tbuckley/cabot-search huggingface dataset:
SAT0580 Osteoarticular tuberculosis: a retrospective study of 119 cases
Authors: R Sonia, S Boussaid, I Abdelkafi, S Hela, C Ilhem, E Mohamed
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Bone and joint involvement in tuberculosis is uncommon. Wile osteoarticular tuberculosis most commonly occurs in the vertebral column, less frequently affected sites are the hip, knee and sacroiliac joints. The multifocal form of skeletal tuberculosis is exceptional. <h3>Objectives</h3> To evaluate the clinical and diagnostic features of osteoarticular tuberculosis. <h3>Methods</h3> We reviewed the files of all patients admitted to our department from 2000 to 2015 with a diagnosis of osteoarticular tuberculosis. <h3>Results</h3> We identified 119 patients (52 men, 67 female), having osteoarticular tuberculosis lesions. Mean age was 43 years [21–82]. Diagnosis delay was 4 months. Pain, low-grade fever and loss of weight were the most common presenting symptoms. All the patients consulted because of pain. The spine was involved in 81 patients. Peripheral osteoarticular tuberculosis was diagnostic in 38 cases, mainly in the knee (21 cases). Five patients have a multifocal involvement of the osteoarticular tuberculosis. The tuberculin skin test was positive in 75% of the cases. The diagnosis of spondylodiscitis was provided by CT-scan and /or magnetic resonance imaging. Paraspinal and epidural abscesses has been reported in 11 cases. Bacteriological and /or pathological diagnosis was made in 72 cases (60.5%). The Quantiferon test was done in 7 cases and was positive. The antibiotic treatment led to recovery in all cases. Tree patients have presented neurological signs. <h3>Conclusions</h3> Our results were similar to those of the literature. Elderly population was especially at risk. The idiagnosis can be delayed espacially in negative investigations. Therefore it is recommendable to do a very large screening tests especially in endemic areas. <h3>Disclosure of Interest</h3> None declared
AB0142 A case of diffuse idiopathic skeletal hyperostosis (dish) with an extremely rare complication
Authors: H Kocyigit, N Erdogan, E Uluc, N Hizli, I Ozdemir, O Polat
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Diffuse idiopathic skeletal hyperostosis (DISH) is a disorder characterised by new bone growth at entheses. In the literature, it has been reported that the anterior bony excrescences in the cervical region due to thickening and ossification of the anterior longitudinal ligament may be up to maximum 12 mm thick. Advanced forms of cervical DISH may give rise to dysphagia, cervical myelopathy, and very rarely dyspnea. We present a 70-year-old man with advanced DISH whose only complaint was severe dyspnea. Cervical computed tomography revealed the large excrescences reaching to 15 mm in thickness. Surgical excision of his anterior cervical osteophytes resulted in relief of his symptoms. <h3>Objectives</h3> <h3>Methods</h3> <h3>Results</h3> <h3>Conclusion</h3>
SAT0504 Predictive ability of biomarkers linked with synovitis for future incidence of painful knee osteoarthritis in a community based cohort of middle-age women
Authors: CS Thudium, S Kluzek, JL Newton, T Spector, D Hart, MA Karsdal, AC Bay-Jensen, N Arden
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Radiographic knee osteoarthritis (RKOA) is associated with the knee pain. However, more than half of the middle-aged individuals with RKOA will report no concurrent knee pain. Specific matrix metalloproteinases (MMPs) generated protein fragments have been associated with knee synovitis and suggested as specific neo-epitope biomarkers of joint remodelling. <h3>Objectives</h3> The aim of the study was to evaluate the association between MMP-derived neo-epitope biomarkers measured in serum, and future incidence of either painful RKOA or RKOA without pain, in a cohort of middle-aged women with no RKOA at baseline. <h3>Methods</h3> 585 participants (mean age 53.2, mean BMI 25.1) from the Chingford 1000 Women Study Chingford Women Study had serum biomarker levels of MMP- degraded of CRP (CRPM), collagen type II (C2M) and collagen type III (C3M) measured at year 2 or 3 of the study. All participants had a Kellgren Lawrence (KL) score of 0 in both knees at baseline. Ten years following the recruitment, incidence of RKOA was determined as KL ≥2 and painful RKOA was defined as the presence of pain on any number of days in the preceding month in the knee with RKOA. Log-transformed normalised biomarker levels were utilised in