tbuckley/cabot-search huggingface dataset:
SAT0418 Anxiety and depression on disease activity and quality of life of spondyloarthritis patients under biologic therapies
Authors: N Madeira, J Borges, A Cardoso, L Miranda, F Barcelos, C Miguel, C Silva, S Fernandes, R Trinca, D Medeiros, R Campanilho-Marques, H Santos, R Leitão, A Faustino
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Several studies describe an association between anxiety, depression and disease activity in Spondyloarthritis (SpA). <h3>Objectives</h3> To assess disease activity and quality of life in anxious and depressed SpA patients. <h3>Methods</h3> Observational, retrospective, cross-sectional study of SpA patients on bDMARDs, registered at Reuma.pt, Portuguese Rheumatology registry, with ≥1 clinical evaluation from November 2015 to July 2016. Demographic and clinical outcomes including: BASDAI, BASMI, BASFI, ASDAS, DAS 28–3V ESR in peripheral psoriatic arthritis, tender and swollen 44 joints count (TJC, SJC), patients9 pain and global assessments, physician9s global assessment, CRP, ESR, ASQoL, EQ-5D, FACIT-F for fatigue and HADS scale with 2 domains, HADS-A for anxiety and HADS-D for depression (a cutoff of 8 defining these symptoms), were collected. Statistics: Mann-Whitney test, p&lt;0.05. SPSS® v.17. <h3>Results</h3> 160 patients were included, 41.9% were male, with mean: current age 50.7±11.9, age at diagnosis 36.9±11.96, at 1st bDMARD 46.2±11.8, time from diagnosis 18.5±10.3, years. The mean DAS 28–3V ESR was 3.2±1.4, BASDAI 2.98±2.2, ASDAS 2.4±1.2, BASFI 2.68±2.26, BASMI 3.36±1.7, patient9s global assessment 28.8±24.1, physician9s global assessment 14.5±15.2, ESR 18.8±18.1 mm/h, CRP 6.7±16.01 mg/L, ASQoL 6.2±5.6, FACIT-F 37.2±10.1 and EQ-5D 0.417±0.19. The mean HADS-A was 5.96±4.01 and HADS-D was 5.05±4.1 (HADS-A≥8 in 39.5% and HADS-D≥8 in 28.3% patients). Comparison of anxious vs non-anxious and depressive vs non-depressive groups appears on table 1. <h3>Conclusions</h3> These results suggest that anxious and depressed patients may have higher disease activity, more functional limitations and worse quality of life. These symptoms should not be underestimated, but instead, they should be controlled to achieve clinical improvement. <h3>Disclosure of Interest</h3> None declared
AB0077 Investigation of the influence of teriflunomide plasma concentrations on diseaseactivity in leflunomide-treated patients withrheumatoidarthritis
Authors: R Tekaya, A Ben Tekaya, H Sahli, O Saidane, I Mahmoud, L Abdelmoula
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Leflunomide has become of increasing value for the treatment of rheumatoidarthritis (RA), and leflunomideisused via its active metabolite teriflunomide. The European League Against Rheumatism (EULAR) suggestedthatboth LEF and methotrexatewerefundamentalmedicines for the treatment of RA. <h3>Objectives</h3> To investigate the relationshipbetweenteriflunomideplasma concentrations and diseaseactivity in patients with RA. <h3>Methods</h3> This was a cross-sectional multicenter study (four rheumatology departments) over a four years period.Patients withRA on a stable and dailyleflunomide dose for &gt;2 monthswereincluded. Socio-demographic data and clinical data were recorded. Respectively, disease status and functional disability were assessed by disease activity score (DAS28) and Health Assessment Questionnaire (HAQ). Treatment response was evaluated according to the EULAR criteria (variation of DAS28). Quantitative determination of teriflunomide (active metabolite of leflunomide) plasma concentrationswas carried out by high-performance liquid chromatography with ultraviolet detection. <h3>Results</h3> A total of 24 patients were enrolled; sex ratio =1. The mean age of the sample was 51,71 (±15,3) years; the mean disease duration at study baseline was 135,2 (±80,26) months; 70% of patients were RF positive, and 58% ACPA positive.The mean score on VAS pain was 43 mm (±22,92). Respectively, the mean swollen and tender joint counts (SJC-28, TJC-28) were4,3 (±6,1) and 2,8 (±3,09). The mean HAQ was 2,01 (±0,78). At baseline, the mean DAS28 score was 4,17 (±1,12); 56% weregood and moderate EULAR responders. The mean leflunomide treatment duration was 34,94 months (±32,47). The meanteriflunomide plasma concentrations was 38,34 ug/ml (±24,92). Residualteriflunomide plasma concentrations was significantly associated SCJ-28 and DAS28 decrease (p=0,0027). However, all these parameters (VAS pain, TJC-28, HAQ, C reactive protein, prescription duration of leflunomide and EULAR response) were not correlated with residualteriflunomide plasma concentrations. <h3>Conclusions</h3> This studyconcludedthatresidualteriflunomide plasma concentration isassociatedwithlow active disease. <h3>Disclosure of Interest</h3> None declared
