tbuckley/cabot-search huggingface dataset:
AB0757 Impact of disease activity on physical function and health-related quality of life in patients with psoriatic arthritis
Authors: K Nas, G Kilic, R Cevik, AZ Dagli, E Kilic, S Sag, U Erkorkmaz, A Kamanli, I Tekeoglu
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Psoriatic arthritis (PsA) is a chronic progressive inflammatory disease characterized by peripheral arthritis, dactylitis, axial joint involvement and extraarticular features. Disease consequences such as chronic pain, severe joint damage and fatigue may adversely effect on a patient9s physical function and health-related quality of life (QoL) to perform daily activities. <h3>Objectives</h3> The aim of this study was to investigate the potential relationship between physical function and health-related QoL and disease activity measures in patients with PsA. <h3>Methods</h3> For all participating patients, quality of life, functional and disease activity measures were measured by different ways: Nottingham Health Profile (NHP), psoriatic arthritis quality of life (PsAQoL), Ankylosing Spondylitis Quality of Life (ASQoL), SF36 health survey, Health Assessment Questionnaire (HAQ), BASFI, VAS pain, DAS28, BASDAI and acute phase markers including ESR and CRP.Patients with PsA were discriminated into low and high disease activity according to BASDAI (≥6 vs ≤4). <h3>Results</h3> A total of 186 patients with PsA (116 female, 70 male, mean age 43,9±12,6) who met CASPAR criteria were included. Their mean symptom duration was 7.9±9.1 years. Patients with higher BASDAI score (≥6) had significantly higher scores on all important items including health related QoL, fatigue, pain, and functional status. Correlation coefficients between disease activity and various health related QoL measurements were given in Table1. SF36 physical component score was significantly correlated with VAS-pain, BASDAI and DAS28 compared to SF36 mental component. Also, physical activity subscore of NHP was found higher correlated with disease activity indices for PsA in all NHP sections. Other quality of life measurements including PsQoL, HAQ and ASQoL were also significantly correlated with disease activity measurements. <h3>Conclusions</h3> Psoriatic arthritis has a major impact on patients9 lives. Variable disease activity measurements were found correlated with all important QoL measurementss including NHP, SF36, PsQoL, HAQ and ASQoL. In patients with PsA, high disease activity may lead to severe impairments in daily activities and influence on participation in society. <h3>Disclosure of Interest</h3> None declared
Improvement of Genetic Testing for Cutaneous Melanoma in Countries With Low to Moderate Incidence
Authors: Juliette Delaunay, Ludovic Martin, Brigitte Bressac-de Paillerets, Gerard Duru, Olivier Ingster, Luc Thomas
Journal: JAMA Dermatology (2017)

Genetic testing for melanoma-prone mutation in France, a country with low to moderate incidence of melanoma, is proposed in cases with 2 invasive cutaneous melanomas and/or related cancers in the same patient, or in first- or second-degree relatives (rule of 2). In preclinical studies, these rules led to disclosure of mutation(s) in more than 10% of these families, the threshold widely accepted to justify genetic testing for cancers.To reconsider these criteria in a general population testing of patients.This was a retrospective study, performed from 2004 to 2015 at Angers and Lyons University Hospitals, of a cohort of 1032 patients who underwent genetic testing.Frequency of mutation in high (CDKN2A, CDK4, and BAP1) and intermediate (MITF) susceptibility genes; statistical effect of histologic subtype, age, dysplastic nevi syndrome, and associated cancers on mutation rate; and evaluation of cases with anamnestic uncertainty.The mutation rate was 67 of 1032 patients (6.5%). Their mean (SD) age was 54.5 (14.2) years [range, 18-89 years], and 543 (52.6%) were men. It increased to 38 of 408 patients (9.3%) when applying a rule of 3 (those with ≥3 primary melanomas or genetically related cancers) (P = .68) and to 27 of 150 patients (18.0%) with a rule of 4 (4 primary melanomas or related cancer) (P < .001). The impact of age at first melanoma was observed only in those younger than 40 years, with a rate of 32 of 263 (12.1%) (P = .12) for the rule of 2 and 22 of 121 (18.2%) (P = .001) for the rule of 3. Use of the rule of 2 in patients younger than 40 years reduced the number of missed CDKN2A-mutated-families when applying the rule of 3 from 14 of 43 to 7 of 43. Anamnestic uncertainty, found in 88 families (8.5%), if excluded, would have led us to withdraw of only 21 cases (23.8%), and only 1 mutation would have been missed.We propose using the rule of 3 to recommend genetic testing in France and countries with low to moderate incidence of melanoma, except in families and patients with a first melanoma occurrence before age 40 years in whom the rule of 2 could be maintained.
