tbuckley/cabot-search huggingface dataset:
AB0755 Skin score progression after discontinuation of mycophenolate treatment in systemic sclerosis patients
Authors: F.A. Mendoza, C.P. Lee Ching, S.A. Jimenez
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rapid progressive skin involvement in diffuse Systemic Sclerosis (rp-dcSSc) is associated with higher mortality and internal organ involvement. Treatment with Mycophenolate Mofetil (MMF) has been shown to halt the progression of the disease. However, the optimal duration of therapy is unknown and has not been studied. We follow up a known cohort of rp-dcSSc patients treated with MMF after discontinuation of therapy. <h3>Objectives</h3> To describe the progression of skin involvment in rp-dcSSc patients after discontinuation of MMF <h3>Methods</h3> Twenty-five previously untreated consecutive patients with recent-onset (&lt;24 mo) rp-dcSSc received MMF as the only disease-modifying therapy. Their Modified Rodnan skin score (mRSS) and Pulmonary function tests were followed after discontinuation of MMF after 2 years of treatment. Patients were followed up every 3–6 months. Therapy was re-initiated if their mRSS increased more than 20% or worsening respiratory symptoms with progression of restrictive lung disease were reported. <h3>Results</h3> Six patients lost follow up after terminating the open label trial with MMF. From the 19 patients followed up after MMF discontinuation, 26.3%<sup>5</sup> required to resume MMF. All these patients required to resume MMF within 6 months after discontinuation. All of them presented increase in mRSS. Two of them (10.5%) presented respiratory symptoms associated with restriction pattern at PFTs. Skin score returned to baseline in 80% of the patients after resuming therapy. <h3>Conclusions</h3> Recurrent skin progression occurs in up to 26.3% of patients with rp-dcSSc after discontinuation of 2 years of MMF, requiring longer term immunosuppression. In this group, all patients presented active skin disease recurrence within 6 months of treatment discontinuation. Ergo, slow decrease of MMF dose over time and very close follow up is recommended in patients with rp-dcSSc discontinuing MMF even after a prolonged period of time. In addition, these findings support the therapeutic effect of MMF in rp-dcSSc. <h3>References</h3> [1] Mendoza FA, Nagle SJ, Lee JB, Jimenez SA. A prospective observational study of mycophenolate mofetil treatment in progressive diffuse cutaneous systemic sclerosis of recent onset. J Rheumatol. 2012;39:1241–7 [2] Steen VD, Medsger TA Jr. Improvement in skin thickening in systemic sclerosis associated with improved survival. Arthritis Rheum. 2001; 44(12):2828–35. <h3>Disclosure of Interest</h3> None declared
Cardiometabolic Polygenic Risk Scores and Osteoarthritis Outcomes: A Mendelian Randomization Study Using Data From the Malmö Diet and Cancer Study and the <scp>UK</scp> Biobank
Authors: George Hindy, Kristina E. Åkesson, Olle Melander, Krishna G. Aragam, Mary E. Haas, Peter M. Nilsson, Umesh T. Kadam, Marju Orho‐Melander
Journal: Arthritis & Rheumatology (2019)

To investigate the causal role of cardiometabolic risk factors in osteoarthritis (OA) using associated genetic variants.We studied 27,691 adults from the Malmö Diet and Cancer Study (MDCS) and replicated novel findings among 376,435 adults from the UK Biobank. Trait-specific polygenic risk scores for low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels, triglyceride levels, body mass index (BMI), fasting plasma glucose (FPG) levels, and systolic blood pressure (BP) were used to test the associations of genetically predicted elevations in each trait with incident OA diagnosis (n = 3,559), OA joint replacement (n = 2,780), or both (total OA; n = 4,226) in Mendelian randomization (MR) analyses in the MDCS, and with self-reported and/or hospital-diagnosed OA (n = 65,213) in the UK Biobank. Multivariable MR, MR-Egger, and weighted median MR were used to adjust for potential pleiotropic biases.In the MDCS, genetically predicted elevation in LDL cholesterol level was associated with a lower risk of OA diagnosis (odds ratio [OR] 0.83 [95% confidence interval (95% CI) 0.73-0.95] per 1SD increase) and total OA (OR 0.87 [95% CI 0.78-0.98]), which was supported by multivariable MR for OA diagnosis (OR 0.84 [95% CI 0.75-0.95]) and total OA (0.87 [95% CI 0.78-0.97]), and by conventional 2-sample MR for OA diagnosis (OR 0.86 [95% CI 0.75-0.98]). MR-Egger indicated no pleiotropic bias. Genetically predicted elevation in BMI was associated with an increased risk of OA diagnosis (OR 1.65 [95% CI 1.14-2.41]), while MR-Egger indicated pleiotropic bias and a larger association with OA diagnosis (OR 3.25 [1.26-8.39]), OA joint replacement (OR 3.81 [95% CI 1.39-10.4]), and total OA (OR 3.41 [95% CI 1.43-8.15]). No associations were observed between genetically predicted HDL cholesterol level, triglyceride level, FPG level, or systolic BP and OA outcomes. The associations with LDL cholesterol levels were replicated in the UK Biobank (OR 0.95 [95% CI 0.93-0.98]).Our MR study provides evidence of a causal role of lower LDL cholesterol level and higher BMI in OA.
