tbuckley/cabot-search huggingface dataset:
AB0686 Association between drug serum levels and disease activity in espondiloarthritis patients treated with golimumab
Authors: C Redondo, A Martínez, C Plasencia, A Jochems, D Pascual-Salcedo, V Navarro-Compán, MG Bonilla, I Monjo, A Balsa
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Efficacy and safety of Golimumab (Glm) has been demonstrated for spondiloarthritis (SpA). Nonetheless, there is little data determining an association between an optimal drug levels concentration and the maintenance of a good control of disease activity. In Spa-Paz cohort we defined previously an optimal Glm levels concentration associated with a good clinical response. <h3>Objectives</h3> To investigate the association between serum levels of Glm, based on the optimal concentration defined previously in Spa-Paz cohort, and disease activity in a larger cohort of SpA. <h3>Methods</h3> Observational prospective SpA-Paz cohort study treated with Glm. Disease activity was measured by ASDAS and clinical improvement using Delta-ASDAS at baseline, 6 and 12 months of biologic therapy. ASDAS&lt;2.1 was considered as low activity and clinically important improvement as Delta-ASDAS≥1.1. Drug levels were measured by ELISA at 6 and 12 months of therapy and classified in 3 groups based on the optimal concentration range previously defined in our cohort: Group 1:&lt;0.7 mg/L, group 2: 0.7–1.4 mg/L, group 3: &gt;1.4 mg/L. At 12 months we made a LOCF analysis to include patient data (11 patients) with less than 12 months of treatment. We used the software Graph-Pad Prism 6 for statistical analysis. <h3>Results</h3> 46 patients of 79 with SpA treated with Glm were included in this study. The average age was 49 years old (age range 22–72 years old), 31 men (67%) and 15 women (33%). 22 patients (48%) were non-smokers and 13 (28%) active smokers. 25 (54%) were HLA-B27 positive. In total, 17 patients (37%) were classified in group 1, 16 (35%) in group 2 and 13 (28%) in group 3. At 12 months of therapy, most patients in low disease activity were in groups 2 and 3 but nevertheless, the majority of high disease activity patients were in group 3 (76% in groups 2 and 3 vs. 41% in group 1 with ASDAS&lt;2.1; 24% in group 2 and 3 vs. 53% in group 1 with ASDAS≥2.1; p&lt;0.0001). Likewise, clinical improvement was significantly higher in groups 2 and 3 patients (62% in groups 2 and 3 vs. 35% in group 1, p&gt;0.0002). There were no differences in clinical improvement between group 2 and 3. 11 patients (24%) discontinued the treatment, 1 for adverse effect and 10 for inefficacy, 50% of which (5 patients) were in group 1 at the suspension moment. <h3>Conclusions</h3> In our Glm treated SpA cohort, the majority of low activity patients and higher clinical improvement were classified in optimal or supraoptimal concentration group. Overoptimal concentration drug levels do not seem to contribute to major benefit in clinical improvement. <h3>Disclosure of Interest</h3> None declared
Action plan for optimizing the design of clinical trials in chronic kidney disease
Authors: Vlado Perkovic, Jonathan C. Craig, Worawon Chailimpamontree, Caroline S. Fox, Guillermo Garcia-Garcia, Mohammed Benghanem Gharbi, Meg J. Jardine, Ikechi G. Okpechi, Neesh Pannu, Benedicte Stengel, Katherine R. Tuttle, Katrin Uhlig, Andrew S. Levey
Journal: Kidney International Supplements (2017)
AB0688 Effect of treatment with non-steroidal anti-inflammatory drugs on disease activity in patients with early axial spondyloarthritis base on data from 2 years follow up of corsar cohort
Authors: D Rumiantceva, T Dubinina, O Rumyantseva, A Demina, E Agafonova, S Erdes, S Krasnenko
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Currently non-steroidal anti-inflammatory drugs (NSAIDs) are the first-line drugs for treatment of axial spondyloarthritis (axSpA) and much discussed question of influence frequency of intake NSAIDs on axSpA disease activity. <h3>Objectives</h3> To compare the frequency of intake NSAIDs with early axSpA disease activity. <h3>Methods</h3> The research included 65 patients (pts) with axSpA (criteria ASAS 2009) with disease duration &lt;5 years and age at onset &lt;45 years. Pts at least 2 years follow up, 32 (49,2%) males, pts mean age was 28,5 (5,8) y., average disease duration - 24,1 (15,4) mo, 60 (92,3%) pts were HLA-B27 positive. At baseline all pts were NSAID-naïve, DMARD-naïve, anti-TNF-naïve. For 2 years pts taking NSAIDs at therapeutic doses. The dosages of NSAIDs accounted by the ASAS NSAID index. 