tbuckley/cabot-search huggingface dataset:
SAT0269 Rdw levels are associated with damage accrual in systemic lupus erythematosus patients
Authors: C Reategui-Sokolova, M Ugarte-Gil, R Gamboa-Cárdenas, F Zevallos, J Cucho-Venegas, J Alfaro-Lozano, M Medina, Z Rodríguez-Bellido, C Pastor-Asurza, G Alarcόn, R Perich-Campos
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Systemic Lupus Erythematosus (SLE) patients show higher Red blood cells Distribution Width (RDW) regardless of anaemia status<sup>1</sup>. RDW has been found to positively correlate with serum IgM, CRP, ESR, and SLE Disease Activity Index 2000 (SLEDAI-2K), and glucocorticoid treatment decreased both SLEDAI-2K and RDW<sup>2</sup>. <h3>Objectives</h3> To determine whether RDW levels in SLE are associated with damage accrual. <h3>Methods</h3> This cross-sectional study was conducted in 276 SLE patients, 257 females and 19 males. Evaluations included interview, medical records review, physical examination and laboratory tests. Disease activity was measured with the SLEDAI. Damage accrual was ascertained with the SLICC/ACR damage index (SDI). Univariable and multivariable Poisson regression models were performed to determine if RDW levels were associated with damage accrual. These models were stratified by tertiles of RDW. The multivariable model was adjusted for variables known to be associated with this outcome [age at diagnosis, gender, socioeconomic status, ethnicity, tobacco use, disease duration, SLEDAI, anemia, antimalarials and immunosuppressive drugs use, average daily dose and time of exposure to prednisone (PDN)]. <h3>Results</h3> The patients mean (SD) age at diagnosis was 34.38 (13.33) years; nearly all patients were mestizo. Disease duration was 7.04 (6.16) years. The SLEDAI was 5.24 (4.67) and the SDI 0.92 (1.28). The average daily dose of PDN was 6.90 (6.07) mg/d and the time of exposure to PDN was 6.58 (9.59) years. RDW levels were 14.57 (1.52)%. Hemoglobin levels were 12.4 (1.7) g/dl. We divided the RDW levels into tertiles with cut points in 13.8 and 14.0; the highest tertiles were associated with disease damage; with a Rate Ratio (RR) 1.57 (1.07–2.28; p: 0.020 for the highest tertile, and 1.67 (1.15–2.42; p: 0.007) for the medium tertile. <h3>Conclusions</h3> Higher RDW levels are associated with damage accrual in SLE patients independent of other well-known risk factors for such occurrence. <h3>References</h3> Vayá A, Alis R, Hernández J-L, et al. RDW in patients with systemic lupus erythematosus. Influence of anaemia and inflammatory markers. Clin Hemorheol Microcirc 2013; 54: 333–9. Hu Z-D, Chen Y, Zhang L, et al. Red blood cell distribution width is a potential index to assess the disease activity of systemic lupus erythematosus. Clin Chim Acta 2013; 425: 202–205. <h3>Disclosure of Interest</h3> None declared
AB1080 Results in the follow-up of the nursing consultation for the monitoring of rheumatologic patients treated with intravenous therapies
Authors: C Nájera Herranz, I Cánovas Olmos, J Ivorra Cortes, E Grau Garcia, C Alcañiz Escandell, K Arévalo Ruales, I Chalmeta Verdejo, CM Feced Olmos, JJ Fragio Gil, R Mazarío González, L Gonzalez Puig, E Sánchez Labrador, I Martínez Cordellat, R Negueroles Albuixech, JE Oller Rodriguez, FM Ortiz-Sanjuan, E Vicens Bernabeu, D Marín Hervás, JA Román Ivorra
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> In the management of rheumatologic patients treated with intravenous therapies, its regular monitoring is recommended in order to ensure its safety. The Nursing Consultation for monitoring rheumatologic patients treated with Intravenous Therapies (NCIT) represents a major support to patient caring for it provides patient monitoring before treatment administration and prior to rheumatologist consultation. <h3>Objectives</h3> To analyze number and types of incidents detected in the NCIT. <h3>Methods</h3> A cross-sectional longitudinal, observational study of data from patients followed-up in the NCIT (which was initiated in 2012) was performed. We have collected data of gender, diagnosis, drug administered, incidents detected previously to the drug administration, and if the incident was detected by telephone (one day before drug administration) or by personal interview. Biostatistical analysis with R (3.3.2.) was performed. <h3>Results</h3> We analyzed 7809 drug infusions corresponding to 545 patients (73% women). 