tbuckley/cabot-search huggingface dataset:
AB1104 Malignancy-related arthropathies in paediatric patients seen in a tertiary hospital
Authors: M.A. Bayo-Ang, C.B. Bernal, M.T.M. Collante
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Along with constitutional symptoms such as fever, fatigue, and weight loss, childhood malignant diseases often also present with various musculoskeletal symptoms and findings, prompting consult or referral to a paediatric rheumatology clinic. <h3>Objectives</h3> The study described the characteristics of patients seen at the paediatric rheumatology clinic who were eventually diagnosed with malignancy. <h3>Methods</h3> Medical records of 35 children diagnosed with hematologic or solid malignancy who were seen at the paediatric rheumatology clinic from August 2013 to December 2017 because of with joint pains or difficulty in ambulation were reviewed. <h3>Results</h3> Twenty of the 35 patients (57.1%) were males and 15 (42.9%) were females. The mean age at diagnosis was 7.3 years old ±4.1 (range 2.5–17.0). The time of diagnosis from the onset of symptoms has a mean of 4.5 months±7.4. Fever was the most common constitutional symptom (82.8%), followed by pallor (45.7%) and weight loss (37.1%), while the most common musculoskeletal symptom or finding was joint pains (100%), followed by difficulty in ambulation (40%), joint swelling (37.1%) and nocturnal pains (31.4%). Mean haemoglobin level was 93.9 g/L±18.9. Mean white cell count was 11.9 × 10<sup>9</sup>/L±7.1, mean segmenters was 41.6%±21.7, and mean lymphocytes was 53.0%±24.2. Mean platelet count was 294.0 × 10<sup>9</sup>/L±220.5. Mean ESR was 99.6 m/h±33.7 at baseline. Radiographic evaluation done were all normal. Peripheral blood smears and bone marrow aspiration study were done in all patients. Thirty-three patients (94.2%) were diagnosed with acute leukaemia, 18 of which was acute lymphocytic leukaemia, 14 acute lymphocytic leukaemia pre-B, and 1 acute myelogenous. One patient had Non-Hodgkins Lymphoma and 1 patient had hemoblastoma. <h3>Conclusions</h3> Children with joint pains associated with findings atypical of a rheumatologic disorder presentation should be further investigated for the possibility of malignancy. <h3>Reference</h3> [1]Papp ZEet al; Early symptoms of childhood malignancy; Orv Hetil. 2017May;158(21):829–834 <h3>Disclosure of Interest</h3> None declared
AB0988 Bone quality evaluation using the new trabecular bone score (TBS) tool in rheumatoid arthritis patients supplemented with vitamin d
Authors: A. Casabella, S. Paolino, B. Ruaro, A. Sulli, C. Pizzorni, E. Alessandri, D. Fasciolo, C. Seriolo, L. Molfetta, P. Odetti, B. Seriolo, M. Cutolo
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Patients affected by Rheumatoid Arthritis (RA) show an increased risk of low bone mass, as a result of multi-systemic disorders including toxic drug, low vitamin D levels, use of glucocorticoids and physical inactivity. Trabecular Bone Score (TBS), is an index extracted from the dual-energy X-ray absorptiometry (DXA) images, that provides an indirect measurement (Score) of bone axial microarchitecture and allows to get information about bone quality.<sup>1,2</sup> <h3>Objectives</h3> The aim of this investigation was to evaluate by TBS the bone quality in AR patients (high risk population) receiving vitamin D supplementation from at least 3 months (1000 IU/die). <h3>Methods</h3> 108 female patients (mean age 61±8 years) affected by RA and 60 age- matched controls (CNT) (mean age 64±11 years) were analysed in winter time. Bone Mineral Density (BMD, g/cm<sup>2</sup>) of the lumbar spine (L1-L4) was analysed using a DXA scan (GE, Lunar Prodigy). Lumbar spine TBS (TBS iNsight Medimaps) was derived for each spine DXA examination. All patients were evaluated for serum 25 hydroxyvitamin D (25(OH)D) serum