bluuebunny/crossref_metadata_2025_split huggingface dataset:
P034 Results of first survey of NRAS SMILE-RA e-learning programme users
Authors: Bosworth Ailsa , Jacklin Clare 
Published: April 2023

Abstract

Background/Aims
An important but insufficient aspect of care in people with inflammatory arthritis (IA) is empowering patients to acquire good understanding of their disease and building their ability to deal effectively with the practical, physical and psychological impacts of it. The ability to self-manage in inflammatory arthritis (IA), with the right support (including from patient organisations), represents an essential component of care that goes beyond drug therapy and supports the patient in managing these impacts. In July 2021, EULAR Taskforce published Recommendations for Self-Management strategies in patients with Inflammatory Arthritis. Co-Convenors of the Taskforce were Ailsa Bosworth, NRAS and Elena Nikiphorou, King’s College Hospital. NICE quality standards also relate to provision of education and self-management resources. In September 2021, NRAS launched their unique e-learning programme SMILE-RA (self-management individualised learning environment). After launch, the first goal was to get a sufficient body of people using the programme in order to determine whether our key aims for each of the modules were being met. The first survey of participants took place in late summer 2022.

Methods
A survey with 21 questions was developed using Sogolytics on subjects including: navigation and ease of use, what people had learnt/gained from each module. The survey was emailed on 11 Jul, 2022 to 913 people who had registered for SMILE-RA. A follow up reminder was sent on 18th of July 2022. The survey closed on 15th of August 2022. 132 responses were received representing a response rate of 14%

Results
• Majority of respondents heard about SMILE through NRAS, only 10% through their rheumatology team. • Nearly 80% think length of the modules is just right • 86% think that the links to other resources, whether NRAS or external, are extremely (majority) or quite clear and helpful • 68% had increased their knowledge of their disease • 72% had increased their understanding of the importance of self-management • 62% had increased their knowledge of medicines used in the treatment of RA • 84% would recommend SMILE to another person.

Conclusion
These initial results from the first survey of users indicate a very high proportion of people are achieving the learning objectives of each module and are improving their understanding of their disease and how to self-manage their condition better. NRAS will build on this feedback and these results to target resources where they are most needed. These results are particularly interesting and important in the light of the move to put stable patients onto patient-initiated follow up pathways where consultations with their team are set for an interval of up to 2 years. Building patients’ knowledge of their disease, how to manage symptoms and their confidence to self-manage between appointments will improve health outcomes.
Disclosure
A. Bosworth: None. C. Jacklin: None.
P036 Gout and work participation in British adults: findings from the Health and Employment After Fifty study
Authors: D'Angelo Stefania , Walker-Bone Karen , Goodson Nicola 
Published: April 2023

Abstract

Background/Aims
The prevalence of gout is increasing in the UK and gout is the most common inflammatory arthritis among men aged 40 and older. As well as acute and chronic musculoskeletal manifestations, it is also associated with cardiometabolic disease and renal impairment. Given its risk factors and associated morbidities, it has potential to significantly impact work ability, but this has received little attention to date.

Methods
Data came from the Health and Employment After Fifty (HEAF) study, a cohort of 8134 men and women recruited in 2013-14 when aged 50-64. Consenting participants also agreed to data linkage to their Clinical Practice Research Datalink (CPRD) primary care records. Participants were coded as having gout if they had at least 2 CPRD records diagnosing/treating gout at any time before the baseline questionnaire. Annual follow-up questionnaires enquired about jobs altered mainly or partly because of health reasons which was coded as health-related job loss (HRJL). Other outcomes assessed were: any sickness absence in past 12 months (vs no sickness absence); prolonged sickness absence (defined as &gt; 20 days of sickness absence in past 12 months vs less than 20 days); and any sickness absence because of musculoskeletal pain (vs no sickness absence because of musculoskeletal pain). Participants with gout who were in paid work at baseline were individually matched by sex and age (within 1 year) with 3 participants also working but without a diagnosis of gout. Associations between having gout and a subsequent work outcome were explored with multilevel logistic regression with random intercept, to account for the repeated measures for each participant, and results expressed as ORs with 95%CIs.

Results
Of the 7673 HEAF participants who consented to CPRD data linkage, 149 (1.9%) were classified with gout. The proportion of participants in work at baseline was similar among those with gout (73.8%) and without gout (67.9%). Participants with gout were mostly men, average age 58 years. Gout participants were more likely than controls to be: obese, previous smokers, heavy drinkers, to report fair/poor self-rated health (SRH) and to have prevalent hypertension as compared with those without gout. After adjustment for age, sex, time of follow-up, BMI, alcohol, and SRH, having gout was significantly associated with any sickness absence (OR = 2.68 95%CI 1.58,4.54) and musculoskeletal sickness absence (OR = 2.50 95%CI 1.15,5.43) but no association was seen with HRJL or prolonged sickness absence.

