tbuckley/cabot-search huggingface dataset:
SAT0207 Long-term effect of biological therapies on bone mineral density (BMD) for ra patients compared to patients treated by synthetic dmard over an 8-year follow-up
Authors: L Bustamente, V Breuil, R Fabre, L Euller-Ziegler, C Pradier, C Roux
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Secondary osteoporosis is a comorbidity of Rheumatoid Arthritis (RA). Previous studies have suggested that biological therapies may reduce the rate of generalized bone loss in RA. Most of them focus on the short-term effect of Tumor Necrosis factor alpha (TNFα) inhibitors while the long-term effect of biological therapies is rarely studied. <h3>Objectives</h3> Our primary aim was to analyze the long-term effect of biological therapies on bone mineral density (BMD) for RA patients compared to patients treated by synthetic DMARD over an 8-year follow-up. <h3>Methods</h3> Patients were selected from a prospective, observational cohort of RA patients meeting the ACR/EULAR 2010 settings in Nice University Hospital between 2001 and 2016. BMD was assessed before the introduction of the biological therapy and during the follow-up. Two groups were studied: patients treated by biological therapies (TNFα inhibitors, Tocilizumab, Abatacept, Rituximab or Anakinra) and patients treated by synthetic DMARD only. Demographic, disease and treatment data were collected at each visit and BMD of the lumbar spine, femoral neck and total hip were assessed using dual energy X-ray absorptiometry (DXA) at baseline and after 1, 2, 3, 5 and 8 years. <h3>Results</h3> A total of 181 patients with active RA starting a biological therapy were included versus 131 patients treated by synthetic DMARD. In both groups, the BMD of the lumbar spine, femoral neck and total hip remained stable after a 2-year follow-up (respectively -0.37%, p=0.66 versus +0.02%, p=0.83, -3.70%, p=0.77 versus -5.35%, p=0.74 and -3.31%, p=0.45 versus -4.84%, p=0.16), while a significant bone loss was found between initial measurement and 3, 5 and 8 -year- follow-up at femoral neck and total hip level. There was no significant difference between patients whether treated by biological or non-biological DMARD neither over the 0–1-year period nor over the 0–2, 0–3, 0–5 and 0–8-periods. Bone loss in patients treated by Tocilizumab were statistically lower at femoral neck level compared with TNFα inhibitors (p=0.02), Abatacept (p=0.02) and Rituximab (p=0.02), but also at total hip level, in comparison with TNF α inhibitors (p=0.05) and Abatacept (p=0.05). <h3>Conclusions</h3> This study is the first to assess the effects of biological RA therapies as compared to synthetic DMARD ones. It highlights the protective effect of both biological and non-biological DMARD on bone loss during the first two years of treatment with no significant difference between them. Our results suggest that the effects of RA treatments depend on the inflammatory and disease activity which must be monitored clearly. Tocilizumab seems to be more effective than the other biological therapies, but further studies are necessary to confirm or infirm this tendency. <h3>Disclosure of Interest</h3> None declared
AB0571 Factors related to alexithymia in systemic lupus erythematosus
Authors: F. Basta, D.P.E. Margiotta, G. Dolcini, V. Batani, A. Vernuccio, M. Vadacca, A. Afeltra