48.25% of patients were diagnosed with osteoporosis (OP), 30.1% rheumatoid arthritis (RA), 5.7% ankylosing spondylitis (AS), 4.2% systemic lupus erythematous (SLE), 2.9% psoriatic arthritis (PsoA) and 8.3% had other diagnosis. The intravenous therapies were antiosteoporotic drug (7.8%) and biological and immunosuppressive treatment, being the most common drugs tocilizumab (38.89%), infliximab (31.9%) and abatacept (18.05%). In the 7809 treatment infusions, 477 incidents (4.1%) were registered, 33 of them related to the antiosteoporotic therapies and the other 444 incidents (93%) occurred in the biological therapies. The 63.7% of the incidents were detected by telephone one day before drug infusion. Statistical analysis showed that SLE patients exhibit higher tendency to incidents (4.8% of incidents in the 392 treatments for SLE patients; P=0.026) than other autoimmune diseases. On the other hand, RA and AS patients have incidents detected mainly by telephone ((P=0.047 y P=0.029 respectively). We also observed a high number of incidents in the intravenous administration of TCZ (P=0.009). <h3>Conclusions</h3> The NCIT has performed the follow-up of more than 5oo patients with only 6% of incidents, contributing to an improvement in the patients9 health and in its caring. Moreover, the fact of identifying the incidents helps to reduce the number of personal consultations, avoids drug preparation in those cases where this infusion is suspended, and in summary it improves management of hospital resources. <h3>Disclosure of Interest</h3> None declared
SAT0237 Bone marrow as a target organ of systemic lupus erythematosus: analysis of cases with autoimmune myelofibrosis
Authors: D Üsküdar Cansu, H Üsküdar Teke, S Işıksoy, C Korkmaz
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Cytopenia in the course of systemic lupus erythematosus (SLE) may be due to multiple factors. One of these factors can be SLE-associated autoimmune myelofibrosis (AIMF). However, the frequency of SLE-associated AIMF is not well known and the role of clinical and laboratory parameters in the development of AIMF is not clear. <h3>Objectives</h3> Our aim was to identify the frequency of SLE-associated AIMF and compared SLE-associated AIMF group with non-AIMF group in terms of clinical findings and morphological properties of the bone marrow (BM) in cytopenic SLE patients. <h3>Methods</h3> We retrospectively analyzed 224 SLE patients9 files who met 1997 revised Classification criteria for SLE. BM aspirates and trephine biopsies were re-examinded. Patients were divided into two groups according to whether they had myelofibrosis or not (AIMF and non-AIMF groups). Concurrent SLE organ involvements, and drugs given pre- and post-AIMF were recorded. BM cellularity, the presence of fibrosis (reticulin or collagen) and grade of fibrosis, the presence of dysplasia, and lymphoid infiltration were recorded. <h3>Results</h3> 45 (20%) of 224 SLE patients were found to experienced BM biopsy due to cytopenia. Four patients were excluded from analyses (2 drug-induced cytopenia, 1 lymphoma, 1 insufficient BM biopsy samples). While AIMF was detected in 29 (70.7%) of the 41 patients, 12 patients did not have AIMF. All patients with AIMF had reticulin fibrosis, 2 patients (6.9%) had also collagen fibrosis. Between the AIMF and non-AIMF groups, no differences were identified in terms of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), SLEDAI, BM cellularity, or BM dysplastic changes (p=0.989, p=0.387, p=0.788, p=0.672, and p=0.494, respectively). In the AIMF group, 27 patients responded to immunosuppressive therapy and corticosteroids, but 2 patients were unresponsive. The response time was longer for the AIMF group compared to the non-AIMF group (3.3±3.1 months vs 1.7±1.2 months, p=0.091). Correlation analysis revealed that higher the grade of BM fibrosis, longer the response time (r=0.471, p=0.002). <h3>Conclusions</h3> AIMF may be underestimated in SLE patients. AIMF as an additional factor for cytopenia in SLE patients may lead to delayed response to appropriate therapy, which was dependent on the presence of high grade fibrosis. <h3>Acknowledgements</h3> None declared <h3>Disclosure of Interest</h3> None declared
OP0260-HPR Higher satisfaction with activity-related symptoms after 15-week resistance exercise in women with fibromyalgia
Authors: K Mannerkorpi, A Larsson, A Palstam, M Ernberg, B Gerdle, E Kosek
