tbuckley/cabot-search huggingface dataset:
FRI0430 Dual trajectories of disease activity and health-related quality of life in patients with ankylosing spondylitis
Authors: A van Tubergen, M Imkamp, A Boonen, S Arends, M Dougados, R Landewé, S Ramiro, F van den Bosch, D van der Heijde, F Wink, A Spoorenberg, V Lima Passos
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The ultimate goal of managing Ankylosing Spondylitis (AS) is to improve and maintain the patient9s health-related quality of life (HRQoL). To reach this goal, rheumatologists target towards low disease activity, as this is the main modifiable factor. To date, there is insufficient insight into (1) the co-evolution of disease activity and HRQoL, and (2) the heterogeneity in such trajectories among patients. <h3>Objectives</h3> To explore the heterogeneous character of AS by identifying different temporal patterns of co-dependence between disease activity and HRQoL over 8 years follow-up. <h3>Methods</h3> Data from Outcome in AS International Study (OASIS; n=161) and Groningen Leeuwarden AS (GLAS; n=264) cohorts were used. All patients had an established diagnosis of AS. In GLAS, all patients started a biological. HRQoL and disease activity were measured bi-annually using ASQoL and ASDAS-CRP respectively. Patients were classified into latent groups with individuals following a similar course of disease activity and HRQoL. These trajectories were estimated by Group-Based Trajectory Modelling. Next, the trajectories were profiled by comparing the latent groups with respect to baseline factors with ANOVA and Chi-square test. <h3>Results</h3> Five dual trajectories were revealed (Figure): 1. Low impact of AS on patient (13%): stable low ASQoL and ASDAS inactive disease; 2. Moderate impact (24%): stable moderate ASQoL and ASDAS high disease; 3. Improving impact (21%): major improvement in ASQoL and ASDAS; 4. High impact (29%): moderately severe ASQoL with very high but improving ASDAS; 5. Very High Impact (13%): persistently severe ASQoL with high ASDAS. Low impact of AS was mainly characterized by male gender and HLA-B27; improving impact by younger age, short symptom duration, and biological intake; high impact by higher age, long symptom duration, and (bridging) syndesmophytes (Table). <h3>Conclusions</h3> We identified five dual trajectories of disease activity and HRQoL, each demonstrating a clear mutual relationship. These trajectories and their profiles provide insight into the heterogeneity of the impact of AS on patients9 health and overall functioning. <h3>Disclosure of Interest</h3> None declared
SAT0610 Temporal artery ultrasound in the diagnosis of giant cell arteritis in a cohort with elevated clinical impression
Authors: PV Estrada, D Reina, V Navarro, D Roig, D Cerdà, V Torrente, S Heredia, H Corominas
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Giant cell arteritis (GCA) is the most frequent vasculitis in adulthood. The delay in diagnosis sets back treatment and can lead to serious consequences. Diagnosis is complex, and is followed by the classification criteria according to the American College of Rheumatology (ACR). The is an increasing interest on the utility of temporal artery ultrasound (TAUS) as a tool to evaluate inflammation on the vessel wall. <h3>Objectives</h3> to evaluate the utility of TAUS in GCA. <h3>Methods</h3> During 2016, 120 TAUS were carried out in 60 patients with clinical suspicion for GCA. The TAUS was carried to completion by rheumatologist with experience. The symptoms that lead to a TAUS was either one or more of these clinical scenarios: 1) cranial symptoms (recent onset headache, mandibular claudication, visual disturbances) 2) polymyalgic syndrome 3) toxic o febril unspecific syndrome 4) vertebrobasilary (VB) stroke. Demographic and laboratory data were collected, and a follow-up was done to learn the final diagnosis. As for TAUS, the "halo" sign was considered positive if an anechoic image surrounded the vessel was present, and measured &gt;0,30 mm in both, longitudinal and transverse cuts. Other more unspecific signs as stenosis or occlusion were also registered. A temporal artery biopsy was performed whenever the physicians considered necessary, based on clinical criteria, every case in no more than 30 days. <h3>Results</h3> Fifty-two percent were women, mean age 76±7.8 years old. Mean laboratory parameters: eritrosedimentation rate 85±41.9 mm/h, C-reactive protein 77±80 mg/L, Haemoglobin 11.4±2.2 g/L, white blood count 10,228±3,520, platelet count 