OP0098 Remission and maintenance of efficacy in a phase 2b study of vobarilizumab, an anti-interleukin 6 receptor nanobody, in patients with moderate-to-severe rheumatoid arthritis despite treatment with methotrexate
Authors: T Dörner, M Weinblatt, P Durez, R Alten, K Van Beneden, EJ Dombrecht, K De Beuf, P Schoen, RK Zeldin
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Vobarilizumab is a Nanobody® consisting of an anti-IL-6R domain and an anti-human serum albumin domain in development for treatment of RA. The efficacy and safety were assessed in a 24-week double-blind global phase 2b study in patients with active RA on a stable background of MTX. Main efficacy and safety results were previously reported [1]. <h3>Objectives</h3> To report the impact of treatment with vobarilizumab on secondary efficacy endpoints including SDAI and CDAI remission and the sustained response at 4 consecutive visits based on ACR50, ACR70 and DAS28<sub>CRP</sub>. <h3>Methods</h3> Patients were randomized to receive subcutaneously administered placebo or 1 of 4 dose regimens of vobarilizumab in addition to MTX. SDAI and CDAI remission at Week 24 was evaluated, as was maintenance of efficacy as defined by sustained DAS28<sub>CRP</sub>&lt;2.6 responses at 4 consecutive visits (i.e., at Weeks 12, 16, 20 and 24). In addition, a post-hoc analysis was performed on sustained ACR50 and ACR70 responses from Week 12 through Week 24. Proportions of patients achieving response for these endpoints were summarized by treatment group. Subjects with missing values were analyzed as non-responders. <h3>Results</h3> A total of 345 patients were randomized. Demographics and baseline characteristics were similar across groups with mean baseline DAS28<sub>CRP</sub> between 5.8 and 6.2. At Week 24, up to 19% and 20% in the vobarilizumab groups reached CDAI and SDAI remission, respectively vs. 10% and 9% who received placebo (Table 1). At Week 24, up to 61% and 45% of the patients in the vobarilizumab groups achieved an ACR50 or ACR70 response, respectively (39% and 17% on placebo). Approximately one third of the randomized patients in the 3 highest treatment groups had a sustained ACR50 response from Week 12 through Week 24 (Table 2). Sustained remission defined by DAS28<sub>CRP</sub>&lt;2.6 at 4 consecutive visits, i.e. at weeks 12, 16, 20 and 24, was observed in 20% to 25% of the patients in the 3 highest dosing arms compared with 3% of those receiving placebo. <h3>Conclusions</h3> In patients with active RA, treatment with vobarilizumab at the 3 highest dose regimens in addition to MTX had a positive and sustained impact on disease activity through Week 24 as defined by clinically relevant efficacy endpoints. <h3>References</h3> Weinblatt et al. (Annual Scientific Meeting, Canadian Rheumatology Association, 2017). <h3>Disclosure of Interest</h3> T. Dörner Consultant for: Ablynx, M. Weinblatt Consultant for: Ablynx, P. Durez Consultant for: Ablynx, R. Alten Consultant for: Ablynx, K. Van Beneden Employee of: Ablynx, E. Dombrecht Employee of: Ablynx, K. De Beuf Employee of: Ablynx, P. Schoen Employee of: Ablynx, R. Zeldin Employee of: Ablynx
Contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) 2017 – a review of important differences compared to the CT/MRI system
Authors: Tae Kyoung Kim, Seung Yeon Noh, Stephanie R Wilson, Yuko Kono, Fabio Piscaglia, Hyun-Jung Jang, Andrej Lyshchik, Christoph F. Dietrich, Juergen K. Willmann, Alexander Vezeridis, Claude B Sirlin
Journal: Clinical and Molecular Hepatology (2017)

Medical imaging plays an important role in the diagnosis and management of hepatocellular carcinoma (HCC). The Liver Imaging Reporting and Data System (LI-RADS) was initially created to standardize the reporting and data collection of CT and MR imaging for patients at risk for HCC. As contrast-enhanced ultrasound (CEUS) has been widely used in clinical practice, it has recently been added to the LI-RADS. While CEUS LI-RADS shares fundamental concepts with CT/MRI LI-RADS, there are key differences between the modalities reflecting dissimilarities in the underlying methods of image acquisition and types of contrast material. This review introduces a recent update of CEUS LI-RADS and explains the key differences from CT/MRI LI-RADS.