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Physical exercise is troublesome for most patients with fibromyalgia (FM) due to activity-induced pain. A reason for activity-induced pain is a low pain threshold. In the present study we investigated if experience of physical activity changed after 15-week progressive person-centred resistance exercise. The control group participated in 15-week relaxation program. <h3>Objectives</h3> To investigate how experience of physical activity changed after 15-week resistance exercise in women with FM, and if experiences correlated with pain threshold. <h3>Methods</h3> 130 women (age 22–64 years, symptom duration 0–35 years) with FM were randomized to 15-week resistance exercise or to a parallel relaxation program. The participants completed Experience of physical activity scale (EPA) comprising five subscales (0–7), assessing how exercise was perceived in terms of Physical relaxation (PR), Well-being (WB), Activity beliefs (AB), Activity-related symptoms (ARS), and Activity Habits (AH) (1). A lower score indicates a higher satisfaction. Pain threshold was investigated with algometer. Within-group and between-group analyses were conducted by non-parametric statistics. Correlations between algometry and ratings on EPA were investigated by Spearman correlation coefficient. <h3>Results</h3> The resistance exercise group scored significantly higher satisfaction at posttest than before the intervention in their ratings on how they experienced exercise in terms of PR, WB, ARS and AH (p&lt;0.05), Table 1. Between-group analyses showed that the resistance exercise group scored significantly higher satisfaction in ARS subscale (p&lt;0.006) after the intervention when compared to the relaxation group. Significant correlations were found between algometry and PR (rs -0.32, p=0.017) as well as ARS (-0.33, p=0.015) at post-test in the resistance exercise group. <h3>Conclusions</h3> Women with FM experienced a higher satisfaction with activity-related symptoms after having participated in a person-centered resistance exercise program, which is an important knowledge for health care professionals when motivating patients for exercise. Correlations between algometry and ratings on PR and ARS indicate that activity-related symptoms are partly associated with the pain threshold. <h3>References</h3> Mannerkorpi K, Rivano-Fischer M, Ericsson A, Nordeman L, Gard G. Experience of physical activity in patients with fibromyalgia and chronic widespread pain. Disabil Rehabil 2008;30 (3):213–21. <h3>Disclosure of Interest</h3> None declared
PARE0004 Patient reported long term effects of six week progressive resistance training programme for rheumatoid arthritis
Authors: R Tekkatte, A Suarez, B Berntzen, D Collins, E Price, L Williamson
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> We introduced six week physiotherapy led progressive resistance training (PRT) programme for Rheumatoid arthritis (RA) patients to improve physical function and prevent the muscle loss (rheumatoid cachexia). Six week data showed improvement in body composition, physical function and fatigue scores<sup>1</sup>. There is little published data about the longer term benefits of short exercise interventions and therefore we wished to study longer term effects on exercise behaviour in our patient group. <h3>Methods</h3> We surveyed 79 RA patients who had completed the six weeks PRT programme between 2013 and 2016 using two methods: Anonymous postal questionnaire; Direct telephone questionnaire. Patients were asked the same following questions: 1. Describe the best you feel at present following the exercise programme? Same/ Better/ Worse. 2. Have you continued with progressive resistance exercises? Yes/ No. 3. Do you feel the programme was worthwhile? Yes/No. 4. Did you feel the programme was too long, just right or too short? <h3>Results</h3> <h3>Postal questionnaire</h3> 45% (36/79) patients returned the postal questionnaire. Time from PRT programme completion to postal questionnaire was: range (mean) 12–36 (26) months. 69% (25/36) still felt better; 25% (9/36) felt the same; 3% (1/36) worse since the programme. 91% (33/36) felt the programme was worthwhile. 75% (27/36) continued PRT exercises. 81% (22/27) of these still felt better, compared with 33% (3/9) who have not continued PRT (p=0.006). The duration of the programme was just right for 69% (25/36) and too short for 30% (11/36). <h3>Telephone questionnaire</h3> 54% (43/79) patients were contactable by telephone. Time from PRT programme completion to telephone questionnaire was: range (mean) 14–38 (26) months. 58% (25/43) still felt better; 18% (8/43) felt the same; 23% (10/43) worse since the programme. 