bluuebunny/crossref_metadata_2025_split huggingface dataset:
P116 Effectiveness and safety of biosimilar etanercept GP2015 in patients with rheumatoid arthritis in the UK: results from the COMPACT study
Authors: Askari Ayman , Both Charlotte , Martin Angela , Walsh David A , Sheeran Tom 
Published: April 2024

Abstract

Background/Aims
COMPACT is a non-interventional, multinational cohort study to evaluate effectiveness, safety and quality of life (QoL) outcomes in patients with rheumatic diseases treated with GP2015, an approved etanercept (ETN) biosimilar, under real-world conditions. Here, we present data from patients in the UK with rheumatoid arthritis (RA) enrolled in the COMPACT study, focusing on those who switched to GP2015 from reference ETN or another biosimilar ETN.

Methods
The COMPACT study included patients (≥18 years of age) with rheumatic diseases treated with GP2015. This analysis includes patients from the UK diagnosed with RA who were in treatment Group A (patients in clinical remission or low disease activity under treatment with reference ETN or other biosimilar ETN, who switched to GP2015 prior to study enrolment). Effectiveness and QoL outcomes were assessed using Disease Activity Score 28-joint count (DAS28) and health assessment questionnaire-disability index (HAQ-DI), respectively, and are presented up to Week 24. Safety outcomes were assessed, including rates of adverse events (AEs) and serious AEs (SAEs).

Results
A total of 112 patients with RA who switched to GP2015 from reference ETN or another biosimilar ETN (Group A) were enrolled in the UK. The mean ± standard deviation (SD) age was 62.9 ± 11.3 years and 74.1% of patients were female. The mean ± SD DAS28 score remained unchanged from baseline (2.6 ± 1.3) to Week 24 (2.5 ± 1.6). The mean ± SD HAQ-DI score displayed no major difference between baseline (1.2 ± 0.8) and Week 24 (0.9 ± 0.8). Overall, 67.9% (n = 76) of patients experienced ≥1 AE and 9.8% (n = 11) of patients experienced ≥1 SAE (Table).

Conclusion
Over 24 weeks of treatment with GP2015, disease activity remained low and stable in patients with RA previously switched from reference ETN or from another biosimilar ETN, with no new safety concerns observed. These results from a cohort of patients with RA treated in the UK are consistent with effectiveness, QoL and safety data reported previously for the total population in the COMPACT study.

Disclosure
A. Askari: None. C. Both: None. A. Martin: None. D.A. Walsh: Consultancies; Consultancy fees paid to University of Nottingham: Contura International A/S, Glaxo SmithKline, AKL Research and Development Ltd, Consultancy fees paid to University of Nottingham: Pfizer Ltd, Abbvie Ltd, Ely Lilly & Co.Ltd, Galapagos Ltd., Reckitt Benckiser Health Ltd. Honoraria; Speaker fees paid to David Walsh: Irish Society of Rheumatology, Speaker fees paid to University of Nottingham: Medscape International, Pfizer Ltd, Abbvie Ltd. Grants/research support; Grants paid to University of Nottingham: Versus Arthritis, UKRI, NIHR, Nuffield Foundation, Pfizer Ltd, Ely Lilly & Co Ltd, UCB Pharma, Grants paid to University of Nottingham: GlaxoSmithKline Research and Development, Orion Corporation. T. Sheeran: None.
P129 Interdisciplinary collaboration in the care of patients with connective tissue disease-related interstitial lung disease in Wales: an interview study
Authors: Evans Philip , Hett Kirsty , Hutchinson Nicola-xan , Beynon Celia 
Published: April 2024

Abstract

Background/Aims
Patients with connective tissue disease-related interstitial lung disease (CTD-ILD) often receive care from both rheumatologists and respiratory physicians to manage their conditions. As treatment options become increasingly complex with immunosuppressing and antifibrotic agents, there is a growing recognition of the importance of collaborative approaches to ensure accurate diagnosis, aid management decisions and deliver patient-centred care. However, there is currently no agreed optimal model for shared care, leading to significant practice variation. This study aimed to explore the perspectives of rheumatologists and respiratory physicians regarding the benefits and challenges of cross-speciality management in CTD-ILD. A better understanding of this will enhance the development of services and improve patient-centred care.

Methods
Semi-structured interviews, both face-to-face and virtual, were conducted with 11 respiratory physicians and nine rheumatologists working in Wales, ensuring representation from all health boards. Interview transcripts were analysed using thematic analysis to identify themes.