concentrations. <h3>Results</h3> RA patients showed lower 25(OH)D concentrations (18.4±1.3 ng/ml) than CNT (26.2±0.9 ng/ml; p&lt;0.04) possibly due to low dosage and short treatment. Seventy-eight RA patients (80% of study population) presented a bone loss that was significant when compared to the control group (p&lt;0.001). In particular, BMD was found significantly lower in RA patients compared with matched control group (respectively, Lumbar spine: 0.862±0.194 g/cm<sup>2</sup> vs 1.240±0.932 g/cm<sup>2</sup>;Femoral neck: 0.668±0.141 g/cm<sup>2</sup> vs 0.845±0.164 g/cm<sup>2</sup>; Ward: 0.486±0.221 g/cm<sup>2</sup> vs 0.657±0.106 g/cm<sup>2</sup>; Trochanter: 0.598±0.231 g/cm<sup>2</sup> vs 0.725±0.143 g/cm<sup>2</sup>; Total hip: 0.764±0.244 g/cm<sup>2</sup> vs 1.033±0.161 g/cm<sup>2</sup>, all p&lt;0.001). Likewise, lumbar spine TBS score was found significantly lower in RA patients when compared with CNT (0.904±0.148 vs 1.361±0.126, both p&lt;0.001) <h3>Conclusions</h3> This study shows in RA patients a reduction of TBS values that seem placed side by side with reduced BMD values and in presence of serum 25(OH)D insufficiency. A more carefull analysis of the clinical status/treatments should let to better identify RA patients at higher risk of bone loss. <h3>Reference</h3> [1] . Cutolo M et al. Autoimmun Rev 2011:12;84–7,2. Avouac J, et al. Arthritis Care Res 2012;64:1871–8 <h3>Disclosure of Interest</h3> None declared
FRI0458 The onset, clinical course and outcomes of ssc- overlap with pm/dm or ra (SSC-PM/DM AND SSC-RA)
Authors: O. Desinova, M. Starovoytova, L. Ananieva
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Systemic sclerosis (SSc) concurrent with other connective tissue diseases (poly/dermatomyositis, rheumatoid arthritis and oths) seem to be still underexplored clinical forms of SSc. <h3>Objectives</h3> To study specific features of the onset, clinical course and outcomes of systemic scleroderma- poly/dermatomyositis (SSc-PM/DM) and SSc-RA overlap syndromes. <h3>Methods</h3> Totally 115 patients were examined, 75 – with SSc-PM/DM and 40 with SSc-RA, among them 98 women and 17 men aged 17–74 years (mean age 44±14,5) and disease duration from 6 months to 35 years (median 8[2–8]). <h3>Results</h3> In 18% of overlapping SSc pts the disease manifested with isolated Raynaud's syndrome (RS) at the onset, in 61% – RS came in combination with cutaneous and/or joint and muscle pathology, and in remaining 7% and 2% overlapping SSc manifested with the isolated articular syndrome or muscular involvement (proximal weakness), respectively. During the first 3 years SSc generalisation with emerging signs of PM/DM occurred in 61% of patients, erosive arthritis manifested in 51%; and in 20% of pts arthritis was detected later. Limited skin involvement predominated, while diffuse skin lesions were present in 23% of SSc-PM/DM cases, 1/3 of them showed signs of DM. All pts with overlapping SSc syndrome received a glucocorticoids (GCs)-based combination therapy (SSc-PM/DM 30–60 mg/day, SSc-RA –10–20 mg/day), with NSAIDs and vascular drugs, 74% were administered cytotoxic agents, more often methotrexate (48%) and 7% – antifibrotic drugs. Two types of overlapping SSc evolution patterns were identified: type I is favourable (stabilisation and slow progression without significant disease activity, and preserved work capacity); type II is unfavourable (continuing activity, rapid progression, disability and deaths). Favourable overlapping SSc pattern prevailed (79%) in this study group, while unfavourable (21%) mainly consisted of SSc-PM/DM cases. Favourable overlapping SSc evolution was observed in patients with the onset before the age of 40 y, while unfavourable course was documented in pts with the late SSc onset at &gt;40 y, with prevailing SSc-PM/DM. Fatal outcomes in 10% of