95% (41/43) felt the programme was worthwhile. 51% (22/43) continued PRT exercises. 77% (17/22) still felt better, compared with 38% (8/21) who have not continued PRT. (p=0.009). 49% (21/43) had not continued PRT exercises, of whom 43% feel worse at present. The duration of the programme was just right for 47% (20/43) and too short for 53% (23/43). <h3>Conclusions</h3> Over 90% of patients who responded found the six week PRT programme worthwhile. More than half (51–75%) of the patients continued a PRT exercise programme. Patients who continued exercises felt better compared with those who did not continue exercises. <h3>References</h3> Berntzen et al A Six-Week Progressive Resistance Training Class Improves Function and Fatigue in RA Patients: Annals of the Rheumatic Diseases 75 (S2):254 2016. <h3>Disclosure of Interest</h3> None declared
AB0140 Lupus-prone slam haplotype exerts monocytosis and develops specific phenotype of autoimmune disease introduced by yaa mutation
Authors: H Amano, K Nishikawa, Q Lin, S Kawano, K Yamaji, S Hirose, N Tamura
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> We previously obtained a 129-derive FcγRIIB-deficient C57BL/6 (B6) congenic strain of mice, which spontaneously developed severe rheumatoid arthritis (RA)<sup>1</sup>. The introduction of the <i>Yaa</i> (Y-linked autoimmune acceleration) mutation, which is a consequence of a translocation from the telomeric end of the X chromosome containing the <i>Tlr7</i> gene onto the Y chromosome, to the FcγRIIB-deficient B6 mice (B6.FcγRIIB-/-. <i>Yaa</i>) developed lupus like nephritis but not RA<sup>2</sup>. <h3>Objectives</h3> By extensively backcrossing 129-based FcγRIIB-deficient mice to B6 mice, we established wildtype FcγRIIB and 129-derive autoimmune-prone SLAM haplotype (<i>Slam</i><sup>129</sup>). We examined the phenotype of <i>Slam</i><sup>129</sup> mice, and also <i>Slam</i><sup>129</sup>.<i>Yaa</i> mice by introducing <i>Yaa</i> mutation to these mice. <h3>Methods</h3> We analyzed peripheral blood monocyte subset and also serum autoantibodies as well as immunohistopathological findings of kidneys and lungs. <h3>Results</h3> <i>Slam</i><sup>129</sup> mice showed age-associated monocytosis with marked expansion of Gr-1 negative monocytes, also perivascular inflammatory cell infiltration in lungs. But they did not show any pathogenic autoantibodies. When introducing <i>Yaa</i> mutation, <i>Slam</i><sup>129</sup>.<i>Yaa</i> mice showed significant increase the serum levels of anti-RNP antibodies and anti-Sm antibodies. Although they showed significant increase of serum levels of IgM class anti-dsDNA antibodies, they did not show the elevation of IgG class anti-dsDNA antibodies. Also they developed nephritis but the pathological score was significantly lower than B6.FcγRIIB-/-.<i>Yaa</i> mice. <h3>Conclusions</h3> Autoimmune-prone SLAM haplotype plays a role for Gr-1 negative monocytosis and <i>Slam</i><sup>129</sup>.<i>Yaa</i> mice developed specific lupus phenotype with elevation of anti-RNP and anti-Sm autoantibodies. <h3>References</h3> Sato-Hayashizaki A, Ohtsuji M, Lin Q, Hou R, Ohtsuji N, Nishikawa K, Tsurui H, Sudo K, Ono M, Izui S, Shirai T, Takai T, Nishimura H, Hirose S. Presumptive role of 129 strain-derived Sle16 locus in rheumatoid arthritis in a new mouse model with Fcγ receptor type IIb-deficient C57BL/6 genetic background. Arthritis Rheum. 63(10):2930–8, 2011. Kawano S, Lin Q, Amano H, Kaneko T, Nishikawa K, Tsurui H, Tada N, Nishimura H, Takai T, Shirai T, Takasaki Y, Hirose S. Phenotype conversion from rheumatoid arthritis to systemic lupus erythematosus by introduction of Yaa mutation into FcγRIIB-de ficient C57BL/6 mice. Eur J Immunol. 43:1–9, 2013. <h3>Disclosure of Interest</h3> None declared
AB1129 A systematic review on prevalence of back pain and spondyloarthritis based on copcord studies
Authors: J Moreno-Montoya, J Rodriguez-Amado, R Burgos-Vargas, I Pelaez-Ballestas