THU0250 Effect of fetal umbilical artery doppler on prediction of adverse pregnancy outcomes in women with systemic lupus erythematosus
Authors: Z Zhan, D Chen, Q Qiu, Y Yang
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Pregnancies in women with SLE resulted in an increase of adverse pregnancy outcomes (APOs). The predictive value of fetal umbilical artery Doppler examinations for APOs has been reported, while not widely be assessed in SLE pregnant women. <h3>Objectives</h3> To ascertain the predictive value of fetal umbilical artery Doppler for fetal APOs in SLE pregnancies. <h3>Methods</h3> A fetal Doppler ultrasound examination was performed on all fetuses during the third trimester (28∼36 weeks of gestation) and the term pregnancy (37∼42 weeks of gestation). The Doppler flow parameters of umbilical arteries were recorded, including pulsatility parameter (PI), resistance index (RI), the peak value of umbilical arteries at end-systole (Vmax, also abbreviate as S) and the peak value of umbilical arteries at end-diastole (Vmin, also abbreviate as D). The value of S/D was automatically calculated. Clinical data and pregnancy outcomes were also analyzed retrospectively. <h3>Results</h3> In total, 109 cases of pregnant SLE women performed fetal umbilical artery Doppler at the third trimester and 82 at the term pregnancy. Among the 109 cases, 65 resulted in one or more APOs, including 45 with premature delivery, 23 with intrauterine growth restriction (IUGR), 16 with fetal distress, 8 with neonatal lupus (NLE) and 3 with congenital malformation. Fetus with APOs had higher S/D values compared with fetus without APOs (2.9±0.9 VS. 2.4±0.5, <i>P</i>=0.001). In addition, other Doppler indexes did not differ significantly across groups. The area under the receiver operating characteristic curve was 0.7 (<i>P</i>=0.003) for S/D values, with the optimal cutoff of 2.8. At this cutoff, sensitivity (46.2%) and specificity (90.9%) had the best combination, whereas the positive and negative predictive values were 83.3% and 52.1%, respectively. Among the 82 cases with term pregnancy, 23 resulted in APOs, including 11 with IUGR, 15 with fetal distress, 4 with NLE and 1 with congenital malformation. All of the Doppler indexes (S/D, PI, RI, Vmax and Vmin) in fetus with APOs were higher than those without APOs, but no statistical significance were found between the 2 groups. <h3>Conclusions</h3> Umbilical artery Doppler was a good monitor method for APOs in the third trimester. S/D values were sensitive and specific predictors for APOs in pregnancies complicated by SLE. Women with more than 2.8 S/D could start strict monitoring to rapidly identify and treat obstetric complications. <h3>Disclosure of Interest</h3> None declared
FRI0727 Impact of maternal systemic autoimmune rheumatic diseases on neonatal outcomes: a population-level analysis
Authors: SO Keeling, A Savu, P Kaul
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The impact of systemic autoimmune rheumatic diseases (SARDS) on peripartum outcomes is not well described at a population level despite the potential for active disease in this period. <h3>Objectives</h3> We examined the association between SARDs and neonatal outcomes in a contemporary pregnancy cohort in the province of Alberta, Canada. <h3>Methods</h3> The patient population consisted of women giving birth between January 1, 2005 to December 31, 2014 (n=312,081). For women with multiple gestations during the period, one birth event was randomly selected. Women with SARDs included any of the following: systemic lupus erythematosus, systemic sclerosis, myositis and sjogren9s syndrome, diagnoses based on the presence of International Classification of Disease version 9/10 codes in outpatient or inpatient records. Baseline characteristics, comorbidities, medication use (available for all births after January 1, 2009), and neonatal outcomes among women with and without SARDs were compared. <h3>Results</h3> Compared to women with no SARDs (n=311,755), women with SARDs (n=326, 0.1%) were slightly older (SARDs 31.3 vs No SARDs 29.3 years (p&lt;0.01)) but did not differ in terms of rural residence, ethnicity, median household income or nulliparity. However, rates of pre-term delivery, emergent cesearian section, induction, hypertensive disorders/eclampsia and mortality were higher among women with SARDs than those with no SARDs (Table 1). Offspring of women with SARDs had lower birth weights, were more likely small for gestational age (SGA), and had longer stays in neonatal ICU (Table 1). Among women with SARDs, prescription rates in the 270 days prior to delivery were highest for anti-malarials (Table 2). After multivariable adjustment, both NSAIDS use (OR (95% CI): 5.24 (1.57, 17.52), p&lt;0.01) and steroid use (OR (95% CI): 3.15 (1.31, 7.59), p&lt;0.01) were significantly associated with a higher risk of preterm delivery. <h3>Conclusions</h3> Women with SARDs are at an increased risk of adverse outcomes during pregnancy. The association between corticosteroid and NSAID use and preterm delivery requires further investigation. Our findings suggest the need for closer monitoring and coordinated care with obstetrics and perinatology in these high risk women. <h3>Disclosure of Interest</h3> None declared
Which Patients With Ischemic Stroke and Insulin Resistance May Benefit From Pioglitazone Hydrochloride?
