tbuckley/cabot-search huggingface dataset:
SAT0699 Rapid assessment predicts disease activity improvement in newly diagnosed rheumatoid arthritis (RA)
Authors: M Yates, J Galloway, N Snowden, S Norton, JM Ledingham, EM Dennison, A Rivett, AJ Macgregor
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Early intervention in RA is associated with improved outcomes in randomised trials. UK guidelines stipulate that those with suspected RA are assessed by a rheumatologist within 3 weeks of referral. However, there are limited real world data confirming the value of early assessment. Previous work suggests social deprivation predicts severe disease at presentation and a worse clinical course (1). The impact of deprivation in early assessment has yet to be characterised on a national level. <h3>Objectives</h3> To investigate if rapid assessment in secondary care associates with achieving a good treatment response, and if this is modulated by social deprivation. <h3>Methods</h3> An audit, designed as a prospective longitudinal observational study, was conducted to assess early RA care. All NHS providers in England and Wales were required to participate. Follow up data were captured over 3 months for subjects with a diagnosis of RA. Rheumatologist assessment within 3 weeks of referral was the predictor variable. The primary outcome was good EULAR DAS response; the secondary outcome was meaningful improvement in RAID score. Logistic regression was used to estimate for associations. Confounders including age, gender, baseline DAS28 and RAID scores were considered in analyses. The index of multiple deprivation (IMD) rank was calculated for each individual based on super-output geographical areas. The IMD rank was then stratified into quintiles and included as a confounder. <h3>Results</h3> 136 of 146 eligible trusts submitted data. 11,752 subjects consented, 5,622 were diagnosed with RA. 94/5622 (1.7%) had incomplete assessment date data. DAS28 response was available for 2234/5622 (39.7%), and RAID response for 901/5622 (16%). The table shows baseline characteristics and response for subjects with complete data. Assessment within 3 weeks associated with a significantly greater improvement in DAS28 and RAID scores, with an adjusted odds ratio for a good EULAR response 1.38 (1.15–1.66) and meaningful RAID reduction 1.44 (1.03–2.02). <h3>Conclusions</h3> These real world data confirm rapid assessment significantly predicts treatment response, in terms of clinical disease activity and patient reported outcomes. Amongst those who were assessed within 3 weeks of referral, an additional 8% achieved a good EULAR response. The association with RAID response was strengthened when social deprivation was included as a confounder. The relationship between IMD and RAID response appears to be non-linear and requires further study. <h3>References</h3> ERAS Study Group. Socioeconomic deprivation and rheumatoid disease:What lessons for the health service? Ann rheum dis. 2000;59(10):794–9. <h3>Disclosure of Interest</h3> None declared
Cardiomyopathies Due to Left Ventricular Noncompaction, Mitochondrial and Storage Diseases, and Inborn Errors of Metabolism
Authors: Jeffrey A. Towbin, John Lynn Jefferies
Journal: Circulation Research (2017)

The normal function of the human myocardium requires the proper generation and utilization of energy and relies on a series of complex metabolic processes to achieve this normal function. When metabolic processes fail to work properly or effectively, heart muscle dysfunction can occur with or without accompanying functional abnormalities of other organ systems, particularly skeletal muscle. These metabolic derangements can result in structural, functional, and infiltrative deficiencies of the heart muscle. Mitochondrial and enzyme defects predominate as disease-related etiologies. In this review, left ventricular noncompaction cardiomyopathy, which is often caused by mutations in sarcomere and cytoskeletal proteins and is also associated with metabolic abnormalities, is discussed. In addition, cardiomyopathies resulting from mitochondrial dysfunction, metabolic abnormalities, storage diseases, and inborn errors of metabolism are described.