1 year after baseline – 9 (13,8%) pts started treatment with anti – TNF because of high activity of the disease and absence of effect from 2 NSAIDs. 2 years after baseline number of pts with anti-TNF equal - 15 (23,0%). <h3>Results</h3> Compared with baseline characteristic after 2 years have significantly reduced disease activity and increased the number of ASAS partial remission (PR) in patients with axSpA (Table 1). There were no statistical differences between the frequency of NSAIDs intake and early axSpA disease activity (Table 2). <h3>Conclusions</h3> Long reception of NSAIDs in patients with early axSpA reduces disease activity, however, the receive frequency does not affect the activity of the disease. <h3>Disclosure of Interest</h3> None declared
FRI0304 The utility of 18F FDG-PET/CT in distinguishing benign from malignant retroperitoneal fibrosis
Authors: Y Wang, Z Guan, D Gao, J Zhu, J Zhang, F Huang
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Retroperitoneal fibrosis (RPF) could be idiopathic or secondary to various factors including malignancy. Pathology remains the most reliable diagnostic approach. However, the pathological features have yet been well defined and the feasibility of biopsy procedure depends on several factors such as the proximity of the lesions to abdominal aorta. <sup>18</sup>F FDG-PET/CT may help exclude malignancy by assessing FDG-uptake and mapping the whole body, especially when biopsy procedure is inaccessible. <h3>Objectives</h3> To evaluate the utility of PET/CT in distinguishing benign from malignant RPF. <h3>Methods</h3> Patients with benign or malignant RPF diagnosed between September 2011 and June 2016 were included. Morphologic features, FDG-uptake of retroperitoneal lesions and lymph nodes (LNs) were compared. FDG-uptake of retroperitoneal lesions was assessed visually with the referrence of liver and assessed semiquantitatively with SUVmax. LNs were regarded as specific LNs if frequencies of LNs with high FDG-uptake were observed differently between two forms of RPF. ROC analyses were performed to evaluate the diagnostic accuracy. <h3>Results</h3> Seventy-one cases with benign RPF and 21 cases with malignant RPF secondary to lymphoma (15) or metastatic carcinoma (6) with primary sites of pancreas (2), colon (2), stomach (1) and kidney (1) were included. The craniocaudal length, axial width, and distances between anterior or posterior limits and aorta were less in benign RPF, however, significant differences were only observed when comparing with lymphoma (p values: all &lt;0.001) but not with metastatic carcinoma (p value: 0.396, 0.181, 0.112 and 0.64). A greater frequency of retroperitoneal lesions with high FDG-uptake (100% vs 77.5%, p value: 0.017) and a higher mean SUVmax (12.2 vs 4.8, p value: &lt;0.001) were observed in malignant RPF. The frequencies of LNs with high FDG-uptake were greater with significance in malignant RPF except for hilar/mediastinal and cervical LNs, hence the rest LNs were regarded as specific LNs. At ROC analyses, the AUCs of SUVmax and specific LNs were 0.893 and 0.947. The sensitivity and specificity were 85.7% and 81.4% when the SUVmax was 6.23. The AUC of logistic regression model combining SUVmax and specific LNs was 0.974 with sensitivity of 90.5% and specificity of 90.1%. <h3>Conclusions</h3> PET/CT could help distinguish benign from malignant RPF, especially when taking into account the FDG-uptake of retroperitoneal process and LNs. <h3>Disclosure of Interest</h3> None declared
SAT0654 The recall survey: differencies of ultrasound examination between early vs long lasting rheumatoid arthritis patients in clinical remission
Authors: P Macchioni, A Iagnocco, M Canzoni, C Bonali, OM Epis, E Filippucci, A Delle Sedie, S Tropea
