tbuckley/cabot-search huggingface dataset:
SAT0338 Survival in a turkish inflammatory myositis cohort: a single-centre study
Authors: E Gülbezer Er, F Yargucu Zihni, G Karabulut, G Keser, Y Kabasakal
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Inflammatory myositis is an uncommon group of diseases that can be associated with significant morbidity and mortality related to systemic involvement or treatment-related complications. <h3>Objectives</h3> This study aimed to describe the clinical features and survival of patients with inflammatory myositis in our centre. <h3>Methods</h3> We performed a single-centre, retrospective study on patients with inflammatory myositis (polymyositis [PM], dermatomyositis [DM], or Anti-Jo1 syndrome) seen from 2000 to 2014, noting their demographic data, clinical features and outcome until December 2016. The primary outcome assessed was all-cause mortality. Cumulative mortality rates were estimated using the Kaplan-Meier test; the Log Rank (Mantle-Cox) test was used to compare subgroup differences in survival. <h3>Results</h3> Seventy-four patients (19 PM, 28 DM, 27 Anti-Jo1 syndrome) were available for the study. Median age at diagnosis was 47 years (min 17, max 75) and median follow-up time was 93 months (min 4, max 311). Sixty-one patients (82, 4%) were female and 13 (17, 6%) were male. Malignancy was found in 4 patients (2 invasive ductal adenocancer of breast, 1 over cancer and 1 non-small cell lung cancer) and they were all female DM patients. Nineteen patients (25,7%) died at the end of the follow-up. The 19 patients with PM consisted of 15 female and 6 male, with a median age at diagnosis of 45 years (min 22, max 74) and median follow-up time of 88 months (min 5, max 204). The 28 patients with DM consisted of 24 female and 4 male, with a median age at diagnosis of 52 years (min 17, max 75) and median follow-up time of 80 months (min 4, max 288). The 27 patients with Anti-Jo1 syndrome consisted of 22 female and 5 male, with a median age at diagnosis of 50 years (min 22, max 63) and median follow-up time of 117 months (min 5, max 311). Overall survival rates of the whole group were 91%, 83%, and 76% for 1, 5, and 10 years, respectively. The survival rates at 1, 5 and 10 years from the diagnosis were respectively 88%, 82%, %82 for PM, %88, 80%, %80 for DM and 96%, 88%, 74,5% for Anti-Jo1 syndrome. But there was no significant difference between the survival rates of the diagnose groups (p=0,734). Also there wasn9t a significant difference between the survival rates of sex and age groups (p=0,503), (p=0,112). But the survival rates were significantly lower in patients with the time from diagnose less than 8 years (p=0,000). <h3>Conclusions</h3> Our study involved 74 patients followed up for a median of 7, 7 years and is one of the largest cohorts of patients with inflammatory myositis in Turkey. Survival was quite similar with the literature. Usually mortality has been expected in the first years after the diagnosis. <h3>Disclosure of Interest</h3> None declared
SP0044 Screening for comorbidities in daily practice: who and how?
Authors: L Gossec
Journal: Annals of the Rheumatic Diseases (2017)

Comorbidities are frequent in RMDs, as in many other chronic diseases. In inflammatory rheumatic diseases, the most frequent comorbidities are cardio-vascular diseases, depression, infections and cancers. Some of these diseases are more frequent than in persons without RMDs, some are not more frequent but are more often under-assessed and under-treated. These comorbidities and their risk factors need to be screened for. Screening in daily practice is not so simple since it necessitates time, physician expertise and patient cooperation. In this talk, we will address recent recommendations on how to screen for comorbidities, how often and in which setting this should be performed, and the respective roles in screening of rheumatologists, rheumatology nurses and persons with RMDs. <h3>Disclosure of Interest</h3> None declared
AB0393 Adverse skin reactions in rheumatoid arthritis patients recieving tumor necrosis factor alpha inhibitor – an analysis of data from the slovenian biological registry
Authors: S Drljača, A Podovšovnik, Ž Rotar, A Hočevar, S Praprotnik, M Tomšič
