tbuckley/cabot-search huggingface dataset:
THU0168 Patients' positive beliefs and certainty predict methotrexate adherence in a rheumatoid arthritis cohort: the rams study
Authors: HF Hope, K Hyrich, F Varney, S Wilkes, SM Verstappen, L Cordingley
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Living with RA confers substantial uncertainty about the long-term outcomes of the disease and the occurrence of possible medication associated adverse events (ADEs). This latter uncertainty may be particularly apparent when new therapies are initiated and reduce patient adherence. <h3>Objectives</h3> The aim of this study was to evaluate whether patients9 negative and/or uncertain illness beliefs during methotrexate (MTX) therapy are associated with adherence. <h3>Methods</h3> This was a sequential mixed-methods design study using data from the Rheumatoid Arthritis Medications Study (RAMS). RAMS is a 12 month observational study in the UK recruiting patients with RA commencing MTX for the first time. Clinical and demographic data were collected at baseline and patients were asked to complete a weekly diary recording MTX intake (adherence) and reasons for not taking MTX. In addition there was a free text section in the diary where patients could comment about any aspect of their disease or care. Six month diary data were used for the purpose of this study.Patients were categorised as non-adherent if the proportion of adherent weeks was &lt;90%. Phase 1:Using a random sample (n=50/417) of patient diaries with free text comments a coding system was developed to categorise illness events and beliefs contained in these data. Inter-rater reliabilities for codes rated by three judges were calculated using intraclass correlation coefficients (ICC) and unreliable codes (ICC&lt;0.6) dropped. Phase 2:179 of 200 diaries from adherent and non-adherent individuals were randomly selected, coded and categorised into illness belief profiles (IBPs) by three researchers blind to adherence data.Univariate logistic regression analyses adjusted for age and gender were used to investigate the association between IBPs and MTX non-adherence behaviour (&lt;90% adherence). <h3>Results</h3> Phase 1: ten codes with ICCs ranging from 0.6–1.0 were used to create three IBPs (Table):"Positive &amp; Certain" (PC), "Negative &amp; Certain" (NC) and "Negative and Uncertain" (NU) (Fig.). Phase II, the median age of the sample was 62 [51.8–65.6] years, 67% were women and the median disease activity score was 4.3 [3.4–5.2]. Being PC lowered the odds of non-adherence (OR 0.32, 95% CI 0.12–0.85), being NU increased the odds of non-adherence (OR 2.7, 95% CI 1.0–7.0), but being NC didn9t associate with non-adherence during the first six months of therapy (OR 0.98, 95% CI 0.31–3.2). <h3>Conclusions</h3> People who are uncertain about how to attribute illness events are less likely to adhere within the first six months of starting MTX therapy. Encouraging patients to actively monitor their progress with therapy and providing them with support to understand likely effects of MTX may help optimise DMARD use. <h3>Disclosure of Interest</h3> None declared
AB0324 Is low serum vitamin d level associated with increased neuropathic pain in rheumatoid arthritis patients? a cross-sectional study
Authors: H Yesil, U Sungur, S Akdeniz, G Gurer, B Yalcın, U Dundar
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rheumatoid arthritis (RA) is a systemic, autoimmune, progressive condition characterised by progressive synovitis with resultant joint destruction, functional disability and significant pain. Recent experimental data indicates that there may be a neuropathic component of pain perception in RA. <h3>Objectives</h3> The aim of this study was to examine the development of neuropathic pain (NP) in patients with RA and its relationship with vitamin D. <h3>Methods</h3> We used the Leeds assessment of neuropathic symptoms and signs (LANSS) questionnaire to evaluate NP in 93 patients with RA. Clinical parameters included general demographics, and disease activity scores were evaluated. The patients also completed Short form-36 survey, and Health Assessment Questionnaire. <h3>Results</h3> Of all the patients who were eligible for the study, 75 were female (80.6%). Mean serum vitamin D level of the