separate logistic regression models adjusted for age. Outcomes were defined as either RKOA without pain or painful RKOA. Further analyses were performed adjusting for both age and BMI. <h3>Results</h3> 24.6% of women developed RKOA during 10 years after the recruitment, but only 8.9% of developed RKOA associated with concurrent knee pain. After adjusting for age, statistically significant positive associations were found between C3M and CRPM and the risk of developing painful RKOA with odds ratio (OR) =3.4 (95% confidence interval (CI): 1.4 to 8.2), and OR=2.5 (95% CI: 1.2, 5.2) respectively. After adjusting for age and BMI, only C3M was positively associated with risk of developing painful RKOA with OR=3.2 (95% CI: 1.3, 7.8). <h3>Conclusions</h3> In a population of middle-aged women without knee osteoarthritis, an MMP generated neo-epitope of collagen III previously linked with knee synovitis (C3M) can independently identify high-risk individuals for developing painful RKOA. These findings indicate that targeting MMP activity may be a promising therapeutic strategy in well-targeted populations. <h3>Disclosure of Interest</h3> C. Thudium Employee of: Nordic Bioscience, S. Kluzek: None declared, J. Newton: None declared, T. Spector: None declared, D. Hart: None declared, M. Karsdal: None declared, A. Bay-Jensen: None declared, N. Arden: None declared
AB0910 Infectious spondylodiscitis in the sanitary area of torrelavega between 2000 and 2016: 62 cases
Authors: I Morante Bolado, M Santos-Gόmez, I Villa Blanco, E Aurrecoechea Aguinaga, T Ruiz Jimeno, J Alén Calvo
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> To analyze the clinical characteristics, most frequent diagnostic methods and different treatments used in spondylodiscitis (SD) in our sanitary area. <h3>Methods</h3> Descriptive and retrospective study of patients with the diagnose of infectious SD (clinical or microbiological) from 2000 to 2016. In each case we studied the presence of underlying diseases, an episode of infection in the previous 6 months, way of presentation, location, diagnostic methods, treatment and evolution, comparing among different etiologies. <h3>Results</h3> 62 patients were diagnosed of spondylodiscitis. 41 men (24–90 years: mean 71,7). 58 were pyogenic, 3 tuberculous (TBC) SD, and 1 candida. The patients with TBC were younger (mean age: 45.3; p&lt;0.05). An underlying disease was observed in 51 patients, specially Diabetes Mellitus (DM) (31% of SD). 4 patients were Rheumatoid Arthritis patients. A previous episode of bacteriemia or a primary source of infection was identify in a 33% of the cases, obtaining a microbiological isolation in 47/62 (75.8%) SD (43 bacterial, 3 TBC and 1 Candida). The most frequent pathogens were Gram +(G+) (50% of the total SD) being S. aureus and S epidermidis responsible of 21/62 cases (33.8%). In the 94% of SD caused by G+, hemocultures positive were obtained, in comparison to a 55% of SD caused by G- (p=0.016). The most frequent presentation symptoms were: lumbar pain (95.1%), fever (50%) and neurological deficit (18%). Leucocytosis was present in only a third of the SD, observing an increase of ESR and CRP in the pyogen etiology (p no significative for low number of patients in SD group caused by TBC) and lower levels of hemoglobin, cholesterol and albumin. Lumbar area was affected in the 77% of SD (77% in G+ and 50% in G-). In a 13% of patients, more than one intersomatic space was affected, being visible the presence of an abscess in 44/62 cases (71%). It was necessary surgical treatment in 7/44 (16%). 5 patients died due to pathology related to SD (8%), without any correlation with a risk factor and other 5 presented a relapse in the subsequent months. <h3>Conclusions</h3> the bacterial SD are the predominant group, being DM the most frequent risk factor. The incidence of SD due to TBC and fungi is scarce in our environment, being absent the Brucella etiology. The G+ SD usually have a previous associated bacteriemia. The majority of the patients had pain in the presentation, but only half of them had associated fever. The most frequent location of SD was lumbar. We established a 8% of mortality rate in our sanitary area. <h3>Disclosure of Interest</h3> None declared
AB1233-HPR Cognitive complaints in patients with active systemic lupus erythematosus and past neuropsychiatric symptoms
Authors: D Usheva, D Ivanova, J Petrova
