tbuckley/cabot-search huggingface dataset:
SP0190 Facts and figures: how mental health care addresses the psychological burden of rmd's in europe
Authors: E Dures
Journal: Annals of the Rheumatic Diseases (2017)

It is recognised that patients have to make behaviour changes and psychological adjustments to address the impact of inflammatory arthritis on their lives. Challenges include fluctuating pain, fatigue and flares of disease activity, and emotional consequences. Meeting these challenges effectively requires patients to engage in medical management, role management, and emotional management. For some patients this can be a struggle, and the rheumatology team can be a valued source of support. This session will examine patient perspectives on the psychological impact of inflammatory arthritis and the role of the rheumatology team in meeting the associated support needs. It will look at the relationship between psychological distress, well-being and self-management, and will highlight patients9 views on the characteristics of patient-centred, collaborative care. It will look at factors that influence psychological impact, adaptation and self-management; present data from patients on ways in which well-being and self-management can be enhanced or diminished through clinical interactions with the rheumatology team; and will consider the implications for clinical practice, including the training needs of the rheumatology team. <h3>Disclosure of Interest</h3> None declared
Orangeness—Peeling Back the Myths Behind Carotenemia
Authors: Chu Hsiao, Christopher Jordan Clukay
Journal: JAMA Dermatology (2017)

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AB0726 Subclinical atherosclerosis in patients with ankylosing spondylitis
Authors: M Ismail, A Mosallam, M Abdelaziz, A Moshrif
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Systemic inflammatory response of various autoimmune diseases has been reported as a cause of accelerated atherosclerosis which is a risk factor for cardiovascular complications. <h3>Objectives</h3> This study aimed to evaluate atherosclerosis in patients with ankylosing spondylitis (AS) and its relation to disease activity. <h3>Methods</h3> The study was carried out on thirty AS patients, who fulfilled the modified New York criteria. Thirty apparently healthy normal volunteers, age and sex matched served as control. Complete History taking, General and systemic examination, Body mass index (BMI), Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI), lipid profile, inflammatory markers and serum glucose level were done. Based on BASADI score, patients were then classified to active and inactive groups comprised 11 patients (37%) and 19 patients (63%) respectively. Carotid intima-media thickness (CIMT) was measured using real-time gray-scale sonography. The intima-media thickness (IMT) of common carotid artery, carotid bulb and internal carotid artery was determined. <h3>Results</h3> 25 males (83.3%) and 5 females (16.7%) with mean age 39.1±12.38, their mean disease duration 13.13±8.03 while controls were 21 males (70%) and 9 females (30%) with mean age 39.7±12.6. While IMT was found significantly increased in patients (0.87±0.49) versus controls (0.5±0.12) (P&lt;0.001), there was no significant difference regarding the presence of plaques and there was no stenosis found in cases or controls. No significant difference was found between active and inactive cases as regard to components of lipid profile. The mean IMT in active and inactive cases was 0.74±0.11 and 0.72±0.17 respectively with no significant difference. we found no significant correlation between IMT and different disease scores, ESR or CRP. <h3>Conclusions</h3> AS patients have a higher risk for developing atherosclerosis. IMT of common carotid artery could be added as a further investigation for detection and follow up of atherosclerosis in AS patients. <h3>Disclosure of Interest</h3> None declared
FRI0741-HPR Screening for depression and anxiety in an outpatient rheumatology clinic using validated self-applied questionnaires