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Alexithymia describes the difficults of people in identifying, differentiating and articulating emotions of others and themselves and in discriminating those from bodily sensations, with a limited fantasy and a concrete, externally oriented cognitive style.<sup>1</sup> A high prevalence of alexithymia has been found in patients with a variety of health conditions, including SLE.<sup>2</sup> Previous authors identified mood states<sup>2</sup> and quality of life<sup>3</sup> as the main factors related to alexithymia in Systemic Lupus Erythematosus (SLE). <h3>Objectives</h3> Aim of our study was to assess the impact of clinical, immunological, psycho-social factors on the presence of alexithymia in Systemic Lupus Erythematosus (SLE). <h3>Methods</h3> We consecutively enrolled 104 patients in a cross-sectional study. Alexithymia was assessed using the Toronto Alexithymia scale (TAS-20). We also evaluated symptoms of mood disorders using BDI and HAM-H, quality of life using MOS-SF36, sleep disorders with PSQI and physical activity using IPAQ. <h3>Results</h3> The mean (standard deviation) TAS-20 score was 49.5 (15.6). The prevalence of alexithymia (TAS-20 ≥61) was 28%. Alexithymic patients (TAS-20 ≥61) were significantly older (p 0.0005), presented more severe depressive and anxiety symptoms (p&lt;0.0001), a higher score of sleep disorders (p&lt;0.0001), a reduced Facit-Fatigue score (p 0.0007), reduced SF-36 mental and physical component summary scores (p 0.0001 and 0.004) and increased daily sedentary time (p 0.002). In the multiple logistic regression analysis the variables associated to the presence of alexithymia were age (OR 1.07, p 0.02) and the score of depressive symptoms (OR 1.15, p 0.02). <h3>Conclusions</h3> About a third of SLE patients presented a dysfunctional processing of emotion. It is necessary to carefully consider the symptoms of mood disorders to optimise SLE patient management. <h3>References</h3> [1] Taylor GJ, Bagby RM. Measurement of alexithymia. Recommendations for clinical practice and future research. Psychiatr Clin North Am. 1988Sep;11(3):351–66 [2] Vadacca M, Bruni R, Terminio N, Sambataro G, Margiotta D, Serino FM, Afeltra A. Alexithymia, mood states and pain experience in systemic lupus erythematosus and rheumatoid arthritis. Clin Rheumatol. 2014;33(10):1443–50.3. [3] Barbosa F, Mota C, Alves M, Alcântara C, Rossiñol B, Patrício P, Barbosa A, Ferreira C. Alexithymia in systemic lupus erythematosus patients. Ann N Y Acad Sci. 2009Sep;1173:227–34 <h3>Disclosure of Interest</h3> None declared
PML is a ROS sensor activating p53 upon oxidative stress
Authors: Michiko Niwa-Kawakita, Omar Ferhi, Hassane Soilihi, Morgane Le Bras, Valérie Lallemand-Breitenbach, Hugues de Thé
Journal: The Journal of Experimental Medicine (2017)

Promyelocytic leukemia (PML) nuclear bodies (NBs) recruit partner proteins, including p53 and its regulators, thereby controlling their abundance or function. Investigating arsenic sensitivity of acute promyelocytic leukemia, we proposed that PML oxidation promotes NB biogenesis. However, physiological links between PML and oxidative stress response in vivo remain unexplored. Here, we identify PML as a reactive oxygen species (ROS) sensor. Pml-/- cells accumulate ROS, whereas PML expression decreases ROS levels. Unexpectedly, Pml-/- embryos survive acute glutathione depletion. Moreover, Pml-/- animals are resistant to acetaminophen hepatotoxicity or fasting-induced steatosis. Molecularly, Pml-/- animals fail to properly activate oxidative stress-responsive p53 targets, whereas the NRF2 response is amplified and accelerated. Finally, in an oxidative stress-prone background, Pml-/- animals display a longevity phenotype, likely reflecting decreased basal p53 activation. Thus, similar to p53, PML exerts basal antioxidant properties but also drives oxidative stress-induced changes in cell survival/proliferation or metabolism in vivo. Through NB biogenesis, PML therefore couples ROS sensing to p53 responses, shedding a new light on the role of PML in senescence or stem cell biology.