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> To determine, through a systematic review and meta-analysis, the prevalence of back pain (BP) and spondyloarthritis (SpA) in the adult general population and explore the heterogeneity between studies in and out Latin America (LATAM). <h3>Methods</h3> MEDLINE, Embase, BIREME, LILLACS and Web of Science were searched using a strategy combining key words and related database-specific subject terms to identify relevant cross-sectional studies based on COPCORD methodology published since 2006. Included articles were assessed for risk of bias and quality based on the STROBE statement. Prevalence figures for BP and SpA (European Spondyloarthropathy Study Group criteria) were analyzed according to female percentage of sampled individuals, mean age and sample size. A mixed effect model was used to obtain the combined prevalence and a meta-regression to estimate the effects of these variables. Prevalence stratified values were obtained according to its geographical location. <h3>Results</h3> 44 out of 127 papers in English, Spanish or Portuguese were selected. Of them, 16 contained BP or SpA prevalence data. Estimates for any Spa prevalence ranged from 0,1% to 2%, with an average of 0,3% (95% CI: 0,01%&gt;0,05%). The random-effects pooled prevalence was 0,18% (0,06%&gt;0,36%). The prevalence of BP was 6.54% (3.8%&gt;9.2%) with a pooled value of 5.24% (2.6%&gt;8.7%). In both cases the heterogeneity was significant (p&lt;0.01). No effect was associated to SpA heterogeneity, but an increase in the prevalence of BP was associated to sample size (random effect coefficient: 0,045, p=0.04). The stratified analysis did not show differences in terms of heterogeneity or prevalence for BP (Pooled prevalence for BP: 5.4%; 2.9%&gt;8.5%, p=0.9); on the contrary, for Spa, for non-LATAM studies, the pooled proportion was significant bigger (prevalence in LATAM 0.05%, 0.01%&gt;0.012%; non-LATAM: 0.35%, 0.09%&gt;0.78%, p=0.03) <h3>Conclusions</h3> We found significant variations in prevalence across this review. In particular, they related to sample size of BP studies. Similarly, there was a significant variation between LATAM versus other latitudes respect to the prevalence of SpA. The limited number of studies included in this meta-analysis however, prevents clear explanations of the mechanisms underlying these results. <h3>Disclosure of Interest</h3> None declared
AB1156 The descriptive epidemiology of cutaneous lupus erythematosus in three large u.s. administrative databases, 2010-2014
Authors: SA Hall, L Li, S Eaton, C Musselli, A Dilley
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Previous epidemiologic studies of cutaneous lupus erythematosus (CLE) have not described the pediatric burden, and have focused on specific geographic areas, limiting generalizability. <h3>Objectives</h3> To describe the demographics, comorbid conditions and pharmacy drug utilization of CLE patients, 3 large sources of U.S. administrative claims data: 1) commercial insurance, 2) Medicaid insurance, and 3) Medicare insurance were utilized. <h3>Methods</h3> The data source was Truven Health MarketScan® Databases, containing medical service and prescription drug claims from commercial, Medicaid (11 states) and Medicare supplemental insurance plans for &gt;80M US patients. CLE cases were identified by presence of ≥2 service dates with an ICD-9 code 695.4 on unique dates ≥28 days apart during the study period (Jan 1 2010-Dec 31 2014). For the most recent study year, the 5 most frequent comorbidity categories were reported using Clinical Classifications Software (CCS) Level 2 groupings. Similarly, the 5 most frequent pharmacy dispensings among CLE cases in 2014 were reported. <h3>Results</h3> In the Commercial, Medicaid, and Medicare claims data, 35,781, 7,361 and 5,594 CLE patients, respectively, were identified. CLE cases were &gt;80% female with &lt;6% aged &lt;19 (Table). The most frequent CCS category (in all databases except Medicare) was CCS 13.7 (SLE and connective tissue disorders including systemic sclerosis, sicca syndrome, dermatomyositis, and polymyositis) where 63.1%, 76.6%, and 59.4% of CLE cases in the Commercial/Medicaid/Medicare data, respectively, had ≥1 claim. The most frequently-dispensed medication was corticosteroid hormone (62.5%, 72.1%, and 62.3% in the Commercial/Medicaid/Medicare data), while antimalarials were used by 58.3%, 55.9%, and 52.1% of CLE patients in the 3 databases, respectively. <h3>Conclusions</h3> Our results document a low relative burden of pediatric CLE. Notably, 23 to 41% of CLE patients did not have a claim for SLE or other connective tissue disease. Limitations include the inability of code 695.4 to distinguish between CLE subtypes, including discoid and subacute cutaneous lupus. <h3>Disclosure of Interest</h3> S. Hall Shareholder of: Biogen, Employee of: Biogen, L. Li Shareholder of: Biogen, Employee of: Biogen, S. Eaton Shareholder of: Biogen, Employee of: Biogen, C. Musselli Shareholder of: Biogen, Employee of: Biogen, A. Dilley Shareholder of: Biogen, Employee of: Biogen