participants was calculated to be 22.8±11.9 ng/mL. According to the LANSS questionnaire 31 patients (33.3%) were classified as having NP. There was a negative correlation between vitamin D levels and LANSS value (p=0.001). We have determined that patients with vitamin D serum levels below 20 ng/mL have significantly higher NP positivity rate (p=0.012), besides they have 5.8 times more risk of developing NP when compared to patients with vitamin D serum levels ≥30 ng/mL. <h3>Conclusions</h3> We conclude that Vitamin D deficiency is prevalent in RA patients with NP. Once it is the right diagnosis, Vitamin D deficiency treatment is relatively easy, safe, inexpensive and with satisfactory outcomes; therefore, an underlying vitamin D deficiency should be explored in the etiology of NP in patients with RA. <h3>References</h3> Bellucci E, Terenzi R, La Paglia GM, Gentileschi S, Tripoli A, Tani C, Alunno A. One year in review 2016: pathogenesis of rheumatoid arthritis. Clin Exp Rheumatol. 2016; 34(5):793–801. Koop SM, Klooster PM, Vonkeman HE, Steunebrink LM, van de Laar MA. Neuropathic-like pain features and cross-sectional associations in rheumatoid arthritis. Arthritis Research &amp; Therapy.2015; 17:237. Shehab D, Jarallah KA, Abdella N, Mojiminiyi OA, Mohamedy HA. Prospective Evaluation of the Effect of Short-Term Oral Vitamin D Supplementation on Peripheral Neuropathy in Type 2 Diabetes Mellitus. Med Princ Pract. 2015; 24:250–256. <h3>Disclosure of Interest</h3> None declared
Treatment of hepatitis C virus infection with direct‐acting antiviral drugs is safe and effective in patients with hemoglobinopathies
Authors: Raffaella Origa, Maria Laura Ponti, Aldo Filosa, Alfonso Galeota Lanza, Antonio Piga, Giorgio Maria Saracco, Valeria Pinto, Antonino Picciotto, Paolo Rigano, Salvatore Madonia, Rosamaria Rosso, Domenico D'Ascola, Maria Domenica Cappellini, Roberta D'Ambrosio, Immacolata Tartaglione, Lucia De Franceschi, Barbara Gianesin, Vito Di Marco, Gian Luca Forni
Journal: American Journal of Hematology (2017)

Progression of liver fibrosis in patients with hemoglobinopathies is strongly related to the severity of iron overload and the presence of chronic hepatitis C virus (HCV) infection. Effective iron chelation therapy and HCV infection eradication may prevent liver complications. The European Association for the Study of the Liver guidelines recommend interferon-free regimens for the treatment of HCV infection in patients with hemoglobinopathies. However, data regarding the use of direct-acting antiviral drugs (DAAs) in this patient population are few. This observational study evaluated the safety and efficacy of therapy with DAAs in an Italian cohort of patients with hemoglobinopathies, chronic HCV infection and advanced liver fibrosis. Between March 2015 and December 2016, 139 patients received DAAs and completed 12 weeks of follow up after the end of treatment for the evaluation of sustained virological response (12SVR). The 12SVR (93.5%) was comparable with that typically observed in cirrhotic patients without hemoglobinopathies. Three patients died during the period of observation of causes unrelated to DAAs. One patient did not achieve a virological response and five (3.6%) relapsed during 12 weeks of follow-up after the end of therapy. In addition, patients showed significant reductions in serum ferritin at 12 weeks to levels similar to those observed in a control group of 39 patients with thalassemia major without HCV infection, who adhered to chelation therapy and had no overt iron overload. In conclusion, the use of DAAs appears to be safe and effective in patients with hemoglobinopathies and advanced liver disease due to HCV.
Sarcomatoid Renal Cell Carcinoma: The Apple Doesn't Fall Far from the Tree
Authors: Paulo Bergerot, Neeraj Agarwal, Sumanta K. Pal, Jeremy Jones
Journal: Clinical Cancer Research (2017)

The most comprehensive sequencing effort of sarcomatoid renal cell carcinoma (sRCC) to date reinforces the notion that the sarcomatoid component is closely related to the epithelial component of the cancer. This work also challenges the notion that sRCC evolves from low-grade RCC and identifies potential mediators of sarcomatoid differentiation. Clin Cancer Res; 23(21); 6381-3. ©2017 AACRSee related article by Wang et al., p. 6686.