THU0052 Levels of inflammatory serologic biomarkers in HLA-B27 and HLA-B15 positive patients with spondyloarthritis
Authors: J Londono, AM Santos, JC Rueda, P Peña, I Briceño, E-L Saldarriaga, J-I Angarita, E Calvo, M Avila, N Martinez-Rodriguez, H Cubides, V Parra, JF Medina
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> A main challenge in spondyloartritis (SpA) management was the availability of reliable biomarkers related with disease activity, or predicting joint damage and the response to treatment. Although erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are currently used as biomarkers for disease activity, they lack sensitivity, specificity and reproducibility. With the understanding of SpA pathogenesis, additional biomarkers like metalloproteinase 3 (MMP-3), interleukin (IL)-1a, IL-6, lipopolysaccharide-binding protein (LBP), tumour necrosis factor a (TNFa), macrophage colony stimulating factor (M-CSF), interferon gamma (INF-g), IL-17 and IL-23, had been proposed <h3>Objectives</h3> We aimed to evaluate the associations of MMP-3, IL-1a, IL-6, M-CSF, LPB, IL-17 and IL-23 levels in SpA patients positive for HLA-B27 or HLA-B15 <h3>Methods</h3> 178 patients (100 men and 78 women) with SpA according to ASAS criteria were included in the study. HLA typing was performed by PCR using the Biorad® HLA-SSP ABDR plates. The levels of TNFa, IL-1a, IL-6, INF-g and IL-17 were measured by a cytometric bead-array (CBA Flex Set) using a FACS Canto II Flow CytometerÔ. Enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of IL-23, M-CSFand MMP-3. CRP and LBP levels were measured by chemiluminescence. Statistical analysis was made with SPSS v19. For comparison of quantitative variables with a normal distribution we used the Student9s <i>t</i>-test. Categorical variables were presented in frequency charts and percentages, and the Chi-squared test and Fisher9s exact test were used when necessary, for comparing groups. Two-tailed P-value &lt;0.05 was considered statistically significant <h3>Results</h3> Of the 178 patients, 70 were positive for HLA-B27, 34 for HLA-B15 and 74 had other HLA-B. According to ASAS classification criteria, 152 patients had axial SpA (axSpA) manifestations, 161 had peripheral SpA (pSpA) manifestations, and 148 patients had mixed axial and peripheral manifestations. Figure 1 shows the mean levels of inflammatory serologic biomarkers in these subgroups of patients <h3>Conclusions</h3> High levels of IL-17 and IL-23 were associated with the presence of HLA-B27, which mainly correlates with an axial presentation of the disease as compared to HLA-B15 patients. Accordingly, the genotype (presence of HLA-B27 or HLA-B15) and phenotype (axial or peripheral involvement) may help physicians when considering a targeted therapy of SpA patients with IL-17 inhibition in a context of personalized medicine <h3>Disclosure of Interest</h3> None declared
AB0017 Therapeutic effect of umbilical cord-derived mesenchymal stem cells transplantation in a mouse model of primary biliary cirrhosis
Authors: J Fan, Q Wang, R Feng, G Yao, X Tang, L Sun
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Primary biliary cirrhosis (PBC) is a cholestatic liver disease characterized by slowly progressive non-suppurative cholangitis with immune mediated destruction of intrahepatic bile ducts. Previous studies have shown beneficial effects of mesenchymal stem cells (MSCs) transplantation in many autoimmune diseases. However, few studies have focused on the effects of MSCs on PBC. <h3>Objectives</h3> In our study, we investigated the therapeutic effect of umbilical cord-derived mesenchymal stem cells (UC-MSCs) transplantation in a well-defined mouse model of PBC and explored the potential mechanism. <h3>Methods</h3> After 2OA-BSA-induced autoimmune cholangitis was created in C57BL/6 mice, cultured human UC-MSCs or a vehicle control was administered. Liver injury severity was assessed by clinical and histologic analysis. The immunity suppression effects and mechanism of UC-MSCs were tested. <h3>Results</h3> UC-MSCs administration alleviated bile duct damage and intrahepatic inflammatory cell infiltration in