tbuckley/cabot-search huggingface dataset:
FRI0278 Prevalence of primary sjÖgren's syndrome in a population-based cohort in the united states
Authors: G Maciel, C Crowson, E Matteson, D Cornec
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Different studies worldwide reported highly discrepant estimates for the prevalence of primary Sjögren9s syndrome (pSS), ranging from 0.01% of the general population to more than 3%. No previous study reported the prevalence of pSS in the United States. <h3>Objectives</h3> To report the 2015 point prevalence of pSS in the first population-based study performed in the U.S. <h3>Methods</h3> Cases of all potential pSS patients living in Olmsted County, Minnesota on January 1, 2015 were retrieved using the Rochester Epidemiology Project resources, and ascertained by manual medical record review. Definite pSS cases were defined according to physician diagnosis. All patients with doubtful cases and all patients with an associated systemic autoimmune disease were excluded. The use of diagnostic tests was assessed and the performance of classification criteria in this community-based cohort was evaluated. The number of prevalent cases in 2015 was also projected based on 1976–2005 incidence data from the same source population. <h3>Results</h3> A total of 106 patients with pSS were included in the study: 86% were female, with a mean (SD) age of 64.6 (15.2) years and disease duration of 10.5 (8.4) years. A majority were anti-SSA positive (75%) and/or anti-SSB positive (58%), but only 22% met American-European Consensus Group or American College of Rheumatology criteria because the other tests required for disease classification were rarely performed in clinical practice (ocular dryness objective assessment, salivary gland functional or morphologic tests, or salivary gland biopsy). According to the physician diagnosis, age and sex adjusted prevalence of pSS was 10.3/10,000 inhabitants, but according to classification criteria this prevalence would be only 2.2/10,000. The analysis based on previous incidence data projected a similar 2015 prevalence rate of 11.0/10,000. Using figures from the 2015 general U.S. population census, a total of 248,000 patients with pSS (35,000 males and 213,000 females) would currently live in the country. If only cases fulfilling classification criteria are considered, there would be only about 53,000 prevalent cases of pSS in the U.S. <h3>Conclusions</h3> This study reports the first prevalence rate of physician-diagnosed pSS in a well-defined population in the U.S. The estimated prevalence of 10.3/10,000 inhabitants in 2015 is higher than previous results obtained in other geographical areas, probably due to different methodological designs of the studies. Because physicians rarely used tests included in the classification criteria to diagnose the disease in this community setting, current classification criteria do not reflect accurately the diagnosis of pSS in routine clinical practice. <h3>Disclosure of Interest</h3> None declared
SAT0407 Rise in the diagnosis of non-radiographic form of axial spondyloarthritis in northern israel over time
Authors: K Zilber, S Ginsberg, D Rimar, M Rozenbaum, N Boulman, L Kaly, A Awisat, N Jaries, I Rosner, G Slobodin
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Approach to the diagnosis of axial spondyloarthrithis (axSpA) has changed in the last decade, with the aim of diagnosing the disease in its early form. <h3>Objectives</h3> The objective of this study was to explore change in the diagnostic pattern of axSpA in Northern Israel over the last 15 years. <h3>Methods</h3> Patients with the clinical diagnosis of axSpA from six rheumatology practices affiliated with the Rheumatology Unit of the Bnai Zion Medical Center in Haifa, Israel were recruited to the study. Ankylosing Spondylitis (AS) was diagnosed in the presence of sacroiliitis grade 2 or more on X-ray films; all other patients were considered as having non-radiographic axSpA. All patients were subdivided by time periods to 5 groups, and percentages of patients diagnosed in the non-radiographic stage of the disease, as well as patient demographic data were compared using exact Fisher test. <h3>Results</h3> One hundred twenty five patients were subdivided to 5 groups by periods of diagnoses (before 2000, 2001–2004, 2005–2008, 2009–2012, 2013–2016). Gradual increase in a proportion of patients diagnosed with non-radiographic axSpA was observed over years, with statistical significance achieved in 2013–2016 (p&lt;0.05) (Fig.1). Patients` gender and age distribution did not differ significantly among the groups. <h3>Conclusions</h3> Progressive increase in the proportion of patients diagnosed with non-radiographic form of axSpA over years was observed in this study. This finding, made on the basis of real life data, reflects change in the diagnostic approach to spondyloarthritis during the last decades. <h3>Disclosure of Interest</h3> None declared