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Paradoxical skin reactions (PSR) are defined as a new onset or worsening of skin conditions during treatment with tumour necrosis factor alpha (TNF-α) inhibitors that generally improve or respond to this therapy. The list of PSR is growing. The most commonly reported are psoriasiform skin eruptions. <h3>Objectives</h3> To evaluate the frequency of PSR in the group of rheumatoid arthritis (RA) patients treated with TNF-α inhibitor at the time of development of skin eruption. <h3>Methods</h3> We conducted the analysis of the data from the mandatory Slovenian national registry of patients treated with bDMARDs (BioRx.si) which includes spontaneous adverse reaction reports between 01.01.2008–31.05.2016. The analyses were limited to patients with RA. <h3>Results</h3> During the observation period, 1,046 RA (82% female; median (IQR) age at initiation of TNF-α inhibitors 56 (49–63) years) patients treated with TNF-α inhibitors for 3,140 person years. We identified 14 cases with PSR (71% female, median age (IQR) 45 (53–62)). There were 6 PSR cases on adalimumab, 4 on etanercept, 3 on certolizumab – pegol, and 1 on infliximab. 10 patients developed psoriatic/psoriasiform eruptions, 2 patient leucocytoclastic vasculitis, one had lichen planus, and one undifferentiated skin changes. The incidence rate of new onset of psoriasis in RA patients treated with TNF-α inhibitors was estimated at 3.2 cases/1000 patient-years (95% CI 2.58 to 3.82). The incidence rate of leucocytolastic vasculitis was 0.64/1000 person-years (95% CI 0.36 to 0.92), and of lichen planus 0.32/1000 person-years (95% CI 0.12 to 0.52). <h3>Conclusions</h3> The most commonly reported PSR in RA patients treated with TNF-α inhibitor was psoriasiorm PSR, which is in line with published data. <h3>Disclosure of Interest</h3> None declared
FRI0470 Cigarette smoking has a dose-dependent relationship with disease activity and correlates with more functional limitation and worse health assessment in the patients with ankylosing spondylitis
Authors: Y Jiang, Z Liao, Z Lin, M Yang, Y Zhang, Q Li, J Gu
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Ankylosing spondylitis (AS) is a chronic inflammatory disease that mainly affects the axial skeleton by causing inflammatory and osteoproliferative changes in the sacroiliac joints and spinal structures [1]. Cigarette smoking is associated with poor outcome in patients with established and early AS [2]. <h3>Objectives</h3> Our study was to investigate the relationship between cigarette smoking and pain, disease activity, functional limitation, and health assessment in Chinese patients with AS. <h3>Methods</h3> Patients with AS (n=683) from China took part in a cross-sectional survey. Smoking status was obtained by a standardized questionnaire, involving smoking status (non-smokers, exsmokers, current smokers), the age when starting smoking, cigarette numbers a day and smoking status of family numbers. The Bath AS Disease Activity Index (BASDAI), the Bath AS Functional Index (BASFI), visual Analogue scale of pain, Health Assessment Questionnaire for Spondyloarthropathy (HAQ-S) were analyzed in terms of smoking status and relationship with pack-year history. <h3>Results</h3> Of all the 683 patients, 168 are current smokers, while 108 were ex-smokers and 407 patients never smoked. Mean scores of degree and duration of morning stiffness, overall pain, nocturnal back pain, overall back pain, CRP, BASDAI and BASFI score were all higher in the current smoker group compared to those who had never smoked (<i>P</i>&lt;0.05). In Spearman correlation analysis, pack years of smoking in current smokers were significantly associated with disease duration, morning stiffness (VAS) and duration, nocturnal back pain, overall back pain, CRP, and BASDAI (<i>P</i>&lt;0.01), and overall pain, BASFI and HAQ-S (<i>P</i>&lt;0.05). <h3>Conclusions</h3> Cigarette smoking has a dose-dependent relationship with disease activity and correlates with more functional limitation and worse health assessment in patients with AS. <h3>References</h3> Braun, J. and J. Sieper, Ankylosing spondylitis. Target treatment criteria. Z Rheumatol, 2009. 68(1): p. 30–6. Ward, M.M., et al., Risk factors for functional limitations in patients with long-standing ankylosing spondylitis. Arthritis Rheum, 2005. 53(5): p. 710–7. <h3>Acknowledgements</h3> None. <h3>Disclosure of Interest</h3> None declared
SAT0359 The course of mouth opening and its relationship with disease characteristics, global functioning, health-related quality of life and mouth handicap in patients with systemic sclerosis