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> Cognitive complaints are common in patients with systemic lupus erythematosus (SLE). Their association with disease and non-disease related factors have been inconsistently reported. We studied their relation to disease related factors including disease activity, neuropsychiatric history and non-disease related factors such as anxiety or depression. <h3>Methods</h3> We used cognitive symptoms inventory (CSI) for measuring cognitive impairment at 3 time-points 12 months apart/2015–2016/ and Hospital Anxiety and Depression Scale (HADS)-HADS-A and D.Disease activity was measured by SLEDAI. <h3>Results</h3> 93 SLE patients were recruited at baseline (T0). Among them 59 had first re-evaluation (T1) and 34 had second re-evaluation (T2) at 12-month interval. Majority (72%, 24/34) of patients had stable CSI whereas 5.5% (2/34) of patients worsened CSI over 12 months. At T0, multivariate analysis revealed that higher CSI was associated with history of NPSLE (p=0.005) and psychiatric disease (p=0.04), higher HADS-A (p&lt;0.001) and HADS-D (p&lt;0.001) scores. CSI of active patients (SLEDAI&gt;6) was not different from inactive patients. It did not change despite regression of disease activity in 12 months. There was no difference in CSI between T0 and T1 regardless of history of NPSLE, change in anxiety and depression at T1 (HADS-D&gt;11 as cutoff).Multivariate linear regression analysis revealed change in HADS-A as the only significant predictive factor of change in CSI over time (β=0.774, 95% CI 0.43 – 1.12, p&lt;0.001). <h3>Conclusions</h3> 11.5% of SLE patients reported persistent cognitive symptoms.CSI had worsened in patients with NPSLE and psychiatric illness, anxiety or depression. <h3>Disclosure of Interest</h3> None declared
AB0788 Differences in the phenotypic expression of recent onset psoriatic arthritis among men and women: baseline data from the reapser study
Authors: R Queiro, A Laiz Alonso, HS Park, C Montilla Morales, E Galíndez Agirregoikoa, JJ Bethencourt Baute, S Bustabad Reyes, P Menéndez Tejόn, MΆ Belmonte, JA Pinto Tasende, E Alonso Blanco Morales, J Ramír
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The natural history of psoriatic arthritis (PsA) according to gender of patients is an aspect of the disease only partially studied. In prospective PsA cohorts such information is barely known. <h3>Objectives</h3> To analyze baseline gender differences in the REAPSER cohort (Psoriatic Arthritis Registry of the Spanish Society of Rheumatology). <h3>Methods</h3> Observational, multicenter study (34 centers), with consecutive inclusion. We included adults of both sexes 18 years of age or older with PsA that met CASPAR criteria, and duration of less than two years since the appearance of symptoms attributed to PsA. Annual follow-up visits will be carried out for 5 years. Measurements: socio-demographic data; employment status and impact of the disease; family history of PsA and other inflammatory diseases; comorbidities and treatment; lifestyle; use of health services; clinical status at the time of diagnosis of PsA; anthropometric data; clinical evaluation of PsA manifestations; radiographic evaluation; analytical determinations; treatment of PsA. The study has been approved by the Ethical committees of the participating centers. Comparative statistical analysis: for qualitative variables, the χ-square or the Fisher exact statistic were used. For non-normal quantitative variables, non-parametric tests were used and for normal quantitative variables, Student9s t-test was used. <h3>Results</h3> The results are expressed in the table. <h3>Conclusions</h3> The baseline data from this prospective cohort point to significant differences in the phenotypic expression of PsA between men and women. Thus, in women, the prevalence of dactylitis and pustular psoriasis was higher, there were higher rates of depression and a perception of higher disease activity. Women scored higher on the pain linked to their arthritis and the activity of axial disease. They also had biological activity parameters (ESR) higher than that of men. It is necessary to determine if these differences are maintained or change over time. <h3>Disclosure of Interest</h3> None declared
FRI0036 Association between the 18fdg-pet imaging and the pathological findings of rheumatoid synovitis
Authors: C Okura, Y Yonemoto, K Okamura, T Suto, M Tachibana, H Chikuda