Oral precancerous lesions and their relation to stress among marble mine laborers in India
Authors: Rushabh Dagli
Journal: Clinical Cancer Research (2008)

B44  Background and objective: To determine the prevalence of oral precancerous lesions among Green Marble Mine laborers and find its relation to occupational stress. Method: The participants were selected by stratified cluster sampling technique among four geographic zones. A total of 513 subjects were included in final study which were divided among four age cohorts: 15-24, 25-34, 35-44, and 45-above. The study has been conducted following the research methodology recommended by World Health Organization criteria; recording of data for oral lesions was based on same guidelines. A questionnaire for stress assessment,“Union of Shops, Distribution, and Allied Worker (USDAW) Nationwide”, was used for mine workers, and clinical examination of oral mucosa was conducted by one of three examiners with the aid of an artificial light source. The kappa statistics for diagnoses of available oral precancerous lesions, leukoplakia, oral submucous fibrosis, and papilloma, was determined (field teams versus expert) to be 0.81, 0.92, and 0.89, respectively, two days prior to the examination. Data was analyzed using bivariate and multivariate analysis. Results:An overall higher prevalence of all three oral-mucosal lesions was found among mine workers (36.7%), particularly leukoplakia, which affected 171 mine workers (33.3%). The affected workers were having problems such as headache, backache, and stress due to underpayment. Individuals having papilloma have faced problems at work like noise, dust, or fumes and poor maintenance of equipment. Multiple logistic regression analysis model of oral-mucosal lesion have shown a highly significant relation (p
AB0381 Change is good, but what is better? retrospective study in clinical practice first switch with different biological therapies in rheumatoid arthritis
Authors: FA Ojeda, C Pérez-García, E Beltran, A Pros, T Salman-Monte, F Castro, L Polino, P Corzo, I Carriόn, S Castell, P Benito
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The effectiveness of the switch when the first anti-TNF failure in patients with rheumatoid arthritis has been demonstrated in multiple studies. But what is more effective, if you make the switch to another anti-TNF or another molecule, is not clearly defined. <h3>Objectives</h3> A retrospective study was performed in clinical practice to determine if there is a response to DAS 28 at 6 months of change and whether there is a difference in response if the switch is performed on another anti-TNF or another biological. <h3>Methods</h3> From a total of 254 that met ACR 2010 criteria for RA, which have been biologically treated at Rheumatology of the Parc Salut Mar from 2000 to 2016, 61 (24%) were the first switch and the DAS 28 response at 3 and 6 months of follow-up. The following variables were analyzed: age, sex, years of evolution RA, erosions, FR, ACPA, type of biological treatment, DAS 28 at the start of the switch, 3 months and 6 months,% of patients presenting DAS 28 &lt;2, 6 at 6 months.The statistical study was performed with SPSS 20 for paired and independent quantitative variables with Student9s T and chi2 for qualitative variables <h3>Results</h3> Of the total of 61 first treatment changes, 27 (44.3%) were to another anti-TNF alpha, 23 (37.7) to tocilizumab (TCZ), 7 to abatacept (11.5%) and 4 to RTX (6,6). The demographic and response data DAS 28 are shown in Table 1. There are no differences in the years of evolution,% of women, FR or ACPA positive, erosions and disease activity, as measured by DAS 28, before the switch, between The two groups (anti-TNF vs non-anti-TNF). Patients in the anti-TNF group were slightly younger than non-anti-TNF.When the DAS 28 response is evaluated at 3 and 6 months, modifying the treatment is effective (DAS 28 beginning 4,40 vs DAS 28 6 months 2.8 p&lt;0.001). When assessing the response to change, there is no difference in the DAS 28 response at 3 months or 6 months, if you switched to anti-TNF or non-anti-TNF (3.18 vs 2.52 p=0.122). When comparing the patients with anti TNF alpha vs TCZ, 62.5% of the patients with TCZ are in remission compared to 38, 5% (p=0.047). <h3>Conclusions</h3> In this retrospective study in daily clinical practice, it is evident that the change in treatment after failure of the first biological one, without differences if the change is to an anti TNF or another treatment. The percentage of patients who are remission at 6 months is higher if the change is at TCZ. Given the small number of patients, larger studies would be needed to confirm the results. <h3>References</h3> Johnston SS et col. Comparison of Biologic Disease-Modifying Antirheumatic Drug Therapy Persistence Between Biologics Among Rheumatoid Arthritis Patients Switching from Another Biologic. Rheumatol Ther. <h3>Disclosure of Interest</h3> None declared