Authors: SJH Khidir, M Boonstra, GWM Boerrigter, EM Voogt-van der Harst, SA Bergstra, MK Ninaber, N Ajmone Marsan, TWJ Huizinga, JK Vries-Bouwstra de
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Systemic sclerosis (SSc) is a fibrotic disease which can lead to reduced maximal mouth opening (MMO). Previous cross-sectional research showed that reduced MMO in SSc correlated with higher disease severity and lower oral quality of life. Interpretation of interventions that possibly influence MMO is difficult, as the natural history of MMO in SSc is not well described. <h3>Objectives</h3> To evaluate in SSc 1) the course of MMO 2) disease characteristics predictive for decreasing MMO and 3) the relationship between the course of MMO and global functioning, health-related quality of life (HRQoL) and mouth handicap. <h3>Methods</h3> SSc patients from the Leiden Combined Care In Systemic Sclerosis (CCIS) cohort, Leiden University Medical Center were included if at least one MMO measurement was available. Annual clinical assessment includes MMO measurement, global functioning (HAQ), HRQoL (Short Form-36; SF-36), mouth handicap (Mouth Handicap in Systemic Sclerosis scale; MHISS). We assessed mean MMO, prevalence of microstomia (MMO&lt;30.00 mm) and decreasing MMO (decline &gt;5.00 mm/year) over time. Predictors for decreasing MMO were assessed by a linear mixed model (LMM), including baseline clinical parameters reflecting 7 domains (peripheral vasculopathy, skin, heart, gastrointestinal, lung, renal, musculoskeletal). Additionally, MMO over time was correlated with baseline HAQ, SF-36 and MHISS in separate LMMs adjusted for gender, Body Mass Index, age and disease characteristics correlated significantly (<i>p</i>&lt;0.05) with the course of MMO. <h3>Results</h3> 382 patients were included with mean age 54±14 years, 83% female and 25% diffuse cutaneous SSc. Mean MMO during 6 years of follow-up ranged from 39.4 to 42.5 mm. The annual mean percentage of patients with microstomia was 9%, range 6 to 12% (Figure 1a). A decrease in MMO between two consecutive annual measurements was observed in 5 to 17% of patients, mean 12% (Figure 1b). More extended cutaneous involvement, peripheral vasculopathy, pulmonary and gastrointestinal involvement at baseline were predictive for decreasing MMO over time (Table 1). Baseline HAQ (β=-1.6, 95% CI=-2.7 to -0.6), SF-36 physical component (β=0.1, 95% CI=0.0 to 0.1) and MHISS (β=-0.2, 95% CI=-0.2 to -0.1) correlated with longitudinal MMO. <h3>Conclusions</h3> Over time, MMO is relatively stable in the majority of SSc patients. Microstomia is seen in 9% and important decrease of MMO in 12% and is associated with more severe organ involvement. Even though this concerns only a small subgroup of SSc patients, a significant association with global functioning and HRQoL was demonstrated, underlining the need for treatment strategies improving MMO. <h3>Disclosure of Interest</h3> None declared
THU0145 Impact of different formulations of “patient global assessment” on remission classification by disease activity indices in rheumatoid arthritis
Authors: G Eugénio, R Ferreira, C Silva, C Medeiros, JAP Silva, C Duarte
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Patient global assessment (PGA) of disease activity is included in a large number of composite indices of disease activity and definitions of remission in Rheumatoid Arthritis (RA). However, the actual question is formulated in a variety of different ways according to the instrument considered. <h3>Objectives</h3> To evaluate how 6 different formulations of PGA affect patient estimates and impact upon disease activity and remission rates as assessed by 4 Disease Activity Indices. <h3>Methods</h3> Consecutive RA patients followed in a Rheumatology outpatient department were included in this cross-sectional study. Data collection comprised: 28 joint counts (tender and swollen), C-reactive protein (CRP) and 6 different PGA formulations. The chosen formulations were the ones stated in the: v1) Portuguese National Registry Reuma.pt, the locally used formulation; v2) ACR/EULAR provisional definition of remission (considered in this study as the "standard"); v3) CDAI and SDAI; v4) Disease Activity Score (DAS28) assessment of general health; v5) DAS28 assessment of disease activity (the currently used); v6) one, exploratory, developed by the investigators, including idiomatic cultural expressions. ACR/EULAR Boolean criteria, CDAI, SDAI, and DAS28-CRP (4v) were used