Authors: LF Perez, A Martinez, M Moreno, L Silveira
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Anxiety and depression are often present in chronic rheumatic diseases. Recognition of these psychological disorders is fundamental for proper patient management. The absence of screening leaves more than &gt;50% of patients with depression unidentified. Patient Help Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) are two validated self-applied questionnaires that are appropriate to assess the presence of, depression and anxiety, respectively. <h3>Objectives</h3> 1) To assess the prevalence of depression and anxiety in a hospital based outpatient Rheumatology clinic and 2) To provide the attending physician with appropriate instruments that allow a rapid orientation on the psychological status of her/his patient. <h3>Methods</h3> Consecutive patients that attended our outpatient Rheumatology clinic from March to June 2016 were invited to participate in this crosssectional study. Participants filled out PHQ-9 and GAD-7 in the waiting room. The prevalence and severity of anxiety and depression were calculated for the most prevalent diagnoses. <h3>Results</h3> A total of 410 patients were recruited; 339 (82.8%) were female. Overall, 191 (46.6%) patients reported depressive symptoms (PHQ-9&gt;5). Of them, 87 (21.2%) were classified as having moderate depression or higher (PHQ-9 &gt;10). Prevalence of depression and anxiety among study participants according to each rheumatic disease is depicted in Table 1. Prevalence of moderate or severe depression was significantly different among various rheumatic diseases (p=0.001). Regarding anxiety symptoms, they were reported in 168 (40.7%); 67 (16.2%) of them had moderate or severe anxiety. <h3>Conclusions</h3> This cross-sectional study shows that anxiety and depression are frequent in the Rheumatology clinic. We demonstrated that the use of a self-applied screening tool can help clinicians to properly detect depression and anxiety associated with diverse rheumatic diseases. Specia attention should be paid to patients with fibromyalgia and osteoarthritis. <h3>Disclosure of Interest</h3> None declared
CK2β regulates thrombopoiesis and Ca2+-triggered platelet activation in arterial thrombosis
Authors: Patrick Münzer, Britta Walker-Allgaier, Sascha Geue, Friederike Langhauser, Eva Geuss, David Stegner, Katja Aurbach, Daniela Semeniak, Madhumita Chatterjee, Irene Gonzalez Menendez, Melanie Märklin, Leticia Quintanilla-Martinez, Helmut R. Salih, David W. Litchfield, Thierry Buchou, Christoph Kleinschnitz, Florian Lang, Bernhard Nieswandt, Irina Pleines, Harald Schulze, Meinrad Gawaz, Oliver Borst
Journal: Blood (2017)
AB0038 Increased interferon-alpha production by plasmacytoid dendritic cells stimulated with a TLR-7 agonist in systemic lupus erythematosus
Authors: G Murayama, N Furusawa, A Chiba, K Yamaji, N Tamura, S Miyake
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Type I interferon (IFN) appears to contribute to the development of systemic lupus erythematosus (SLE). IFN-α production is known to be increased in peripheral blood mononuclear cells (PBMCs) from SLE patients. Although plasmacytoid dendritic cells (pDCs) is a major source of IFN-α, previous reports showed that IFN-α production by pDCs stimulated with a TLR-9 agonist was decreased in SLE compared to healthy controls (HC). <h3>Objectives</h3> We set out to investigate an other endosomal TLR-signaling pathway in SLE by using TLR-7 agonist stimulation. <h3>Methods</h3> Blood samples were obtained from 55 HC and 73 SLE patients, diagnosed according to the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus (2012). PBMC from SLE patients and HC were stimulated with a TLR-9 agonist, CpG-A oligodeoxynucleotides (CpG-A ODN)-2216, and a TLR-7 agonist, imiquimod. The proportion of pDCs producing IFN-α was investigated by intracellular cytokine staining and flowcytometory. PBMC were pretreated with IFN-α for 24 hours, and then IFN-α production by pDCs was assessed after imiquimod