tbuckley/cabot-search huggingface dataset:
SAT0667 Presepsin and procalcitonin are of diagnostic value for bacterial infection in patients with connective tissue diseases
Authors: Y Ichimura, Y Kawaguchi, A Tochimoto, T Higuchi, M Tochihara, Y Katsumata, H Yamanaka
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Recently, presepsin (soluble CD14-subtype) and procalcitonin are reported as a good diagnostic markers of bacterial infection, especially sepsis. However, their utility in patients with connective tissue diseases (CTDs) has been unknown. <h3>Objectives</h3> To assess the diagnostic value of presepsin and procalcitonin in patients with CTDs. <h3>Methods</h3> We enrolled the consecutive patients with CTDs, who checked the level of procalcitonin and/or presepsin during January to September, 2016, retrospectively. We divided two groups; the infection group and non-infectious group. Infection was diagnosed by symptoms, micro-bacterial methods and the good response to antibiotics. The data analysis were assessed using IBM SPSS statistics 22. <h3>Results</h3> Eighty-four patients with CTDs were enrolled, including 42 patients with rheumatoid arthritis (RA). The level of procalcitonin was evaluated in all patients, and the level of presepsin was in 48 patients. Thirty-six patients were classified in infection group; 38 patients in the CRP-positive non-infection group; and 10 patients in CRP-negative non-infection group. The level of presepsin was significant higher in infection group than CRP-positive non-infection group (693 +/- 577 pg/mL vs. 250 +/- 101 pg/mL, p&lt;0.01) (Fig. 1). Among the patients with RA, the level of presepsin was significant higher in infection group than non-infection group (809 +/- 637 pg/mL vs. 233 +/- 135 pg/mL, p&lt;0.01). AUCs of procalcitonin (0.823) and presepsin (0.821) showed similar diagnostic value. The cut-off value of presepsin and procalcitonin were 265 pg/mL and 0.16 ng/mL, respectively (sensitivity: 78.3% and 82.6%, specificity: 76.0% and 76.0%). <h3>Conclusions</h3> Procalcitonin and presepsin may be of diagnostic value for bacterial infection in patients with CTDs, especially may distinguish bactrial infection from active phase in patients with CTDs. <h3>Disclosure of Interest</h3> None declared
AB0249 Identification of inflammatory- and immune disorder- related proteins as putative biomarker candidates for improving rheumatoid arthritis monitoring
Authors: L González-Rodríguez, V Calamia, L Lourido, P Fernández-Puente, M Camacho-Encina, C Ruiz-Romero, A Julià, A Fernández-Nebro, J Tornero, S Marsal, FJ Blanco
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rheumatoid arthritis (RA) is a long-lasting inflammatory autoimmune disorder that ultimately leads to the destruction of joint architecture. <h3>Objectives</h3> Using the DAS28 activity index, 80 RA serum samples (40 with low activity and 40 with high activity) were selected in order to be analyzed by mass spectrometry. The aim of this study was to find possible protein biomarkers that could discriminate patients with different RA activity in the daily clinical routine. <h3>Methods</h3> In order to facilitate the complex measurement of these serum samples, a simple, fast and reproducible albumin-specific depletion method using ethanol was optimized and applied to this study. Four independent pools of the 40 high RA activity samples (10 samples per pool) and 4 pools of the 40 low RA activity samples were firstly albumin-depleted, and then the remnant serum proteins were digested and differentially labelled with iTRAQ 8-plex reagents. Subsequently, the 8 labelled pools were combined and cleaned using StageTips-C18. Finally, the pool mixture was fractionated by HPLC (Zorbax-C18) and the resulting fractions were analyzed by nanoLC-MS/MS using two different equipments for validation (MALDI-TOF/TOF and TripleTOF). <h3>Results</h3> The mass spectrometry analysis led to the identification of 186 proteins. Among these, Haptoglobin, Kininogen-1, Alpha-2-HS-glycoprotein, Serum Amyloid A, Afamin and Histidine-rich-glycoprotein, exhibited a differential relative abundance depending on the RA activity of the patients (p&lt;0.03) in both analysis. These proteins were also validated by other orthogonal techniques (western blot, ELISA and protein arrays). <h3>Conclusions</h3> In this proteomic study, 9 proteins were found to be modulated between patients with high and low RA activity. Most of these proteins are related with the RA process and the effects caused by this type of disease (inflammation and immune disorder in joints). Therefore, these proteins are possible biomarker candidates for improving RA monitoring. Future validation experiments and prospective studies are needed to facilitate their implementation in the clinical routine. <h3>Disclosure of Interest</h3> None declared
