SPANISH NATIONAL REGISTRY OF BELIMUMAB IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

BackgroundBelimumab (BLM) is a monoclonal antibody that inhibits B-lymphocyte stimulating factor (BlyS) approved as a specific treatment for systemic lupus erythematosus (SLE) in 2011. We present the experience with BLM in a Spanish cohort with more than 460 patients.ObjectivesTo describe demographic characteristics, efficacy and safety of BLM in patients with SLE in Spanish population since its approval.MethodsDescriptive, retrospective, multicenter study in patients diagnosed with SLE according to EULAR/ACR 2019, SLICC and/or ACR 1997 diagnostic criteria. Data regarding SLE patients treated with BLM were collected from medical records (2011-2022). Demographic features, efficacy, laboratory variables, SLEDAI, renal involvement, steroid dose, administration routes and safety were assessed. To see whether a trend in BLM prescription had changed or not over time, two periods of time were analyzed: 2011-2016 (period1) and 2017-2022 (period2).ResultsBaseline characteristics of patients are summarized in Table 1.A total of 462 patients (36 hospitals) were included, 50.9% were on intravenous (IV), 34% on subcutaneous (SC) and 15.1% switched from IV to SC route. The median number of pre-BLM csDMARD use was 2.0 (2.0-3.0), being hydroxychloroquine (HCQ) the most frequently used (94.5%). Fifty-two patients were treated with IV cyclophosphamide with a median of 6 bolus received. At the time of BLM start, 443 patients were on prednisone with a median dose of 6.2 mg (5.0-10.0). Significant decreases in prednisone dose, SLEDAI and anti-DNA antibodies were observed from baseline until the last visit, whereas complement C3 and C4 values raised (Figure 1). A total of 118 patients (27.4%) had renal involvement with a median proteinuria of 1.0 g/day (0.5-2.4). Renal biopsy was done in 102 out of 118 patients, being class IV (33%), class III (21%) and class V (16%) the most frequently reported. After BLM, 73.3% of these patients improved (median proteinuria of 0.2 g/day (0.1-0.7).In period1, 100 patients started BLM compared to 362 in period2. The median time from SLE diagnosis to BLM begin was 7.1 (4.0-13.7) and 6.2 (2.1 -14.4) years in period1 and period2, respectively (p=0.454). We found a trend to use more csDMARD before BLM treatment in period1: 2.5 (2-3) vs. 2 (2-3) (p=0.088).A total of 143 (30.5%) patients discontinued treatment mostly due to inefficacy (55.9%) and infections (11.9%). In fact, 116 patients developed infections, mostly mild;2 patients died, 16 had COVID-19 and 4 patients developed tumors requiring discontinuation of the drug.ConclusionIn our cohort of SLE patients in a real-world setting, BLM has been effective, safe and seems to be a good choice to treat renal involvement.References[1]Navarra SV, Guzmán RM, Gallacher AE, et al. Lancet. 2011;377(9767):721-31.[2]Stohl W, Hiepe;rt al. Arthritis Rheum. 2012;64(7):2328-37.[3]Furie R, Rovin BH, Houssiau F, et al. N Engl J Med. 2020;383(12):1117-1128.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