Results
Five main themes were identified: navigating complexity and uncertainty, reliance on clinical experience, prioritisation of efficiency, educational and training benefits, and inconsistent access to services for clinicians and patients.

Conclusion
The complexity of CTD-ILD care, combined with varying levels of physician expertise and a perceived lack of guidelines, presents significant challenges for clinicians. Cross-speciality collaboration is actively sought by physicians and is perceived to enhance patient care by improving efficiency, aiding confidence in decision-making and providing educational benefits to clinicians. However, resource limitations and geographical variations in service access hinder the implementation and development of shared care models. Physicians perceive that patients like being seen in joint clinics; future exploration of patient perspectives and experiences of joint care systems will be crucial to ensure the direction of clinical practice development remains patient-centred. In addition to implementing integrated cross-speciality clinical services, the development of joint respiratory and rheumatology guidelines as well as greater availability of training opportunities would assist physicians in delivering optimal care to patients with CTD-ILD.

Disclosure
P. Evans: None. K. Hett: None. N. Hutchinson: None. C. Beynon: None.
P144 Extended examination of post-challenge rewarming in patients with systemic sclerosis, as assessed by thermography
Authors: Ndosi Abigail , Dinsdale Graham , Manning Joanne , Mandzuk Melissa , Wilkinson Sarah , Herrick Ariane , Murray Andrea 
Published: April 2024

Abstract

Background/Aims
Clinical trials of systemic sclerosis (SSc)-related Raynaud’s phenomenon require better objective outcome measures. Thermography-monitored cold-challenge is a validated imaging technique. Cold-challenge is monitored for 15-minutes during rewarming, however, patients often do not fully rewarm. Knowing rewarming time enables better planning of daily trial protocols (e.g. challenges before and after treatment). The aim of this study was to test the hypotheses that 15-minute rewarming measurements are predictive of two-hour rewarming and that patients rewarm within a two-hour period.

Methods
Baseline thermography of the hands and cold-challenge was performed (1 minute, 15oC water, gloved hands submerged). Post-cold challenge, images were taken every 15s (to 15 minutes), every 5 minutes (to 30 minutes), every 10 minutes (to 60 minutes) and every 15 minutes (to 120 minutes). Baseline finger temperature (average, eight fingers, Tbase) and distal dorsal difference (DDD, temperature difference between dorsum ofthe hand and distal finger) were calculated from baseline images. Mean finger temperature difference (post-cold challenge-baseline, Tdiff), time to 25% (t25%), 50% (t50%), 100% (t100%) rewarming, maximum temperature achieved (Tmax), time to Tmax (tmax), area under the rewarming curve (AUC), and final temperature (Tf) were calculated. Cox regression assessed associations between Tbase, Tmax, Tf, DDD and AUC.

Results
Twenty patients with SSc were recruited; median (interquartile range) age 62 (53-69), duration of RP 16 (7-26) years. Fourteen patients (70%) rewarmed within two hours. Data, Table 1. Cox regression showed positive relationship between AUC and t25%, t50% and t100% and a negative relationship between Tbase, t50% and t100%. In the non-rewarming subset, 3/6 and 1/6 achieved t25%, t50% in 15 minutes. 13/14 patients that rewarmed achieved t25% and 11/14 achieved t50% within 15 minutes. Results suggest that the likelihood of longer-term rewarming is predicted the initial 15-minute rewarming.

Conclusion
Tbase was reached by the majority of patients with SSc in a two-hour window, therefore, a second or third cold challenge could be incorporated into early Phase II study protocols within a study day. Patients reaching t50% within 15 minutes were highly likely to rewarm fully over two hours; thus 15-minute rewarming may aid screening to identify patients who will fully rewarm.

Disclosure
A. Ndosi: None. G. Dinsdale: None. J. Manning: None. M. Mandzuk: None. S. Wilkinson: None. A. Herrick: None. A. Murray: None.
P147 M2 macrophage associated fibrosis in early stage systemic sclerosis: an update on plasma biomarkers
Authors: Leeves Laura A , Kannan Zestranjyan , Ali Yunus , Pan Liyang , Malley Tamir , Abraham David , Leask Andrew , Riser Bruce , Abdi Bahja Ahmed , Stratton Richard J 
Published: April 2024

Abstract

Background/Aims
Systemic sclerosis is an autoimmune connective tissue disease characterised by vasculopathy and fibrosis. The CCN family of matricellular proteins have a regulatory role in inflammation and fibrosis. CD206, an M2 macrophage surface marker, is cleaved by metalloproteases to release soluble form of CD206; this acts as an active disease marker in systemic sclerosis. We investigated the profile of CCN2 and CCN3 in the presence of soluble CD206 (sCD206) in patients with early and late stage diffuse systemic sclerosis (dcSSc).