SAT0445 Short-term effects of secukinumab on bone turnover markers and wnt signaling antagonists in patients with psoriatic arthritis
Authors: A Fassio, L Idolazzi, O Viapiana, C Benini, E Vantaggiato, M Rossini, D Gatti
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> psoriatic arthritis (PsA) is a chronic inflammatory disease characterized also by increased levels of cells producing IL-17 [1], and these levels have been shown to correlate with measures of disease activity and structural damage and bone loss [2]. Secukinumab is a new monoclonal antibody licensed woth the treatment of PsA which selectively binds to and neutralizes interleukin-17 (IL-17). Currently, data about the effects on the activity of either bone-reabsorbing cells and bone-forming cells secondary to the inhibition of the IL-17 pathway are completely absent. <h3>Objectives</h3> the aim of our study was to explore the short-term effects of secukinumab on bone turnover markers (BTM) and Dkk-1 and sclerostin. <h3>Methods</h3> we enrolled 28 patients with PsA, classified with the CASPAR criteria and 43 healthy controls (HC). For the PsA group DAS28 was recorded and serum samples were stored at baseline and then at the first, the third and the sixth month of therapy. Intact N-propeptide of type I collagen (PINP) and C-terminal telopeptide of type I collagen (CTX-I). Dickkopf-related-protein 1 (Dkk-1) and sclerostin were dosed too. For the HC group, a single blood sample was taken. <h3>Results</h3> Neither P1NP nor CTX showed any statistically significant variation. Baseline Dkk-1 for the PsA group was lower than HC. Both Dkk-1 and sclerostin demonstrated a significant increase at the sixth month. When the PsA groups was compared to HC, the difference between the levels of Dkk-1 lost significance at month six. <h3>Conclusions</h3> our study demonstrated that the treatment with secukinumab has little influence on the levels of BTM within the first six months of treatment but a definite influence on some fine regulators of the bone cells activity such as the WNT inhibitors and it is able, in some way, to normalize the Dkk-1 levels in PsA patients. The clinical implications of this trend are currently unclear thought it might suggest an drug-induced inhibition of the over-proliferation of bone typical of the joint lesions of PsA. Further studies with greater numbers of patients are warranted to determine whether these preliminary results have clinical relevance. <h3>References</h3> Jandus C, Bioley G, Rivals J-P, et al. Increased numbers of circulating polyfunctional Th17 memory cells in patients with seronegative spondylarthritides. Arthritis Rheum 2008;58:2307–17. doi:10.1002/art.23655. Uluçkan Ö, Jimenez M, Karbach S, et al. Chronic skin inflammation leads to bone loss by IL-17-mediated inhibition of Wnt signaling in osteoblasts. Sci Transl Med 2016;8:330ra37. doi:10.1126/scitranslmed.aad8996. <h3>Disclosure of Interest</h3> None declared
OP0191 Comparison of ultrasonography and radiography of the wrist for diagnosis of calcium pyrophosphate deposition
Authors: A Combier, M Forien, A Gardette, E Palazzo, P Dieudé, S Ottaviani
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The gold standard for diagnosis of calcium pyrophosphate (CPP) deposition (CPPD) is the identification of CPP crystals in synovial fluid. However, aspiration of synovial fluid can be challenging in small joints such as the wrist, a usual location of arthritis in CPPD. Despite its low sensitivity, the most widely used imaging modality is conventional radiography but ultrasound (US) seems a useful tool for diagnosis of CPPD. <h3>Objectives</h3> We aimed to compare the performance of US and conventional radiography of the wrist for diagnosis of CPPD. <h3>Methods</h3> Patients with joint effusion (knee, hip, shoulder, ankle or wrist) were consecutively included. CPPD was diagnosed by CPP crystals identified in synovial fluid. Patients without CPP crystals in synovial fluid were controls. As recommended, we used the term chondrocalcinosis (CC) to assess imaging