SAT0611 Intima-media thickness reference ranges depicting halo sign for the diagnosing of large vessel giant cell arteritis by ultrasound
Authors: M Milchert, M Brzosko
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Color duplex ultrasonography (CDU) is most promising tool for the assessment of large vessel giant cell arteritis (LV-GCA). There is a need to define ultrasound findings consistent with the diagnosis of GCA. <h3>Objectives</h3> We aimed to score intima-media thickness (IMT) reference ranges for LV-GCA in polish patients. <h3>Methods</h3> 214 patients suspected for GCA and evaluated with CDU were included in the study and followed up for min 9 months. Large vessel CDU, together with arteritis/non-arteritis categorization, were performed before or within 1 week after treatment initiation by a single physician. Vasculitis was defined as hypoechoic, homogenous, increase of IMT with distorted wall structure resulting in no clear intima-media structure, over long distance (not limited only to the place of arterial bifurcations). ROC curves were calculated. <h3>Results</h3> GCA was diagnosed in 81 patients, polymyalgia rheumatica (PMR) in 131 (characteristics – Table 1). Extracranial LV-GCA was diagnosed in 43 patients: axillary vasculitis in 23 patients, common carotid artery (CCA) – 24, subclavian – 18, superficial femoral – 11, brachial (all spreading per continuum from axillary arteritis) – 8. In 83 remaining patients other diagnosis was confirmed, and they served as non-GCA/PMR controls. Mean IMT in LV-GCA was significantly higher versus controls and isolated PMR (Fig. 1). IMT in GCA was not significantly influenced by gender, hypertension and smoking in contrast with IMT in controls. Proposed cut off values for IMT depicting vasculitis in GCA patients are presented in Table 2. 100% specificity for vasculitis (vs GCA without large vessel vasculitis) was reached with axillary IMT of 1.06 mm (62% sens.), subclavian – 1.35 mm (38% sens.), superficial femoral – 1.55 mm (60% sens.), CCA – 1.27 mm (22% sens.). <h3>Conclusions</h3> We demonstrated that cut off values may discriminate between GCA and its mimics as well as between presence and lack of vasculitis in different arteries in GCA. <h3>References</h3> Milchert M, Diamantopoulos A, Brzosko M. Atlas of ultrasound application in large vessel arteritis: giant cell arteritis and Takayasu arteritis. Wydawnictwo Pomorskiej Akademii Medycznej, Szczecin, 2016. <h3>Disclosure of Interest</h3> None declared
AB1201-HPR The validity and test-retest reliability of the turkish patient specific functional scale in chronic neck pain patients. a preliminary report
Authors: G Yalcinkaya, B Kara, MN Arda
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Current clinical guidelines recommend to use both clinical and self-reported measurements for evaluation of chronic neck pain. Among the self-reported outcomes, Neck Disability Index (NDI) and Patient Specific Functional Scale (PSFS) are the most widely used and recommended instruments.<sup>1</sup> Although, NDI was validated in Turkish language before, no validation study related to the PSFS was detected in the literature. <h3>Objectives</h3> The aims of this study were to translate PSFS in Turkish language and to establish the test-retest reliability and validity of the PSFS-T in chronic neck pain patients. <h3>Methods</h3> The PSFS was translated into Turkish by using the "translation-backward translation" method as recommended in the guidelines.<sup>2</sup> The demographic information, PSFS-T and NDI were recorded at the first visit of the patients. Thirty patients were called by phone for the retest evaluation of PSFS-T. The construct validity of PSFS-T was determined by investigating the correlation between NDI and PSFS-T scores. The Cronbach9s alpha was used for the internal consistency. Intra-class coefficient (ICC) was employed to determine the test-retest reliability. <h3>Results</h3> The final form was completed by 42 chronic neck pain patients (18 F) until now. The mean age was 42±14. The internal consistency was found as good (Cronbach9s alpha:0.89). A positive moderate correlation was determined between NDI and PSFS-T scores (p&lt;0.05;r=0.405). The ICC for test-retest reliability was determined in high level (ICC: 0.88). <h3>Conclusions</h3> The PSFS-T is a reliable and valid instrument for chronic neck pain patients. However,the preliminary results should be confirmed by completing the study. <h3>References</h3> Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, Sopky BJ, Godges JJ, Flynn TW. Neck pain: Clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association.JOrthop Sports Phys Ther. 2008;38(9):A1-A34. Beaton DE, Bombardier C, Guillemin F, Ferraz MB.Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186–91. <h3>Disclosure of Interest</h3> None declared