Methods
Patients with a diagnosis of dcSSc at the UCL Centre for Rheumatology and Connective Tissue Diseases were recruited. Informed consent was obtained from patients and healthy controls (HC). Blood samples were taken from which plasma was isolated and stored at -80 °C prior to assay. Expression of CCN2, CCN3, and sCD206 was measured in these plasma samples by ELISA. Study participants were categorised into healthy controls (n = 20), early stage dcSSc (n = 20) and late dcSSc (n = 20), with early stage defined as the blood sample taken within two years since diagnosis, and late stage defined as over five years since diagnosis.

Results
Plasma CCN2, CCN3 and sCD206 levels were significantly higher in early dcSSc patients, when compared to HC. CCN2 was raised in early dcSSc patients (early dcSSc mean 20,221pg/ml, SD 16,503, p &lt; 0.05) with concentration in late disease matching that of HC (late dcSSc 12,893pg/ml, HC 11,289pg/ml). CCN3 was significantly higher in early and late disease when compared to HC (early mean 16,526pg/ml, late 12,838pg/ml, HC 4,201pg/ml, p &lt; 0.05). sCD206 levels were higher in early dcSSc (mean 5356pg/ml, SD 3154, p &lt; 0.05), with there being no significance between levels in late dcSSc (mean 4184pg/ml, SD 3900, p &gt; 0.05) and HC (mean 3319pg/ml, SD 1925). CCN2 expression was higher compared to that of CCN3 in early disease, with CCN2:CCN3 ratio elevated in early dcSSc (mean 3.17, SD 8.26) compared to late dcSSc (mean 1.26, SD 0.99) and HC.

Conclusion
This investigation demonstrates that upregulation of CCN2 and CCN3 expression has a regulatory role in fibrosis in early stage dcSSc. These biomarkers of M2 macrophage associated fibrosis are to be correlated with their clinical phenotype and have potential for a role in targeted treatment of systemic sclerosis.

Disclosure
L.A. Leeves: None. Z. Kannan: None. Y. Ali: None. L. Pan: None. T. Malley: None. D. Abraham: None. A. Leask: None. B. Riser: None. B. Ahmed Abdi: None. R.J. Stratton: None.
P159 Development of digital neuropsychological battery: a use case in Indian SLE patients
Authors: Singhal Pragya , Srivastava Priyanka , Rajasekhar Liza , Samhitha Nallapothula Sai 
Published: April 2024

Abstract

Background/Aims
While cognitive dysfunction and mood disorders are frequently reported as adverse effects of SLE, there is a scarcity of neuropsychological (NP) data for Asian SLE patients. Existing English-centric NP tests are inadequate for the linguistic and culturally diverse population. This study examines SLE's effects on mood and cognitive functions using an indigenously developed language-neutral digital NP test battery and validated anxiety, stress, depression and quality of life instruments.

Methods
We recruited SLE patients fulfilling 2012 SLE classification criteria as cases and caregivers (CG) and college students (CS) as controls aged above 18 years and at least 10th standard education. All participants provided written informed consent. Institutional ethics committees approved the study. The NP battery comprised five cognitive tasks: Montreal Cognitive Assessment (MoCA) and modified versions of attention network test (ANT), sustained attention to response task (SART), picture naming and N-back, and five psychological tests (PHQ-9, GAD-7, STAI-T, PSS-4 and WHOQOL-BREF). Mann-Whitney test with conditional Bonferroni's corrections was used to compare cases with CG and CS.

