tbuckley/cabot-search huggingface dataset:
OP0073 Performance of the eular definition of arthralgia suspicious for progression to rheumatoid arthritis – a longitudinal study
Authors: LE Burgers, F Siljehult, RM ten Brinck, HW van Steenbergen, RB Landewé, S Rantapää-Dahlqvist, AH van der Helm-van Mil
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Recently a European League Against Rheumatology (EULAR)-taskforce has defined arthralgia suspicious for progression to rheumatoid arthritis (RA)<sup>1</sup>, in order to allow inclusion of homogeneous sets of arthralgia patients in clinical studies. This was done as the field is currently shifting towards performing trials in very early disease phases as there is growing evidence that very early treatment initiation allows better disease modification and treatment of arthralgia may even prevent the development of RA. The definition was developed with the clinical expertise as reference. It is intended for use in arthralgia patient that rheumatologists9 consider to be at risk for progression to RA <h3>Objectives</h3> To longitudinally evaluate the EULAR definition of arthralgia suspicious for progression to RA in: (1) patients in whom rheumatologists felt that imminent RA was more likely than other arthralgia9s (Clinically Suspect Arthralgia, CSA); this target population fulfils the entry criterion and (2) in arthralgia patients referred to secondary care prior to rheumatologic evaluation; in these patients the entry criterion was ignored. <h3>Methods</h3> The definition was assessed in 241 Dutch CSA-patients and 113 patients referred to the Umeå university hospital with recent-onset arthralgia in small joints. The external reference was arthritis development &lt;2-years follow-up. <h3>Results</h3> CSA-patients with a positive definition (≥3/7 parameters present) had an increased risk on arthritis development compared to definition-negative CSA-patients (HR 2.1, 95% CI 0.9–4.7). The sensitivity of a positive definition was 84% and the positive predictive value (PPV) 30%. In arthralgia patients in whom the definition was applied prior to rheumatologic evaluation, a positive definition was neither sensitive (10%) nor predictive (PPV 3%). Sensitivity analyses with fulfilment of the 2010 criteria for RA or initiation of DMARDs &lt;2-years of follow-up as external reference showed similar results. <h3>Conclusions</h3> The EULAR definition of arthralgia suspicious for progression to RA is sensitive when used to support the expert9s opinion on imminent RA. It was not discriminative in patients without prior rheumatologic evaluation. These data suggest that the definition should be used as designed and serves to further homogenize patients that rheumatologists consider at risk for RA. <h3>References</h3> van Steenbergen HW, Aletaha D, Beaart-van de Voorde LJJB de, et al. EULAR definition of arthralgia suspicious for progression to rheumatoid arthritis. Ann Rheum Dis 2016; annrheumdis-2016–209846. doi:10.1136/annrheumdis-2016–209846. <h3>Disclosure of Interest</h3> None declared
AB0973 Antiphospholipid antibodies in children with systemic lupus erythmatosus and juvenile idiopathic arthritis
Authors: W Gouda, A Mohamed
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Antiphospholipid antibodies (aPL) are a family of autoantibodies that present in a small percentage of the population but occur more commonly in patients with Antiphospholipid syndrome (APS) and Systemic lupus erythematosus (SLE). <h3>Objectives</h3> We aimed to determine of the level of anti-β2-glycoprotein I (anti-β2GPI) (IgG and IgM) isotypes and anticardiolipin antibodies (aCL) as inflammatory markers in children with SLE and Juvenile Idiopathic Arthritis (JIA) and figure out their relation to the clinical manifestations and activity of the disease. <h3>Methods</h3> This prospective study included one hundred twenty children, sixty five having SLE and fifty five having JIA, their ages range between 4.5 – 16 years (37 males and 83 females).In addition, twenty apparently healthy children of comparable age, sex and nutritional status were used as a control group. All patients and normal controls were subjected to full clinical and laboratory investigations included aCL and anti-β2GPI level (IgG and IgM) measured by a standardized ELISA. <h3>Results</h3> IgG isotype of anti-β2GPI was found to be positive in 27.7% and 14.5% for SLE and JIA groups respectively. However IgM isotype of anti-β2GPI was found to be positive in 24.6% and 