IMPACT of COVID-19 on PATIENTS with RHEUMATIC DISEASES in A SECOND LEVEL HOSPITAL

Background: Covid-19 has generated a change in society and in people's daily lives. Patients with rheumatic diseases have suffered physically and mentally, both due to mobility restrictions and to the impact on personal, family, work and social life that COVID-19 has brought [1-4]. Objectives: To examine the impact of the pandemic COVID-19 on patients with rheumatic diseases. Methods: Cross-sectional descriptive study in patients with rheumatic diseases. Data collection was done through an online questionnaire to assess the impact of COVID-19, adapted for this purpose and made up of 5 scales of the 9 of the Coronavirus Psychological Impact Questionnaire [3]. This instrument is divided into two parts: 1) sociodemographic variables and 2) Experience with Coronavirus(ECOVI);Preventive Behaviour Use(UCP);Fear against coronavirus Scale(EMC);Interference with the coronavirus Scale(EIC) and positive psychological aspects(EEPA). This questionnaire was accessed through a QR code (provided to all patients both in consultations and in the day hospital) by the rheumatology team for two weeks between November-December 2021. In addition, this code was sent by the nurse via WhatsApp to all patients registered in our database. Statistical analysis: SPSS 24.0 and Pearson Chi-square, T-Student and ANOVA tests. Results: n=362 online surveys;72% women with a mean age of 63 years ± 14.21 (22-70 years). The most frequent rheumatic diseases were Rheumatoid Arthritis (50%) and Spondyloarthritis (31%). 83.2% had only one rheumatic disease (mean 1.26 ± 0.66) and 90% self-completed survey. In experience with the Coronavirus (ECOVI), 89% patients had not had symptoms or con-frmed diagnosis of coronavirus, 98% were not hospitalized, 91% had con-fdence in our health system;Regarding the Use of Preventive Behaviors (UCP), 98% used a mask outside the house and 78.5% kept a safe distance;In relation to the most common fears associated with the Coronavirus (EMC), 40% were a little afraid of getting infected (34% quite a bit) and 50% were almost nothing afraid of losing their job;Regarding the interference that the coronavirus has caused in these patients (EIC), 73% had not had serious work problems and 74% had not had difficulties in their studies. In reference to the positive psychological aspects (EEPA), 48% had discovered new hobbies, 19% had become more religious,83% had learned to value personal relationships more. It was signifcant that women were more afraid of infecting themselves or a loved one or family member and/or dying from coronavirus than men (p=0.02;p=0.011 and p=0.002 respectively). Regarding age, younger patients (45y) were more concerned that they could lose their job compared to older patients (61y), p=0. Conclusion: The COVID-19 disease has impacted patients with rheumatic diseases. In our sample, women have been more concerned about being infected and dying themselves and their closest relatives/friends, and younger people more concerned about job loss and economic income than older people. It has to be considered that the majority of this population has not been hospitalized or diagnosed with COVID-19 and also has great confdence in our health care system. More studies are necessary to examine the impact of the COVID-19 after the 6th wave of the pandemic.

Museum digital strategies during the pandemic: Prado National Museum and Reina Sofia National Art Center Museum

The global pandemic derived from Covid-19 affected cultural institutions since 2020 implied an adaptation by museums to the new social reality. The context favored fostering digital interactions to connect with the public and digital communication prospered towards dialogue with society during the confinement and the Spanish state of alarm. This article analyzes the digital strategies carried out by two Spanish museum: the Museo Nacional del Prado and the Museo Nacional Centro de Arte Reina Sofia in order to understand how the four essential functions outlined by UNESCO (research, preservation, education and communication) were implemented during the pandemic. The results indicated that the communicative actions were the most used together with the educational ones. Digital technologies focused on education had as their epicenter social networks and numerous initiatives that helped educommunicate Spanish heritage during the health crisis.

Museums and the Pandemic: Strategies for the Educommunication of Heritage

This article compares the strategies between nine museums in Ecuador, Spain and Peru to address the educommunication activities developed as a result of the 2020 pandemic. Focused on content analysis, the research takes into account the activity of their web pages and the interaction on their social networks. The results show that in Spain informative and informative actions prevailed, while Ecuador and Peru focused on cultural and educational ones. The most relevant contents were oriented to the teaching-learning of heritage, mainly through the development of webinars and online conferences. © Global Knowledge Academics, authors. All rights reserved.

THE ATTRACTIVENESS OF QUEBEC'S HERITAGE SITES IN THE ERA OF COVID-19

UNESCO World Heritage site designation is an opportunity to achieve international status. Studies have demonstrated that many of these sites are major attractions to international visitors and first-time visitors. While Covid-19 has limited international mobility during 2020, this study aims to understand how those responsible for tourism and World Heritage sites have communicated the heritage of the Historic District of Old Quebec (Canada) to local and national visitors. To measure tourist attractiveness, the study analyzed publications posted on Instagram during the summer of 2020. Strategies for diffusion revealed an approach to enhance natural sites more than the cultural heritage. © Global Knowledge Academics, authors. All rights reserved.

Digital strategies for museum dissemination in the era of covid-19. a comparative study between ecuador, spain and peru

The communication strategies implemented by the museums after the COVID-19 health crisis implied the closure of the institutions to the public. Hence the need to contrast how Ecuador, Spain and Peru acted by highlighting the culture and heritage available to the population. The exploratory study was approached through mixed content analysis. The actions implemented by museums in the context of the pandemic were classified and they categorized, taking into account the type of content and resources deployed to reach the public. Finally, focus was placed on identifying UNESCO's strategic areas of action. The supranational trend registered changes depending on the situation of each country. In this sense, it was noted that the actions deployed from Spain were in line with international reports. From Ecuador and Peru, the 'Digital Activities' and the 'Activities on Social Networks' turned out to be more representative than the average described by the reports. At the thematic level, the content disseminated was mostly of a communicational and educational nature, with topics related to research and preservation being relegated. © 2021 Inst Francais Proche Orient. All rights reserved.