features suggesting CPPD. Two blinded operators assessed CC in all patients by US and conventional radiography of the wrist. The presence of CC in triangular fibrocartilage (TFC) and wrist hyaline cartilage in US and TFC and radiocarpal (RC) joint in radiography was noted. A patient was considered to have CC if at least one wrist had imaging features of CC. <h3>Results</h3> We included 58 patients with joint effusion (32 with CPPD). The remaining 26 patients, controls, had rheumatoid arthritis (n=13), spondyloarthritis (n=6), gout (n=6), and osteoarthritis (n=1). The mean age was 67.1±16.3 years. Location of joint effusion was as follows: 34 knees, 15 wrists, 3 shoulders, 2 ankles, 3 hips and 1 elbow. Among CPPD patients, US revealed CC in 30 (93.7%) and radiography in 17 (53.1%) (p&lt;0.001). The sensitivity (Se) and specificity (Sp) of US for the diagnosis of CPPD were 94% and 85%, respectively; the positive likelihood ratio was 6.1. When analyzing US features of CC separately, US Se was higher at the TFC than RC joint, 81% and 50% respectively. The Se and Sp of radiography were 53.1% and 100%, respectively. Intraobserver reliabilities for US and radiographic CC were almost perfect: κ coefficient 0.832 [95% confidence interval 0.651–1.0] and 0.880 [0.314–0.880], respectively. In all 58 patients, 113 joints were analyzed (3 patients had radiography of only one wrist). The κ coefficient between US and radiography for CC was moderate: 0.33 [0.171–0.408]. <h3>Conclusions</h3> Our study suggests that wrist US should be considered a relevant tool for the diagnosis of CPPD, with higher sensitivity than radiography. <h3>Disclosure of Interest</h3> None declared
THU0581 What we see, what we learn, and the prevalence of rheumatic diseases in our population: a diagnosis correlation study
Authors: D Vega-Morales, JA Esquivel-Valerio, R Ortiz-Lopez, AC Arana-Guajardo, MA Garza-Elizondo
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The postgraduate program in rheumatology aims learning of musculoskeletal and autoimmune disorders. In México, objectively-structured clinical examination (OSCE) is applied in postgraduate certification processes by the Mexican Board of Rheumatology annually [1]. Peláez-Ballestas et al. described an epidemiological study (COPCORD, Community Oriented Program for the Control of Rheumatic Diseases) of 19,213 individuals in 5 regions in our country where they found a prevalence of musculoskeletal pain in 25.5%, osteoarthritis in 10.5%, back pain in 5.8%, rheumatic regional pain syndromes in 3.8%, rheumatoid arthritis (RA) in 1.6%, and fibromyalgia in 0.7% [2]. <h3>Objectives</h3> The aim of the study is to describe the student training in rheumatic diseases and correlate them with OSCE assessment and the prevalence of rheumatic diseases in our population. <h3>Methods</h3> An observational and analytical study was made between March 2014 to March 2015 in a single rheumatology training center at University Hospital. Student training was defined according to the times they evaluated patients with a determined diagnosis, this information was obtained by medical records. We categorize OSCE questions according to the rheumatic diagnosis. Finally, the two results were compared with prevalence of the rheumatic diagnosis according to COPCORD, which were registered according a score pain &gt;4. We made descriptive statistics and a Spearman9s Rho to evaluate the correlations of the diagnosis frequencies by each category. <h3>Results</h3> We reviewed 6279 medical records, 854 (13.6%) were of first-time evaluation. We had 5,400 (86.4%) women, with a mean age of 47.9 (SD 15.45) years. Descriptive statistics are in Table 1 and Figure 1, which included: medical consultations, OSCE assessment and a column with rheumatologic diagnosis according to COPCORD. The Spearman correlation coefficients of the 32 different diagnoses were: student training vs OSCE 0.492 (p=0.004), student training vs COPCORD 0.597 (p=0.01) and OSCE vs COPCORD 0.624 (p=0.01). <h3>Conclusions</h3> Although the most common musculoskeletal disease in our community did not obtain the frequency observed by students or evaluated in the OSCE, we observed a moderate correlation. We considered it is important to enhance the knowledge and improve the OSCE according to the most prevalent diseases to prepare the future rheumatologists. <h3>References</h3> Pascual Ramos V, et al. Reumatol Clin 2014; doi: 10.1016/j.reuma.2014.10.007. Peláez-Ballestas I, et al. J Rheumatol Suppl 2011;86:3–8. <h3>Disclosure of Interest</h3> None declared