AB1376 Urinary monocyte chemoattractant protein 1 cannot differentiate between histological classes of lupus nephritis
Authors: R.K. Gone, V. Dhir, A. Sandhu, A. Sharma, M. Rathi, R. Nada, S. Sharma, S.K. Sharma
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Lupus Nephritis, one of the commonest manifestation of SLE, seen in 60% of adult SLE patients at some point of time, carries poor prognosis when compared to those with no renal involvement. The natural course of the LN has recurrent flares, necessitating the need for early detection and treatment. Despite being the gold standard in diagnosing Lupus nephritis and its severity, renal biopsy is an invasive procedure with potential complications, and difficult to repeat. Hence, a novel biomarker, reflecting the disease activity and severity is needed to predict flare. Monocyte chemoattractant Protein 1, a chemokine produced locally during Lupus Nephritis flare, was shown in many previous studies as a promising biomarker <h3>Objectives</h3> We studied the role of Urinary MCP-1 as a biomarker of disease activity in LN and compare its value among different histological classes of Lupus nephritis <h3>Methods</h3> This is a case-control study conducted at a tertiary care centre in North India from July 2016 to December 2017. Cases were those patients undergoing renal biopsy satisfying the inclusion criteria set for SLE with LN(n=36). Controls were patients of SLE without active LN [Control I-prior LN (n=11) and Control II-never had LN (n=15)]. Urinary MCP-1 measurement was done using Sandwich ELISA kit <h3>Results</h3> The mean age in cases was 31.1±10.2 years and mean age in control-I was 34.6±8.0 and in control II was 36.3±10.4. Urinary MCP-1 values in cases (1214±1467.1 pg/mg) was significantly higher compared to Controls (184.5±186.8). However, no significant difference was observed between Control I (170.5±150.8) and Control II (194±214). Urinary MCP-1 levels show significant correlation when compared with classical disease markers like 24 hour proteinuria, 24 hour PCR, Spot PCR and SLEDAI. Cut off value (339 pg/mg, p&lt;0.001) obtained from ROC curve has sensitivity and specificity of 80% and 92% respectively. However, there was no significant difference of Urinary MCP-1 levels was observed among different classes of LN (p=0.593). ROC curve comparison of urinary MCP-1 (AUC=0.879) with 24 hour urine protein to creatinine ratio (AUC=0.964) and spot urine protein to creatinine ratio (AUC=0.872) showed that it is not a better marker of disease activity than both of them. Urinary MCP-1 levels didn't show significant correlation with Renal activity index calculated on renal biopsy. <h3>Conclusions</h3> In this study we found higher Urinary MCP-1 levels in active LN compared to Inactive LN and its level was correlated well with the presently used disease markers. However there was no significant difference among different histological classes of LN. <h3>Disclosure of Interest</h3> None declared
Mesenchymal stem cell-derived extracellular vesicles and retinal ischemia-reperfusion
Authors: Biji Mathew, Sriram Ravindran, Xiaorong Liu, Leianne Torres, Mohansrinivas Chennakesavalu, Chun-Chieh Huang, Liang Feng, Ruth Zelka, Jasmine Lopez, Monica Sharma, Steven Roth
Journal: Biomaterials (2019)
Case 1-2019: A 34-Year-Old Veteran with Multiple Somatic Symptoms
Authors: Abigail L. Donovan, Timothy J. Petersen, Mireya F. Nadal-Vicens, Yelena S. Kamenker-Orlov
Journal: New England Journal of Medicine (2019)

A 34-year-old male war veteran was evaluated at this hospital for headaches, cognitive changes, mood symptoms, flashbacks, chest pain, arm tingling, and gastrointestinal symptoms. Examination and laboratory testing were unrevealing. A diagnosis was made.