310,603±123,918. The symptoms that motivated requesting the TAUS were: cranial symptoms (62.2%), toxic, unspecific, febrile syndrome (44%), polymyalgic syndrome (30%), VB stroke (5%). A temporal artery biopsy was carried out in 45% of patients (N=27); it was positive in 40.7%, negative in 40.7% and unspecific (given it reported an inflammatory histologic pattern, but without the characteristic giant cells) in 18.5%. From all 60 patients in whom a TAUS was performed, 36% were diagnosed with GCA, based on ACR criteria. The sensibility and specificity for TAUS was 80% and 94% respectively, with a posivite predictive value of 88.9% and a negative predictive value of 89.2% <h3>Conclusions</h3> TAUS is a useful, non-invasive, fast, accessible tool for evaluating temporal arteries with a great diagnostic valu <h3>Disclosure of Interest</h3> None declared
SP0178 Gut dysbiosis and other challenges precipitate arthritis
Authors: C Mackay
Journal: Annals of the Rheumatic Diseases (2017)

Environmental factors contribute to development of autoimmune diseases. For instance, human autoimmune arthritis can associate with intestinal inflammation, cigarette smoking, periodontal disease, and various infections. The cellular and molecular pathways whereby such remote challenges might precipitate arthritis or flares remain unclear. We have defined many of the pathways in the gut that contribute to homeostasis, particularly GPCRs such as GPR43 and their ligands the short chain fatty acids. Such receptors and their ligands are anti-inflammatory. To probe peripheral inflammation connections to arthritis, we used a transfer model of self-reactive arthritis-inducing CD4 cells from KRNtg mice that, upon transfer, induce a very mild form of auto-inflammatory arthritis in recipient animals. This model enabled us to identify external factors that greatly aggravated disease, such as microbiota effects or disruption of gut homeostasis. We show that several distinct challenges precipitated full-blown arthritis, including intestinal inflammation through DSS-induced colitis, and bronchial stress through Influenza infection. Both triggers induced strong IL-17 expression primarily in self-reactive CD4 cells in lymph nodes draining the site of inflammation. Moreover, treatment of mice with IL-1b greatly exacerbated arthritis, while transfer of KRNtg CD4 cells lacking IL-1R significantly reduced disease and IL-17 expression. Thus, IL-1b enhances the autoaggressive potential of self-reactive CD4 cells, through increased Th17 differentiation, and this influences inflammatory events in the joints. We propose that diverse challenges that cause remote inflammation (lung infection, colitis, gut dysbiosis) result in IL-1b -driven Th17 differentiation, and this precipitates arthritis in genetically susceptible individuals. Thus the etiology of autoimmune inflammatory arthritis likely relates to diverse triggers that converge to a common pathway involving IL-1b production and Th17 cell distribution. <h3>Disclosure of Interest</h3> None declared
AB0923 Meeting the fibromyalgia criteria has a negative impact on tnf inhibitors efficacy in patients with axial spondyloarthritis
Authors: A Dantu, J Michaud, M Gauthier Prieur, F Da Silva, S Pouplin, T Lequerre, O Vittecoq, M Verdet
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Fibromyalgia and spondyloarthritis can coexist and the overlap between the two diseases could have consequences on TNF inhibitors efficacy. <h3>Objectives</h3> To evaluate TNF inhibitors efficacy in patients with axial spondyloarthritis fullfilling or not fibromyalgia criteria. <h3>Methods</h3> Prospective observational bicentric study on 25 patients who met ASAS 2009 axial spondyloarthritis criteria. Fibromyalgia was defined by ACR 2010 fibromyalgia criteria or by a ≥5/6 score of the Fibromyalgia Rapid Screening Tool. Following items were recorded before and after a 6 months treatment with TNF inhibitors: Visual Analog Scale for pain and for patient global disease activity, values of ESR and CRP, number of tender joints, MASES score, number of Yunus tender points. All patients filled a self-questionnaire with BASDAI, BASFI, FiRST and ACR 2010 fibromyalgia scale items using SSS and WPI. Criterion of judgment: an ASAS partial remission state was compared in patients with or without fibromyalgia. <h3>Results</h3> Of the 25 patients enrolled, 15 (60%) fulfilled ACR 2010 fibromyalgia criteria and 9 (36%) had a ≥5/6 FiRST score. The proportion of patients fulfilling an ASAS partial remission state was significantly