SAT0588 Healthcare workers are not more at risk to low back pain than other occupations
Authors: F Kemta Lekpa, MS Doualla, HB Ngahane Mbatchou, AS Mkoh, H Namme Luma
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Low back pain is common among healthcare workers but is it more frequent than in other occupations? <h3>Objectives</h3> In order to answer this question, we carried out this study with the aim of determining if healthcare workers was more at risk for low back pain in the same institution than non-healthcare workers, administrative and technical workers. <h3>Methods</h3> We performed a survey on all permanent workers (n=584) of the Douala General Hospital in Cameroon from January to May 2016. Socio-demographic characteristics of workers (distinction with different occupations – healthcare workers, administrative workers, technical workers) and the main features of low back pain were collected. A p&lt;0.05 was significant. <h3>Results</h3> Of the 584 questionnaires distributed, 474 responses were obtained (81.1%). We excluded 27 for incomplete data. 447 were retained for the final analysis: 296 healthcare workers, 79 administrative workers, and 72 technical workers. The mean age was 40±10 years [22–66 years] and 258 (57.7%) were female. Mean BMI was 27±4.3 kg/m<sup>2</sup> with 103 (23%) obese. At the end of the study, 252 (56.4%) workers described low back pain, including 170 (57.4%) healthcare workers, 44 (55.7) administrative workers and 38 (52.7) technical workers. There was no significant difference between the different groups (p&gt;0.05). Same for sex (p=0.9). The overall independent risk factors associated with low back pain were: seniority in their current position (OR 4.97, 95% CI 1.80–13.68, p=0.002), office chair quality (OR 3.06, 95% CI 1.29–7.26, p=0.01), and job satisfaction (OR 1.55, 95% CI 105–2.54, p=0.048). The specific risk factors for each occupation are presented in Table 1. <h3>Conclusions</h3> In an institution like Douala General Hospital, where the administrative, technical and healthcare workers are subjected to the same professional stress in terms of quality of care and performance, we did not find any difference on prevalence among these 3 occupations. Preventive measures must be performed for all staff but need to be tailored to each occupation. <h3>Disclosure of Interest</h3> None declared
AB0667 Clinical and therapeutic differences between polymyositis and dermatomyositis in a colombian cohort with idiopathic inflammatory myopathy
Authors: R Fuentes, F Vargas, MA Alzate, D Hernandez-Parra, JC Salazar-Uribe, P Ortiz-Salazar, R Pineda
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The idiopathic inflammatory myopathies (IIM) are a group of immune-mediated systemic conditions characterized by chronic muscle inflammation, resulting in muscle weakness (1). <h3>Objectives</h3> To characterize the disease in a Colombian cohort with idiopathic inflammatory myopathy, assessing differences in its classification, cutaneous and systemic manifestations, laboratory results, and therapeutic approach, according to the type of myopathy. <h3>Methods</h3> A cross-sectional study was conducted in 112 patients, in whom sociodemographic, clinical and therapeutic characteristics were analyzed based on the type of myopathy. Statistical association was examined by means of Chi-square tests, Mann-Whitney test, and logistic regression analyses. <h3>Results</h3> From the 112 patients recruited, 59 had polymyositis (PM) and 53 had dermatomyositis (DM). The patients were classified with Peter &amp; Bohan criteria as: “definite” diagnosis 67 (60%), “probable” 35 (31%) and “possible” 9 (10%). A high proportion of males were found in this cohort. Our most notable findings are listed in Table 1, noticing for this population a high rate of polyautoimmunity associated to PM (OR 3.81 95%IC 1,003–14,53) and an association between ANAs antibodies positivity and DM (OR 7.03 95%IC 2,16–22,9). Patients with PM presented higher values of CK, LD and transaminases. Also, according to the therapeutic approach, PM was positively associated with the use of azathioprine and immunoglobulins (OR 2,59 95%IC 1,18–5,69 and OR 3,21 95%IC 1,19–8,19, respectively), while chloroquine and hydroxychloroquine were mainly used in DM patients. <h3>Conclusions</h3> In this Colombian sample, a high proportion of patients were classified as definite diagnosis, high frequency of male-gender compromise, low association with cancer, and low prevalence of articular, pulmonary and cardiac involvements were found. <h3>References</h3> Rosa J, Garrot LF, Navarta DA, Saucedo C, Scolnik M, Bedran Z, et al. Incidence and prevalence of polymyositis and dermatomyositis in a health management organization in Buenos Aires. J Clin Rheumatol. 2013;19(6):303–7. <h3>Disclosure of Interest</h3> None declared
AB0372 Associated factors of cervical and lumbar spinal instability in patients with rheumatoid arthritis