Tumor Specific cfDNA Predicts Treatment Response of Multiple Myeloma Patients
Authors: David Vrabel, Jana Gregorova, Lenka Sedlarikova, Martina Almasi, Renata Bezděková, Martin Stork, Marta Krejci, Zdenek Adam, Ludek Pour, Roman Hajek, Sabina Sevcikova
Journal: Blood (2018)
Comprehensive Clinical-Molecular Transplant Risk Model for Myelofibrosis Undergoing Allogeneic Stem Cell Transplantation
Authors: Nico Gagelmann, Markus Ditschkowski, Rashit Bogdanov, Marie Robin, Bruno Cassinat, Michael Heuser, Rabia Shahswar, Felicitas Thol, Dietrich W. Beelen, Anita Badbaran, Nicolaus Kroeger
Journal: Blood (2018)
FRI0474 Classification of skin involvement in levamisole-adulterated cocaine induced vasculopathy
Authors: C.H. Muñoz-Vahos, S. Herrera-Uribe, Á. Arbeláez-Cortés, D. Jaramillo-Arroyave, L.A. González-Naranjo, G. Vásquez-Duque, M. Restrepo-Escobar, L.A. Correa-Londoño, J. Hernández-Zapata, A.L. Vanegas-García
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Up to 88% of cocaine is tainted with levamisole, an anthelmintic withdrawn from the market due to toxicity. Since 2010 levamisole-adulterated cocaine induced vasculopathy (LACIV) patients, characterised by retiform purpura, ear necrosis, multisystemic compromise and positivity for multiple autoantibodies, have been reported. Knowing the pattern and the severity of skin involvement is essential in the approach of these patients. <h3>Objectives</h3> To describe the cutaneous manifestations of patients with LACIV and to propose a classification of skin involvement. <h3>Methods</h3> We describe the skin compromise of 30 patients with LACIV evaluated between December 2010 and May 2017. Based on this series and the review of the literature, we propose a classification according to the distribution and severity of the lesions. <h3>Results</h3> All patients were mestizo, median age of 31 (IQR 27–38), male:female ratio 5:1, time from symptoms to diagnosis 12 months (IQR 6–24). The most frequent clinical manifestations were skin lesions: ear necrosis (73%) and retiform purpura (83%) affecting the extensor part of the limbs, buttocks, face, and abdomen; sparing the scalp, palms and soles. Retiform purpura was classified in four grades according to distribution and severity (image). Skin biopsies revealed leukocytoclastic vasculitis (24%), pseudo-vasculitis (19%), thrombotic vasculopathy with leukocytoclastic vasculitis (19%), thrombotic vasculopathy with pseudo-vasculitis (19%), and pyoderma gangrenosum with vasculopathy (5%). <h3>Image</h3> <b>LACIV retiform purpura classification. A. Grade 1:</b> livedo reticularis or racemosa with incipient purpura (individual lesions≤1 cm)<b>. B. Grade 2:</b> More extended purpuric lesions which sometimes coalesce (individual lesions&gt;1 cm)<b>. C. Grade 3:</b> Purpuric lesions with haemorrhagic blisters<b>. D. Grade 4:</b> Deep purpuric lesions with associated ulceration. <h3>Conclusions</h3> Given the higher consumption of cocaine and its contamination with levamisole, the report of LACIV patients is increasing. A classification of the skin involvement in LACIV is proposed, according to the frequency of affection and the stratification of purpuric lesions in four degrees of severity. Cutaneous involvement is one of the pillars for the diagnosis and properly treatment, therefore a detailed description of distribution and characteristics of the lesions are fundamental for these patients care. <h3>References</h3> [1] Pearson T, et al. Vasculopathy related to cocaine adulterated with levamisole: A review of the literature. Dermatol Online J2012;18:1. [2] Gillis JA, et al. Levamisole-induced vasculopathy: staging and management. J Plast Reconstr Aesthet Surg2014;67:e29–31. <h3>Disclosure of Interest</h3> None declared
SAT0735-HPR Sex differences in illness perceptions and self-management in patients with gout
Authors: U. Bergsten, M. Dehlin, E. Klingberg, A. Landgren, L. Jacobsson
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Illness perceptions are important and can influence all aspects of management in chronic diseases. Differences in gender aspects of illness perceptions have been shown for other diseases, but have scarcely been examined in gout. Lifestyle and dietary adjustments are principal components of self-management of gout. <h3>Objectives</h3> to examine illness perception, self-management strategies and advice from healthcare professionals in Swedish patients with gout by sex. <h3>Methods</h3> All patients above 18 with diagnose of gout were identified from 12 primary centres (serving a population of 1 00 000 inhabitants) and one rheumatology clinic within western Sweden. Patients were sent a questionnaire including gout characteristics, demographics, illness perception questionnaire (B-IPQ), questions about diet, alcohol and advice from health care professionals. Age-adjusted differences between sexes were analysed in logistic regression models <h3>Results</h3> Of 1589 individuals with a gout diagnosis, 868 (69,3%) responded to the survey. The proportion of men was 80%. Mean age was 70 years for men and 75 years for women. Women reported modest but significant worse illness perception with regard to severity of disease, identity, concerns and emotional response (see table 1). Women had made more dietary food changes, whereas there was no difference regarding changes in alcohol reduction. Advice from health personal regarding dietary changes had more often been given to men (53% vs 22%) and among obese patients (BMI &gt;30 kg/m<sup>2</sup>) more men (65% vs 47%) had been given advice about weight reduction. <h3>Conclusions</h3> Men with gout perceive their illness as less serious and are less likely to make dietary adjustments compared to women, despite been given more lifestyle advice from health care personal. There may be a need to focus more on how advices regarding disease and life style changes are given from a gender perspective for achieving optimal results. <h3>Disclosure of Interest</h3> None declared
SAT0223 Predictive factors of early failure to first line treatment with methotrexate in patients with rheumatoid arthritis. results from the gisea registry.