THU0492 Macrophage activation syndrome as the initial manifestation of juvenile systemic lupus erythematosus
Authors: S Sato, Y Uejima, E Suganuma, T Takano, S Fujinaga, Y Kawano
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Macrophage activation syndrome (MAS) is a severe, potentially life-threatening complication of autoimmune diseases in children. Little is known about the association between MAS and the onset of juvenile systemic lupus erythematosus (jSLE). <h3>Objectives</h3> The aim of this study was to determine the frequency and clinical features of MAS as the initial complication of jSLE. <h3>Methods</h3> During 2004 and 2016, we retrospectively reviewed the clinical and laboratory features of 46 jSLE patients diagnosed at the Saitama Children9s Medical Center. Patients who were complicated with MAS at the same time as jSLE. These patients were compared with a control group composed of jSLE patients without MAS. The MAS was diagnosed according to preliminary guidelines. <h3>Results</h3> Fifteen patients (32.6%) developed MAS during the initial stage of jSLE. Fever, leukopenia, thrombocytopenia, hyperferritinemia hypofibrinogenemia, increased aspartate aminotransferase (AST), and increased lactate dehydrogenase (LDH) were more frequently observed in patients having jSLE with MAS than in those having jSLE without MAS. No differences were observed in serum C3 and C4 levels, or erythrocyte sedimentation rate (ESR) (P&lt;0.05). Especially, Seven patients (46.7%) had <i>neurologic</i> symptoms that were significantly higher in those with MAS (P&lt;0.01). All patients received corticosteroids when jSLE with MAS diagnosis was established, among whom seven received pulse methylprednisolone therapy. Two patients were treated with IVIG. Nine patients with MAS were treated with immunosuppressants, including cyclophosphamide and mycophenolate mofetil, <i>azathioprine</i>. No patient involved in this study died. <h3>Conclusions</h3> MAS can be the initial manifestation of jSLE. MAS may be an underrecognized complication of jSLE. MAS with jSLE should be suspected in patients with high fever, cytopenia, and a liver disorder. In addition, we found that in jSLE with MAS patients, they had more neurologic symptoms compared to jSLE without MAS. Early diagnosis and intensive therapy is essential to improve the clinical outcome. <h3>References</h3> Parodi A, Davì S, Pringe AB, Pistorio A, Ruperto N, et al. Macrophage activation syndrome in juvenile systemic lupus erythematosus: a multinational multicenter study of thirty-eight patients. Arthritis Rheum. 2009 Nov;60(11):3388–99. Pringe A, Trail L, Ruperto N, Buoncompagni A, Loy A, et al. Macrophage activation syndrome in juvenile systemic lupus erythematosus: an under-recognized complication? Lupus. 2007;16(8):587–92. Gormezano NW, Otsuzi CI, Barros DL, da Silva MA, Pereira RM, et al. Macrophage activation syndrome: A severe and frequent manifestation of acute pancreatitis in 362 childhood-onset compared to 1830 adult-onset systemic lupus erythematosus patients. Semin Arthritis Rheum. 2016 Jun;45(6):706–10. <h3>Disclosure of Interest</h3> None declared
AB0549 Demographic features and clinical aspects of behÇet's disease in omani patients
Authors: AS Al Ghafri, H Al Wahshi
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Behçet9s disease (BD) is a chronic, relapsing, multi-system vasculitis of unknown aetiology. Few reports support the hypothesis that BD has a primarily hereditary basis. It complicated diversified clinical features predominantly involving oral and genital ulcers, ocular and cutaneous lesions. The clinical features of this disease have been described to be different according to geographical areas and gender. <h3>Objectives</h3> The objective of the study is to explore the demographic features and clinical aspects of BD in Omani patients. <h3>Methods</h3> 56 BD patients were recruited and clinical data parameters were recorded including age, sex, age at diagnosis, duration of symptoms till diagnosis, disease characteristics such as oral and genital ulcers, ocular manifestations, the presence of arthritis and cutaneous lesions such as papulopustular lesions and erythema nodosum. Furthermore, other systemic involvement was studied including gastrointestinal, neurological &amp; vascular manifestations. Laboratory tests of BD and treatment used were recorded in each patient. <h3>Results</h3> The onset was between 6–74 years with a male predominance. Oral ulcers were the most common manifestation, followed by genital ulcers, ocular lesions and arthritis. Vascular lesions and GI manifestations were less common. Cutaneous manifestations were rare in patients with BD. The frequency of neurological involvement was significantly high. There were no reported cardiac or urogenital manifestations. <h3>Conclusions</h3> There are quite significant clinical geographical and gender differences among BD patients in which genetic and immunological factors might participate it9s aetiopathogenesis. <h3>Acknowledgements</h3> The authors thank Department of research, Oman Medical Specialty Board, Muscat, Oman, for their excellent technical assistance. <h3>Disclosure of Interest</h3> None declared