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Ultrasound (US) examination is able to show subclinical synovitis and structural changes of joints in patients (pts) with RA in clinical remission (CR). <h3>Objectives</h3> To investigate the differencies of US examination of small joints of hands, feet and wrists in pts with very early (VERA, &lt;1y) vs early (ERA, &lt;3y duration) vs long lasting RA (LRA, &gt;7 y duration) in clinical remission (CR). <h3>Methods</h3> In 2015 an educational event (RECALL survey) focused on the added value of US in RA pts was held in 22 rheumatology centers in Italy. In every center, the local rheumatologists provided RA pts to be examined by US. Pts signed an informed consent and a brief history of them was collected by the local rheumatologists (previous and current therapy, DAS28, HAQ score). Bilateral US examinations of wrists, metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints were performed by rheumatologists expert in US, to assess synovitis (joint effusion, synovial proliferation, and power Doppler (PD) signal), and bone erosions, using a Logiq E R7, General Electrics, with a 4.2–13 MHz linear probe. All US findings were scored using a 4 degree semiquantitative scoring system. <h3>Results</h3> Eighty-eight pts were classified as VERA, 183 as ERA and 165 as LRA. Drug usage was not different among the three groups of pts. LRA patients were older (p&lt;0.001), had longer disease remission before US examination (p&lt;0.001) and had an higher prevalence of female sex (p&lt;0.01). Table 1 reports the differences of US examination between VRA vs ERA vs LRA patients. LRA patients had more erosions at MTP and wrists with no differences at MCP joints. Synovial hypertrophy and PD signal had the same degree and distribution in the two groups of patients. LRA patients had more MTP joints with effusion with lower degree as compared to patients with ERA and VERA (see table 1). <h3>Conclusions</h3> At US examination VERA, ERA and LRA pts in CR have the same degree of synovial hyperplasia and PD signal despite the differences of duration of CR. Higher degree of erosive disease (at wrist and MTP joints), lower degree of MTP effusion and higher prevalence of joint effusion at MTP joints were present among LRA vs ERA and VERA pts. <h3>Disclosure of Interest</h3> None declared
Role of the IL-12/IL-35 balance in patients with Sjögren syndrome
Authors: Olivier Fogel, Elodie Rivière, Raphaèle Seror, Gaetane Nocturne, Saida Boudaoud, Bineta Ly, Jacques-Eric Gottenberg, Véronique Le Guern, Jean-Jacques Dubost, Joanne Nititham, Kimberly E. Taylor, Philippe Chanson, Philippe Dieudé, Lindsey A. Criswell, Bernd Jagla, Alice Thai, Michael Mingueneau, Xavier Mariette, Corinne Miceli-Richard
Journal: Journal of Allergy and Clinical Immunology (2017)
SAT0293 Pneumococcal infection in patients with systemic lupus erythematosus
Authors: J Schurder, T Goulenok, R Jouenne, A Dossier, D van Gysel, T Papo, K Sacre
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> A 5-fold increase in the risk of death is due to infection in systemic lupus erythematosus (SLE) patients when compared to age- and sex-matched controls Pneumococcal infection (PI) has been reported to be more frequent and severe in SLE <h3>Objectives</h3> Our study aimed to analyze the risk factors associated with the occurrence and severity of PI in SLE patients <h3>Methods</h3> Medical records of all SLE patients and all patients admitted with PI in the Department of Internal Medicine (Bichat Hospital, Paris, France) from January 2005 to December 2014 were retrospectively reviewed. Clinical characteristics associated with PI occurrence and severity were analyzed, both in SLE and non SLE patients. <h3>Results</h3> One hundred and ninety SLE patients (42.2+14.9 years; 87.4% females) were hospitalized over a 10-year period. PI was the reason for admission in 6 (3.2%) patients, including 5 cases of invasive infection. With a follow-up of 2112.8 years for the total cohort, incidence of invasive PI in SLE was of 236/100.000 patient-years. As compared to the incidence in general French population, invasive PI was 26 times more frequent in SLE patients. PI occurred at a younger age (43.5+14.9 versus 65.3+18.7 years, p=0.009) and was more severe, with a higher frequency of invasive infection (p&lt;0.001) and higher need for ICU admission (p=0.015) in SLE as compared to non SLE patients. Of note, unusual PI sites, including pneumococcal endocarditis (n=1), arthritis (n=1) and peritonitis (n=1) were observed in SLE patients only. Risk factors associated with PI in SLE patients were a serum gammaglobulin level &lt;5g/L (p=0.003) and a past history of lupus nephritis (p=0.047), only. Steroids (p&lt;0.001) and immunosuppressive drugs (p=0.027) were associated with infection severity. <h3>Conclusions</h3> Pneumococcal infections occur at a younger age, are more frequent and severe in SLE patients. Hypogammaglobulinemia and lupus nephritis increased the risk for PI, whereas steroids and immunosuppressive drugs were associated with infection severity only. Our study shows that SLE patients have an increased risk for invasive PI and points to the need for vaccination against <i>streptococcus pneumoniae</i> in SLE. <h3>Disclosure of Interest</h3> None declared