Authors: Y Sugimura, N Miyakoshi, T Kashiwagura, M Kobayashi, T Aizawa, H Aonuma, Y Shimada
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Few studies have compared rheumatoid arthritis (RA)-related disorders of the cervical and lumbar spine. <h3>Objectives</h3> The objectives of this study were to examine the prevalence of and risk factors for cervical and lumbar spinal instability in patients with RA. <h3>Methods</h3> From a total of 1,843 patients registered in the Akita Orthopedic Group on Rheumatoid Arthritis (AORA), 135 patients [118 women, 17 men; mean age, 66 (41–84) years; mean disease duration, 14 (1–63) years] who underwent a radiographic examination were enrolled in this study. In the cervical spine, we defined instability as one of the following characteristics: (1) atlantodental interval (ADI) &gt;3 mm, (2) Ranawat value &lt;13 mm on a neutral plain radiograph, or (3) anteroposterior translation &gt;3 mm at the subaxial cervical spine on an anteroposterior bending plain radiograph. In the lumbar spine, instability was defined as anteroposterior translation &gt;3 mm on a neutral plain radiograph. At the time of radiographs evaluation, demographic characteristics, clinical variables, medical history and current medications were investigated. The patients were classified into two groups: with both cervical and lumbar spinal instabilities and without. The independent risk factors for both cervical and lumbar spinal instabilities were then determined using multivariate logistic regression analysis. <h3>Results</h3> Forty-six (34.1%) patients exhibited cervical spinal instability, and 50 (37.0%) patients exhibited lumbar spinal instability. Twenty-four patients (17.8%) exhibited both cervical and lumbar spinal instability. The presence of both cervical and lumbar spinal instability was significantly and independently associated with disease duration (OR: 1.06; 95% CI: 1.01–1.12). <h3>Conclusions</h3> The prevalence of both cervical and lumbar spinal instability in patients with RA was 17.8%. Disease duration was independent risk factor for presence of both cervical and lumbar spinal instability in this study. <h3>Disclosure of Interest</h3> None declared
SAT0636 Ultrasonography definitions for synovitis grading in children: the omeract pediatric ultrasound task force
Authors: J Vojinovic, S Magni-Manzoni, P Collado, D Windschall, V Ravagnani, C Hernandez-Diaz, JC Nieto Gonzales, C Malattia, N Tzaribachev, G Susic, N Damjanov, S Guillaume Czitrom, T Herlin, S Lanni, G Bruyn, A Iagnocco, L Terslev, M-A D'Agostino, E Naredo
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Ultrasound (US) was found to have face and content validity for detecting synovitis in juvenile idiopathic arthritis (JIA) with higher sensitivity than clinical examination. In order to test validity and improve the applicability of US in JIA, the OMERACT US pediatric subtask force recently published preliminary definitions for the sonographic features of synovitis in children. <h3>Objectives</h3> Aim of this study was to confirm and improve B-mode and color power/Doppler (PD) US definitions for synovial components and grading in children, by using an image and patient based exercise. <h3>Methods</h3> The definitions were confirmed and modified in a multi-step process. In the 1st step, definitions were developed in multi-round Delphi web based consensus process were ≥80% of participants would need to reach ≥80% of agreement on a Likert scale from 1–5 (1 strongly disagree, 2 disagree, 3 neutral, 4 agree, 5 strongly agree). In the 2nd step, in a face to face meeting, a subgroup of these experts revised the definitions for final wording and performed intra- and inter-observer reliability exercise study in JIA patients as the final 3rd phase of the process. The definitions were tested in four joints (wrist, 2nd MCP, knee and ankle) of JIA patients divided in four age groups following standardized image acquisition and machine setting protocol. Statistics program R (version 3.3.0) was used for the statistical analyses. For intra-rater agreement Cohen kappa and for inter-rater agreement prevalence and bias adjusted kappa (PABAK) were calculated if needed. <h3>Results</h3> Reliability exercise included 20 JIA patients (distributed in equal numbers by age groups), 14 observers, 4 joints/observer, 3 observers/joint, 360 intra- and 360 inter-observer tests. A 0–3 semi-quantitative B-mode and color power/Doppler US definitions for synovial components and grading, were agreed (presented in Figure 1). <h3>Conclusions</h3> The proposed synovitis grading for children showed to be reliable why the next step should be to test sensitivity to change in order to possibly be used as an outcome tool in JIA. <h3>Disclosure of Interest</h3> None declared
Phase III study of NEPA, a fixed combination of netupitant and palonosetron, versus an aprepitant regimen for prevention of chemotherapy-induced nausea and vomiting (CINV).