cases mostly belong to SSc-PM/DM pts (8%). The specific features of overlapping SSc evolution included augmentation of SSc-characteristic symptoms – both, peripheral – teleangiectasias, calcification, osteolysis and digital trophic lesions, mainly in SSc-PM/DM pts, and visceral – involving heart, lungs, and oesophagus, which determined the unfavourable prognosis. RA manifestations (articular syndrome) in overlapping SSc pts tended to decrease, while signs of PM tended to resolve. <h3>Conclusions</h3> Timely detection of overlapping SSc pathological symptoms with administration of adequate therapy and dynamic monitoring of patients will improve the prognosis and outcomes of the disease. <h3>Disclosure of Interest</h3> None declared
SAT0450 Estimating duration of response in systemic lupus erythematosus trials
Authors: M. Kim, J. Merrill, K. Kalunian, L. Hanrahan, P. Izmirly
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The primary endpoint in SLE trials is usually response to therapy at a landmark visit. However, during a trial, patients may alternate between response and non-response states. Duration of response would therefore be important to assess, but the optimal approach for estimating response duration has not been determined. Analysing response duration only among responders at a landmark visit can result in selection bias. Drop-outs and missed visits further complicate estimation of response duration. <h3>Objectives</h3> To quantify response duration and assess baseline predictors of transitions into and out of response in SLE patients receiving standard of care (SoC) by fitting a multi-state Markov (MSM) model. <h3>Methods</h3> Data on 759 SLE patients with active disease (SLEDAI ≥6 at entry) randomised to SoC in 52 week trials was obtained from the Collective Data Analysis Initiative (CDAI) database of the Lupus Foundation of America. The following monthly response endpoints (without medication stipulations) were analysed: SRI-4, SRI-5, SRI-6, and BICLA. A MSM model allowing for bi-directional transitions between response and non-response states was fit to estimate the probability of being in response at 52 weeks, average duration of response (sojourn time) and mean total time in response. Predictors of attainment and loss of SRI-5 response were also identified. <h3>Results</h3> Based on the MSM model, the probability of being in response at 52 weeks ranged from 42% (SRI-6) to 61% (SRI-4), higher than conventional 52 week landmark response rates that assume non-response for missing data. The estimated mean duration of response ranged from 20.4 weeks (BICLA) to 31.5 weeks (SRI-4). Mean total time in response over 52 weeks based on all patients was 16.4–24.8 weeks. After adjusting for baseline SLEDAI score, patients with lower anti-dsDNA titers were more likely to achieve and maintain SRI-5 response (p&lt;0.001). Younger age (p&lt;0.001) and higher protein/creatinine ratio (p&lt;0.001) were associated with higher frequency of SRI-5 response but also shorter response duration. Response duration was also shorter in patients who were non-White (p&lt;0.001), had longer history of disease (p=0.03), and lower lymphocyte count (p=0. 001) at baseline. <h3>Conclusions</h3> Factors associated with greater disease severity were consistently associated with shorter response duration on SoC, despite exhibiting variable effects on the probability of achieving response at a given time. Response duration might therefore provide a more discriminating measure to distinguish effective investigational treatments from background SoC, although this remains to be tested. Multi-state models make better use of complex longitudinal clinical trial data and provide a more comprehensive view of the response profile and the role of patient characteristics in different aspects of response. <h3>Disclosure of Interest</h3> None declared
Cervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology
Authors: Wui-Jin Koh, Nadeem R. Abu-Rustum, Sarah Bean, Kristin Bradley, Susana M. Campos, Kathleen R. Cho, Hye Sook Chon, Christina Chu, Rachel Clark, David Cohn, Marta Ann Crispens, Shari Damast, Oliver Dorigo, Patricia J. Eifel, Christine M. Fisher, Peter Frederick, David K. Gaffney, Ernest Han, Warner K. Huh, John R. Lurain, Andrea Mariani, David Mutch, Christa Nagel, Larissa Nekhlyudov, Amanda Nickles Fader, Steven W. Remmenga, R. Kevin Reynolds, Todd Tillmanns, Stefanie Ueda, Emily Wyse, Catheryn M. Yashar, Nicole R. McMillian, Jillian L. Scavone
Journal: Journal of the National Comprehensive Cancer Network (2019)

Cervical cancer is a malignant epithelial tumor that forms in the uterine cervix. Most cases of cervical cancer are preventable through human papilloma virus (HPV) vaccination, routine screening, and treatment of precancerous lesions. However, due to inadequate screening protocols in many regions of the world, cervical cancer remains the fourth-most common cancer in women globally. The complete NCCN Guidelines for Cervical Cancer provide recommendations for the diagnosis, evaluation, and treatment of cervical cancer. This manuscript discusses guiding principles for the workup, staging, and treatment of early stage and locally advanced cervical cancer, as well as evidence for these recommendations. For recommendations regarding treatment of recurrent or metastatic disease, please see the full guidelines on NCCN.org.
SAT0143 The arrest of bone mineral density loss at the lumbar spine and hip in patients with active rheumatoid arthritis during rituximab therapy
Authors: K. Keywani, H. G. Raterman, M. M. ter Wee, M. T. Nurmohamed, A. E. Voskuyl, I. E. Bultink, W. F. Lems
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> One of the well-known characteristics of rheumatoid arthritis (RA) is generalized bone loss.<sup>1–2</sup> Although rituximab is a frequently prescribed biologic disease-modifying anti-rheumatic drug (bDMARD) for the treatment of RA, data regarding changes in bone mineral density (BMD) in RA patients during rituximab therapy are limited. <h3>Objectives:</h3> To study the extent of BMD loss at lumbar spine and hip in patients with active rheumatoid arthritis treated with rituximab. <h3>Methods:</h3> Consecutive RA patients with an active disease status (DAS28&gt;3.2) starting rituximab treatment were enrolled in a prospective cohort study. BMD of the lumbar spine and hip was measured before treatment and after one year using dual energy X-ray absorptiometry (DXA) to assess BMD changes. Clinical response was defined using the European League Against Rheumatism (EULAR) response criteria. <h3>Results:</h3> A total of 43 subjects (18.6% men) with mean age of 53.6 (SD 10.7) years were included in the study. Median disease duration was 9.5 (IQR 0.7–40.2) years and baseline mean DAS28 was 5.6 (SD 1.3). In responders, the DAS28 decreased with 1.97 points (SD 0.78) 95% CI 1.67 – 2.28 p&lt;0.001; and in non-responders, the DAS28 decreased with 0.01 points (SD 0.67) 95% CI -0.35 – 0.37 p=0.945. All changes in BMD were not statistically significant (table 1). <h3>Conclusions:</h3> The findings of this study indicate that patients with active RA treated with rituximab have arrest of bone loss at both the lumbar spine and hip. Moreover, these results suggest that rituximab has bone-saving abilities even in the absence of clinical response. <h3>References</h3> [1] McInnes IB, et al. The New England journal of medicine2011;365:2205–2219. [2] Firestein GS, et al. Nature2003;423:356–361. <h3>Disclosure of Interest:</h3> None declared
THU0517 Identification of candidate genes associated with fibromyalgia susceptibility in southern spanish women: the al-Ándalus project