FRI0673 Clinical remission in tocilizumab-using rheumatoid arthritis patients can be overestimated: a cross sectional study using ultrasound sonography
Authors: S Nakabo, Y Tsuji, M Inagaki, H Tsuji, T Nakajima, M Hashimoto, M Furu, M Tanaka, H Ito, T Fujii, Y Fujii, T Mimori
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Several clinical remission (CR) criteria of rheumatoid arthritis (RA) contain acute-phase reactants [C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR)] as their components. However, it is known that they can be underscored by the usage of tocilizumab (TCZ). This may cause overestimation of CR. On the other hand, ultrasound sonography (US) provides objective information independent of acute-phase reactants and assessment by physician and patient, and can detect synovitis in RA patients in CR, which is called sonographic residual synovitis (SRS). <h3>Objectives</h3> To assess whether CR of TCZ-using RA patients are overestimated, by using US. <h3>Methods</h3> We recruited 402 RA patients. Bilateral 2–5 MCP, wrist, ankle, and 2–5MTP joints were scanned by using the Aplio500 (TOSHIBA) with a 12 MHz transducer. Power Doppler (PD) images were obtained by Superb Micro-vascular Imaging (SMI). Gray scale (GS) and PD images were scored using a 0–3 semi-quantitative scale. Clinical information was obtained from the Kyoto University Rheumatoid Arthritis Management Alliance (KURAMA) database, which is based on the assessments by physicians who were blind to the US results. The patients were divided into 4 groups based on their treatment: tumor necrosis factor alpha inhibitors (TNFi), TCZ, abatacept (ABT), and non-biologic (non-Bio) users. Two patients treated by tofacitinib were excluded because the number was too small to analyze. The Boolean (BL)-based, Simplified Disease Activity Index (SDAI)-based, Clinical Disease Activity Index (CDAI)-based, and Disease Activity Score (DAS)28-ESR-based CR criteria were assessed using SRS. <h3>Results</h3> A total of 400 RA patients were analyzed. The number of patients in each treatment group is shown in the Table. When the BL-based, SDAI-based, and DAS28-ESR-based CR criteria were used, SRS in TCZ group was significantly stronger than the other groups (Fig 1–3). On the other hand, when CDAI-based CR criteria was used, the difference was not significant among 4 groups (Fig 4). In TCZ group, CRP and ESR were significantly lower than the other groups, although other clinical indicators were comparable (Table). <h3>Conclusions</h3> US revealed that CR in TCZ-using can be overestimated by BL-based, SDAI-based, and DAS28-ESR-based CR criteria. For TCZ users, CDAI-based CR criteria is more reliable than the other criteria. <h3>Disclosure of Interest</h3> None declared
OP0250 Can rankl serum levels predict future progression to rheumatoid arthritis in acpa negative patients?
Authors: A Burska, J El-Jawhari, AL Tan, R Wakefield, H Marzo-Ortega, P Conaghan, P Emery, F Ponchel, J Freeston
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Making the earliest diagnosis of rheumatoid arthritis (RA) is crucial to initiate treatment and prevent further disease progression and joint damage. Despite recent advances with the discovery and integration of anti–cyclic citrullinated protein antibody (ACPA) in classification criteria, there is still an unmet need for new diagnostic biomarkers, notably for ACPA-negative disease. Power Doppler ultrasound has been shown to identify poor prognosis disease in ACPA negative patients. <h3>Objectives</h3> The receptor-activator-nuclear-factor-κB axis (RANK/RANKL) is known to regulate bone homeostasis. The aim of this pilot study is to establish whether serum RANKL levels in people with early inflammatory arthritis are associated with RA diagnosis at follow-up and to evaluate the added value of RANKL with ultrasound for early RA diagnosis. <h3>Methods</h3> Serum from 298 subjects (95/204 Male/Female) was collected at the baseline participant visit to the Leeds Early Arthritis clinic. Demographic (age, gender