7.25% for SLE and JIA groups respectively. The mean levels of both IgG and IgM isotypes of anti-β2GPI were found to be significantly increased in comparison to controls (P&lt;0.001) in both SLE and JIA groups. IgG isotype of aCL was found to be positive in 23.1% and 18.2% for SLE and JIA groups respectively. However IgM isotype of aCL was found to be positive in 18.5% and 18.2% for SLE and JIA groups respectively. A significant positive correlation was found between IgM and IgG isotypes of anti-β2GPI and with their corresponding class of aCL in both SLE and JIA groups. A significant positive correlation was found between the elevation of anti-β2GPI (IgG) and thrombocytopenia together with neuropsychiatric disease in SLE. While in JIA elevation of anti-β2GPI was found to be correlated only with elevation of aCL irrespective to clinical or laboratory data. <h3>Conclusions</h3> The study reported a higher prevalence of aPL in children with SLE and JIA. Elevated levels of anti-β2GPI (IgG) correlated with thrombocytopenia together with neuropsychiatric disease in SLE. <h3>Disclosure of Interest</h3> None declared
AB0197 Subclinical intersticial lung disease in early rheumatoid arthritis
Authors: C Fernández-Díaz, M Calderόn-Goerckel, J Martin-Varillas, B Atienza-Mateo, A Corrales-Martinez, V Portilla-Gonzalez, V Calvo-Rio, J Rueda-Gotor, N Palmou-Fontana, M Agudo-Bilbao, N Vegas-revenga, L Domingues-Casas, J Cifrian-Martinez, MA Gonzalez-Gay, R Blanco
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Interstitial lung disease (ILD) is a severe extra-articular complication of Rheumatoid Arthritis (RA). The decrease in DLCO diffusion is the most sensitive value for the detection of ILD, DLCO is also a prognostic factor. <h3>Objectives</h3> To study the prevalence of subclinical lung involvement in early RA. <h3>Methods</h3> Cross-sectional study of lung involvement in early RA. The following criteria were used: A) RA according to the EULAR-2010 criteria. B) Early RA if evolution from the onset of symptoms to the diagnosis of RA was less than one year. C) Lung affectation if DLCO diffusion was lower than 80%. In each patient we evaluate: a) presence of dyspnea according to MMRC (Modified British Medical Research Council) scale; B) Respiratory function tests (FVC, FEV1, FEV1/FVC; C) DLCO; classifying the degree in: i) normal&gt;80% (mild decrease 80–60%); ii) Moderate decrease (60–40%) and iii) Severe reduction (&lt;40%); D) Chest x-ray: assessed by radiologist. E) Joint activity of RA (DAS28), F) CRP and ESR. G) RF, CCPA, H) Presence of atheroma plaque on carotid ultrasound. Quantitative variables were expressed as mean±SD or median [IQR] and were compared with the Student t or Mann Whitney U test, respectively. Dichotomous variables were expressed as percentages and compared using the chi-square test. Statistical analysis was performed with the SPSS 15.0 program. <h3>Results</h3> 20 patients (15 women/5 men) with early RA were studied; mean age of 54.1±13.4 years. Some patients were using disease-modifying antirheumatic drugs (DMARDs) prior to performing respiratory function tests (PFR): methotrexate (7) 3 of them with less than 14 days of treatment, hydroxychloroquine (4), sulfasalazine (1). The table shows the main characteristics of patients according to pressence of lung disease. We observed a decrease in DLCO in 15/20 patients (75%) who were mild (DLCO &lt;80%) in 4 (27%); Moderate (DLCO &lt;60%) in 9 (60%) and severe (DLCO &lt;40%) in 2 (13%). Chest x-ray showed these alterations in 3 patients: signs of air trapping, laminar atelectasis and scarring tracts. There were no alterations in FVC in any patient. <h3>Conclusions</h3> We find a high frequent of lung involvement in early RA, in most of cases subclinical. Performing Respiratory function tests may help in early detection of lung involvement. These results should be ratified in larger series. <h3>Disclosure of Interest</h3> None declared
THU0101 Cardiovascular magnetic resonance imaging characterisation of cardiovascular abnormalities in individuals at risk of developing rheumatoid arthritis
Authors: GJ Fent, L Hunt, KS Mankia, B Erhayiem, JR Foley, P Garg, PP Swoboda, J Andrews, JP Greenwood, P Emery, S Plein, MH Buch
