tbuckley/cabot-search huggingface dataset:
SP0164 Barriers and facilitators to adherence to medication in patients with inflammatory arthritis
Authors: K Koutsogianni
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Inflammatory arthritis can cause pain, stiffness, joint damage and even disability without proper and early guided treatment. The full benefits of several treatments recommended, can be achieved if patients strictly follow drug regimens. However, rates of adherence to prescribed medications in patients with inflammatory arthritis seem to be suboptimal. <h3>Objectives</h3> To identify the barriers and facilitators for adherence to medication on patient9s perspective and to suggest ways to facilitate the patients with chronic conditions as the inflammatory arthritis are, to understand the value of compliance to treatment. <h3>Methods</h3> The problem of poor patient compliance was detected about 2,000 years ago when Hippocrates taught his students to pay particular attention to the analysis of the causes that led their patients to lie regarding compliance with medical instructions given to them. The adherence to medication of patients suffering from chronic diseases reaches only 50% (WHO-2003) while the rate of compliance to prescribed medicines for patients with rheumatoid arthritis tend to be quite low and range from 30–80%. Fear and insecurity about the side effects of the medicines, the doubt of efficacy of medications, the refusal to accept the IA diagnosis and the long term treatments, the desire to stop treatment to be free of the ongoing dependency on medication, the lack of competence by some physicians to involve the patient in the treatment procedure and the large amount of patients co-payment are the most significant barriers to patients adherence. A survey conducted among patients of the Arthritis Foundation of Crete aiming to assess the degree of their adherence to MTX showed that 1 in 4 patients reported missing at least one dose of MTX on their own initiative during the last 6 months without referring to their doctor and the main reason was due to side-effects. Experiencing beneficial effects of the medications and being able to maintain autonomy and social participation, receiving clear and understandable information about the treatment options, having support from family and friends, having a good relationship with the treating physician and being involved in shared decision making process are the keys for leading the patients to better adherence. <h3>Conclusion</h3> A good patient-health professional relationship, knowledge about treatment options and appropriate amount of information provided by HCPs as well as the patients9 acceptance of their health condition and understanding of the necessity of long term therapy appear to improve adherence to medication for patients with inflammatory arthritis. <h3>Disclosure of Interest</h3> None declared
SAT0100 Acpa and abdominal adiposity are independent predictors of increments in basal insulin in patients with ra
Authors: E Gomez-Bañuelos, K Arrona-Rios, S Duran-Barragan, L Gonzalez-Rosas, J Aguilar-Arreola, FDJ Perez-Vazquez, G-I Diaz-Rubio, E Chavarria-Avila, F Corona-Meraz, A Saldaña-Millan, R-E Navarro-Hernandez, M Vázquez-Del Mercado
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Insulin resistance (IR) is a comorbidity found in about 40%of RA patients. Currently, there is little information regarding the role of antibodies against citrullinated proteins and IR development in RA. Patients positive for ACPA and/or RF may be at higher risk of IR since these group of patients has a higher expression pro-inflammatory citokines like TNFa and IL-6, both implicated in the pathogenesis of IR. <h3>Objectives</h3> To analyze the contribution of autoantibodies positivity (ACPA and/or RF) and their impact in the