symptom duration) and clinical data (swollen and tender joint counts (SJC, TJC), CRP, DAS28, rheumatoid factor (RF) and ACPA, shared epitope (SE)) were collected. A commercial ELISA (BioVENDOR) was used to measure RANKL. Ultrasound of 26 joints (bilateral elbows, wrists, MCP 2–3, PIP 2–3, knees, ankles and MTP 1–5) was performed at baseline recording summative scores for power Doppler (PD), grey scale hypertrophy (GS) and erosions (ERO). <h3>Results</h3> At 1 year follow-up, 151 patients had a confirmed diagnosis of RA (EULAR 2010 criteria) and 147 were classified as non-RA (undifferentiated arthritis, other inflammatory diagnoses or non-persistent inflammation). All routinely used biomarkers were associated with RA diagnosis (ACPA, RF, SE, TJC, SJC, CRP, DAS28, p&lt;0.0001), as were imaging biomarkers (PD, GS, ERO, p&lt;0.001). RANKL levels were significantly higher in RA (RA 1002.4±1053.2pmol/L, non-RA 339.2±451.5pmol/L, p&lt;0.0001). A regression analysis suggested that four parameters were sufficient to account for all associations with RA: RANKL, age, SJC, and PD with 75.3% accurate prediction. An AUROC analysis suggested a cut-off for each parameter and a score was calculated, adding 1 point for each of the factors (RANKL&gt;700, age&gt;62, TPD&gt;3, SJC&gt;4). This score predicted RA with an AUROC of 0.782 ((0.23–0.840), p&lt;0.0001). The same analysis repeated for ACPA negative patients only (n=193) showed similar results, providing accurate diagnosis of RA (77.6% correct by regression) and with an AUROC of 0.774 ((0.690–0.858), p&lt;0.0001). <h3>Conclusions</h3> A score incorporating RANKL, age, SJC and PD showed good predictive value for non-RA when low and for RA when high. Furthermore, the analysis redone in ACPA-negative patients performed particularly well for predicting RA with a good AUROC value. <h3>Disclosure of Interest</h3> None declared
FRI0256 Ultrasound consensus definitions on normal and abnormal findings in salivary glands in sjÖgren's syndrome: results of an omeract delphi process
Authors: S Jousse-Joulin, F Gandjbakhch, S Ohrndorf, M Backhaus, G Tamborrini, I Chary-Valckenaere, L Terslev, A Iagnocco, P Collado, C Hernandez-Diaz, E Naredo, W Schmidt, G Filippou, C Dejaco, M Mortada, A Hocevar, S Chrysidis, G Mardenly, JJ De Agustin, R Thiele, D Mac Carter, S Finzel, P Hanova, C Glaser, D Hammerfors, M-A D'Agostino, G Bruyn
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Ultrasonography (US) of salivary glands (USSG) may support diagnosis and evaluation of disease activity in primary Sjögren9s syndrome pSS. In order to extent the use of USSG in daily practice, consensus definitions of normal and abnormal USSG findings are needed. <h3>Objectives</h3> To obtain consensual definitions of normal and abnormal USSG findings using a Delphi process. <h3>Methods</h3> Twenty-seven experts participated in the Delphi process. A Likert scale from 1–5 was used in which 1 indicated complete disagreement and 5 complete agreement. Three core items were proposed: 1. Consensus of assessment of SG (parotid gland (PG), submandibular glands (SMG), sublingual glands SLG)). 2. Consensus for elementary lesions of PG, SMG, and SLG changes in PSS patients. 3. Consensus on grading of PG, SM, and SLG in pSS. <h3>Results</h3> The consensus of definitions between experts was reached after three rounds.The results (table 1) showed agreement with more than 75% of agreement in normal and abnormal definitions in SG and concluded to not evaluate SLG in pSS patients as well as to score pSS SG patients with at least two abnormal glands out of 4 (2 PG and 2 SMG) with a scoring system &gt;2 for each abnormal gland. <h3>Conclusions</h3> We developed a consensual US definition of normal and abnormal USGS findings through a Delphi exercise process. This finding will be used as a basis to further proceed with the validation of USGS for clinical application. <h3>Disclosure of Interest</h3> None declared
SP0046 Prevention and the protective role of exercise and lifestyle interventions on comorbidities in rheumatic diseases
Authors: S Garcia Diaz
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> It has been recognised that patients with rheumatic diseases are at increased risk of developing comorbid conditions such as cardiovascular disease (CVD), malignancies, infections and osteoporosis (among others). Lifestyle interventions (non smoking, non alcohol, healthy diet and exercise) may play an important role to reduce comorbidities in these patients. <h3>Objective</h3> To find if lifestyle interventions and especially exercise play a vital role in preventing comorbidities in rheumatic diseases through an extensive review of recent literature. <h3>Disclosure of Interest</h3> None declared