Prenatal Serum Concentrations of Brominated Flame Retardants and Autism Spectrum Disorder and Intellectual Disability in the Early Markers of Autism Study: A Population-Based Case–Control Study in California
Authors: Kristen Lyall, Lisa A. Croen, Lauren A. Weiss, Martin Kharrazi, Michela Traglia, Gerald N. Delorenze, Gayle C. Windham
Journal: Environmental Health Perspectives (2017)

Background: Prior studies suggest neurodevelopmental impacts of polybrominated diphenyl ethers (PBDEs), but few have examined diagnosed developmental disorders. Objectives: Our aim was to determine whether prenatal exposure to brominated flame retardants (BFRs) is associated with autism spectrum disorder (ASD) or intellectual disability without autism (ID). Methods: We conducted a population-based case–control study including children with ASD (n=545) and ID (n=181) identified from the California Department of Developmental Services and general population (GP) controls (n=418) from state birth certificates. ASD cases were matched to controls by sex, birth month, and birth year. Concentrations of 10 BFRs were measured in maternal second trimester serum samples stored from routine screening. Logistic regression was used to calculate crude and adjusted odds ratios (AOR) for associations with ASD, and separately for ID, compared with GP controls, by quartiles of analyte concentrations in primary analyses. Results: Geometric mean concentrations of five of the six congeners with ≥55% of samples above the limit of detection were lower in mothers of children with ASD or ID than in controls. In adjusted analyses, inverse associations with several congeners were found for ASD relative to GP (e.g., quartile 4 vs. 1, BDE-153: AOR=0.56, 95% CI: 0.38, 0.84). When stratified by child sex (including 99 females with ASD, 77 with ID, and 73 with GP), estimates were consistent with overall analyses in boys, but in the opposite direction among girls, particularly for BDE-28 and -47 (AOR=2.58, 95% CI: 0.86, 7.79 and AOR=2.64, 95% CI: 0.97, 7.19, respectively). Similar patterns overall and by sex were observed for ID. Conclusions: Contrary to expectation, higher PBDE concentrations were associated with decreased odds of ASD and ID, though not in girls. These findings require confirmation but suggest potential sexual dimorphism in associations with prenatal exposure to BFRs. https://doi.org/10.1289/EHP1079
Robot-assisted Kidney Transplantation: The European Experience
Authors: Alberto Breda, Angelo Territo, Luis Gausa, Volkan Tuğcu, Antonio Alcaraz, Mireia Musquera, Karel Decaestecker, Liesbeth Desender, Michael Stockle, Martin Janssen, Paolo Fornara, Nasreldin Mohammed, Giampaolo Siena, Sergio Serni, Luis Guirado, Carma Facundo, Nicolas Doumerc
Journal: European Urology (2017)
SAT0399 Headache as a clinical complaint at initial presentation and during the disease course in patients with spondyloarthritis indicates concomitant / secondary fibromyalgia
Authors: E Roussou, M Karela, A Georgiou
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> To evaluate the symptom of headache as being able to clinically distinguish associated secondary fibromyalgia in patients with spondyloarthropathies (SpA). To compare the incidence of MSK complaints (related to SpA) in patients with headache to those that did not. To assess headache during the SpA disease course. <h3>Methods</h3> Registry data from 776 patients seen in clinic with SpA were analysed with reference to headache as symptom at presentation. The data of those patients presented with headache were compared with data of those patients who did not report headache with regards to demographics and disease characteristics. In addition, other MSK complaints, fatigue and pain during disease course were also analysed. <h3>Results</h3> From a total of 776 patients (m: f=265:508) age 48.3 ( SD +14.1), 13 were excluded as no answer was recorded. 117/ 763 patients (15.08%) representing 28 males and 89 females (23.9% vs 76.1% ratio 1:3.1) reported headache at disease onset. During the disease course, 13 patients out of the initial 117 did not record an answer to the question and were excluded. From remaining 104 patients, 95 patients (91.3%) continued to describe headache as a symptom. From those not reporting headache as initial symptom, (n=659) 148 did not record an answer and were excluded. From the remaining 511 patients, 194 (37.9%) reported headache during the disease course. On the data obtained from these 2 sub-groups, comparison took place using paired sample t-test. Table shows demographics and disease characteristics as well as differences between the 2 SpA sub-groups. Those presenting with headache describe worse disease, more fatigue and a greater percentage describe pain at pressure points and MSK system. <h3>Conclusions</h3> Headache can clinically represent secondary FM among SpA patients. A proportion of patients (representing 15%) report headache at presentation. The majority of those patients (&gt;90%) continue to describe headache during the disease course. From those patients who did not have headache at presentation, 38% report headache during the disease course. Patients describing headache at presentation have more MSK complaints at presentation. <h3>Disclosure of Interest</h3> None declared
SP0045 Do patient organisations have a role to play in preventing co-morbidities?