development of IR in patients with RA. <h3>Methods</h3> We retrospectively analyzed patients classified with RA per ACR 1987 and ACR/EULAR 2010 criteria with at least one year of follow-up in a cohort of RA patients without comorbidities from Hospital Civil "Juan I. Menchaca". DAS-28, basal insulin, HOMA-IR and anthropometric parameters: Body weight, body mass index (BMI), Sum 4 skinfold thicknesses (S4T), Waist to hip ratio (WHR), waist circumference (WC) and total fat mass (FM); were determined at current and baseline. Mean differences between the two time points were calculated. A multiple regression model was constructed considering mean insulin change as dependent variable. <h3>Results</h3> We studied 57 RA patients, 44% (25) with IR and 56% (32) without IR. Of these, 21% (12) developed IR during follow-up. BMI, FM and ST4 were higher at baseline in patients with current IR at baseline. Ptients who developed IR during follow-up had a mean increase of DAS-28 of 1.27 (P&lt;0.005 vs. patients who improved or never developed IR). Patients positive for ACPA had a greater increase in IR during follow-up. Multivariate analysis revealed that ACPA, increments in WHR and ST4 were independent predictors of basal insulin increases during follow-up. <h3>Conclusions</h3> ACPA and abdominal adiposity (WHR) are independent predictors of IR development in RA <h3>Disclosure of Interest</h3> None declared
SAT0176 Patterns of biologic dmard monotherapy in a large nationwide rheumatoid arthritis cohort: data from 1036 patients
Authors: K Thomas, E Kaltsonoudis, A Drosos, I Papalopoulos, P Sidiropoulos, P Katsimbri, D Boumpas, P Tsatsani, S Gazi, EP Grika, PG Vlachoyiannopoulos, K Fragiadaki, M Tektonidou, PP Sfikakis, K Karagianni, LI Sakkas, L Pantazi, K Boki, T Dimitroulas, A Garyfallos, D Kasimos, G Evangelatos, A Iliopoulos, C Georganas, P Vounotrypidis, M Areti, P Georgiou, K Delis, K Mavragani, I Bournazos, G Katsifis, C Mavromatis, GD Kitas, D Vassilopoulos
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> There are limited literature data regarding the characteristics of rheumatoid arthritis (RA) patients treated with biologic DMARD (bDMARD) monotherapy. <h3>Objectives</h3> To evaluate the disease and treatment characteristics of RA patients treated with bDMARD monotherapy. <h3>Methods</h3> Multicenter, cross-sectional RA epidemiological study in Greece (06/2015–05/2016, ERE RA Study Group). Demographics, disease characteristics, treatment and co-morbidity data were collected via a web-based platform <h3>Results</h3> 1036 RA patients treated with bDMARDs were identified during the one year recruitment period (female: 82%, mean age: 61.5±13 years, mean disease duration: 12.5±8.9 years, mean DAS28-ESR: 3.4±3.3). Among them, 26% (n=273) were receiving bDMARDs as monotherapy and 8% (n=23) of them had never tried conventional synthetic DMARDs (csDMARDs) before; The latter group (n=23) compared to the csDMARD-exposed (92%, n=250) group, had more often co-morbidities [cardiovascular disease (22% vs. 8%, p=0.029), chronic hepatitis (13% vs. 3%, p=0.02), hypertension (57% vs. 38%, p=0.08), COPD (13% vs. 4.4%, p=0.07)] or were active smokers (41% vs. 14%, p=0.001). csDMARD discontinuation was mainly due to adverse events (AEs, 58%) followed by inadequate response (IR, 44%). Compared to the cs- and b-DMARD combination therapy group, monotherapy treated patients were more frequently seropositive (64% vs. 57%, p=0.003), had lower DAS28-ESR (3.2 vs 3.5, p=0.009) and were more likely to have discontinued csDMARDs for AEs (58% vs. 21%, p&lt;0.001) or IR (44% vs. 27%, p&lt;0.001). Tocilizumab (22.3% vs. 12.7%, p&lt;0.001) and rituximab (19.8% vs. 13.5%, p=0.013) were utilized more often, whereas adalimumab less often (8.8% vs. 14.8%, p=0.012) as monotherapy compared to as part of combination therapy. <h3>Conclusions</h3> In our large RA cohort, one out of four bDMARD treated patients, were receiving bDMARDs as monotherapy. Co-morbidities rather than RA characteristics influence the initial decision for bDMARD monotherapy whereas among those starting combination cs- and b-DMARD therapy, the majority discontinue csDMARDs due to AEs. <h3>Acknowledgements</h3> Grant support from the Hellenic Rheumatology Society and Professional Association of Rheumatologists. <h3>Disclosure of Interest</h3> None declared