SAT0340 Subclinical cardiovascular disease in scleroderma: a study with cardiovascular risk charts, ct coronary calcium score and carotid ultrasonography
Authors: I Pérez Sanz, F Martínez Valle, A Guillén del Castillo, N Pizzi, A Pérez Roque, H Calàbria Cuéllar, A Fernández Codina, E Callejas Moragas, V Fonollosa Pla, CP Simeόn Aznar
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Recently published population-based cohort studies had shown a high prevalence of cardiovascular (CV) disease in Systemic Sclerosis (SSc) patients. <h3>Objectives</h3> The aim of this study is to compare three different methods to measure CV risk in patients with scleroderma. <h3>Methods</h3> We conducted a cross-sectional study in a single center that included 43 SSc patients without CV events. We used both CV risk assessment charts SCORE for populations with low CV risk and REGICOR algorithm adjusted to Spanish subjects. Coronary Compute Tomography (CT) with coronary arterial calcium score (CACscore) was performed considering several cut-off points as predictors of CV risk. Carotid doppler ultrasound was performed to measure the Carotid Intima Media Thickness (CIMT) and for the detection of cholesterol plaques, according to Mannheim consensus criteria. <h3>Results</h3> Risk factors and SSc related features are described in table 1. None of the patients were catalogued as high risk according to SCORE chart (&gt;5%). According to REGICOR chart, 17 patients (39,5%) were catalogued as intermediate risk and none as high risk. Twenty-two patients (51,2%) had carotid plaques (CP) and the CACscore of these patients was 283.4. In patients without CP CACscore was 53,2 (p&lt;0.05). Based on the presence of CP we performed ROC curve with CACscore. The AUC was 0.778. The best cut off point was 28 with a sensibility of 71% and a specifity of 82%. Kappa9s coefficient was 0.54. Twenty patients (46.5%) had CACscore&gt;28. Compared to patients with CACscore&lt;28 statistical significance was found on CIMTmax (0.93 vs 0.80mm; p&lt;0.01), presence of CP (79% vs 25%, p&lt;0.01) and number of CP (2.55 vs 0.43, p&lt;0.01). There was no statistical significance on CIMTm (0.71 vs 0.64mm p: 0.11). If the presence of CP or CAC score&gt;28 were considered as subclinical atheromatosis disease (SAD), a total of 26 patients (60.5%) were diagnosed. We performed multivariate regression analysis, CIMTm, CIMTmax, low High Density Lipid (HDL), high erythrocyte sedimentation rate (ESR) and age were independent factors for the presence of SAD. <h3>Conclusions</h3> SSc patients often have SAD which is misdiagnosed by CV risk charts. Plaque detection by carotid ultrasonography and CT CACscore are useful to detect SAD. The optimal cut-off point of CACscore in this study is 28. SAD detection would be indicated in elderly, patients with low HDL or high ESR. The measure of CIMT could be useful in some cases. <h3>Disclosure of Interest</h3> None declared
OP0060 Health behavior in adolescents with juvenile idiopathic arthritis- results of the inception cohort of newly diagnosed patients (ICON)
Authors: M Listing, I Liedmann, M Niewerth, J Klotsche, K Mönkemöller, I Foeldvari, J Kümmerle-Deschner, T Hospach, K Minden
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Knowledge concerning health behavior in adolescents with juvenile idiopathic arthritis (JIA) is essential for assessing their health risks. Although there is some evidence about a relationship between low socioeconomic status (SES) and health risk behavior in adulthood, it is less clear whether this association is also true for adolescents with JIA. <h3>Objectives</h3> To compare the health behavior between adolescents with JIA and healthy peers and to examine the association with sex and SES. <h3>Methods</h3> Data of adolescents (aged 13 to 17) with JIA and healthy peers enrolled in ICON were considered for this analysis. Health behavior was assessed via questionnaire within the first years of disease. SES- Score (low, moderate, high) was determined by using an established German multidimensional aggregated index and based on the parents9 education level as well as household net income. <h3>Results</h3> A total of 334 adolescents with JIA (61% female, mean age 15.1 (SD 1.1), mean disease duration 1.3 (SD 1.7)) and 181 