to test how these 6 PGA formulations change the rates of remission. PGA differences were assessed by descriptive analyses (including patients with PGA ≤10 and ≤20mm) and Bland-Altman test. <h3>Results</h3> In total, 193 patients were included (82% female, mean (SD) age of 59 (13) years, mean disease duration of 12 (9) years and 31% under biologics). The average PGA ranged from 42.3 (25.3) to 48.1 (26.7)mm as measured in different formulations. The ACR/EULAR (v2) formulation yielded the largest proportion of patients scoring ≤10mm (16.1%), corresponding to a difference of up to 4.7% versus other PGAs. Similar results were found for the ≤20 cut-off (Table 1). By using different PGA9s formulations the rates of remission calculated with different indices can vary between 4.7% and 6.7% (Table 2). Bland-Altman chart confirmed the low agreement between ACR/EULAR formulation and the other PGA formulations (p&lt;.05), except for the DAS "general health" (p=.054). <h3>Conclusions</h3> The use of different PGA formulations has clinical implications in disease activity, which, in turn, can influence therapeutic decisions. The establishment of a single standardised formulation seems warranted. <h3>Disclosure of Interest</h3> None declared
SAT0216 Abatacept experience in biologic naive rheumatoid arthritis patients: hur-bio real life results
Authors: A Sari, B Armagan, L Kilic, A Erden, O Karadag, A Akdogan, S Apras Bilgen, S Kiraz, U Kalyoncu, I Ertenli
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Abatacept (ABA), a T lymphocyte blocker, is one of the treatment options in rheumatoid arthritis (RA) patients who are resistant to initial therapy with non-biologic disease modifying drugs (DMARDs). <h3>Objectives</h3> Aim of this study was to evaluate the effectiveness, safety and drug survival rates of ABA in RA patients registered in HUR-BIO (Hacettepe University Rheumatology Biologic Registry) database. <h3>Methods</h3> HUR-BIO is a prospective,single center database of biological treatments including 1229 RA patients by August 2016. In total, 247 of patients had received ABA and in 175 (71%) of them ABA was the first biological agent. In this analysis, 158 patients were evaluated due to lack of first follow-up visit in 17 patients. Demographics, clinical and serological data were evaluated. DAS-28 and HAQ-DI scores before ABA and last follow-up visit were also assesed. Kaplan-Meier analysis was used to estimate drug survival rates. <h3>Results</h3> Among 175 (82% female) patients, mean age was 53.6±11.3 and mean disease duration was 10.3±7.3. Seropositivity for RF and/or ACPA was present in 74.8% of patients. Table 1 represents DAS-28 scores of patients before ABA and last follow-up visit. Mean duration from ABA initation to first and last follow-up visit was 4.5±3.1 and 15.1±10.2 months, respectively. Female gender was found as a risk factor in terms of remaining of DAS-28 above 3.2 at first control [OR 5,63 (%95 CI 1,72–18,41)]. In first follow-up visit, improvement in DAS-28 score of ≥1,2 from baseline was more frequent in ACPA positive patients (48/62 (77.4%) vs 17/33 (51.5%), p=0.01). HAQ score of &gt;1.0 was observed in 57.8%, 36.3%and 26.1% of patients at baseline, first follow-up visit and last follow-up visit, respectively. ABA had been cessated in 60 (38.0%) patients during follow-up. The reason for ABA withdrawal was primary unresponsiveness in 22 (36.6%) patients and infection in 2 (3.3%) patients. Drug survival for ABA was shown in Figure 1. Log- rank between RF positive and negative patients was found as 0.067. <h3>Conclusions</h3> In our database, 70% of RA patients received ABA were biologic naive. Remission or low-disease activity was achieved approximately 50% of patients in first follow-up visit with an average of 4.5 months after begining of the treatment. Functional improvement was observed in two thirds of patients. Death or life threatening side effects were not seen during follow-up. ABA is an acceptable treatment option in DMARD resistant biologic naive RA patients. <h3>Disclosure of Interest</h3> None declared
Resilience Mediates the Influence of a Polymorphism in the Serotonin Transporter Gene on the Relationship between the Burden of Chronic Illness and Depression
Authors: Foteini Delis, André F. Carvalho, Nafsika Poulia, Petros Bozidis, Vassiliki Paika, Elisavet Ntountoulaki, Dimitra Papaioannou, Else Guthrie, Katerina Antoniou, Thomas N. Hyphantis
Journal: Psychotherapy and Psychosomatics (2017)