Conclusion
Gout was an independent risk factor for sickness absence but not health related job loss. As the impact of sickness absence associated with gout is likely to increase with rising disease prevalence and an older workforce, there is need to explore whether improved management of hyperuricaemia and gout can improve work outcomes.
Disclosure
S. D'Angelo: None. K. Walker-Bone: None. N. Goodson: None.
P060 A survey of COVID-19 infections in rheumatology patients in Shropshire, UK
Authors: Rashid Ali El , Patil Raghvendra Prasad , Burgress Lisa , Ball Patrick , Morrissey Hannah , Askari Ayman 
Published: April 2023

Abstract

Background/Aims
To assess the incidence and vulnerability of rheumatology patients to COVID-19 infection in early stages of pandemic.

Methods
Self completed questionnaire was posted to patients.

Results
Patients diagnosed with rheumatic diseases were categorised as people at high risk of infection with COVID-19 (pharmacologically immunosuppressed) and with possible worsening outcomes than the general population. This study was a self-completed questionnaire which was sent to all patients registered under a National Health Services specialist rheumatology department in the UK, between May 2020 and May 2021. A total of 610 responses were received and data was analysed statistically. The aim from this survey was to assess COVID19 infection prevalence amongst rheumatology patients under the care of this department, and to examine the profiles of patients with reported COVID-19 infection, their comorbidities, rheumatoid-related medications and infection severity and outcome. Of 610 responders diagnosed with rheumatoid diseases, 12 patients (1.96%) received a diagnosis of COVID-19 based on their clinical presentation.
However, when patients undertaken a Polymerase Chain Reaction

test, only 2 patients (16.6%) returned positive results. In both the COVID-19 and non-COVID groups 60% were shielding (n = 361). In our sample infection rate was around 30 times (1 in 50 rheumatoid patients, 2% in the sample population) the prevailing rate for the general population in the region (75 in 100,000, 0.075% in the general population). Negative testing did not preclude the presence of disease, but this may reflect poor efficacy and reliability of testing in the early days of the pandemic. The sample means and SD+/- were 63.96/13.23 for age and 27.76/5.79 for BMI. Sample population characteristics presented in Table 1.

Conclusion
This patient group were more vulnerable to COVID-19 infection compared to the general population but appear not to be at greater risk of severe disease.
Disclosure
A. El Rashid: None. R. Patil: None. L. Burgress: None. P. Ball: None. H. Morrissey: None. A. Askari: None.
P062 Immune responses to mRNA vaccines against SARS-CoV2 in patients with immune-mediated inflammatory rheumatic diseases
Authors: Santos Cristiana Sieiro , Calleja Antolín Sara , Morales Clara Moriano , Castro Carolina Álvarez , Díez Álvarez Elvira , Ruiz de Morales Jose Maria Garcia 
Published: April 2023

Abstract

Background/Aims
Patients with immune-mediated rheumatic diseases (IMRD) are commonly treated with immunosuppressors and are prone to infections. Recently introduced mRNA SARS-Cov2 vaccines have demonstrated extraordinary efficacy across all ages. Immunosuppressed patients were excluded from phase III trials with SARS-We aim to fully characterize B and T cell immune responses elicited by mRNA SARS-Cov2 vaccines in patients with rheumatic diseases under immunotherapies, and to identify which drugs reduce vaccinés immunogenicity.

Methods
Humoral, CD4 and CD8 immune responses were investigated in 147 SARS-Cov2-naïve patients with selected rheumatic diseases under immunosuppression after a two-dose regimen of SARS-Cov2 mRNA vaccine. Responses were compared with age, gender, and disease-matched IMRD patients not receiving immunosuppressors and with healthy controls

Results
IMRD patients showed decreased seroconversion rates (63% vs 100%, p = 0.04) and cellular immune responses (59% vs 100%, p = 0.007). Patients on methotrexate achieved seroconversion in 62% of cases and cellular responses in 80% of cases. Abatacept deeply affected humoral and cellular responses. Rituximab (31% responders) and belimumab (50% responders) showed severely impaired humoral responses but cellular responses were often preserved. Antibody titers were reduced with mycophenolate and azathioprine but preserved with leflunomide.