lower in patients with fibromyalgia according to the ACR 2010 criteria (20% vs 70%, p=0,034) or to the FiRST score (0% vs 62,5%, p=0,0028). These patients had more severe disease activity and physical fonction than the patients without fibromyalgia. In this study, some factors were related with absence of ASAS partial remission: female gender, prior TNF inhibitor failure, ACR 2010 fibromyalgia criteria positivity, to have more than 11 Yunus points and to have a ≥5/6 FiRST score. <h3>Conclusions</h3> Meeting the fibromyalgia criteria might have an impact on ASAS partial remission state and on efficacy of TNF inhibitors in patients with axial spondyloarthritis. The FiRST score was more specific to predict an absence of ASAS partial remission than the ACR 2010 fibromyalgia criteria. TNF inhibitors should be used with circumspection in case of FiRST score ≥5/6 in patients with axial spondyloarthritis. <h3>References</h3> Perrot S., Bouhassira D., Fermanian J., the CEDR (2010) Development and validation of the Fibromyalgia Rapid Screening Tool (FiRST). Pain 150(2):250–256. Wolfe F., Clauw DJ., et al. (2011) Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. J Rheumatol 38:1113–1122. <h3>Disclosure of Interest</h3> None declared
SP0025 The use of biomarkers for osteoporosis clinics
Authors: K Akesson
Journal: Annals of the Rheumatic Diseases (2017)

The balance between bone resorption and bone formation is maintained through a complex regulatory system of systemic and local factors acting on bone cells, such as calcium regulating and sex hormones, growth factors and cytokins. Furthermore, the competence of the bone cells and the number of active cells will determine the production of bone matrix proteins, while other incompletely understood intrinsic mechanisms will determine mineralization and micro-structure. Exposure of the matrix after osteoclastic activation allows for proteolytic enzymes to commence the degradation of the collagenous structure. The signals responsible for termination of bone resorption and initiation of bone formation (coupling) are not yet completely understood. Nevertheless, a tight coupling between resorption and formation is required to maintain bone mass and to preserve the micro-architectural integrity of bone. Based on this knowledge markers of bone metabolism have been developed. These markers have been evaluated in terms of their ability to predict fracture, change in bone mass, and response to pharmacological treatments in clinical trials and additionally to monitor treatment in clinic. The lecture will cover the use of markers in clinical trial, interpretation of change in markers from currently available and potential new drugs and to what extent and how to best apply in clinic. <h3>Disclosure of Interest</h3> None declared
Dual Functioned Pegylated Phospholipid Micelles Containing Cationic Antimicrobial Decapeptide for Treating Sepsis
Authors: Wonhwa Lee, Eun Ji Park, Gahee Min, Joonhyeok Choi, Dong Hee Na, Jong-Sup Bae
Journal: Theranostics (2017)

Despite intensive investigation of molecular mechanisms underlying the pathogenesis of sepsis, many aspects of sepsis remain unresolved; this hampers the development of appropriate therapeutics.In the present study, we developed a biologic nanomedicine containing a cationic antimicrobial decapeptide KSLW (KKVVFWVKFK), self-associated with biocompatible and biodegradable PEGylated phospholipid micelles (PLM), and analyzed its efficacy for treating sepsis.KSLW was modified with polyethylene glycol (PEG)-aldehyde or was conjugated with distearoylphosphatidylethanolamine (DSPE) -PEG-aldehyde.We compared the antibacterial and antiseptic effects of PEG-KSLW and PLM-KSLW with those of unmodified KSLW both in vitro and in vivo.We found that the PLM-KSLW improved the survival rate of sepsis mouse models without undesired immune responses, and inhibited lipopolysaccharide (LPS)-induced severe vascular inflammatory responses in human umbilical vein endothelial cells compared with unmodified KSLW or PEG-KSLW.Furthermore, PLM-KSLW dramatically reduced the bacterial count and inhibited bacterial growth.We also found a new role of PLM-KSLW in tightening vascular barrier integrity by binding to the glycine/tyrosine-rich domain of occludin (OCLN).Our results showed that PLM-KSLW had a more effective antiseptic effect than KSLW or PEG-KSLW, possibly because of its high affinity toward OCLN.Moreover, PLM-KSLW could be potentially used to treat severe vascular inflammatory diseases, including sepsis and septic shock.