THU0536 Childhood onset of behÇet disease (BD) symptoms in an adult cohort of BD patients
Authors: V Paisal, E Al-Abadi, S Protheroe, D Carruthers, D Situnayake, S Powell, D Mitton, T Southwood
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Behçet Disease (BD) is rarely reported in children. It a systemic inflammatory condition characterised by autoinflammatory and vasculitic clinical features including recurrent oral aphthosis, genital ulceration, skin, eye, neurological and vascular inflammation, which is most commonly diagnosed between 20–40 years of age. It is unclear how many adult patients with BD have the onset of symptoms during childhood. <h3>Objectives</h3> The aim of our study was to investigate the age of symptom onset in a large cohort of adult patients with BD. <h3>Methods</h3> Since 2012, the Behçet Syndrome National Centre of Excellence, Birmingham and Midland Eye Centre, has used a multidisciplinary approach aiming to shorten time to diagnosis of BD, reduce blindness and morbidity, improve knowledge and ensure equity in access to biological therapies. Patient demographic and disease information, including patient recalled age at symptom onset, symptom sequence, documented clinical signs, treatment and outcome data are maintained in a secure web-based clinical data archive. For this study, the database was interrogated to determine patient age at recalled onset of the first BD symptoms, the sequence in which symptoms appeared and whether the ISG classification criteria for the diagnosis of BD were fulfilled before the age of 16 years. <h3>Results</h3> To June 2016, 478 patients aged between 11–68 years had data recorded in the BD database. 60 patients (12.7%, 49 females) who fulfilled International Study Group criteria for the diagnosis of BD, reported that the onset of their first symptoms was before the age of 16 years (range 2–15 years). All 60 patients reported recurrent oral ulceration and 55 reported genital ulceration but with a reported time interval between the onset of these 2 features of 0–44 years. Of the 60 patients, 26 patients reported sufficient symptoms to have fulfilled ISG criteria before their 16th birthday, including the coincident onset of recurrent oral and genital ulceration in 15/26 patients. Eye disease was only reported in 1 patient and a positive family history of BD in 5/26 patients. 11/26 patients reported a delay between the onset of oral and genital ulcers of a mean of 5.45 years (range 1–11 years). <h3>Conclusions</h3> Many adults with BD recall the onset of their first symptoms before their 16th birthday, usually with recurrent oral and genital ulceration. We speculate that greater awareness of BD in childhood may reduce the delay in diagnosis of this chronic condition. <h3>Disclosure of Interest</h3> None declared
SAT0424 Axial disease in psoriatic arthritis: burden of underdiagnosed disease and risk factors in real life
Authors: SZ Aydin, U Kalyoncu
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The frequency of axial disease in Psoriatic Arthritis (PsA) is around 24–78% with additional patients with subclinical disease who have spondylitic changes or sacroiliitis in the absence of clinical findings. Despite that most of the physicians do not perform routine imaging with the argument that subclinical disease has no effects on management decisions. <h3>Objectives</h3> We aimed to explore barriers for diagnosing axial disease in PsA and its implications in real life. <h3>Methods</h3> PsART (Psoriatic Arthritis Registry of Turkey) is a prospective, multicentre registry where PsA patients are consecutively recruited. Radiographs of the spine and sacroiliac joints were scored by one central reader, whenever available. Patients with axial disease according to the physician were compared with patients with imaging findings only and risk factors for being underdiagnosed were investigated. <h3>Results</h3> Among 1195 patients, 35% had axial disease according to the physician who