SAT0414 Differences in clinical presentation by gender in colombian patients with spondyloarthropathies
Authors: MA Alzate, F Vargas, F Ramirez, D Hernandez-Parra, JC Salazar-Uribe, P Ortiz-Salazar, R Pineda
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Spondyloarthropathies (SpAs) are a group of auto-inflammatory diseases, with overlapping symptoms, that include ankylosing spondylitis (AS), psoriatic arthritis (PsA), undifferentiated spondyloarthritis (Und SpA), enteropathic arthritis, and reactive arthritis (1). Historically, SpAs have been viewed as diseases that predominantly affected men (2). <h3>Objectives</h3> To analyze the influence of gender on disease patterns and therapeutic approach in a large cohort of Colombian patients with SpAs. <h3>Methods</h3> A cross-sectional study was conducted in 621 patients with SpAs, in whom clinical and therapeutic characteristics were analyzed based on gender. Statistical association was examined by means of Chi-square tests, Mann-Whitney test, and logistic regression analyses. <h3>Results</h3> The male-to-female ratio was 1,1:1 in this cohort. Younger age at diagnosis was found in males. AS was the most frequent disease (54,7%), followed by PsA (35,7%), and undifferentiated SpA (9,5%). The male gender was positively associated to the presence of AS (OR 2,29 95%IC 1,31–4,04), radiographic sacroilitis (OR 3,46 95%IC 1,82–6,56), HLAB27 positivity (OR 1,95 95%IC 1,31–2,91), low back pain (OR 1,85 95%IC 1,34–2,54) and axial involvement (OR 1,98 95%IC 1,42–2,77). According to the therapeutic profile, female gender was positively associated to the use of conventional DMARD therapy (i.e., methotrexate (p=0,03), leflunomide (p=0,0057), chloroquine (p=0,013)), while male patients were more associated to the use of biologic therapy. <h3>Conclusions</h3> In this Colombian large sample with SpA, male patients have a younger onset of disease, higher proportion of axial involvement, HLAB27 positivity, evidence of radiographic sacroilitis and higher use of anti-TNF therapy. <h3>References</h3> Roussou E, Sultana S. Spondyloarthritis in women: differences in disease onset, clinical presentation, and Bath Ankylosing Spondylitis Disease Activity and Functional indices (BASDAI and BASFI) between men and women with spondyloarthritides. Clin Rheumatol. 2011;30(1):121–7. Ibn Yacoub Y, Amine B, Laatiris A, Hajjaj-Hassouni N. Gender and disease features in Moroccan patients with ankylosing spondylitis. Clin Rheumatol. 2012;31(2):293–7. <h3>Disclosure of Interest</h3> None declared
AB1102 Low bone mineral density is a major contributor in the european health burden due to road traffic accidents in people aged 50 years and above
Authors: N Wilson, L Sanchez-Riera, D Prieto-Alhambra, C Cooper, K Dreinhöfer, A Woolf, L March, P Halbout