C57BL/6 mice that had undergone 2OA-BSA immunization. Serum levels of ALT and ALP were significantly decreased. Also, UC-MSCs reduced the production of anti-mitochondrial autoantibodies (AMA) in PBC mice. UC-MSCs downregulated inflammatory cytokine, such as IFN-γ, TNF-α, IL-12 and IL-17A production both in peripheral blood and local liver. Notably, Infusion of UC-MSCs resulted in an increase in regulatory T cells (Tregs) in peripheral blood but a decrease of this kind of cells in liver tissues. Furthermore, UC-MSCs significantly suppressed Th1- and Th17-cell responses and these alternations could be detected in spleen, peripheral blood and liver in PBC mice. <h3>Conclusions</h3> In summary, the current study shows that UC-MSCs based therapy has profound inhibitory effects on inflammatory responses and immunoregulatory effects both in local and systemic abnormalities in PBC. These findings also provide further evidence regarding the role of MSCs in the clinical trials of PBC. <h3>Disclosure of Interest</h3> None declared
Developing a prediction model for cardiovascular risk after orthotopic liver transplantation
Authors: Fu‐Shan Xue, Ya‐Yang Liu, Gui‐Zhen Yang
Journal: Hepatology (2017)

Potential conflict of interest: Nothing to report. TO THE EDITOR: We read with great interest the recent article by VanWagner et al.,1 developing and validating a point‐based prediction model (CAR‐OLT score) for cardiovascular risk after orthotopic liver transplantation (OLT). They show that the CAR‐OLT score can identify patients at risk for cardiovascular complications after OLT and has a better discriminative performance than other published risk models. Given that cardiovascular complications after OLT are common and are main causes of death after surgery, the CAR‐OLT score has significant potential utility. However, we noted that when establishing the CAR‐OLT score, the model only included preoperative risk factors, but not intraoperative factors, affecting the occurrence of cardiovascular complications and death. The available evidence indicates that, other than health status and comorbidities of patients, surgical burden is mostly an important determinant for postoperative complications and mortality. In fact, intraoperative massive blood loss, transfusion, adverse cardiovascular events, use of inotropic agents, total fluid volume, complications, and long operative time are associated significantly with increased risks of postoperative complications and mortality after OLT. For example, even short duration of an intraoperative mean arterial pressure MAP <55 mm Hg can result in postoperative myocardial injury, with an independent graded relationship between duration of intraoperative hypotension and postoperative myocardial injury.2 Thus, we argue that not including intraoperative risk factors would have decreased the sensitivity, specificity, and predictive value of the CAR‐OLT score developed in this study. Although the CAR‐OLT score outperforms other published risk models, its C statistic and bias‐corrected C statistic are only 0.78 and 0.77, respectively, indicating that it is still a predictive score with moderate discrimination ability. It must be emphasized that preoperative factors commonly used for prediction models may not completely explain postoperative outcomes. Some dynamic intraoperative parameters not related to pre‐existing comorbidities are also associated significantly with increased risk of postoperative complication and mortality. In available literature, performance of preoperative score in predicting postoperative complications and mortality of OLT patients has been questioned.3 Furthermore, compared with the surgical risk stratification only based on preoperative risk factors, the model including intraoperative risk factors can provide an improved ability to predict a postoperative mortality and adverse cardiac events. Thus, we believe that discrimination ability and predictive value of the CAR‐OLT score developed in this study would have further improved, if study design had included the intraoperative factors affecting risks of postoperative complications and mortality following OLT surgery.