Methylphenidate for Apathy in Community-Dwelling Older Veterans With Mild Alzheimer’s Disease: A Double-Blind, Randomized, Placebo-Controlled Trial
Authors: Prasad R. Padala, Kalpana P. Padala, Shelly Y. Lensing, Daniel Ramirez, Varun Monga, Melinda M. Bopp, Paula K. Roberson, Richard A. Dennis, Frederick Petty, Dennis H. Sullivan, William J. Burke
Journal: American Journal of Psychiatry (2017)

Objective: Apathy is a common behavioral problem in Alzheimer’s disease. Apathy has profound consequences, such as functional impairment, higher service utilization, higher caregiver burden, and increased mortality. The authors’ objective was to study the effects of methylphenidate on apathy in Alzheimer’s disease. Method: A 12-week, prospective, double-blind, randomized, placebo-controlled trial (methylphenidate versus placebo) was conducted in community-dwelling veterans (N=60) with mild Alzheimer’s disease. The primary outcome for apathy (Apathy Evaluation Scale–Clinician) and secondary outcomes for cognition (Mini-Mental State Examination, Modified Mini-Mental State Examination), functional status (activities of daily living, instrumental activities of daily living), improvement and severity (Clinical Global Impressions Scale [CGI]), caregiver burden (Zarit Burden Scale), and depression (Cornell Scale for Depression in Dementia) were measured at baseline and at 4, 8, and 12 weeks. Results: Participants were all men (77 years old, SD=8). After adjusting for baseline, the methylphenidate group had significantly greater improvement in apathy than the placebo group at 4 weeks, 8 weeks, and 12 weeks. At 12 weeks, there was also greater improvement in cognition, functional status, caregiver burden, CGI scores, and depression in the methylphenidate group compared with the placebo group. Conclusions: Methylphenidate improved apathy in a group of community-dwelling veterans with mild Alzheimer’s disease. Methylphenidate also improved cognition, functional status, caregiver burden, CGI scores, and depression.
THU0719 Long-term course of health and working capacity after a rehabilitation program for whiplash injury
Authors: T Benz, P Haiduk, S Lehmann, F Gysi-Klaus, BA Michel, A Aeschlimann, F Angst
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Persistent pain and disability of whiplash injury associated disorders (WAD) cause high burden for the individual and costs for healthcare. <h3>Objectives</h3> The aim of this study was to determine state and change of health and working-capacity five years after a standardized inpatient pain management program of four weeks. <h3>Methods</h3> This prospective cohort study quantified health and quality of life by the generic Short Form 36 (SF-36, 100=best), the neck-specific Northern American Spine Society (NASS) form, and the Coping Strategies Questionnaire (CSQ). SF-36 data were compared to age-, sex-, and comorbidity-specific German population norms (1). Changes of health were determined using effect sizes (ES) at the 6 month and the 60 month follow-up. Changes of health were determined using effect sizes (ES) (2). <h3>Results</h3> The 59 participants had mean age of 40.3 years (sd=12.3), 83% were women, and 37% had one or more comorbidites. At 5 years, health was worse on all SF-36 scales when compared to the norms (p&lt;0.001), varying from mean 41.5, norm 82.3 on role physical to mean 65.7, norm 71.0 on mental health (all p&lt;0.001). Median working capacity improved from 0 at entry to 21 at 6 months and to 30 hours/week at 5 years. <h3>Conclusions</h3> Moderate to large long-term effects were observed. Substantial improvements still occurred between 6 and 60 months after start of the pain program, especially in pain, catastrophizing, and physical role performance. Improvements observed after the inpatient pain program can be maintained and expanded in the long-term at home (3). <h3>References</h3> Kurth BM, Ellert U. The SF-36 questionnaire and its usefulness in population studies: Results of the German Health Interview and Examination Survey 1998. Soz Praeventivmed 2002;47:266–277. Kazis ES, Anderson JJ, Meenan RF. Effect sizes for interpreting changes in health status. Med Care 1989;27(3 Suppl):S178–89. Haiduk P, Benz T, Lehmann S, Gysi-Klaus F, Aeschlimann A, Michel BA, Angst F. Interdisciplinary rehabilitation after whiplash injury: An observational prospective five year outcome study. Medicine 2017;in press. <h3>Disclosure of Interest</h3> None declared