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Road traffic accidents (RTAs) are the second leading injury health burden and cause of death in Europe, after falls (1). A significant but as yet unreported proportion of such burden is potentially due to low bone mineral density (BMD), especially among older people, through its relationship with fractures. <h3>Objectives</h3> To measure the percentage of deaths, disability-adjusted life years (DALYs) and years lived with disability (YLDs) due to RTA in people aged 50 years and above attributable to low BMD in the European population for the year 2015. <h3>Methods</h3> The estimates followed the Counterfactual Risk Assessment Methodology used in the GBD study (1). Systematic review was performed seeking population-based studies with femoral neck BMD (FNBMD) measured by Dual-X-Ray-Absorptiometry in people 50 years and over. Age- and sex- specific levels of mean +/-SD FNBMD (g/cm<sup>2</sup>) were extracted from eligible studies, and this was used as the exposure variable. The age and sex-specific 99th percentile from non-Hispanic whites in National Health and Nutrition Examination Survey (NHANES) 2009–2010 was used as theoretical minimum risk factor exposure distribution, to estimate the potential impact fraction (PIF) of FNBMD for fractures. Relative risks of FNBMD for fractures were obtained from a previous meta-analysis (2). Attributable deaths due to RTA-related fractures were obtained through coded hospital data. Disability levels were established by applying disability weights to each type of fracture. Then, PIFs were applied to obtain attributable deaths and disability due to low BMD. <h3>Results</h3> In the European population aged 50–69 and 70 years and above, 10.8% (95% CI: 8.9–12.4%) and 30.9% (29.1–32.4%) of RTA-related deaths, respectively, were attributable to low BMD. In the age group 50–69 this was the second most important risk factor following alcohol use and in those 70 years and above became the most important risk factor, with double the weight of alcohol use. This represents 2,537 and 5,460 absolute deaths in those aged 50–69 and 70 years and above, respectively. The percentage of health burden and disability caused by RTAs attributable to low BMD grew steadily from the ages of 50 and onwards. <h3>Conclusions</h3> This data shows the non-previously reported important role of low BMD as a preventable risk factor for European RTAs9 health burden in population 50 years and over, which requires urgent attention. <h3>References</h3> Forouzanfar et al. Lancet 2016. Johnell et al. JBMR 2005. <h3>Disclosure of Interest</h3> None declared
AB0641 Arterial stiffness and clinical association in patients with systemic sclerosis
Authors: K La Cruz Rodríguez De, G Martínez Bonilla, V Díaz González, K García Osuna, J Reyes Rueda, C Lόpez Gόmez, J Polanco Cruz, A Bernard Medina, E Cardona, A Macías Chumacera, C Ramos Becerra, S Ureña Gutiérrez, S Cerpa Cruz
Journal: Annals of the Rheumatic Diseases (2017)

Abstracts1/320, speckled pattern, but no SSc-related autoantibody has been identified.He had gastrointestinal (upper gastrointestinal tract dysmotility), muscular (myositis) and cardiac (heart failure with secondary cardiac cirrhosis (LVEF 40%, NYHA class III)) involvement, without major pulmonary involvement (no ILD or PAH).He underwent a cardiac transplant at the age of 54, after a disease duration of 7 years.Standard immunosuppressants were initiated.Case 3 is a 50-year-old male with diffuse cutaneous SSc.ANA was negative.He had vascular (digital ulcers), gastrointestinal (upper gastrointestinal tract dysmotility) and cardiac (heart failure with secondary cardiac cirrhosis (LVEF 40%, NYHA class III)) involvement, without major pulmonary involvement (no ILD or PAH).He underwent a cardiac transplant at the age of 49, after a disease duration of 4 years.Standard immunosuppressants were initiated.At present, 1,5 years (case 2 and 3) and 8 years (case 1) after transplant, the donor hearts are still functioning well.No other SSc-related organ manifestations have occurred.Conclusions: We present 3 patients with SSc who successfully underwent cardiac transplant for SSc-related end-stage heart disease.None had other major SSc-related organ involvement.This supports the limited published data that cardiac transplant is feasible and can be considered in end-stage SSc-related cardiomyopathy.