AB1108 Handling of de novo arthritis in adults by general practitioners: a survey in a french cohort
Authors: S Lecauchois, S Gentile, P Champsaur, J-P Mattei, L Dillinger, V Goeb, S Guis
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> A guide of good clinical practice regarding <i>de novo</i> arthritis in adults has been edited. <h3>Objectives</h3> The aim of this work is to identify whether the diagnostic and therapeutic tools proposed by general practitioners (GPs) to adults with a <i>de novo</i> arthritis is in line with the corresponding recommendations. <h3>Methods</h3> A questionnaire regarding the characteristics and the handling of <i>de novo</i> arthritis in adults has been submitted to 300 GPs chosen randomly from a French cohort database. The study period was from February 2015 to February 2016. Fifty seven GPs participated in the study (19%). <h3>Results</h3> No particular specificity was identified in the GP group. The age of patients ranged between 40 and 75 yo. The prevalence of arthritis was less than 5% among the GPs patients. The relative number of each category of arthritis was rheumatoid arthritis (29%), spondyloarthritis (14%), PPR (8%), other kinds of microcrystalline arthritis: chondrocalcinosis, (38.4%), gout (11,6%). Joints with mechanic degenerative effusion related to osteo-arthritis might be misdiagnosed as an inflammatory arthritis. The knee was the most frequently involved joint in arthritis. The initial paraclinical survey was related to biology. Most of the patients were treated with NSAI as an initial intent. A corticoids-based therapy was proposed to 1.4% of the patients and the corresponding specialist was a rheumatologist (98%). <h3>Conclusions</h3> The <i>de novo</i> arthritis prevalence for GPs is less than 5% with the knee being the most affected joint. Most frequently, GP are faced with gout, rheumatoid arthritis and spondyloarthritis. The handling is in line with the corresponding guide of good clinical practice. <h3>Disclosure of Interest</h3> None declared
THU0483 Characteristics of patients with active axial spondyloarthritis and comorbid fibromyalgia. differences according to fibromyalgia screening (first questionnaire) and fibromyalgia classification (ACR1990)
Authors: S Perrot, A Moltό, A Etcheto, N Boudersa, P Claudepierre, N Roux, F Berenbaum, A Martin, L Sparsa, P Coquerelle, M Soubrier, L Gossec, M Dougados
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Fibromyalgia (FM) can be a comorbid condition in axial spondyloarthritis (axSpA). FM screening questionnaires and classification criteria fulfillment may demonstrate different prevalence and patients9 characteristics may differ. <h3>Objectives</h3> To evaluate frequency of comorbid FM, and the differences between axSpA patients with/without comorbid FM according to screening (FiRST) and classification tools (ACR1990 FM criteria). <h3>Methods</h3> A multicenter national study involving 39 rheumatology centers in France included 519 patients with axSpA starting an anti-TNF treatment (PredictSpA study; ClinicalTrials.gov: NCT03039088). Patients (pts) were screened for FM with the FiRST questionnaire and classified as FM by ACR 1990 criteria. Demographic characteristics, comorbidities, axSpA characteristics, CRP and imaging were recorded in all patients. Kappa coefficient (and its 95% CI) was calculated to compare FiRST and ACR1990 criteria. Baseline characteristics associated with FM were evaluated by univariable and multivariable logistic regression (including the variables with a p value&lt;0.20 in the univariable analysis). <h3>Results</h3> In the 519 pts (females: 46%, age: 42±12 years, mean BASDAI 5.7±2.0, mean ASDAS-CRP 3.3±0.9), a comorbid FM was screened in 38% and diagnosed in 16% of pts. Agreement between FiRST and ACR1990 was poor, with a Kappa coefficient of 0.2 [0.2–0.3]. In the multivariable analysis, comorbid FM (by the FiRST questionnaire) in axSpA patients was independently associated with a lower education level, more sick leave, more heel pain, more frequent second line anti-TNF. Comorbid FM defined by the ACR1990 classification criteria was independently associated with heel pain and inversely associated with B27 haplotype. (Table) <h3>Conclusions</h3> FM is frequently associated with active axSpA, with poor correlation between screening (FiRST) and diagnosis (ACR1990) test. Several characteristics are associated with comorbid FM, depending on FM classification and screening tools. <h3>References</h3> Perrot S et al. Development and validation of the Fibromyalgia Rapid Screening Tool (FiRST). Pain. 2010;150:250–6. <h3>Acknowledgements</h3> This study was conducted thanks to an unrestricted grant from MSD. <h3>Disclosure of Interest</h3> None declared