stimulation. <h3>Results</h3> As previously reported, the level of IFN-α production by pDCs stimulated with CpG-A ODN was reduced in SLE compared with HC. However, the proportion of IFN-α producing pDCs stimulated with imiquimod was significantly increased in SLE patients. The percentage of IFN-α producing pDCs stimulated with imiquimod was positively correlated with SLE disease activity index (SLEDAI) score, and that of pDCs stimulated with CpG-A ODN was negatively correlated with SLEDAI. The expression of TLR-7 on pDCs, but not TLR-9, was upregulated in SLE patients compared with HC. Furthermore, pretreatment with IFN-α increased IFN-α production by pDCs upon imiquimod stimulation. <h3>Conclusions</h3> IFN-α production by pDCs form SLE patients was increased when stimulated with a TLR-7 agonist, and this was accompanied with upregulated TLR-7 expression in these cells. In murine lupus-models, TLR7-deletion has been shown to reduce autoimmune disease. The enhanced TLR-7 signaling pathway in pDC may play an important role in lupus pathology. <h3>References</h3> Christensen SR, et al. Toll-like receptor 7 and TLR9 dictate autoantibody specificity and have opposing inflammatory and regulatory roles in a murine model of lupus. Immunity. 2006; 25: 417–28. Sacre K, et al. Hydroxychloroquine is associated with impaired interferon-alpha and tumor necrosis factor-alpha production by plasmacytoid dendritic cells in systemic lupus erythematosus. Arthritis Res Ther. 2012;R155. Fukui R, et al. Unc93B1 restricts systemic lethal inflammation by orchestrating Toll-like receptor 7 and 9 trafficking. Immunity 2011; 35: 69–81. <h3>Disclosure of Interest</h3> None declared
AB0107 The modulation of macrophage polarization by sirt1 maybe new target therapy in rheumatoid arthritis
Authors: SY Lee, SW Lee, WT Chung, SY Park, JH Bae
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The polarization of macrophages was the expressed to M1/M2 phenotype by various stimuli or environment signals. The M1 macrophage was pro-inflammatory phenotype and was key effector cells in the immune response of rheumatoid arthritis (RA). So, M1 macrophage influenced the inflammation of RA synovial membrane and joint destruction in RA, whereas M2 macrophage was anti-inflammatory phenotype and could down-regulate the production of proinflammatory cytokines in RA. The SIRT1 attenuated the RA inflammation via down-regulation of NF-κB signaling. However, the effect of SIRT1 on macrophages polarization remained uncler. <h3>Objectives</h3> We aimed to check out that activated SIRT1 modulated macrophages polarization into M1 phenotype and controlled the inflammation of RA. <h3>Methods</h3> Monocytes from synovial fluid of RA patients, bone marrow–derived monocytes (BMDCs) from mice were studied. monocytes were cultured with M-CSF for 7days to differentiate into M0 macrophages (monocyte-derived mature macrophages M0 phenotype). M0 macrophages were incubated with LPS and IFN-gamma in order to obtain M1 macrophages. M1 macrophage markers were detected by real-time PCR. <h3>Results</h3> Activation of SIRT1 was achieved by Resveratrol, activated SIRT1 attenuated M1 macrophage phenotypes and pro-inflammatory cytokine expression. macrophages obtained from SIRT1-tg mice, which were overexpression of SIRT1, exhibited decreased M1 markers in association with enhanced activation of AMPK/ACC compared with macrophage from control C57BL/6 mice. In addition to SIRT1 activation, M1 polarizing signal, acetylation of NF-κB p65, was suppressed. In SIRT1-deficient macrophages, resveratrol fail to increase AMPK activity and to decrease the expression M1 markers owing to enhanced acetylation of NF-κB p65. <h3>Conclusions</h3> SIRT1 maybe an important modulator of M1 macrophages polarization and increased AMPK activity, which suppressed acetylation of NF-κB p65 during inflammation of RA. so, modulation of SIRT1 maybe a new target in RA treatment. <h3>References</h3> SIRT1 inhibits differentiation of monocytes to macrophages: amelioration of synovial inflammation in rheumatoid arthritis. J Mol Med (Berl). 2016 Aug;94(8):921–31. <h3>Disclosure of Interest</h3> None declared