THU0090 Influence of age at disease onset on clinical, functional, and ultrasonographic outcomes in a monocentric early rheumatoid arthritis cohort
Authors: E Galuppi, I Farina, C De Giorgio, CA Scirè, M Govoni
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rheumatoid Arthritis (RA) onset may occur at any age and peaks in the fifth decade. Because the mean age of general population is continually increasing and since older age could impact on outcomes, late-onset RA (LORA) will probably become a relevant issue for health care system in the next future. A better characterization of LORA could help rheumatologist in the therapeutic decision-making process tailored on the individual patient. <h3>Objectives</h3> To investigate the relationship between age at disease onset and clinical, ultrasonographic and functional outcomes. <h3>Methods</h3> Early RA (ERA) patients fulfilling 2010 ACR/EULAR, with available clinical ad ultrasonographic follow-up of at least 1 year, who consecutively attended our Early Arthritis Clinic between 2009–2014, were retrospectively analyzed. Patients were pooled into 3 groups by age at RA onset: &lt;45 years (young-onset RA [YORA] group 1), 45 to 60 years (intermediate-onset RA [IORA] group 2), and &gt;60 years (late-onset RA [LORA] group 3). At baseline biological, functional and ultrasonographic data were recorded. The following items were compared at baseline and after 12 months from diagnosis: DAS28<sub>CRP</sub> remission rate, functional disability using the Health Assessment Questionnaire (HAQ), power doppler (PWD) score, Methotrexate (MTX) treatment, use of glucocorticoids (GCs). <h3>Results</h3> The main baseline demographic and disease characteristics of the whole sample of ERA (n=223) and the 3 age groups- YORA (46), IORA (81) and LORA (96)- are summarised in Table 1. Age at RA-onset was independently associated with DAS28<sub>CRP</sub> remission at 1 year (Table 2). <h3>Conclusions</h3> In a cohort of ERA, older age at disease onset is associated with a more active pattern disease at the beginning but with a greater probability of DAS28<sub>CRP</sub> remission at 1 year. <h3>Disclosure of Interest</h3> None declared
SAT0423 Increased prevalence of extra-articular manifestations among individuals with ankylosing spondylitis in canada: results from the rhumadata® multicentre registry
Authors: S Szabo, S Chehab, L Coupal, D Choquette
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Among populations with ankylosing spondylitis (AS), the frequency and severity of extra-articular manifestations (EAMs) vary widely; due to underlying geographic and genetic differences, individual characteristics, and the impact of treatment with anti-tumour necrosis factor [TNF] agents. The frequency of EAMs among Canadians with AS has not previously been examined, using data from a large clinical registry. <h3>Objectives</h3> To estimate the prevalence of EAMs, including uveitis, inflammatory bowel disease (IBD), dactylitis, and enthesitis, in a population of Canadians undergoing active management for AS. <h3>Methods</h3> This retrospective study used RHUMADATA®, a multicentre registry developed by rheumatologists of the IRRM and <i>Centre d9ostéoporose et de rhumatologie de Québec</i> to evaluate the effectiveness and safety of rheumatologic therapies. Up to 15 years of real-world observational data on the broad set of patients treated in clinical practice are available. The proportion with EAMs was estimated according to type. The frequency of EAMs was compared according to age at cohort entry (≤40 vs &gt;40 years), sex, AS severity (by BASDAI score), and status of treatment with anti-TNFs (anti-TNF-naive, anti-TNF treated [without switching], and anti-TNF treated [with switching]). <h3>Results</h3> The mean (SD) age at cohort entry was 36.0 (12.6) years, and 60.0% were male. Of the 944 patients, 268 (28.4%) were ever diagnosed with an EAM over a median of 9.66 (10.58) years of follow-up. Prevalence was 14.7% for uveitis, 5.8% for IBD, 4.3% for dactylitis, and 9.0% for enthesitis (Table). The proportion with EAMs was: slightly higher among females versus males (31.0% vs. 26.7%), among older versus younger patients (29.5% vs. 25.9%), among those