3>Methods:</h3> As part of GSYNC, we collected the following patient reported outcomes: visual analogue scale (VAS) before procedure, immediately after biopsy and 4 weeks after the biopsy. Finally, we use a 0-5 Likert scale to assess the following parameters: pain during the biopsy procedure (None, Mild discomfort, Moderate discomfort, Mild pain, Severe pain); how their joint feel compared to before the biopsy (much better, better, the same, worse, much worse) and then likelihood of participating in a repeat biopsy (very likely, somewhat likely, not sure, unlikely, very unlikely). Participants are offered an intra-articular glucocorticoid injection at the end of the procedure if appropriate. <h3>Results:</h3> We have recruited 51 patients and have followed up 50 patients for their four-week phone call. The demographic are as follows: 14 male participants and 39 females with a mean age of 55 (20-70). Disease groups recruited are as follows; PsA 48%, RA 32 %, Seronegative arthritis 18%, Crystal arthropathies 4%, axial spondylarthritis 2% and Sjogren's 2% and OA 12 %. We have biopsied the following joints, 39 Knees, 5 ankles, 3 shoulders, 2 elbow and 2 wrists. At week 4, VAS pain and stiffness were statistically significantly reduced (p=0.001). This is likely to be due to the intra-articular steroid injection that can be given if the patient has a clinical indication following the procedure. We assessed overall pain using the Likert scale, this showed no pain in 49% (25/51), mild pain in 41% (21/51) of patients, a small number stated mild discomfort, 7% (4/51) have stated moderate discomfort and no patient reported severe pain. Our final question shows 81% (39/48) of patients reported to be "very likely" to participate in a future biopsy with a further 12% (6/48) saying they would be 'likely' to take part. No patient reported that they were unlikely to participate in another biopsy. No adverse events related to the procedure were reported. <h3>Conclusion:</h3> These promising preliminary findings show that ultrasound guided synovial biopsies are acceptable, safe, and well tolerated in our patient cohort. This is in line with other published literature. <h3>REFERENCES: NIL.Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>