Authors: AM Bosworth
Journal: Annals of the Rheumatic Diseases (2017)

My talk will look in detail at how patient organisations can play a role in preventing co-morbidities. NRAS is currently engaged in two major projects which are both directly concerned with the prevention of co-morbidities. During RA Awareness Week in the UK, 19–26 June, NRAS will launch "Love your Heart" an on-line, interactive video programme to educate people with RA about their increased risk of heart disease and atherosclerosis. This programme explains in simple terms why people with RA are at increased risk of cardiovascular disease. The programme provides the opportunity to appraise individual risk factors, complete a QRISK2 assessment with their GP and provides a cognitive-behavioural framework to empower people to change their behaviours and achieve a healthier lifestyle, thereby reducing risk of heart disease. Baseline and 6 months evaluations are built into the programme. It has been developed with input from a consultant rheumatologist, GP, and other health experts as well as patients. If time permits I will also a describe a research study we are undertaking with 3 hospitals in the UK whereby we will randomly assign newly diagnosed patients to receive a targeted support fprogramme rom NRAS or be in a control group which does not receive this support for a period of 6 months. Our aim is to show that the group receiving the targetted support has less anxiety and depression, although other outcomes will also be measured. <h3>Disclosure of Interest</h3> None declared
OP0045 Predictors of persistent disease activity and persistent long quiescence in systemic lupus erythematosus – results from the hopkins lupus cohort
Authors: I Giannakou, K Chatzidionysiou, L Magder, R van Vollenhoven, M Petri
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is characterized by a diversity of disease activity. <h3>Objectives</h3> The aim of this study was to identify prognostic factors of persistent disease activity and persistent long quiescence using baseline demographics and clinical characteristics. <h3>Methods</h3> Patients enrolled in the Hopkins Lupus Cohort from 1987 to 2014, who had at least 3 visits per year during 3 years following cohort inclusion and available information on disease activity were included. Three major patterns of SLE disease activity over time (1 year intervals) based on the modified SLE Disease Activity Index have been previously described: long quiescent (LQ), chronic active (CA) and relapsing-remitting (RR) <i>(1)</i>. Based on maintenance of the aforementioned patterns over 3 consecutive years, patterns have been defined as: Persistent Long Quiescent (pLQ), Persistent Relapsing-Remitting (pRR), Persistent Chronic Active (pCA) and Mixed, at least 2 different pattern types. Predictors of pCA (vs. pLQ, pRR and mixed) and pLQ (vs. pCA, pRR and mixed) were identified by univariate and multivariate logistic regression analyses. Several baseline demographics (age, sex, ethnicity, disease duration, tobacco use, years of education and combined annual family income), disease characteristics at baseline (SLEDAI, PGA) and treatment categories (hydroxychloroquine, prednisolone and cytotoxic treatment followed at ≥75% of visits vs &lt;75% of visits) were used as independent variables. <h3>Results</h3> 916 patients were identified. The results of the univariate analyses for pCA are shown in table 1. In the multivariate model, African American ethnicity (OR: 2.43, 95% CI: 1.19–4.94, p: 0.01) and high baseline SLEDAI (OR: 1.09, 95% CI: 1.03–1.16, p: 0.004) remained significant predictors of pCA. Higher education (&gt;12 years; OR. 2.16, 95% CI: 1.11–4.20, p: 0.02) and low baseline SLEDAI (OR: 0.62, 95% CI: 0.52–0.75, p:&lt;0.001) were significant predictors of pLQ in the multivariate analysis while African American ethnicity (OR: 0.36, 95% CI: 0.16–0.78, p:0.01) and female patients (OR: 0.26, 95% CI: 0.12–0.56, p:0.001) were less likely to achieve persistent long quiescence. <h3>Conclusions</h3> In this large SLE cohort, African American ethnicity and high disease activity at the time of diagnosis are predictors of chronic activity, regardless of treatment, even after adjustment for education years and income, while higher education and low disease activity at baseline predict long-term quiescence. <h3>References</h3> Györi N, et al. Disease activity patterns over time in patients with systemic lupus erythematosus – Analysis of the Hopkins Lupus Cohort. Lupus Sci Med. 2017. In press. <h3>Disclosure of Interest</h3> None declared