SAT0077 Clinical features and perforin A91V gene analysis in SO-JIA children with macrophage activation syndrome
Authors: X Chen, H Zeng
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> Macrophage activation syndrome (MAS) is a severe, potentially life-threatening syndrome.Here we aim to review the precipitating events,clinical features, treatment, outcome and perforin A91V gene analysis in systemic onset juvenile idiopathic arthritis (SoJIA) children with MAS. <h3>Methods</h3> Retrospective review of cases of MAS from a collected database of fourteen children with SoJIA from 2003 to 2008. Gene-specific polymerase chain reaction (PCR) primers were used to analyze the perforin A91V gene polymorphism. <h3>Results</h3> Fourteen patients (nine boys) were considered to have evidence of MAS, with age ranged from 4 months to 12 years.The primary diagnosis was systemic onset juvenile idiopathic arthritis.No medication was identified as trigger. Eleven had infections prior to MAS,specific infectious agents were identified in four. High fever, new onset hepatosplenomegaly, lymphadenopathy, liver dysfunction,abnormal lipid metabolism and hemophagocytosis were common clinical features.Two cases were with acute respiratory distress syndrome (ARDS),multiple organ failure (MOF) in three and three died. The perforin A91V (NCBI:SNP rs35947132) variant gene was detected in seven systemic onset juvenile idiopathic arthritis compolicated with MAS cases, but no mutation were found. Glucocorticoid, intravenous immunoglobulin, immunoimpressive therapy were effective and HP (Plasmapheresis) used in one serious case was also effective. <h3>Conclusions</h3> MAS is a rare and potentially fatal complication of childhood rheumatoid diseases,especially systemic onset juvenile idiopathic arthritis. Most of our patients were male, and most cases were preceded by infection. Bone marrow studies support the diagnosis. MOF may be a poor prognostic sign.Aggressive early therapy is essential. <h3>Disclosure of Interest</h3> None declared
FRI0436 Chronic pain in patients with established axial spondyloarthritis and assessment of pain sensitivity by computerized pneumatic cuff pressure algometry: results from the spartakus cohort
Authors: E Mogard, T Olofsson, A Bremander, S Bergman, L-E Kristensen, J Kvistgaard Olsen, JK Wallman, E Lindqvist
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Pain is a common symptom in all arthritides, and remains a problem also with better treatment options. In axial spondyloarthritis (ax-SpA), data on chronic pain remain scarce. <h3>Objectives</h3> To study pain distribution, duration and intensity in ax-SpA, and relate this to disease status and measurement of pressure pain sensitivity. <h3>Methods</h3> Consecutive patients (n=115) with clinical ax-SpA diagnoses (ankylosing spondylitis (AS) or undifferentiated axial spondyloarthritis (USpA)) were examined and answered pain questionnaires. Patients were categorised as having no chronic pain (NCP), chronic regional pain (CRP) or chronic widespread pain (CWP). Pressure pain sensitivity was assessed by computerized pneumatic cuff pressure algometry (CPA) on the dominant lower leg, and pain threshold, pain tolerance and temporal summation (assessed by the temporal summation index, TSI) were recorded. Differences in disease status and pressure pain sensitivity between patients with CWP versus NCP were assessed (Chi-square or Mann-Whitney U-test). Pressure pain sensitivity was also compared between patients with/without unacceptable pain levels (VAS pain &gt;40 versus ≤40; Mann-Whitney U-test). <h3>Results</h3> Fifty percent of patients reported CWP, irrespective of clinical diagnosis (AS 47%, USpA 53%), and more women than men reported CWP (59% versus 37%, p&lt;0.001). Only 18% of all patients reported NCP. Overall, higher disease activity, pain intensity, worse fatigue, global health and function were observed among patients with CWP compared to those