AB0384 Clinical and radiological evolution in rheumatoid arthritis (RA) patients after deintesificate biologics
Authors: J Uceda, R Hernandez, JL Marenco
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> RA is the most common chronic inflammatory arthritis. About 30% of patients are treated with biological therapy (BT). Deintensification of BT for patients in clinical remission, is a strategy used in clinical practice to reduce side effects and burden. <h3>Objectives</h3> The primary endpoint was evaluate clinical and radiological behavior of the RA in patients receiving BT at reduced doses. The secondary endpoint was to analyze the characteristics of patients who remain for a longer period of time in an optimized dose regimen. <h3>Methods</h3> In our Rheumatology Unit we are treating 271 RA patients with BT, the dose was deintensificated for 62 (23%) patients in remission or low disease activity for at least 6 months. We have selected 32 patients with BT reduced for at least 6 years in an observational, descriptive, longitudinal and retrospective study. Disease activity was measured by the DAS 28 index. Structural damage was evaluated by SENS method. <h3>Results</h3> We analyze 32, 20 female, 12 male, mean age at diagnosis 42.6 years old; BT was started after RA evolution of 98.63 months. Drug reduction was performed after full BT for 62 months, mean DAS 28 was 2,47. Patients were 75% FR positive and 56.7% ACPA positive. Etanercept was the BT more commonly reduced 59.4%, followed by adalimumab 21.9%, infliximab 12.5% and certolizumab 6.3%. BT dose returned to normal for 11 patients because of disease activity worsening after an average time of 15.90 months. For 21 patients remaining on reduced doses, the mean DAS28 at time for analysis was 2.67. BT reduction as different drugs: none infliximab reduced dose patients required return to normal dose. All certolizumab reduced (2 patients) patients needed to back to normal dose. Etanercept in 36,8% and adalimumab 28,6%. The mean of SENS score before the optimization was 8.78 and at time for analysis 10.67 for both kind of patients, who continued reduced and those who needed to increase BT dose. For the secondary endpoint 10 out of 12 male continue with deintensificated BT (83%) in the other hand only 11 out of 20 female (55%) maintained reduced dose.More negative for FR (69,2%) and ACPA (75%) patients keep on reduced dose regimen. <h3>Conclusions</h3> We have deintensificated 62 out of 271 RA patients on BT (23%). All patients were in clinical remission at the beginning of BT dose reduction for more than 6 months. Most patients (65%) analyzed remain long time with reduced BT in clinical remission. We have not observed significant X-ray progression for reduced patients, even if they increase disease activity and need to back to the original BT dose. The increase in disease activity was the main reason to interrupt the optimization regime. Infliximab was the drug that remained more time optimized. According to the results of our study, male patients negative for ACPA and FR remain longer with reduced doses <h3>Disclosure of Interest</h3> None declared
FRI0281 Utility of morning sample of urine protein/creatinine ratio for assessment of proteinuria in patients with lupus nephritis
Authors: H Zhang, J Liang, B Hua, L Sun