Authors: F. Estevez-Lopez, D. Camiletti-Moirón, V.A. Aparicio, V. Segura-Jiménez, I.C. Álvarez-Gallardo, A. Soriano-Maldonado, M. Borges-Cosic, P. Acosta-Manzano, R. Geenen, M. Delgado-Fernández, L.J. Martínez-González, J.R. Ruiz, M.J. Álvarez-Cubero
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Family aggregation suggests genetic susceptibility to fibromyalgia.<sup>1</sup> Candidate-gene studies on fibromyalgia susceptibility often include a small number of SNPs,<sup>2,3</sup> which is a limitation.<sup>4</sup> Additionally, there is a paucity of evidence in Europe. <h3>Objectives</h3> To compare genotype frequencies of candidate single nucleotide polymorphisms (SNPs) in a well-characterised sample of Spanish women with fibromyalgia and healthy non-fibromyalgia women. <h3>Methods</h3> Three hundred and fourteen women with a diagnosis of fibromyalgia (cases) and 112 non-fibromyalgia healthy (controls) women participated in the present candidate-gene study. Buccal swabs were collected for DNA extraction. Using TaqMan OpenArray, we analysed 63 single nucleotide polymorphisms (SNPs) of 33 genes related to fibromyalgia susceptibility, symptoms, or potential mechanisms. <h3>Results</h3> The rs841 and rs1799971 GG genotype was more frequently observed in fibromyalgia than in controls (p=0.04 and p=0.02, respectively). The rs2097903 AT/TT genotypes were also more often present in the fibromyalgia participants than in their control peers (p=0.04). <h3>Conclusions</h3> We identified, for the first time, associations of the rs841 (guanosine triphosphate cyclohydrolase 1 gene) and rs2097903 (catechol-O-methyltransferase gene) SNPs with higher risk of fibromyalgia susceptibility. We also confirmed that the rs1799971 SNP (opioid receptor μ1 gene) might confer genetic risk of fibromyalgia. Further studies are needed to confirm or refute the present findings. <h3>References</h3> [1] Arnold LM, et al. Arthritis Rheum2004;50(3):944–52. [2] Lee YH, et al. Rheumatol Int2012;32(2):417–26. [3] Estévez-López F, et al. Rheumatol Int (in press). doi:10.1007/s00296-017-3896-x [4] Klepstad P. Scand J Pain2014;5:8–9. <h3>Acknowledgements</h3> The authors report no conflicts of interest. This work was supported by the Spanish Ministry of Economy and Competitiveness [I+D+ i DEP2010–15639, I+D+ i DEP2013–40908 R, BES-2014–0 67 612]; the Spanish Ministry of Education [FPU2014/02518] <h3>Disclosure of Interest</h3> None declared
AB1252 Prevalence of analgesic usage in patients with rheumatoid arthritis and relationship with disease activity
Authors: L. Villarreal, D. Buitrago-Garcia, M. Cabrera, P. Santos-Moreno
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rheumatoid arthritis (RA) is a systemic, autoimmune disease in which chronic pain is a persistent symptom,<sup>1</sup> aditionally pain management remains as a serious public health issue. Pain is often disabling and can reduce the quality of life of a patient(.<sup>2</sup> <h3>Objectives</h3> To describe prevalence of analgesic usage in patients with rheumatoid arthritis and relationship with disease activity. <h3>Methods</h3> We collected data from the medical charts in a specialised RA centre conducted during 2017, we performed a descriptive analysis, we collected sociodemographic information, DAS28, and the prevalence of prescription of analgesic medications divided in three groups non opioid analgesics, opioid analgesics and NSAIDS. We calculated means, and standard deviations for continuous variables and categorical variables were presented as rates. We estimated the prevalence of comorbidities and evaluate independent associations calculating prevalence ratios. <h3>Results</h3> We included data from 6700 patients, 80% were women and 20% were men. Mean age was 59 years±13, 47% of all patients were between 60 and 80 years; The prevalence of use pain medications was 63.41%. Most of patients received non opioid analgesics 52% (paracetamol or dipyrone) followed by opioids 23% (codein or tramadol), 10% of patients had pain medication combination of non opioids plus opiods. See table 1. The prevalence of pain medications usage was associated with sex but not with disease activity see table 2. <h3>Conclusions</h3> Rheumatoid arthritis is a pain associated condition; two thirds of patients are using of pain medications mainly women; the most prescribed medication was paracetamol or opioids, coinciding with other studies.