Authors: Li Zhang, Shun Lu, Ji Feng Feng, Arunee Dechaphunkul, Salvatore Chessari, Corinna Lanzarotti, Karin Jordan, Matti S. Aapro
Journal: Journal of Clinical Oncology (2017)

10090 Background: Co-administration of multiple antiemetics that inhibit several molecular pathways involved in emesis is required to optimize CINV control in patients receiving highly emetogenic chemotherapy (HEC). NEPA, a novel fixed combination of a highly selective NK 1 receptor antagonist (RA), netupitant (300 mg), and palonosetron (PALO 0.50 mg), a pharmacologically distinct 5-HT 3 RA, has shown superior CINV prevention compared to PALO in cisplatin and AC-based settings. This study is the first head-to-head comparison of NEPA versus an aprepitant (APR)/granisetron (GRAN) regimen, with the primary objective being to demonstrate non-inferiority in preventing CINV. Methods: This randomized, double-blind, parallel group Phase III study conducted in an Asian population was designed to compare efficacy and safety of a single oral dose of NEPA with a 3-day oral APR/GRAN regimen in chemotherapy-naïve patients receiving cisplatin-based HEC. All patients also received oral dexamethasone (DEX) on days 1-4. The primary efficacy endpoint was complete response (CR: no emesis, no rescue medication) during the overall (0-120 h) phase. Non-inferiority was defined as a lower 95% CI greater than the non-inferiority margin set at -10%. Secondary efficacy endpoints included no emesis and no significant nausea (NSN: &lt; 25mm on 100mm VAS). Results: Treatment groups were comparable for the 828 patients analyzed: predominantly male (71%); mean age 54.5 years; ECOG 0-1 (98%); lung cancer (58%). NEPA demonstrated non-inferiority to APR/GRAN for overall CR; no emesis and NSN rates favored NEPA. Most frequent study drug-related adverse events (AEs) for NEPA included constipation (8.0%) and hiccups (2.7%). The type/incidence/severity of AEs were similar for NEPA and APR/GRAN. Conclusions: In this first study comparing NK1RA regimens and 4 days of DEX, NEPA administered only on day 1 was non-inferior to a 3-day oral APR/GRAN regimen in preventing CINV associated with HEC. [Table: see text]
AB0357 Sexuality in women with rheumatoid arthritis - results of a survey
Authors: R Puchner, J Sautner, J Gruber, A Trenkler, E Bragagna, G Eberl, A Alkin, H Pieringer
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Diseases such as rheumatoid arthritis (RA) are distinguished by their chronic and progressive characteristics; they may lead to premature loss of joint function and constitute major social, economic and health burdens. Rheumatic diseases may affect all aspects of life including patients9 sexuality. <h3>Objectives</h3> The objective of the study was to evaluate the impact of RA on women9s sexuality regarding sexual motivation, activity, and satisfaction and to assess the correlation of disease related physical impairment within sexual functioning. <h3>Methods</h3> A group of rheumatologists, a sociologist and a specialist in sexual medicine initiated a substantial survey, including standardised questionnaires. The items asked were assessments of disease activity with the Clinical Disease Activity Index (CDAI) and measurements of illness and medically induced changes in sexual functioning with the Changes in Sexual Functioning Questionnaire-short form (CSFQ-14). Levels of depression were evaluated with the Beck Depression Inventory FastScreen (BDI FastScreen) and to establish disability the Health assessment questionnaire (HAQ) was used. Further questions were concerning demographic and health related data such as comorbidities, medication, alcohol and smoking habits. <h3>Results</h3> 319 questionnaires were distributed to RA-patients and 319 to healthy controls (HCOs). 235 questionnaires from patients (73, 7%) and 180 HCO-questionnaires (58, 8%) were sent back. Women with RA had a significantly lower CSRQ Score than HCOs. 48% of the patients had a total CSFQ score of ≤41, which is defined as an indicator of sexual dysfunction. However, only 14% of the healthy respondents scored similarly. 29.3% of the surveyed patients were in remission, 45.1% in low disease activity, 18.9% in a moderate disease activity and 6.8% in high disease activity. There was no relationship between CDAI and CSFQ. Age and level of education were the most important demographic parameters connected with sexual dysfunction. There was also a moderate and significant relationship between depression and sexual dysfunction. A significant correlation between the HAQ index and the level of sexual dysfunction was to be observed. <h3>Conclusions</h3> Due to the lack of substantive surveys in this field, we tried to undertake a comprehensive study covering sexual dysfunction in women with RA. The study shows that RA has a significant effect on the sexuality of women, compared to healthy individuals. <h3>Disclosure of Interest</h3> R. Puchner Grant/research support from: unrestricted industrial grant Pfizer Austria WI205954, J. Sautner: None declared, J. Gruber: None declared, A. Trenkler: None declared, E. Bragagna: None declared, G. Eberl: None declared, A. Alkin: None declared, H. Pieringer: None declared