Conclusion
IMRD patients exhibit impaired SARS-CoV-2 vaccine-immunogenicity, variably reduced with immunosuppressors. Among commonly used therapies, abatacept and B-cell depleting therapies show the most deleterious effects, while anticytokines preserved immunogenicity. The effects of cumulative methotrexate and glucocorticoid doses on immunogenicity should be considered. Humoral and cellular responses are weakly correlated, but CD4 and CD8 tightly correlate. Seroconversion alone might not reflect the vaccine’s immunogenicity.
Disclosure
C. Sieiro Santos: None. S. Calleja Antolín: None. C. Moriano Morales: None. C. Álvarez Castro: None. E. Díez Álvarez: None. J. Garcia Ruiz de Morales: None.
P069 Stress matters: inflammatory arthritis patients' perspective of impact of stress
Authors: Jacklin Clare , Caton Emma , Matthews Sally 
Published: April 2023

Abstract

Background/Aims
The objective of this survey was to gather patients’ perspectives on how stress triggered their inflammatory arthritis as well as exacerbates flares in their disease.

Methods
NRAS wanted to reach people living with RA and other forms of inflammatory arthritis via a national survey to gauge how they recognise and manage stress, and whether health professionals considered stress as a factor in their active disease. The survey was designed to capture demographics, impact of stress on patients’ disease as well as work status and restrictions on lifestyle. The national online survey was distributed via all NRAS social media platforms as well as email.

Results
1265 responses from across the UK were gathered. The majority of respondents were female (87.0%) and over the age of 55 years old (70.5%). Approximately 45% had a disease duration of more than 10 years, 30% between 4 and 10 years, and 23% less than 3 years. When asked on a scale of 1 (not at all) to 5 (completely) how much stress had impacted the onset of their arthritis symptoms, 56% responded either ‘completely’ or ‘greatly’. Only 9% reported that stress did not have an impact on the onset of their symptoms. When asked if they felt a stressful event in the 12 months prior to their diagnosis had triggered their inflammatory arthritis 28% said yes and 48% responded maybe. Some of the top reported causes of stress prior to diagnosis were: death of a close family member, menopause, work difficulties and family commitments. The majority of respondents (67%) said that health professionals did not ask them about stress during the diagnosis process, with only 11% saying this was discussed. Participants were asked how much they agreed with the statement that they are often asked about their mental health in routine appointments - 75% disagreed or strongly disagreed.

Conclusion
With the majority of respondents identifying that stress and stressful events exacerbate their symptoms of inflammatory arthritis, more should be done to measure and offer support for managing stress. While many had found their own ways of coping with stress more needs to be done to make support more easily accessible. Further research would be beneficial in identifying if managing stress within this patient population could significantly reduce inflammatory arthritis symptoms, reducing the distress and pain caused by flares and also reduce the impact on the health service of clinical intervention.
Disclosure
C. Jacklin: Grants/research support; InMedix funded with hands off grant this survey work. E. Caton: None. S. Matthews: None.
P088 New2JIA Right Start Service from JIA-at-NRAS
Authors: Wilson Debbie 
Published: April 2023

Abstract

Background/Aims
Building on the success of NRAS’s New2RA Right Start service, and after speaking to families and healthcare professionals it was clear that there is a need for a New2JIA Right Start service. “Parents are given an overwhelming amount of information about a new disease, along with countless hospital appointments, blood tests, physio appointments and medication to administer. Add to the mix, trying to explain to your child (if they're old enough) what is going on with their joints and why they are in so much pain and discomfort when you don't really understand yourself! Parents have to deal with all of this, often trying to hold down their job and having other children to look after. Then there's the worry of how your child's future will look. New2JIA Right Start would have been my saviour and my husband’s too.” JIA Ambassador

Methods
Healthcare professionals will refer families to JIA-at-NRAS through a simple (GDPR compliant) form on our website. This is received by JIA-at-NRAS and a zoom call is arranged with up to 6 other families, also referred with children of similar ages. During the call, all aspects of JIA will be discussed, and parents will have the opportunity to ask questions. Families will have a follow up zoom call 10 weeks later to see how they are getting on. The service is being launched in phases throughout the UK, with phase 1 in November 2022, phase 2 in February 2023 and phase 3 in May 2023. Impact measurements will be imbedded to make sure that we are not only meeting the needs of the service user, but also having a positive impact to their lives, their children’s and ensuring they feel better equipped to manage their child’s condition.

Results
This new service not only benefits families but also healthcare professionals. The benefits to families are to: better understand what JIA is, know how it can affect their child and family, not feel alone during a daunting and overwhelming time, get the right support, feel more in control of managing their child’s condition, talk to another parent who has a child with JIA and access useful information resources. The benefits to healthcare professionals are: knowing families have support straight away (including peer-to-peer support), knowing that families are being given trusted information, reduced burden on their team and regular contact with JIA-at-NRAS.