with more severe disease (from 29.2% [mild AS] vs. 34.1% [severe AS]), and among anti-TNF treated patients (18.8% [anti-TNF-naïve] to 47.0% [treated with anti-TNFs, with switching]). <h3>Conclusions</h3> EAMs are common among Canadians with AS, occurring in up to 28% over almost 10 years of follow-up, with uveitis occurring the most frequently (in almost 15% of the cohort). EAMs were most frequent among those with more severe disease (in 34%) and among those treated with anti-TNFs (in 20–50% of such patients). These estimates are useful for comparing to other geographic areas, where the risk factor distribution for AS and its sequelae would differ; and for use in economic models to evaluate the benefits and costs of new therapies. <h3>Disclosure of Interest</h3> S. Szabo: None declared, S. Chehab Employee of: Novartis Canada, L. Coupal Consultant for: Novartis, Speakers bureau: Novartis, D. Choquette: None declared
Titration of the Liver Catalase Activity of Normal and of Tumor-Bearing Rats and Mice
Authors: Jesse P. Greenstein
Journal: JNCI Journal of the National Cancer Institute (1942)

Titration of the Liver Catalase Activity of Normal and of Tumor-Bearing Rats and Mice Jesse P. Greenstein Jesse P. Greenstein research fellow National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 2, Issue 5, April 1942, Pages 525–530, https://doi.org/10.1093/jnci/2.5.525 Published: 01 April 1942
AB0624 Interstictial lung disease in scleroderma: severity associated factors. objetives
Authors: D Sanchez Cano, N Ortego Centeno, MT Cruces Moreno, L Sáez Comet, M Freire, JA Parra Todlí, M Rodríguez Caballeira, C Simeόn Aznar
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Systemic sclerosis (SSc) can virtually affect any organ system (such as lungs, kidneys, gastrointestinal tract, and heart). However, it is the pulmonary manifestations that account for the majority of deaths, especially interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH). <h3>Objectives</h3> Our aim was to assess the differences between severe and mild-to-moderate ILD in SSc. <h3>Methods</h3> A descriptive study was performed, using the available data from the Spanish Scleroderma Study Group (RESCLE). ILD was deemed as serious when forced vital capacity (FVC) was &lt;50%. Patients were classified attending the modified classification criteria proposed by LeRoy and Megdsger. <h3>Results</h3> Fourteen referral centers for SSc participated in the registry. By April 2014, 1374 patients with SSc had been enrolled, 541 of whom (39.4%) had ILD, which was severe in 72 of them (13.2%). There were no significant differences as far as sex and age at onset is concerned. Patients with diffuse SSc presented with severe ILD more frequently than those with limited SSc (57% vs. 35%, p=0.002), as well as those who had tested positive for ATA (51% vs. 33%, p=0.005). Aditionally, prevalence of FVC&lt;50% was higher in patients with myopathy (32% vs. 15%, p=0.002). Mean FVC was 40.2±6.4 in the severe ILD group, whilst it was 80.3±18.9 in the mild-to-moderate one (p&lt;0.001), and mean DLco was 36.7±15.2 and 62.9±34.5, respectively (p&lt;0.001). Likewise, DLco&lt;70% was also more frequent among patients with severe ILD (100% vs. 69%, p&lt;0.001), as well as mean DLco/VA (56.2±24.2 vs. 74.2±42.0, p=0.002). PAPs was equally higher when FVC&lt;50% (42.2±18.2 vs. 35.1±13.4, p=0.034), and so was the frequency of PAPs&gt;40mmHg (66% vs. 29%, p&lt;0.001) and PAH by right heart catheterism (19% vs. 11%, p=0.050). Finally, by means of a multiple logistic regression, both ATA positivity [OR 0.17 (0.05–0.58), p=0.005] and low DLco [0.93 (0.91–0.95), p=0.000] were found to be related with FVC&lt;50% <h3>Conclusions</h3> Patients with ACA positivity and with a limited variant of SSc seem to be at lower risk of severe interstitial lung involvement. Furthermore, the presence of myopathy may contribute to explain the decrease of FVC in SSc patients. <h3>References</h3> Steen VD, Medsger TA. Changes in causes of death in systemic sclerosis, 1972–2002. Ann Rheum Dis 2007; 66: 940–4. LeRoy EC, Medsger TA, Jr. Criteria for the classification of early systemic sclerosis. J Rheumatol 2001; 28: 1573–6. <h3>Disclosure of Interest</h3> None declared