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Inflammation is the primary contributor to excess cardiovascular (CV) disease in rheumatoid arthritis (RA), with evidence of subclinical abnormalities observed even in treatment-naïve, early RA [1]. Preliminary reports suggest citrullinated proteins are present in atherosclerotic plaque [2]. It is unclear whether immunological changes of anti-citrullinated protein antibody (anti-CCP+) positive individuals "at risk" of developing RA are associated with CV abnormality. <h3>Objectives</h3> To perform a pilot study to explore whether subclinical CV abnormalities are present in anti-CCP+ individuals at risk of developing RA. <h3>Methods</h3> Sixteen consecutive patients with non specific MSK symptoms but no synovitis, detectable anti-CCP antibody and 30 age-matched healthy controls (HC) underwent a multi-parametric 3.0T (Philips Achieva) cardiovascular magnetic resonance (CMR) study. Neither group had any history of CV disease. At-risk individuals were categorised as low and high absolute risk for RA development (&lt;50% and ≥50% respectively) according to a published risk model [3]. CMR post-processing was performed using CVI <sup>42</sup> (Circle Cardiovascular Imaging, Canada). <h3>Results</h3> HC and at risk individuals were well matched for baseline characteristics (table 1). Aortic strain values (distensibility, strain and stiffness index β) were lower, indicating increased aortic stiffness, in at-risk individuals than HC, numerically most pronounced those classified high risk (table 2). There were no differences in LV mass and function, late gadolinium enhancement, myocardial T1 (measure of myocardial composition) or LV S prime (longitudinal LV systolic function) (table 2). <h3>Conclusions</h3> Anti-CCP+ individuals with non-specific MSK symptoms (in particular, a high risk group), exhibit increased aortic stiffness. This suggests presence of CV abnormalities prior to development of RA and implies a role of autoantibody-mediated development of atherosclerosis. These findings warrant further investigation in larger scale studies. <h3>References</h3> Erhayiem B et al. Newly diagnosed, treatment-naive patients with rheumatoid arthritis have early abnormalities of vascular and myocardial function. J Cardiovasc Magn Reson 2015;17:P285. Sokolove J et al. Brief report: citrullination within the atherosclerotic plaque: a potential target for the anti-citrullinated protein antibody response in rheumatoid arthritis. Arthritis Rheum 2013;65:1719–24. Rakieh C et al. Predicting the development of clinical arthritis in anti-CCP positive individuals with non-specific musculoskeletal symptoms?: a prospective observational cohort study. Ann Rheum Dis 2015;74:1659–1656. <h3>Disclosure of Interest</h3> None declared
SAT0631 Inter-observer and intra-observer reliability of the omeract ultrasonographic (US) criteria for the diagnosis of calcium pyrophosphate deposition disease (CPPD) at the metacarpal-phalangeal (MCP), wrist, acromion-clavicular (AC) and hip joints
Authors: G Filippou, CA Scirè, N Damjanov, A Adinolfi, G Bruyn, G Carrara, T Cazenave, M-A D'Agostino, A Delle Sedie, ME Diaz Cortes, E Filippucci, F Gandjbakhch, M Gutierrez, D MacCarter, M Micu, I Moller, G Mouterde, MA Mortada, E Naredo, V Picerno, C Pineda, F Porta, AM Reginato, I Satulu, WA Schmidt, T Serban, L Terslev, V Vlad, F Vreju, P Zufferey, S Bellavia, P Bozios, V Di Sabatino, C Toscano, A Iagnocco
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The OMERACT US subtask force “US in CPPD” recently created the definitions for US identification of crystal deposits in joints and tested the reliability at the knee [1]. <h3>Objectives</h3> To assess the inter/intra-observer reliability of US on detecting CPPD at triangular fibrocartilage complex (TFCC) of the wrists, fibrocartilage of the AC joint, hip labrum (HL), hyaline cartilage (HC) of the metacarpal (MC) and femoral head. <h3>Methods</h3> The OMERACT criteria for CPPD were used for the exercise [1] using a 2 steps approach. First, the panel of experts gave a dichotomous score (presence/absence of CPPD) of 120 images of the sites included, using a web platform. The images were evaluated twice to assess the inter/intra-observer reliability. Then, the experts met in Siena for a patient based exercise. Bilateral evaluation of TFCC, AC, HL /HC of the hip and HC of the II-III MCP of 8 patients was carried out twice in a day, using a dichotomous score for CPPD. 8 US machines (3 GE, 1 Samsung and 4 Esaote) equipped with high resolution linear probes were used. <h3>Results</h3> Reliability values of static exercise were high for all sites, demonstrating that definitions were clear. The results of the second step are presented in table 1. On