Results
Total of 142 volunteers (age: median = 25.0, IQR = 9.0, cases [n = 82], CG [n = 40] and CS [n = 20]) participated in the study. Cases exhibited delayed response latencies in N-back, SART, and picture naming tasks compared to controls. They demonstrated reduced accuracy in all N-back conditions, with significant differences observed in hit rate, miss rate, false alarms, and d-prime scores compared to CS with effect size ranging from 0.298 to 0.736 (Table 1). However, the difference was only significant in the 2-back condition compared to CG. Cases displayed lower accuracy in SART Go trials (higher omission errors) than controls but better inhibition in SART No-Go trials (lower commission errors). No differences were observed in alerting, orienting and executive control functions. Cases showed significantly lower scores in MOCA than controls. Cases reported poorer psychological health through increased anxiety and stress levels and reduced WHO-quality of life scores compared to CG.

Conclusion
Contrary to earlier research that often relied on isolated cognitive assessments, our pioneering approach introduces a tailored test battery to establish cognitive baselines for Indian SLE patients.

Disclosure
P. Singhal: None. P. Srivastava: None. L. Rajasekhar: None. N. Samhitha: None.
P161 Self-reported barriers to exercise from a national United Kingdom systemic lupus erythematosus cohort
Authors: Baranskaya Aliaksandra , Wadley Alex J , Reynolds John 
Published: April 2024

Abstract

Background/Aims
Patients with systemic lupus erythematosus (SLE) are more inactive than the general population. Regular physical activity (PA) positively impacts many health parameters, including cardiovascular health. To better understand patient barriers to leisure time PA we conducted a national survey of patients with SLE in the UK.

Methods
An online survey was disseminated via LUPUS UK social media platforms between 5/05/2023 and 28/10/2023. Participants self-reported demographic data including postcodes. Indices of Multiple Deprivation (IMD) were used to define socioeconomic deprivation and were split into quantiles, where quartile 5 represents participants living in 20% least deprived areas in England. Categorical and continuous data were analysed using Fisher’s exact test and Mann-Whitney U test respectively.

Results
There were 249 individual responses. Table 1 describes the cohort demographics alongside response data. On a 0-10 scale (very unsatisfied to very satisfied), 171/244 (70%) of participants rated their satisfaction with their amounts of leisure time PA as ≤ 4. The most commonly reported barriers to PA were fatigue (221/249, 88.8%), pain (155/249, 62.2%) and lupus-related symptoms/flares (145/249, 58.2%). Dislike of exercise was reported by &lt; 10% of cohort (22/249, 8.8%). When asked to identify the primary barrier to PA, 119/244 (48.8%) reported fatigue. Lack of motivation (40/244, 16.4%) and knowledge about exercise (18/244, 7.4%) were other predominant barriers. Concern around injury differed between ethnic groups (p = 0.016). Other barriers did not differ by sex, ethnic group or socioeconomic deprivation. Participants reporting lack of time were younger with a median age of 45 (35-53) versus 54 (43-63) years, p = &lt;0.001. Patients reporting fatigue, pain and self-consciousness had higher BMI in kg/m2 (27.7 [23.6-32.3] vs 23.4 [20.8-28.2]; 28.7 [23.8-33.1] vs 25.4 [22.6-28.8]; 31.4 [27.9-38.4] vs 25.8 [23.1-30.2]), p = &lt;0.001. Lupus-related symptoms/flares and concern that PA may worsen lupus were reported by participants with a shorter disease duration in years (8 [3-17] vs 12 [4.5-24] p = 0.002, and 7 [2-15] vs 10 [4.5-23] p = &lt;0.001 respectively).

Conclusion
70% of patients were dissatisfied with their level of leisure time PA. Fatigue and pain were the most commonly reported barriers to PA. Reported barriers differ between patients highlighting the need for personalised exercise programmes for patients with SLE.

Disclosure
A. Baranskaya: None. A.J. Wadley: None. J. Reynolds: None.
P173 The positive utility of PSAID-12 score in remote monitoring and the impact of gender and treatment on patient reported outcomes in psoriatic arthritis
Authors: Chan Antoni , Soe Nwe Ni 
Published: April 2024

Abstract

Background/Aims
Psoriatic arthritis (PsA) is a chronic inflammatory disease that significantly impacts the quality of life (QOL) of patients. The PSAID-12 score reflects the impact of the PsA from the perspective of the patients. This study assessed patient reported outcomes using the PSAID-12 and evaluated the impact of gender, treatment and disease duration.

Methods
This study was a cross-sectional, observational study of patients with PsA meeting CASPAR critieria. Patients were recruited consecutively from clinic and completed the PSAID-12 questionnaires 14 days prior to their clinic visit digitally or by paper. Demographic and clinical data, including age, gender, disease duration, medication were collected. Disease activity was measured using the the tender/swollen joint count, patient/physician assessment and CRP.