with NCP. There was a trend towards lower pain tolerance in patients with CWP compared to NCP (Table). Lower pain tolerance and higher TSI scores were observed among patients reporting VAS pain &gt;40 versus those with VAS pain scores ≤40 ((mean (SD)) 51.9 (21.2) versus 68.1 (28.1), p=0.007; 0.73 (0.60) versus 0.55 (0.59), p=0.045). <h3>Conclusions</h3> In this population-based, cross-sectional study of established ax-SpA, chronic widespread pain was common, affecting 50% of the patients and generally associated with higher disease activity and worse function. CPA shows promising results regarding assessment of pain sensitivity, although larger studies are needed for more conclusive results. <h3>Acknowledgements</h3> Miriam Walsh-Ingelström performing all CPA assessments <h3>Disclosure of Interest</h3> E. Mogard: None declared, T. Olofsson: None declared, A. Bremander: None declared, S. Bergman: None declared, L.-E. Kristensen Grant/research support from: Oak Foundation, Consultant for: AbbVie, Celgene, BMS, MSD, Novartis, Pfizer, UCB, J. Kvistgaard Olsen: None declared, J. Wallman Consultant for: Celgene, Novartis, UCB, E. Lindqvist: None declared
FRI0142 Neutropenia in rheumatoid arthritis. incidence, prognostic factors, natural history and outcome
Authors: GE Fragoulis, IB McInnes, D Porter, S Siebert
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Neutropenia is an uncommon finding in the context of rheumatoid arthritis (RA). The incidence and association with RA features is not yet well-defined. <h3>Objectives</h3> To determine the incidence and severity of neutropenia in an early RA inception cohort, explore possible association with RA features and describe its impact on patient9s management. <h3>Methods</h3> The Scottish Early Rheumatoid Arthritis (SERA) inception cohort prospectively recruited newly diagnosed RA patients (ACR-EULAR 2010 criteria), who were followed-up every 6 months. Patients who developed at least one episode of neutropenia (grade 1: &lt;2000/μL, grade 2: &lt;1500/μL, grade 3: &lt;1000/μL, grade 4: &lt;500/μL) were compared with patients who never developed neutropenia. Binominal logistic regression was performed, exploiting the enter model and using the occurrence of neutropenia as dependent variable. <h3>Results</h3> 77 episodes of neutropenia were observed in 60 (8.6%) out of 698 RA patients, who were followed up for a median (range) time of 18 (6–48) months. Neutropenia occured in 12 (0–120) [median (range)] months after RA diagnosis. The majority had mild neutropenia (grade 1: n=49, grade 2: n=9, grade 3: n=0, grade 4: n=2) and the mean ± SD number of neutrophils/μL was 1.68±0.35. Of the 77 neutropenic episodes recorded, coexistent lymphopenia was found in 13.0%, leukopenia in 70.1%, thrombocytopenia in 1.3% and anaemia in 32.5%. At the time of the neutropenia, most of the patients were in remission (DAS28&lt;2.6: 53%, DAS28&lt;3.2: 15.5%, DAS28≤5.1: 22.4%, DAS28&gt;5.1: 8.6%). Neutropenia was a single episode in the majority (76.7%) of the patients and led to treatment discontinuation in 11.7% of them. Patients who subsequently developed neutropenia, were more likely females (p=0.03) and non-smokers (p=0.0009) (Table 1). Treatment received for RA was comparable between the two groups. Binominal regression analysis confirmed female gender [p=0.017, Exp(B): 2.587] and not smoking [p=0.032, Exp(B): 2.880] as predictors of neutropenia development. During total follow-up time, patients who had at least one episode of neutropenia they also manifested more commonly anaemia (p=0.04) and lymphopenia (p=0.03). The rate of infections/1000 person-months did not differ between patients who developed neutropenia and those who did not [5.75 (2.47–11.33) vs 4.1 (3.13–5.47), p=0.399]. <h3>Conclusions</h3> Neutropenia was observed in about 9% of patients in this early RA cohort. It was usually mild, transient and not associated with increased infection rates. Interestingly, not-smoking and female gender were associated with neutropenia. <h3>Disclosure of Interest</h3> None declared