Conclusion
Results from the Mental Health Survey, in collaboration with all other JIA charities in 2022, showed that 82% of families said having a child diagnosed with JIA has impacted negatively on their mental health. This service is there to help reduce these anxieties and give them the understanding and tools needed to help manage their child’s condition.
Disclosure
D. Wilson: None.
P091 Outcomes following switching from originator to biosimilar product in children and young people with JIA
Authors: Kearsley-Fleet Lianne , Baildam Eileen , Beresford Michael W , Douglas Sharon , Foster Helen E , Southwood Taunton R , Hyrich Kimme L ,   UK JIA Biologics Register
Published: April 2023

Abstract

Background/Aims
There are many biosimilar products available to use in children and young people with JIA. Due to competitive pricing, patients are being switched from biologic originator to biosimilar (non-medical switch). This analysis aims to describe characteristics of, and outcomes, following TNF-inhibitor originator to biosimilar switch in JIA.

Methods
All patients in the UK JIA Biologics Register switching from an originator to a biosimilar of the same product were identified. Patient characteristics are presented, including time on originator prior to switch. Patients were followed until their final follow-up form was returned. For those with &gt;1 year of follow-up post-switch, treatment persistence and reasons for stopping are described.

Results
As of 28-Sept-2022, 202 children and young people had switched from originator to biosimilar; 125 adalimumab, 55 etanercept, and 22 infliximab (table). Switching was seen in all ILAR categories. Patients were predominantly female (63%), median age at JIA diagnosis six years, 11 years at originator start, 14 years at biosimilar start, median time on originator 2.2 years. Most patients had started originator as their first biologic (74%) and most started biosimilar with no significant treatment gaps. Five patients reported &gt;1 year gap between originator stop and biosimilar start, suggesting a planned period off biologic therapy (two stopped for remission, one for adverse event, two unknown). Of the 134 patients with &gt;1 year of follow-up available after switching (median 1.9 years per patient), 77 remained on biosimilar at their final follow-up, whilst 57 had stopped therapy. Of those who stopped, 10 had stopped for remission, 12 stopped for ineffectiveness, 18 for adverse event, and 17 other/missing reason. Thirty-nine patients then re-started biologic therapy (including four of the remission patients); 16 switched back to the originator mostly due to an adverse event on the biosimilar, and 23 started a different biologic therapy mostly due to inefficacy of the biosimilar.

Conclusion
Many children with JIA have now been switched from TNF-inhibitor originator to biosimilar product, with the majority still receiving their biosimilar after one year. Switching back to originator was uncommon, 12% overall after one year, suggesting good tolerance of non-medical switching in this patient population.
Disclosure
L. Kearsley-Fleet: None. E. Baildam: None. M.W. Beresford: None. S. Douglas: None. H.E. Foster: None. T.R. Southwood: None. K.L. Hyrich: Member of speakers’ bureau; non-personal speakers fees from Abbvie. Grants/research support; BMS, UCB, Pfizer.
P094 Prevalence of fibromyalgia syndrome among patients with type 2 diabetes mellitus
Authors: Salman Sami , Abdali Huda 
Published: April 2023

Abstract

Background/Aims
Fibromyalgia syndrome (FMS) is a non-autoimmune rheumatological disorder characterized by chronic widespread pain, and often tenderness, with additional symptoms such as fatigue, lack of sleep, anxiety, and cognitive problems which are considered significant features in this syndrome. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia that develops as a consequence of insulin deficiency [type1 DM T1DM)] and/or insulin resistance [type2 DM (T2DM)].

Methods
A descriptive cross-sectional study was conducted at Endocrine and Rheumatology unit at Baghdad Teaching Hospital during the period from November 2021 till April 2022. A total random sample of 200 Iraqi patients with Diabetes mellitus type 2 diagnosed according to the WHO criteria for diagnosis of diabetes mellitus (females 128 and males 72) and a total random sample of 200 healthy persons (126 females and 74 males) were involved in this study as controls. A special questionnaire designed for the purpose of the study was used for recording information from the patients and controls, which include demographical data for both group in addition information about current treatment for DM and duration of disease. The 2016 revision of American College of Rheumatology (ACR) criteria was used for the diagnosis of FMS.

Results
There was increase in the risk of developing FMS among diabetes mellitus patients compared to normal individuals (31% vs. 14.5%). Moreover, widespread pain, symptom severity score, and depression were significantly higher [P. Value (0.012, 0.007, 0.019)] respectively among diabetes mellitus patients compared to healthy individuals. It was found that there was a significant increase of having HbA1c increased by 1.38 among fibromyalgia patients compared to healthy individuals.

Conclusion
The prevalence of fibromyalgia among the studied sample with type 2 diabetes mellitus was high and there was correlation between the prevalence rate of FMS and poor DM control.
Disclosure
S. Salman: None. H. Abdali: None.