Young woman with segmental colitis
Authors: Zaid Imam, Bradley W Anderson, Seth Sweetser
Journal: Gut (2017)

A 22-year-old woman was referred with a 4-week history of bloody diarrhoea, tenesmus, abdominal and rectal pain. Prior to presentation, a prednisone taper had been initiated given suspicion for Crohn’s disease. Her medical history was otherwise unremarkable. Physical exam showed normal vital signs and mild left lower abdominal tenderness without peritoneal signs. Laboratory evaluation was significant for mild leucocytosis (white blood cell count 14.3×109/L (normal range 3.5–10.5×109/L)). CT scan of the abdomen/pelvis showed hazy mesenteric fat stranding, mural thickening, oedema and hyperenhancement involving the rectosigmoid colon with widely …
SAT0467 All 10-year cardiovascular risk scores are similar in patients with psoriatic arthritis and psoriasis
Authors: N Ikumi, F Farkas, A Szentpetery, B Kirby, O FitzGerald
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Psoriatic arthritis (PsA) and Psoriasis (PsO) are associated with higher cardiovascular (CV) risk with higher risk in patients with a severe disease phenotype<sup>1,2</sup>. Long-term CV risk is evaluated using several methods for the general population. <h3>Objectives</h3> The aim of the study was to compare CV risk factors and 10-year CV risk scores between patients with PsA and those with PsO only. <h3>Methods</h3> PsA patients fulfilling the CASPAR criteria and PsO with disease duration &lt;10 years were enrolled consecutively from Rheumatology and Dermatology clinics. Fasting bloods were obtained for glucose, insulin and lipids. Patients underwent thorough physical examination, joint and skin assessments and completed questionnaires on health and quality of life. Four different CV risk scores were calculated: (1) Framingham Coronary risk score (FCS); (2) American College of Cardiology and American Heart Association (ACC/AHA) 10-year atherosclerotic cardiovascular disease (ASCVD) algorithm; (3) Systematic Coronary Risk Evaluation (SCORE) algorithm; and (4) QRISK2 (2016). <h3>Results</h3> 232 patients (100 PsA and 132 PsO) were recruited with mean age 52.4 (±10.5) for PsA and 39.7 (±14.4) for PsO. Mean disease duration for PsA was 17.9 (±10) years. There were significantly more patients with hypertension (HTN) and metabolic syndrome in PsA group, and the patients taking DMARDs and/or biologics treatment were also higher compared to PsO. Fasting glucose, insulin, lipids, BMI and waist/hip ratio did not show significant differences. The mean FCS, ASCVD, SCORE and QRISK2 were significantly higher in PsA as compared to PsO (7.6±7.0% vs. 4.7±6.1%, P=0.0002; 8.4±8.2% vs. 4.5±5.8%, P&lt;0.0001; 2.1±2.6% vs. 1.1±1.8%, P=0.0002; 11.2±9.9% vs. 5.2±6.4%, P&lt;0.0001, respectively). However, after adjusting for age and sex, all CV risk scores were similar (P=0.21). Multiple regression analysis revealed that waist/hip ratio significantly correlated with all CV risk scores in both PsA and PsO. <h3>Conclusions</h3> We found similar 10-year risk of CVD in PsA and PsO patients using FCS, ASCVD, SCORE and QRISK2. Waist/hip ratio had significant effect on all CV risk scores suggesting that central obesity should be managed appropriately to reduce long-term CVD in psoriatic disease. <h3>References</h3> Eder L. Ther Adv Musculoskel Dis 2015. Ogdie A. ARD 2015. <h3>Disclosure of Interest</h3> N. Ikumi: None declared, F. Farkas: None declared, A. Szentpetery: None declared, B. Kirby Grant/research support from: abbie, O. FitzGerald Grant/research support from: abbie, Pfizer, BMS, Consultant for: abbie, Pfizer, BMS, Celgene, Janssen, Novartis, UCB, Eli Lilly