live scanning, the TFCC resulted the most reliable site for CPPD assessment, followed by AC. Other sites demonstrated lower kappa values and thus are not reliable for CPPD assessment. <h3>Conclusions</h3> TFCC of the wrist is the most reliable site for CPPD. By adding these results to the previous [2], we confirm that the OMERACT definitions for CPPD can be applied reliably at the knee (meniscus and HC), TFCC and AC, usually the most involved sites in CPPD. The next step of the OMERACT subtask force will be to test these findings in a longitudinal observational study. <h3>References</h3> Filippou G, Scirè CA, Damjanov N et al. Definition and reliability assessment of elementary US findings in CPPD. Results of an international multi-observer study by the OMERACT sub-task force “US in CPPD”. J Rheumatol, in press. <h3>Disclosure of Interest</h3> None declared
SP0137 From glycosylation to inflammation
Authors: M Herrmann
Journal: Annals of the Rheumatic Diseases (2017)

One of the best studied posttranslational modification of immunoglobulin G (IgG) is the addition of a complex glycan to asparagine 297, which is required for IgG to bind to Fc-receptors and for the activation of complement via the classical activation pathway. In the absence of the glycan the IgG usually behave like a lame duck unable to execute its effector functions. The sugar tree is polymorphic and there are several functional consequences related to the glycan. The terminal sialylation, the presence of galactose, the core fucosylalation and the insertion of a bisecting third sugar chain all reportedly modify the biological and functional activities of IgG. As examples for the impact of Asp-297 associated glycans to the activity I will present (I) the sialylation of anti-histon autoantibodies in patients with systemic lupus erythematosus (II) the exposure of sugar epitopes by random IgG isolated from patients with rheumatoid arthritis (III) the molecular analysis of the glycan of random IgG isolated from patients with inflammatory diseases and controls and (IV) and finally the glycosylation of IgG-anti-phospholipid autoantibodies in healthy children. (I) The autoantibodies are mainly found in the non-sialyated fraction of the anti-histon autoantibodies which can be considered inflammatory IgG. (II) The circulating random IgG from patients with rheumatoid arthritis show an increased exposure of the Asp-297 associated glycans. (III) The molecular analysis of the glycan of random IgG isolated from patients with systemic lupus erythematosus, rheumatoid arthritis, sepsis showed disease-specific glycans. (IV) The non-pathogenic IgG-anti-phospholipid autoantibodies isolated from healthy children displayed an increased sialylation when compared to the pathogenic autoantibodies from adults with anti-phospholipid syndrome. The examples point to a strong impact of IgG glycosylation in the etiopathogenesis of chronic inflammatory rheumatic diseases. One should consider to include IgG glycan analyses into the diagnostic repertoire for autoantibodies. <h3>Disclosure of Interest</h3> None declared
AB0742 Ultrasonography of the nail unit in psoriasis and psoriatic arthritis: a qualitative and quantitative analysis
Authors: A Fassio, L Idolazzi, A Zabotti, E Vantaggiato, C Benini, O Viapiana, M Rossini, D Gatti
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> the nail unit is a shared topic of interest both for dermatologist and rheumatologist [1]. It is easy to study using imaging techniques such as ultrasonography. The nail was considered one of the possible target of assessment for the disease, especially when ultrasonography is performed. Ultrasound imaging of nails is a quite new technique, available since high frequencies probes were introduced in musculoskeletal examination and nail was considered one of the possible target for assessing the disease and defining its prognosis [2,3]. <h3>Objectives</h3> to evaluate the presence of the nail involvement and subclinical alterations using ultrasonography in psoriasis and psoriatic arthritis. <h3>Methods</h3> the study sample included 82 patients affected by psoriasis and/or psoriatic arthritis and 50 healthy controls (HC). The patients were consecutively enrolled during their routine visit in the outpatient clinic and they performed clinical and ultrasonographic evaluation of the nail. Activity indexes (DAPSA, PASI, NAPSI) and other clinimetric parameters were considered. <h3>Results</h3> multivariate analysis of variance (mANOVA) was performed between groups and the nail plate and nail bed thickness, PASI, NAPSI, age and BMI were considered (table 1). Post hoc analysis underlined the differences between groups, in particular between healthy and affected. The lesions for nail plate and nail bed in the PASI score were analyzed using Pearson9s chi square test and, secondary, odd ratios for significant results were calculated. Nail plate thickness and nail bed thickness were correlated with PASI, NAPSI, BMI and DAPSA. ROC curves were calculated obtaining also quantitative cut offs for nail plate and nail bed thickness in the affected vs healthy ones. <h3>Conclusions</h3> the application of ultrasonography is of potential advantages supported by the data of this study and strengthens the information available in literature, also adding quantitative parameters for the ultrasonography of the nail. <h3>References</h3> Ash ZR, Tinazzi I, Gallego CC, et al. Psoriasis patients with nail disease have a greater magnitude of underlying systemic subclinical enthesopathy than those with normal nails. Ann Rheum Dis 2012;71:553–6. doi: 10.1136/annrheumdis-2011–200478. Raposo I, Torres T. Nail psoriasis as a predictor of the development of psoriatic arthritis. Actas Dermo-Sifiliográficas Engl Ed 2015;106:452–7. doi: 10.1016/j.adengl.2015.02.001. Gutierrez M, Filippucci E, De Angelis R, et al. A sonographic spectrum of psoriatic arthritis: "the five targets." Clin Rheumatol 2010;29:133–42. doi: 10.1007/s10067-009-1292-y. <h3>Disclosure of Interest</h3> None declared
Early-life home environment and risk of asthma among inner-city children
Authors: George T. O'Connor, Susan V. Lynch, Gordon R. Bloomberg, Meyer Kattan, Robert A. Wood, Peter J. Gergen, Katy F. Jaffee, Agustin Calatroni, Leonard B. Bacharier, Avrahman Beigelman, Megan T. Sandel, Christine C. Johnson, Ali Faruqi, Clark Santee, Kei E. Fujimura, Douglas Fadrosh, Homer Boushey, Cynthia M. Visness, James E. Gern
Journal: Journal of Allergy and Clinical Immunology (2017)
FRI0719 Burden of hepatitis e virus infection in patients with rheumatic diseases
Authors: P Jacques, E Padalko, E Verheugen, L Cattoir, X Verhelst, E Nys, S Van Gucht, V Hutse, V Suin, D Elewaut
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Hepatitis E virus (HEV) is considered an emerging pathogen in developed countries, potentially causing chronic hepatitis. <h3>Objectives</h3> This cross-sectional analysis was undertaken to determine the seroprevalence of HEV in patients with autoimmune or inflammatory arthritis. This subgroup of patients is often treated with immune suppressive drugs, and is generally considered more susceptible to infections. <h3>Methods</h3> Serum samples were obtained from 449 consecutive patients consulting at the department of Rheumatology between October and November 2015. Patient characteristics with respect to diagnosis and treatment were collected. HEV IgM and IgG were measured by ELISA (Wantai Hepatitis E Virus IgG and IgM ELISA, Sanbio BV). Positive or borderline samples were further analyzed for HEV RNA (RealStar® HEV RT-PCR Kit, Altona Diagnostics NRC WIV). <h3>Results</h3> A total of 449 patients were included, 211 men and 238 women. HEV IgG was positive in 82 samples (18.26%), 6 were borderline, and 5 were non-determinable (not enough serum). IgM was positive in only 2 samples (0.45%). These 2 patients had normal liver function tests. Additional PCR was performed on all positive and borderline samples, which turned out negative in all samples. Of the 88 IgG positive and borderline samples, 86 patients had a known diagnosis of chronic inflammatory arthritis, of which 50 patients had previously been diagnosed with rheumatoid arthritis, 18 with spondyloarthritis, 8 with psoriatic arthritis. Fifty patients were treated with biologics (37 TNF inhibitors), 43 patients were treated with methotrexate (mean dose 12.5mg weekly), and 20 were treated with corticosteroids (mean daily dose 5.5mg prednisolone equivalent). <h3>Conclusions</h3> In a consecutive cohort of patients with known diagnosis of autoimmune or inflammatory arthritis, seroprevalence of HEV IgG was 18,2%. No active HEV infection could be detected. We found this to be comparable to a historical cohort of healthy patients from the departments of Orthopedics and obstetrics<sup>1</sup>, where prevalence of HEV IgG was 14%. <h3>References</h3> Van Hoecke F et al. Acta Gastroenterol Belg. 2012 Sep;75(3):322–4. <h3>Disclosure of Interest</h3> None declared