Authors: Graeme J. Hankey
Journal: JAMA Neurology (2017)

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FRI0461 Muscle wasting in male TNF-α blocker naÏve ankylosing spondylitis patients: a comparison of gender differences in body composition with dual-energy X-ray absorptiometry
Authors: SE Vodnizza Ibáñez, IM Visman, JC Denderen van, WF Lems, MT Nurmohamed, IE der horst-Bruinsma van
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Female Ankylosing Spondylitis (AS) patients have different disease characteristics compared to males. This might be explained by differences in body composition (BC), as women have higher total body fat mass, and adipose tissue can produce adipokines and participate in inflammatory and immunological processes. <h3>Objectives</h3> To assess gender differences in BC measured by Dual-Energy X-ray Absorptiometry (DXA) in a cohort of AS patients naïve to TNF-α blockers, and compare the BC with the reference population. <h3>Methods</h3> AS patients (Modified New York Criteria), 18 years old or older, who had a whole body DXA analysis before TNF-α blockers were included. Demographic information and disease activity measures (ASDAS and BASDAI) were reported. Fat Mass (FM) was reported as total FM (sum of trunk, arms, legs, and head), BF% (ratio FM/Total body mass), and Fat Mass Index (FMI= FM kg/height m<sup>2</sup>). Fat Free Mass (FFM), calculated as lean mass + bone mineral content, and its index (FFMI kg/m<sup>2</sup>) were reported. BF%, FMI, and FFMI percentiles, according to the reference population tables, stratified by age and gender, were also reported. <h3>Results</h3> Seventy consecutive patients were included, 60% were men. Baseline demographic characteristics were similar in men and women. Women had significantly higher BF% and FMI, and lower FFMI as absolute values (table 1). The FFMI percentile was markedly low in men (31.7%) (Figure 1). After multivariate analysis, an ASDAS-CRP &gt;3.5 was related with lower FFM in the whole group (β-coefficient -5.1, 95% CI -10.2 to -0.1, P=0.047). ASDAS &gt;3.5 was related to lower fat content in men and to higher fat content in women. The same relationships were found for BASDAI ≥4. <h3>Conclusions</h3> Muscle wasting, measured as low FFMI compared to the reference population, was found in male TNF-α blocker naïve AS patients, especially in those with active disease. Women had higher volumes of body fat than men, but near the median of the reference population. The relationships between fat content and disease activity support the complex association between adipose tissue and inflammation. <h3>Acknowledgements</h3> This study was endorsed by an ASAS (Assessment of SpondyloArthritis international Society) Fellowship. <h3>Disclosure of Interest</h3> None declared
AB0716 Prevalence of structural lesions typical for axial spondyloarthritis in young military recruits before and after mechanical stress
Authors: G Varkas, M de Hooge, T Renson, P Carron, S De Mits, G Souverijns, D Elewaut, F Van den Bosch
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Magnetic resonance imaging (MRI) has become the imaging modality of choice in early SpA. Not only has this imaging technique proven useful in the identification of inflammatory lesions on T2 FS/STIR sequences, also structural lesions such as erosions, sclerosis, fat infiltration and ankylosis can be seen on T1 sequences. There is still ongoing debate concerning the possible inclusion of any structural lesion in the definition of a positive MRI in order to improve specificity. However, erosions and fat infiltration have also been found in respectively more than 10% and 17% of non-SpA patients on MRI of the sacroiliac joints. [1] <h3>Objectives</h3> To evaluate the presence of structural lesions on MRI of the sacroiliac joints (MRI-SIJ) in young, asymptomatic subjects. <h3>Methods</h3> Twenty-five military recruits volunteered to perform a MRI-SIJ before and after 6 week of intense physical training, of which 22 recruits underwent imaging at both time points. The MRIs were scored for structural lesions by 3 trained readers MdH, GV and TR, blinded for time sequence and clinical findings. Regarding the number of lesions