Results
The total number of patients in the study was n = 225. The female:male ratio was 1.0:0.8. The mean disease duration was 27 years (range 2 months to 44 years). The mean age was 52 years (range 18 to 86 years). The number of patients on DMARDs was 89.3 % (201/225) and combined DMARDs and biologics was 26.67 % (60/ 225). The mean PSAID-12 score was 4.09 (SD 2.47). There was a positive correlation between the pre-clinic PSAID-12 score and the in-person calculated tender joint count (r = 0.58), swollen joint count (r = 0.51) and the Likert pain score (r = 0.84). All domains of the PsAID-12 score were higher in female than male (4.53 vs 3.47 respectively), Table 1. Fatigue, discomfort, and pain were the most reported score for females (mean 5.52, 5.22, 5.02 respectively) whereas for males the commonest scores were discomfort, pain and fatigue (mean 4.10, 3.88, 3.88 respectively). The fourth commonest score for both genders was the impact on work and or leisure activities (4.67 for females and 3.83 for males). In terms of disease duration, discomfort is the most common reported score for patients with a disease duration of less than 5 years (mean 5.09) whereas fatigue was the most common complaint in patients with the group of 5-10 years and &gt;10 years (4.56 and 5.11 respectively). There was a lower mean score of skin problems in the biologics compared to the non-biologic group (2.78 vs 3.90). There was a trend towards lower coping, embarrassment, and social participation scores in the biologics group.

Conclusion
The PSAID-12 score correlated well with PsA disease activity. The impact on QOL from PsA was higher in females than males. Fatigue, pain and discomfort were the commonest symptoms and higher scores were reported in early disease, with discomfort being the highest in this group. Fatigue was more commonly reported in patients with longer disease duration. The benefits of the biologics on QOL and skin problems were seen in these patients despite their longer disease duration.

Disclosure
A. Chan: None. N. Soe: None.
P185 Anatomical patterns of pain in primary care patients with polymyalgia rheumatica compared to the general population
Authors: Hammad Niall , Partington Richard , Hider Samantha , Butt Henna , Helliwell Toby , Mallen Christian , Muller Sara 
Published: April 2024

Abstract

Background/Aims
Polymyalgia rheumatica (PMR) is common in older adults, causing severe pain and stiffness, particularly in the shoulder and hip girdles. A tapered course of glucocorticoids is recommended, but not always straightforward, with frequent symptom recurrence. Reasons are unclear, but partial masking of painful comorbidities (e.g., osteoarthritis) may play a part.

Methods
652 people with incident PMR were recruited from English general practice (2012-2014) to a postal survey study (questionnaires at diagnosis, 1, 4, 8, 12, 18, 24, [mean] 61 months). Surveys included a body manikin (front and back views). Participants were asked to shade anywhere they experienced pain &gt;1 day in the last month. 44 mutually exclusive areas were defined as painful or not. For comparison, an age-gender matched random sample of 652 people was selected from a general population survey in North Staffordshire that used the same manikins. Pain prevalence was compared between the 2 studies.

Results
In the PMR study, surveys were completed by 244 participants at 24 months and 197 at 61 months. Pain was reported in a mean of 17.1 areas at diagnosis (Table). Bilateral shoulder and hip pain were present in the majority at diagnosis (shoulder 81%; hips 59%) and in around a third and a fifth of patients respectively throughout the study. The prevalence of bilateral shoulder and hip pain remained higher than in the general population sample, while unilateral pain in these areas was less common. Bilateral hand (27%) and knee (45%) pain were also common at diagnosis. After 1 month, the mean number of pain areas was 7 - similar to the general population. However, prevalence of bilateral shoulder and hip pain remained higher than the general population throughout follow-up. Unilateral hip and knee pain were persistently less common in those with PMR, whilst unilateral hip pain was more common.

Conclusion
Bilateral pain was reported more commonly across the disease course in people with PMR than the general population. Causes of pain cannot be accurately attributed, but are likely multifactorial, including PMR disease activity, treatment and painful comorbidities. However, the persistence of bilateral pain suggests untreated PMR symptoms, requiring further research.

Disclosure
N. Hammad: None. R. Partington: None. S. Hider: None. H. Butt: None. T. Helliwell: None. C. Mallen: None. S. Muller: None.