Authors: A. Manfredi, M. Sebastiani, F. Iannone, E. Gremese, A. Bortoluzzi, E. G. Favalli, R. Gorla, F. Salaffi, E. Fusaro, R. Foti, L. Cantarini, R. Caporali, A. Cauli, S. Alivernini, F. P. Cantatore, A. Carletto, F. Conti, S. D'Angelo, O. Epis, R. Ramonda, A. Marchesoni, F. Atzeni, P. Sarzi-Puttini, G. Ferraccioli, G. Lapadula
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Methotrexate (MTX) is generally recommended as first-line treatment of rheumatoid arthritis (RA). Despite its efficacy is well established, a percentage of patients fails the treatment. Few studies investigated the causes of early discontinuation of MTX; a two-year retention rate of about 66% is described for RA patients with lower age and longer disease duration as independent predictors for discontinuation. <h3>Objectives:</h3> Aim of this study was to detect possible predictive factors for early discontinuation of MTX prescribed as first line treatment in RA patients enrolled in the GISEA (Italian Group for the Study of Early Arthritis) registry. <h3>Methods:</h3> RA patients who began MTX as first line treatment were included in the study. For all patients age, sex, disease duration, smoking status, the intake of glucocorticoids, clinical and serological data, comorbidities and extra-articular manifestations were collected. <h3>Results:</h3> We analyzed 612 RA patients (females/males 477/132, mean age 55.73±14.5 years; mean DAS28 5.35±1.5); rheumatoid factor (RF) was positive in 64.9%, anti-citrullinated peptide antibodies (ACPA) in 42.7%. Comorbidities were observed in 17.5% of patients, while extra-articular RA manifestations were recorded in 1.5%; 68.3% of subjects taken low doses of steroids. One hundred and forty-nine (24.3%) patients discontinued MTX during the first year (for inefficacy in 66/149 (44.3%) patients, adverse events in 51/149 (34.2%), and other reasons in 32/149 (21.5). At univariate analysis early discontinuation of MTX was associated to a lower mean age (p=0.041) and a higher mean tender and swollen joints count (p=0.001 and p=0.024, respectively). Age and tender joints count were confirmed at multivariate analysis (OR 1.014, CI95% 1.001–1.027 and OR 0.951, CI95% 0.923–0.981, respectively) as independent predictors of early withdrawal of MTX. <h3>Conclusions:</h3> More than 75% of RA patients treated with MTX as first-line therapy remained in treatment after 12 months. Age was directly correlated and tender joints count was inversely correlated with early withdrawal of MTX in RA patients. <h3>Disclosure of Interest:</h3> None declared
SAT0266 Use of conventional synthetic dmards and biological dmards in patients with enteropathic spondyloarthritis: a combined gastro-rheumatological approach
Authors: M.S. Chimenti, P. Conigliaro, P. Triggianese, C. Canofari, F. Cedola, S. Onali, E. Calabrese, C. Petruzziello, A. Ruffa, G. Monteleone, L. Biancone, R. Perricone
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Enteropathic spondyloarthritis (eSpA) is a chronic autoimmune disease associated with inflammatory bowel disease (IBD) that is poorly diagnosed and managed. <h3>Objectives</h3> To assess the diagnostic and therapeutic effect of a combined gastro-rheumatological approach in eSpA patients. <h3>Methods</h3> IBD-patients with joint pain referred to a dedicated rheumatologist by gastroenterologist were enrolled. Clinical and biochemical variables, SpA and intestinal disease activity measures, and treatment (biologic; bDMARDs and conventional synthetic; csDMARDs) were recorded at baseline, 3, 6, 12 and 24 months. The association between treatment on demographic and clinical characteristics was evaluated by logistic regression. <h3>Results</h3> From a total of 229 IBD patients, 147 (64.2%) were diagnosed with eSpA; 96 (65.3%) showing peripheral involvement and 51 (34.7%) with axial involvement. The majority (67.3%) of eSpA patients were female (n=99), median age and disease duration of 46 and 14.6 years. bDMARD