a consensus was made by agreement of 2 out of 3 readers. <h3>Results</h3> At baseline, structural lesions were present in 36.4% (8/22) of subjects of which 5 subjects presented with at least 1 erosion, one subject with sclerosis and 3 subjects presented fatty lesions. This increased to 50% subjects (11/22) with structural lesions on MRI-SIJ after 6 weeks of mechanical stress, of which 8 subjects with at least 1 erosion, one subject with sclerosis and 3 subjects with fatty lesions (P=0.453). The change scores for sclerosis, erosions and fatty lesions were respectively 0.0 (±0.0), 0.2 (±0.1) and 0.3 (±0.2). None of the subjects displayed ankylosis. The lesion distribution is visualized in Table1. <h3>Conclusions</h3> Although not prevalent, structural lesions such as erosions, sclerosis and fatty lesions can be found in young asymptomatic subjects. However, these lesions do not seem to increase after 6 week of intense physical training. <h3>References</h3> Weber U, Lambert RG, Ostergaard M, Hodler J, Pedersen SJ, Maksymowych WP. The diagnostic utility of magnetic resonance imaging in spondylarthritis: an international multicenter evaluation of one hundred eighty-seven subjects. Arthritis Rheum. 2010;62(10):3048–58. <h3>Acknowledgements</h3> ASAS research grant 2017. <h3>Disclosure of Interest</h3> None declared
SP0138 The challenges of patient involvement in scientific research. how to achieve true representation of the patients' voice?
Authors: M De Wit
Journal: Annals of the Rheumatic Diseases (2017)

There is a strong call in the western world for collaborative research. Rheumatology is one of the disciplines that has explored best practices and paved the way to implement lessons learned. Although good methodologies for evaluating the impact of patient participation stay behind, we have been able to develop expert-based recommendations for collaboration. They are helpful for both researchers and patient representatives, but they do not address all concerns that occur in daily practice. In this lecture current challenges of integrating the perspectives of patients in clinical research will be discussed: 1. Defining the role and complementary value of patient research partners; How can patients in the role of collaborative partner contribute to research in addition to the data that patients provide as respondent or study participant? 2. Facilitating and guiding researchers in collaborative research; We have experience in preparing and educating patient representatives for their role in research, but how should researchers be trained and supported? 3. Preserving the patients9 voice throughout the research process; Qualitative research may elicit patients9 experiences with health care or health interventions, but what is needed to guarantee that these findings are not lost in the rigorous process of producing scientific knowledge? 4. Demonstrating impact of collaborative research to funders and the public; Despite many case studies reporting a great variety of patient participation methods, there are no clinical trials nor consensus on a validated methodology for assessing the outcomes of patient involvement in research. For each challenge we will try to propose a way forward. These challenges will also be discussed at the newly established EULAR working group for collaborative research. <h3>Disclosure of Interest</h3> None declared
Chronic urticaria and irritable bowel syndrome: a cross-sectional study of 11 271 patients
Authors: G. Shalom, E. Magen, M. Babaev, A. Horev, T. Freud, G. Ben Yakov, D. Comaneshter, D.A. Vardy, A.D. Cohen
Journal: British Journal of Dermatology (2017)

The human body interacts with the environment mainly through three major tissues: the lungs, skin, and gastrointestinal (GI) tract. In each one, an intensive nervous network is present, conjugated with abundant mast cells (MC). While MC-mediated disorders in airways and the skin are extensively discussed, MC-mediated disorders of the GI tract remain relatively uncommon. Since the GI tract is one of the three main environment-interacting tissues, it is reasonable that MC-mediated disorders of the GI may have the same weight and impact as asthma or chronic urticaria (CU).