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> It has been reported that 18FDG-PET (PET) is useful in the evaluation of RA and for monitoring the effects of treatment on the disease activity, so its utility for the evaluation of arthritis is expected. However, the mechanism underlying the uptake of FDG into the inflamed joint is still unclear. <h3>Objectives</h3> The aim of this study was to investigate the associations among the amount of FDG uptake in RA joints, the inflammatory findings with regard to the pathology of the synovium and the clinical findings. <h3>Methods</h3> We performed PET in 18 RA patients who underwent Total Knee Arthroplasty surgery in our hospital just prior to surgery. We calculated the FDG uptake as the standardized uptake value (SUV)max and scored it using the Rooney score, with the degree of inflammation of the synovial tissues used for the pathological evaluation. We evaluated the associations among the SUVmax, Rooney score, CRP level, ESR and MMP-3 level just before surgery. <h3>Results</h3> The subjects were 18 cases with 20 joints, which were in four females and 14 males. At the time of surgery, the average age of the patients was 66.7±7.9 years old, and the mean disease duration was 20.8±14.0 years. Significant correlation was not observed between SUVmax and total Rooney score (r =0.056, p=0.814). But there were strong correlations between SUVmax and some of the individual items in Rooney score, including the "Synoviocyte hyperplasia", and also between SUV max and "Diffuse infiltrates of lymphocytes" (r=0.512, p=0.021 and r=0.581, p=0.007, respectively). <h3>Conclusions</h3> The accumulation of FDG was associated with the extent of "synoviocyte hyperplasia" and "diffuse infiltrates of lymphocytes". It is estimated that accumulation of FDG is associated with relatively early stage of active inflammation of RA. <h3>References</h3> McQueen FM, et al. Clin Rheumatol: 2007. Beckers C, et al. Eur J Nucl Med Mol Imaging; 2006. Okamura K, et al. Rheumatology (Oxford); 2012. <h3>Disclosure of Interest</h3> None declared
Nil per Os Orders for Imaging
Authors: Andrew L. Wickerham, Eric J. Schultz, Eliza B. Lewine
Journal: JAMA Internal Medicine (2017)

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AB0096 Efficacy and safety of oral administration of pure celastrol in aia rats
Authors: R Cascão, T Carvalho, J Goncalves, LF Moita, JE Fonseca
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Celastrol, a pentacyclic-triterpene isolated from <i>Tripterigium wilfordii</i> roots, has shown great therapeutic potential for the treatment of several inflammatory diseases, including rheumatoid arthritis (RA). We have previously demonstrated that celastrol has significant anti-inflammatory and bone protective effects in the adjuvant-induced rat model of arthritis (AIA), when administered via intraperitoneal route. For further preclinical evaluation of celastrol as a candidate compound for RA treatment, an effective and safe oral administration is crucial. <h3>Objectives</h3> In this work we aimed to study the dose range for both therapeutic and toxic effects for oral administration of pure celastrol using the AIA rat model. <h3>Methods</h3> Celastrol (1, 2.5, 5, 7.5, 12.5 and 25μg/g/day, N=5/group) was administrated orally in female AIA rats after 8 days of disease induction (therapeutic model) for a period of 14-days. A group of healthy (N=8) and untreated arthritic (vehicle, N=15) gender and age-matched Wistar rats were used as control. During the period of treatment, the inflammatory score, ankle perimeter and body weight were measured. At the end of the treatment, animals were sacrificed, blood was collected for clinical pathology, and necropsy was performed, with collection of internal organs for histopathological analysis and of paw samples for disease scoring. <h3>Results</h3> Oral administration of pure celastrol at 2.5, 5 and 7.5μ g/g/day reduced the inflammatory score and ankle swelling, preserved articular joint structure with a reduction in synovial inflammatory infiltrates and proliferation, halted articular bone destruction, and diminished the number of synovial CD68+ macrophages (a biomarker of response to anti-arthritic treatment). This compound also reduced the number of osteoclasts and osteoblasts present in joints. Bone resorption and turnover was also reduced at both 5 and 7.5μg/g/day, with a significant decrease in serum levels of TRACP-5b, P1NP and CTX-I. Of note, no significant variation in body weight, evidence of nephro-, hepato- or cardiotoxic effects, nor alterations in blood cell counts were observed at these concentrations. However, the dose of 7.5μ g/g/day was already associated with thymic and hepatotoxic changes, and higher doses showed toxicity signs. The lethal dose (LD) and LD<sub>50</sub> were defined as 25μg/g/day and 12.5μg/g/day, respectively. Of note, oral celastrol at 1μg/g/day had no effect in arthritis progression. <h3>Conclusions</h3> Our results clearly show that 2.5μg/g/day is the lowest and 5μg/g/day is the highest effective and safe oral doses of celastrol in the setting of AIA rat model. These findings suggest that while celastrol is potentially very effective to treat RA, it has a narrow therapeutic window. <h3>Acknowledgements</h3> The authors would like to acknowledge Bruno Vidal and Inês Lopes for technical assistance. <h3>Disclosure of Interest</h3> None declared