AB0205 Carotid intima-media thickness linked to the presence of cardiovascular risk factors in mexican mestizo patients with rheumatoid arthritis
Authors: DA Galarza-Delgado, JR Azpiri-Lopez, IJ Colunga-Pedraza, RE Ramos-Cazares, FJ Torres-Quintanilla, A Valdovinos-Bañuelos, RI Arvizu-Rivera, A Martinez-Moreno, JA Cardenas-de la Garza, JI Garcia-Colunga, G Elizondo-Riojas
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rheumatoid Arthritis (RA) is associated to subclinical atherosclerosis. Traditional risk factors for cardiovascular outcomes do not explain completely the higher risk, which could be caused by chronic systemic inflammation. <h3>Objectives</h3> The aim of this study is to relate abnormal carotid intima-media thickness (CIMT) to the presence of cardiovascular risk factors. <h3>Methods</h3> Observational cross-section design. We included patients who fulfilled the 1987 ACR and/or 2010 ACR/EULAR classification criteria for RA, 40 to 75 years old, with no personal history of atherosclerotic CV disease. A board-certified radiologist performed carotid duplex ultrasounds. Patients were distributed in two groups according to the absence (Group 1) or presence (Group 2) of traditional risk factors for cardiovascular disease (smoking status, dyslipidemia, high blood pressure and diabetes). <h3>Results</h3> A total of 82 patients were included. Demographic characteristics for each group are shown in Table 1. Ultrasound findings are shown in Table 2. CIMT alterations were more common in Group 2 (66.7%) than in Group 1 (38.7%), with statistical significance (<i>p=0.013</i>). Presence of carotid plaque was more common in Group 2 (27.5%) than in Group 1 (16.1%), shown clinical relevance, although did not shown statistical significance (<i>p=0.18</i>). <h3>Conclusions</h3> In this cohort of Mexican patients with RA, we demonstrate relation between the presence of alterations in CIMT (carotid hypertrophy and carotid plaque) and risk factors for cardiovascular disease, which can be enhanced by intrinsic risk of RA. These findings reaffirm the importance of global health assessment in patients with RA to reduce morbidity. <h3>References</h3> Avina-Zubieta JA. Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis. 2012;71(9):1524–9. Galarza-Delgado DA, Serna-Pena G. Carotid atherosclerosis in patients with rheumatoid arthritis and rheumatoid nodules. Reumatol Clin. 2013;9(3):136–41. Mateo I, What measure of carotid wall thickening is the best atherosclerotic loading score in the hypertensive patient: maximum or mean value?]. Rev Esp Cardiol. 2011;64(5):417–20. <h3>Disclosure of Interest</h3> None declared
AB0953 Arthritis following parasitic infection in the differential diagnosis of juvenile idiopathic arthritis
Authors: M Maschio, S Pieropan, F Caldonazzi, G Dallagiacoma, V Ravagnani, D Degani, G Piacentini, D Biasi, M Rossini
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> According to literature arthritis is a rare complication following parasitic infection. In the italian pediatric population parasitic infection is manly caused by Enterobius Vermicularis; it is often asymptomatic but common symptoms can be anal nocturnal itching, insomnia, irritability, abdominal pain together with arthralgia <h3>Objectives</h3> To describe cases of mono or poliarthritis due to parasitic infection in young patients followed at the Verona9s Pediatric Rheumathology Clinic from 2010 to 2016 <h3>Methods</h3> Medical records of 8 patients followed at the Pediatric Rheumatology were analyzed. The mean age of 8 patients was 8 (F:M 3:5). The following data were evaluated: anamnesis data, clinical symptoms (anal itching, irritability, arthralgia, abdominal pain and arthritis), Blood test and scotch tape test. All patients underwent joint ultrasound (US). Physical symptoms of joint9s involvement were evaluated in all children by an experienced rheumatologist. <h3>Results</h3> 6 patients had symmetrical poliathirtis, 2 patients had monoarthritis (knee and hand). Symptom9s complaint were systemic (12,5%), abdominal (25%), and general pruritus (25%).Blood test confirmed high inflammation indices (25%) and hypereosinophilia (12,5%).Serological tests and stool investigations allowed to diagnose the following infections: Enterobius vermicularis (6 cases) giardia lamblia (1 case); dientaomeba fragilis (1 case).Joint US evidenced synovium hyperplasia in 75% of the cases and tenosynovitis in 50% of the cases.After appropriate antiparasitic treatment complete articular and systemic symptomatic remission was observed (100% cases); also joint US control normalized.2 cases, after about 6 months, were re-evaluated for arthritis relapse and in both cases a parasitic reinfection was confirmed. <h3>Conclusions</h3> Analysis of this series of patients underlines the following data: arthritis can be a manifestation of parasitic infection; treatment must be aimed against the parasite involved in order to achieve complete clinical and laboratory data remission; reinfection must always be considered in cases of relapse; differential diagnosis of this form of arthritis with other chronic polyarthritis is fundamental due to the risk of disseminated infection in case of immunosuppressive treatment <h3>Disclosure of Interest</h3> None declared