were more frequently men (41.2% vs 32.2%; p=0.04), younger (44.4 (12.2) vs 47.9 (13); p&lt;0.001), more frequently smokers (44.6% vs 34.1%; p&lt;0.001), more on anti TNFs (37.1% vs 29.4%; p=0.01) and had more nail involvement (49.9% vs 43.2%; p=0.03). Within the IBP criteria, the ASAS criteria had the lowest sensitivity (59.7%) which was even lower in women (53.1%). Forty-nine (15.7%) patients were classified as having axial disease according to the rheumatologist despite not fulfilling any of the IBP criteria which was more frequent for women (21.1%) than men (8.2%, p=0.002). Among 71 patients that had syndesmophytes, 20 patients (28.2%) were not classified as having axial disease according to the physician. This was higher for women (15/42, 35.7%) then men (5/29, 17.2%). There were 126 patients who had sacroiliitis fulfilling the ASAS criteria, despite not being categorized as having axial disease by the clinician. The risk of being underdiagnosed was higher for women (30.8% vs 18.4%; p=0.003). These patients had higher Leeds enthesitis scores, tender and swollen joint counts (table) and were less using anti-TNF medications (14.6% vs 38.7%; p&lt;0.001). The PROs and the physician global assessment were similar, suggesting a similar disease activity state according to the patients and physicians in diagnosed and underdiagnosed groups. <h3>Conclusions</h3> Underdiagnosed axial disease is frequent in PsA, women having higher risk and IBP criteria being less sensitive in women. More complex patients (eg with higher enthesitis and peripheral arthritis) have a higher risk of being underdiagnosed. These patients are less frequently treated with biologic treatments, which could be the right treatment choice if were diagnosed. Axial disease needs to be ruled out using imaging modalities, even if back pain does not clinically suggest an inflammatory pattern. <h3>Disclosure of Interest</h3> None declared
A phase 1 study to evaluate the safety, pharmacokinetics, pharmacodynamics, immunogenicity, and antitumor activity of the OX40 agonist MEDI0562 in combination with tremelimumab or durvalumab in adult aubjects with advanced solid tumors.
Authors: Brendan D. Curti, Todd Michael Bauer, Neeltje Steeghs, A. Craig Lockhart, Francis J. Giles, John D. Powderly, Naiyer A. Rizvi, Jonathan Wade Goldman, Samir Khleif, Matthew Joseph Gribbin, Jennifer T. McDevitt, Scott A Hammond, Victoria L Chiou, Aurelien Marabelle
Journal: Journal of Clinical Oncology (2017)

TPS3100 Background: Recent advances in treatment of solid tumors include single or combined use of monoclonal antibodies (mAbs) against the immune checkpoints CTLA-4 or PD-1/PD-L1 that can reactivate antitumor cytotoxic tumor-infiltrating lymphocytes (TILs) and significantly improve OS (Menon S, et al. Cancers (Basel). 2016;8:E106.) (Antonia S, et al. Lancet Oncol. 2016; 17:299-308). Activation of TILs via the costimulatory OX40 (CD134) molecule, may offer an alternative and non-redundant pathway for increasing antitumor immunity. OX40 costimulation promotes effector T cell expansion and longevity, overcomes regulatory T cell suppression and provides survival benefit in animal models of tumor challenge (Linch SN, et al. Front Oncol. 2015;5:34). MEDI0562 is an investigational, humanized IgG1κ anti-OX40 mAb that triggers OX40 signaling. Coadministration of an OX40 agonist and either a CTLA-4 or PD-1/PD-L1 pathway inhibitor may promote synergistic effects against certain solid tumors and may be tolerable administered in combination. Methods: A Phase 1, multicenter, open-label study (NCT02705482) is underway to evaluate safety (primary endpoint), pharmacokinetics, pharmacodynamics, immunogenicity and antitumor activity (secondary endpoints) of MEDI0562 in combination with either anti-PD-L1 mAb durvalumab or anti-CTLA-4 mAb tremelimumab in adult subjects with previously treated advanced solid tumors. Subjects with primary CNS tumors and hematologic malignancies are excluded. The study includes a dose escalation and expansion phase, with 2 treatment arms in each: MEDI0562/durvalumab combination (Arm A) and MEDI0562/tremelimumab combination (Arm B). Safety assessments include AEs, serious AEs, dose-limiting toxicities, abnormal laboratory parameters, vital signs, and electrocardiogram results. Antitumor efficacy will be assessed as OR, disease control, duration of response, PFS, and OS using RECIST Version 1.1. Subjects will remain on treatment until unacceptable toxicity, progressive disease or other reasons for discontinuation. Clinical trial information: NCT02705482.