SAT0475 Recent onset psoriatic arthritis: baseline data from the reapser study
Authors: R Queiro, A Laiz Alonso, HS Park, C Montilla Morales, E Galíndez Agirregoikoa, JJ Bethencourt Baute, S Bustabad Reyes, P Menéndez Tejόn, MΆ Belmonte, JA Pinto Tasende, EA Blanco Morales, J Ramír
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The natural history of psoriatic arthritis (PsA) is very little known and the information regarding prospective cohorts is very scarce worldwide, including our country. REAPSER (Spanish Rheumatology Society Registry of Psoriatic Arthritis) is the first registry of Spanish patients with recent onset PsA. <h3>Objectives</h3> To describe the baseline characteristics of patients included in the REAPSER cohort. <h3>Methods</h3> Observational, multicentric study (34 centers), with consecutive inclusion. We included adults of both sexes 18 years of age or older with PsA that met CASPAR criteria, and duration of less than two years since the appearance of symptoms attributed to PsA. Annual follow-up visits will be carried out for 5 years. Measurements: socio-demographic data; employment status and impact of the disease; family history of PsA and other inflammatory diseases; comorbidities and treatment; lifestyle; use of health services; clinical status at the time of diagnosis of PsA; anthropometric data; clinical evaluation of PsA manifestations; radiographic evaluation; analytical determinations; treatment of PsA. The study has been approved by the ethical committees of the participating centers. <h3>Results</h3> Two hundred and fifteen consecutive patients were included, mean age 49.8±13.9 years. Values are expressed as percentages, means with standard deviation and medians with their IQR (interquartile range). SDU: Standard Drink Units. PsAID: Psoriatic Arthritis Impact of Disease. <h3>Conclusions</h3> The baseline situation of Spanish patients with newly diagnosed PsA corresponds to that of a disease with slight cutaneous involvement and predominance of oligoarticular arthritis. Unsurprisingly, structural damage is scarce but not zero. The impact of the disease is still low in these early stages, however 18% of patients have a high Charlson9s comorbidity index (&gt;3) and almost 5% of patients have had to change their employment status in the last year due to its PsA. <h3>Disclosure of Interest</h3> None declared
The risk of mycobacterial infections associated with inhaled corticosteroid use
Authors: Sarah K. Brode, Michael A. Campitelli, Jeffrey C. Kwong, Hong Lu, Alex Marchand-Austin, Andrea S. Gershon, Frances B. Jamieson, Theodore K. Marras
Journal: European Respiratory Journal (2017)

Inhaled corticosteroid (ICS) use is associated with an increased risk of pneumonia. This study was performed to determine if ICS use is associated with an increased risk of nontuberculous mycobacterial pulmonary disease (NTM-PD) or tuberculosis (TB). We conducted a population-based nested case–control study using linked laboratory and health administrative databases in Ontario, Canada, including adults aged ≥66 years with treated obstructive lung disease ( i.e. asthma, chronic obstructive pulmonary disease (COPD) or asthma–COPD overlap syndrome) between 2001 and 2013. We estimated odds ratios comparing ICS use with nonuse among NTM-PD and TB cases and controls using conditional logistic regression. Among 417 494 older adults with treated obstructive lung disease, we identified 2966 cases of NTM-PD and 327 cases of TB. Current ICS use was associated with NTM-PD compared with nonuse (adjusted OR (aOR) 1.86, 95% CI 1.60–2.15) and was statistically significant for fluticasone (aOR 2.09, 95% CI 1.80–2.43), but not for budesonide (aOR 1.19, 95% CI 0.97–1.45). There was a strong dose–response relationship between incident NTM-PD and cumulative ICS dose over 1 year. There was no significant association between current ICS use and TB (aOR 1.43, 95% CI 0.95–2.16). This study suggests that ICS use is associated with an increased risk of NTM-PD, but not TB.