healthy peers (57% female, mean age 15.3 (SD 1.3)) were included. Adolescents with JIA were less physically active and reported less consumption of alcohol compared with healthy peers (see Table). In both groups, boys were more frequently physically active and spent more time in playing video games than girls. Whereas girls with and without JIA used more often mobile phones than boys. No gender specific differences in both groups were found in consumption of illicit and legal drugs. After stratification in groups according to the SES- Scores, socioeconomic differences were the same in adolescents with JIA and healthy peers. Teenagers with low social background (n=200) spent significantly more time in consumption of TV, mobile phones and video games than those from families with high SES (n=122). No significant relationship was found between parental SES and alcohol, nicotine and drug consumption by adolescents. The parental SES- Score was strongly associated with the education level of adolescents. <h3>Conclusions</h3> Adolescents with JIA have a similar health behavior as healthy peers, except for alcohol consumption and physical activity level. Gender and socioeconomic status are associated with health behavior of adolescents with and without JIA. Parental SES may affect adolescents9 educational outcomes. <h3>Acknowledgements</h3> ICON is supported by a grant from the Federal Ministry of Education and Research (FKZ: 01ER0812). <h3>Disclosure of Interest</h3> M. Listing: None declared, I. Liedmann: None declared, M. Niewerth: None declared, J. Klotsche: None declared, K. Mönkemöller: None declared, I. Foeldvari: None declared, J. Kümmerle-Deschner: None declared, T. Hospach: None declared, K. Minden Speakers bureau: Pfizer, Roche, Pharm-Allergan
Comment on Lewis et al. Management of Hemoglobin Variants Detected Incidentally in HbA 1c Testing: A Common Problem Currently Lacking a Standard Approach. Diabetes Care 2017;40:e8–e9
Authors: Randie R. Little, Curt L. Rohlfing
Journal: Diabetes Care (2017)

We read with concern the article by Lewis et al. (1) regarding HbA1c analysis in the Vitamin D and Type 2 Diabetes (D2d) Study. Although the article focused on reporting the presence of hemoglobin (Hb) variants after incidental detection of variants by HbA1c high-performance liquid chromatography (HPLC) methods, there was also clear mention of a lack of interference from HbS and HbC with the HbA1c assay used for the study—the Tosoh G8 HPLC. Unfortunately, although the authors claim that there is no interference of these common Hb variants with the Tosoh G8 method, there is clear evidence to the contrary. Our study (2) clearly showed a statistically and clinically significant bias in results from this …
AB1175 Decreased autophagic activity in t lymphocytes from patients with newly diagnosed systemic lupus erythematosus
Authors: X Luo, Y Liu, M Yang
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Alterations in T-lymphocyte homeostasis have been suggested to play a key role in the pathogenesis of SLE. Autophagy is now emerging as a core player in the development and the functioning of the immune system. <h3>Objectives</h3> we investigated the autophagic behavior of T cells from patients with SLE. <h3>Methods</h3> Thirty patients with SLE and twenty-five healthy subjects matched for gender and age were recruited. The levels of mRNA encoding ATG5, ATG7, Beclin-1 and LC3 was determined by quantitative real-time polymerase chain reaction (qPCR), and evaluate autophagy activity in T cells by flow cytometry. The number of autophagic structures was examined by TEM in T cells from SLE patients and healthy controls. <h3>Results</h3> We documented a decreased of mRNA expression of LC3 and Atg7 in T cells from patients with SLE (t=2.282, P=0.027; t=3.573, P=0.001).A decreased percentage of autophagic cells was comfirmed in T cells from patients with SLE, as compared to healthy donors by flow cytometry (t=2.034, P=0.047).no significant correlations between autophagy levels in T cells and the disease activity of patients were observed (p&gt;0.05). <h3>Conclusions</h3> Our results indicate that autophagy activity in T cells from SLE patients is decreased, which may contribute to the development of SLE, and thus that resetting autophagic activity may be an important therapeutic goal in this autoimmune disease. <h3>Acknowledgements</h3> The authors thank Dr Liu Qinsong, and Mr Xia Yanhui for their technical assistance. <h3>Disclosure of Interest</h3> None declared