treatment increased over the follow-up period (baseline-24 months: 32.6%&gt;60%; AOR:3.45, 95% CI: 1.93–6.2, p&lt;0.001), however, their use was less frequent in elderly patients (AOR: 0.73, 95% CI: 0.56–0.96, p=0.023), in ulcerative colitis patients (AOR:0.43, 95% CI:0.2–0.94, p=0.034) and in patients with peripheral involvement (AOR:0.53, 95% CI:0.3–1.04, p=0.067). csDMARD use was increased in patients with peripheral involvement (AOR: 4.65, 95% CI:2.09–10.33, p&lt;0.001) and in patient with ulcerative colitis (AOR:2.30, 95% CI:1.13–4.67, p=0.021) (figure 1). CRP, ESR, ASDAS-ESR levels and BASFI were significantly decreased over the follow-up period whereas pMayo score, BASDAI and HAQ-S were unchanged (figure 2). <h3>Conclusions</h3> A multidisciplinary approach can improve in the therapeutic management and outcome (e.g. disease activity measures) of eSpA patients. bDMARD use paralleled an improvement in disease measures and confirmed a good safety profile. <h3>Disclosure of Interest</h3> None declared
Risk profiling based on p16 and HPV DNA more accurately predicts location of disease relapse in patients with oropharyngeal squamous cell carcinoma
Authors: J.H. Rasmussen, C. Grønhøj, K. Håkansson, J. Friborg, E. Andersen, G. Lelkaitis, J.P. Klussmann, C. Wittekindt, S. Wagner, I.R. Vogelius, C. von Buchwald
Journal: Annals of Oncology (2019)

BackgroundIn the era of precision medicine and HPV-related oropharyngeal squamous cell carcinoma (OPSCC), it is relevant to assess the risk of not only survival, but also the risk of local, regional, or distant treatment failure. The UICC 8th edition uses the surrogate marker p16 to stratify for HPV association but discordance between p16 status and HPV association has been shown. The purpose of this study was to develop a prognostic model to predict the risk of local, regional, and distant metastases and non-cancer-related death for patients with OPSCC, test the prognostic relevance of adding HPV DNA and p16 status, and validate the findings in an independent external dataset.Patients and methodsConsecutive patients diagnosed with OPSCC and treated with curative radiotherapy with or without cisplatin in eastern Denmark from 2000 to 2014 were included. Characteristics included age, gender, TNM stage, smoking habits, performance status, and HPV status assessed with p16 and HPV DNA. The information was used to develop a prognostic model for first site of failure with four competing events: recurrence in T-, N-, and M-site, and death with no evidence of disease.ResultsOverall 1243 patients were eligible for the analysis. A prognostic model with the four events was developed and externally validated in an independent dataset with a heterogeneously treated patient population from another institution. The individual prognostication from the competing risk analysis is displayed in a user friendly online tool (https://rasmussen.shinyapps.io/OPSCCmodelHPV_p16/). Replacing p16 status with the combined variable HPV/p16 status influenced the HR and patients with HPV−/p16+ had significantly higher HR of M-site recurrence than HPV+/p16+ with a HR = 2.56; CI [1.30; 5.02]; P = 0.006 (P = 0.013 in the validation cohort).ConclusionPatients with HPV−/p16+ have significantly higher risk of M-site recurrence and could potentially be relevant candidates for clinical trials testing systemic treatments in combination with conventional treatments.
Prognostic and Biologic Significance of Transfer RNA-Derived Small RNAs (tsRNAs) Expression in Younger Adult Patients (Pts) with Cytogenetically Normal Acute Myeloid Leukemia (CN-AML)
Authors: Marius Bill, Dario Veneziano, Jessica Kohlschmidt, Krzysztof Mrózek, Giovanni Nigita, Maria G. Krantz, Deedra Nicolet, Dimitrios Papaioannou, Allison Walker, Zachary Brannan, Bayard L. Powell, Richard M. Stone, Geoffrey L. Uy, Jonathan E. Kolitz, Eunice S. Wang, Adrienne M. Dorrance, Carlo M. Croce, Ramiro Garzon, Clara D. Bloomfield
Journal: Blood (2018)