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Proteinuria is the principal urinary biomarker for the screening of Lupus nephritis (LN) and for monitoring disease progression. 24-hour urine collection has been the foundation for monitoring disease activity in patients with LN, but collections are often inaccurate and inconvenient. The European League Against Rheumatism and American College of Rheumatology have recommended the urine protein/creatinine ratio (UPCR) for use in management of LN. <h3>Objectives</h3> We aimed to evaluate the diagnostic accuracy of the morning sample of UPCR compared with 24-hour urine collection for the detection of proteinuria and to determine the UPCR for different proteinuria ranges in patients with LN. <h3>Methods</h3> Three hundred and thirty seven LN patients were enrolled. The correlation between the UPCR in the morning spot urine samples and urinary protein excretion in the 24-hour collections was examined using the Pearson correlation test. The best cutoffs for UPCR predicting a 24-hour protein excretion were determined with the receiver operating characteristic curve (ROC). <h3>Results</h3> It was found a good positive correlation between the UPCR and 24-hour protein excretion, with a correlation coefficient (r) of 0.891 (Fig 1). The best cutoff which gave the maximum area under the curve was 0.44 for 0.5 g, 0.92 for 1.0 g, 2.21 for 2.0 g, 2.70 for 3.0 g, 3.49 for 4.0 g and 4.59 for 5.0g. <h3>Conclusions</h3> The UPCR can be used as a screening test as a good predictor for proteinuria of LN patients. Also, UPCR is a valuable tool with which to monitor disease progression. <h3>References</h3> Bertsias GK, Tektonidou M, Amoura Z, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis 2012; 71: 1771–82. Renal Disease Subcommittee of the American College of Rheumatology Ad Hoc Committee on Systemic Lupus Erythematosus Response Criteria. The American College of Rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials. Arthritis Rheum 2006; 54: 421–32. Medina-Rosas J, Yap KS, Anderson M, et al. Utility of Urinary Protein-Creatinine Ratio and Protein Content in a 24-Hour Urine Collection in Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis. Arthritis Care Res (Hoboken) 2016; 68: 1310–9. <h3>Disclosure of Interest</h3> None declared
SAT0411 Correlation between disease activity scores and quality of life in spondyloarthritis
Authors: M Linda, K Baccouche, S Lataoui, S Belghali, Z Alaya, N El Amri, H Zeglaoui, E Bouajina
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Spondyloarthritis (SpA) is a group of chronic inflammatory rheumatism and it is known to be one of the leading causes of disability. <h3>Objectives</h3> This study aimed to investigate the quality of life and the psychological disorders (depression, anxiety and insomnia) in patients with SpA. <h3>Methods</h3> A total of 60 patients were included with the diagnosis of SpA meeting the Amor and New York modified criteria, in a prospective study. In a questionnaire, the characteristics of the disease and sociodemographic patient were collected. Also psychiatric assessment was done using the insomnia severity index score (ISI) and the Hospital Anxiety and Depression scale (HAD). In addition, patients answered to the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire and the SF-12. <h3>Results</h3> The sex-ratio (men/women) was 3.28 (46/14), the average age was 37.95 years (18–70). The average duration of disease progression was 11.5 years (1–30). The mean value of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was 5.11 and the Bath Ankylosing Spondylitis Functional Index (BASFI) was 5.22. Uveitis was reported in 11.7% of patients, osteoporosis in 35%, enthesitis in 36.7% and coxitis in 36.7%. 78.3% of patients received NSIAD and 30% were treated with biotheraby. On the psychological level, 25% of patients had an anxiety, 20% had depression. According to the ISI, 35% of patients had sub threshold insomnia, 20% had moderate insomnia and 10% had severe insomnia. The mean value of the ASQoL was 9 (0–16). The mean value of the physical health was 37.13 (19.34–60.41) and for the mental health was 41.65 (14.9–60.35). A significant positive correlation was found between the disease activity and the ASQoL (p=0.000), the physical health (p=0.000) and the mental health (p=0.002). Also, we found a significant positive correlation between the BASDAI and depression (p=0.01) and insomnia (p=0.001). <h3>Conclusions</h3> SpA is a chronic inflammatory disease that contributes to significant physical disability and decreased quality of life in a significant number of patients. The treatment of those patients must consider the improvement of quality of life, as part of a global approach. <h3>Disclosure of Interest</h3> None declared