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SAT0190 Estimate of clinical and antidestructive effects of rituximab in rheumatoid arthritis
Authors: AV Pivanova, G Lukina, Y Sigidin, A Smirnov, K Kuzikyants, A Kuznetsova
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial hyperplasia, mononuclear cell infiltration, bone erosion and joint destruction. Antirheumatic treatment plays a important role in controlling the inflammation of rheumatoid arthritis and in minimizing joint damage. Rituximab - it is a chimeric monoclonal antibody that targets the CD20 molecule expressed on the surface of B cells. It has been successfully used to treat rheumatoid arthritis, and it is worth noting that his antidestructive effect sometimes does not meet the clinical. <h3>Objectives</h3> to assess clinical and antidestructive effect of Rituximab (RTX) in patients with rheumatoid arthritis (RA). <h3>Methods</h3> 108 patients (pts) with RA, most of them were middle-age women with high disease activity (mean DAS28 6,1±1,04, RF-positive 77%, ACCP-positive 83%) treated with RTX (1000 mgx2 or 500 mgx2). Clinical effect was evaluated by EULAR criteria; radiological progression by SVH method. <h3>Results</h3> 104 patients were treated by RTX (500 x2 or 1000 x2), had good response: after 48 week of treatment clinical improvement was achieved in 65% pts, good and moderate response by EULAR criteria in 23% and 42% pts accordingly. Noteworthy, after 12 months of treatment RTX radiological progression was absent in 50% pts with high disease activity. <h3>Conclusions</h3> RTX treatment slowed joint damage without clinical improvement. Clinical and antidestructive results did not always coincide which suggests different mechanisms of clinical and antidestructive effects of anti-B-cell therapy <h3>Disclosure of Interest</h3> None declared
Staging in multidisciplinary (MDC) v serial care (SC) lung cancer (LCa) patients (Pts).
Authors: Matthew Smeltzer, Nicholas Ryan Faris, Fedoria Elaine Rugless Stewart, Meredith Ray, Nana Boateng, Meghan Brooke Meadows, Courtney Foust, Bianca Jackson, Anita Patel, Carrie Fehnel, Cheryl Houston-Harris, Raymond S Signore, Edward T Robbins, Raymond U. Osarogiagbon
Journal: Journal of Clinical Oncology (2017)

e20079 Background: Multi-modal staging is associated with improved survival for pts with LCa. We evaluated the thoroughness of clinical staging within and outside a co-located MDC. Methods: Prospective cohort study comparing newly-diagnosed LCa patients in MDC to serially referred (SC) pts within the same healthcare system. Pts were enrolled before treatment began. Stage-confirmation was defined as invasive biopsy of a stage-defining lesion. Bimodal staging involved use of either PET scan or invasive biopsy with CT scan, trimodal staging involved all 3. We used the chi-square test and multivariable logistic regression. Results: From 2014-16, 162 pts were enrolled into MDC, 318 into SC. MDC pts were older (median age 69 v 66), more likely to be black (37% v 29%), and less likely to be commercially insured (36% v 43%) than SC pts. MDC pts had node positive disease identified by PET/CT in 70% of cases, but only 42% in SC (p=0.003). MDC pts were more likely to be clinical M0 (70% vs. 55%). M1b pts were biopsied in 45% of MDC v 36% of SC cases. MDC pts were more likely to have bimodal (90% v 73%) and trimodal staging (51% v 29%) (both p&lt;0.0001, Table 1). The stage-confirmation rate (OR: 1.93 [CI 1.32,2.84]); p=0.0007) and mediastinal stage confirmation rate (OR: 2.16[1.46,3.18]; p=0.0001) were both significantly higher in MDC (Table 1). Adjusting for age, gender, clinical N stage, and histology, these results remained significant (aOR=2.13, p=0.0003); (aOR=2.35, p&lt;0.0001). A subgroup of SC patients (N=64) was discussed at a tumor board. This group had a stage confirmation rate (48%) and mediastinal stage confirmation rate (44%) intermediate between MDC and pure SC (p=0.007, p&lt;0.0001). Conclusions: MDC effectively reached a higher percentage of underserved persons based on age, race, and insurance status, while providing significantly more thorough clinical staging. A tumor board alleviated, but did not eliminate, the gap. Clinical trial information: NCT02123797. [Table: see text]