AB0833 Bone mineral density in tunisian patients with autoimmune hepatitis
Authors: M Cheikh, H Romdhane, H Bennejma, R Ennaifer, N Bel Hadj
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Bone loss in autoimmune hepatitis (AIH) is scanty and conflicting. The pathogenic mechanisms are not completely elucidated. <h3>Objectives</h3> This study aimed to assess the prevalence and risk factors for bone loss in patients with AIH. <h3>Methods</h3> Bone mineral density (BMD) using X-ray absorptiometry at both lumbar spine and femoral neck sites was measured in patients with AIH. Were excluded patients with diseases disturbing the bone density. Osteopenia was considered if T-score &lt;-1.5 DS and osteoporosis if T-score &lt;-2.5 DS. <h3>Results</h3> Twenty eight patients were enrolled in the study. They were 19 women (sex-ration M/F=0.6), with a mean age of 54 years [extremes: 13 - 73 years]. Most patients had type 1 AIH (89.2%). Seventeen patients were diagnosed at stage of cirrhosis (60.7%). Associated auto-immune manifestations were observed in 42.8% of cases. Overlap syndrome with primary biliary cirrhosis was noted in 21.4% of cases. Fifty five percent of patients were on steroid treatment with or without azathioprine. BMD was low in 9 patients (32%) as fellow: osteopenia in 6 cases and osteoporosis in 3 cases. There was a correlation between bone loss and use of steroid treatment but it wasn9t statistically significant (p=0.07). <h3>Conclusions</h3> In our series, the prevalence of bone loss in AIH is high (45%). This data suggests that bone status should be assessed routinely in patients with AIH, especially in those on steroid treatment. <h3>Disclosure of Interest</h3> None declared
Origins of myelodysplastic syndromes after aplastic anemia
Authors: Eiju Negoro, Yasunobu Nagata, Michael J. Clemente, Naoko Hosono, Wenyi Shen, Aziz Nazha, Tetsuichi Yoshizato, Cassandra Hirsch, Bartlomiej Przychodzen, Reda Z. Mahfouz, Teodora Kuzmanovic, Mikkael A. Sekeres, Hideki Makishima, Seishi Ogawa, Jaroslaw P. Maciejewski
Journal: Blood (2017)
Lack of effect of bendamustine on Fridericia corrected QT interval (QTcF) in a phase III study of bendamustine-rituximab in advanced indolent non-Hodgkin’s lymphoma (NHL) or mantle cell lymphoma (MCL).
Authors: John M. Burke, Ian Flinn, Michael Craig, Richard H. C. Van Der Jagt, David MacDonald, Doreen M. Hallman, Mihaela C. Munteanu
Journal: Journal of Clinical Oncology (2013)

e19518 Background: Clinical data on the arrhythmogenic potential of bendamustine are limited. Bendamustine and rituximab (BR) are commonly combined, and rituximab concentrations are essentially constant ≥1.5 hours due to its long half-life. This BR single-arm study assessed the effects of bendamustine on QTcF over 1.5 hours in previously untreated adults with advanced indolent NHL or MCL. Methods: Patients in this open-label study were aged ≥18 years with QTc on screening electrocardiogram (ECG) ≤450 ms. Exclusion criteria included low serum potassium or magnesium and history of cardiac conditions with QT prolongation risk. Bendamustine 90 mg/m 2 was given on days 1 and 2 and rituximab 375 mg/m 2 on day 1 of each 28-day cycle. On day 2 of cycle 1, ECGs and blood sampling were performed ~15 min prior to bendamustine infusion (baseline), at the end of infusion (EOI)/C max , and 1 h post-EOI. The primary measure was change in QTcF at EOI. Secondary measures included outlier analyses of QTcF intervals, pharmacokinetic/pharmacodynamic (PK/PD) analysis, and changes in ECG morphology. The ECG analysis included patients with ≥1 ECG at baseline and on treatment. Results: There were 53 enrolled patients (92% white; 60% male; mean age 63.0 y, range 37-84 y; mean body surface area 2.0 m 2 , range 1.4-2.6 m 2 ). No clinically relevant signal of any bendamustine effect on cardiac repolarization was detected based on the mean change in QTcF from baseline and outlier analyses (Table). In the PK/PD analyses, predicted change in QTcF for bendamustine and its metabolites, M3 and M4, were not significant: 5.4 ms (upper CI 7.6 ms), 6.0 ms (8.8 ms), and 7.1 ms (10.1 ms), respectively, but there were few data. No new ECG morphologic changes were seen. Conclusions: In this small population with previously untreated advanced NHL or MCL, bendamustine was associated with a small increase in mean QTcF that was not clinically meaningful. Support: Teva BPP R&amp;D, Inc. Clinical trial information: NCT01073163. [Table: see text]