AB0023 Association between mex-sledai and infections with mbl structural and promoter genotypes in mexican-mestizo patients
Authors: MA Villarreal-Alarcόn, JA Esquivel-Valerio, D Vega-Morales, R Ortiz-Lopez, A Rojas-Martínez, AC Arana-Guajardo, MA Garza-Elizondo
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The mannose-binding lectin protein (MBL) is a multimeric molecule with a structure that is the analogue to the C1q protein. Deficient and low MBL concentrations in serum are due to the presence of mutations in the structural or promoter region <h3>Objectives</h3> To investigate the role of alleles and haplotypes of MBL2 gene in the clinical expression of systemic lupus erythematosus (SLE) and its association with infections in Mexican-mestizo patients. <h3>Methods</h3> An observational, cross-sectional, retrospective study. We included 74 SLE patients and 75 matched controls. All ≥16 years-old who met at least four 1982 or revised 1997 ACR criteria for SLE were included. The association of MBL locus haplotypes with disease activity and past history of infection was studied in those patients. Allele and haplotype determinations in the promoter and structural regions of the MBL2 gene were performed from genomic DNA isolated peripheral blood. Probes were sent to Invitrogen (Carlsbad, California) for synthesis. The disease activity was determined by MEX-SLEDAI. Infections were categorized arbitrarily if patients had ≥4 events. The associations between the codons, clinical activity, and having ≥4 infection events were by odds ratio. <h3>Results</h3> There were 13/73 (17.8%) SLE patients with ≥4 infections. The presence of homozygous C/C codon 57 was observed to be greater risk for SLE activity and present more than 4 infections. The significance of heterozygous HYLX promoter was observed only for the presence of infection. Table 1. <h3>Conclusions</h3> MBL2 gene polymorphisms of the homozygous C/C in codon 57 of the structural region and heterozygous HYLX of the promoter region are associated with increased risk of a higher number of infections. Also, we observed that homozygous C/C in codon 57 was asociated to a higher MEX-SLEDAI. <h3>Disclosure of Interest</h3> None declared
FRI0233 The retention rates of abatacept in elderly ra patients (65 years and above) who cannot be treated with methotrexate: comparison with etanercept and tocilizumab; a single-center, retrospective, case-control study
Authors: E Kikuchi, N Aoki, T Yoshioka, T Okai
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> There are many elderly rheumatoid arthritis (RA) patients who cannot be treated with methotrexate (MTX) for many reasons, but data about the therapeutic strategies by biologic agents for the patients are insufficient. <h3>Objectives</h3> To analyze the retention rate of abatacept in elderly patients with RA who cannot be treated with MTX. <h3>Methods</h3> Data were retrospectively collected from the medical records of patients with rheumatoid arthritis at our center. Abatacept (ABT), etanercept (ETN), or tocilizumab (TCZ) was administered to 68 elderly RA patients who could not be treated with MTX. We analyzed the retention rate of each group by Kaplan–Meier curves and the log-rank test. The primary end point was the 24-month retention rate of the biologics without discontinuation due to adverse events, loss or primary lack of effectiveness. <h3>Results</h3> In the ABT group (26 cases: a mean age of 77.8±6.3 years, ACPA positive 92.3%, oral steroid use 34.6%), the cumulative retention rates for both 12 and 24 months were 0.699. In the ETN group (26 cases: a mean age of 75.8±5.1 years, ACPA positive 92.0%, oral steroid use 73.1%), the cumulative retention rates for 12 and 24 months were 0.450 and 0.315, respectively. In the TCZ group (16 cases: a mean age of 73.7±5.6 years, ACPA positive 87.5%, oral steroid use 56.3%), the cumulative retention rates for 12 and 24 months were 0.433 and 0.325, respectively. There was a significant difference in the retention rates between ABT groups and the other two groups [log-rank test, <i>p</i>=0.018 (ABT vs. ETN), 0.047 (ABT vs. TCZ)]. There are no significant retention rates between ETN groups and TCZ groups. Three cases (11.5%) in the ABT group were discontinued the biologic agents by hospitalization for severe infection within 24 months. Five cases (19.2%) in the ETN group, six cases (37.5%) in TCZ group were hospitalized for severe infection, respectively. <h3>Conclusions</h3> Our data suggested that abatacept can be used for a period longer than etanercept or tocilizumab for elderly RA patients who cannot be treated with methotrexate. <h3>References</h3> Harigai, et al. Mod Rheumatol. 2016 Jul 3; 26(4): 491–498. <h3>Disclosure of Interest</h3> None declared