<sup>2</sup> This descriptive study is useful for further studies to develop in Latin America. <h3>References</h3> [1] Parker JC, Frank RG, Beck NC, Smarr KL, Buescher KL, Phillips LR, et al. Pain management in rheumatoid arthritis patients. Arthritis &amp; Rheumatism. 1988;31(5):593–601. [2] Samison LH, Randriatsarafara FM, Ralandison S. Joint pain epidemiology and analgesic usage in Madagascar. The Pan African medical journal. 2017;26:77. <h3>Disclosure of Interest</h3> None declared
AB1185 Antinuclear antibodies (ANA) in systemic lupus erythematosus (SLE): associations with clinical manifestations and cytokine profiles
Authors: E. Aleksandrova, A. Novikov, Z. Verizhnikova, T. Panafidina, T. Popkova, G. Lukina
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> SLE is a multisystem heterogeneous autoimmune disease characterised by production of antibodies to cellular components, innate and adaptive immune alterations and dysregulation of cytokine production. Multiplex immunoassay is a useful tool for the detection of ANA associated with different clinical phenotypes and cytokine profiles in SLE. <h3>Objectives</h3> To evaluate the relationship between ANA subpopulations, clinical subtypes and cytokine profiles in SLE. <h3>Methods</h3> We studied 61 patients with <sup>SLE (2012</sup> SLICC classification criteria) (8M/53 F), median and interquartile range (25th—75th percentile) of age 30.0 (27.0–45.0) years, disease duration 90.5 (12.5–168.0) months, SLEDAI 2K score 8.0 [4.0–16.0]; SLICC damage index score 1.0 (0–2.0) and 28 healthy donors. Serum samples were analysed for SLE-associated ANA (anti-dsDNA, anti-Sm, anti-chromatin, anti-SS-A/Ro 52 kDa and 60 kDa, anti-SS-B/La, anti-RNP-70, anti-ribosomal P – anti-RibP) using multiplex bead-based immunoassay system BioPlex 2200 (ANA Screen; Bio-Rad Laboratories Inc., USA). The levels of cytokines were determined with Bio-Plex 200 technology (Human Grp I Cytokine 27-plex panel; Bio-Rad Laboratories Inc., USA). <h3>Results</h3> Serum levels of anti-dsDNA, anti-chromatin, anti-Sm and anti-RibP antibodies were positively correlated with SLEDAI-2K scores (r=0.6, r=0.7, r=0.4, r=0.3, p&lt;0.05). Antibodies to dsDNA, chromatin, Sm and SS-A/Ro was most often detected in patients with dermatologic (59%, 57%, 32%, 43%), renal (64%, 66%, 36%, 38%) and neuropsychiatric (61%, 61%, 28%, 39%) manifestations of SLE. Increased serum concentrations of IFN-inducible chemokines: IP 10 and MCP1 were associated with high anti-dsDNA (r=0.3), anti-chromatin (r=0.5), anti-Sm (r=0.5), anti-SS-B/La (r=0.3), anti-RibP (r=0.4) (p&lt;0.05) and anti-Sm (r=0.3), anti-SS-B/La (r=0.3), anti-RibP (r=0.3) (p&lt;0.05) antibodies levels. Hyperproduction of chemokines RANTES and IL-8/MIP-1α negatively correlated with anti-dsDNA (r=−0.3), anti-chromatin (r=−0.3) (p&lt;0.05) and anti-SS-A/Ro (r=−0.3) (p&lt;0.05) antibodies levels, respectively. Low levels of pro-inflammatory cytokines IL-1β, IL-15 were negatively associated with the presence of antibodies to dsDNA and RibP (r=−0.3) (p&lt;0.05), but a positive correlation was found between the levels of anti-inflammatory cytokines IL-10, IL-1ra and anti-Sm (r=0.3), anti-SS-B/La (r=0.3), anti-SS-A/Ro (r=0.3) (p&lt;0.05) antibodies titers. Elevated concentration of GM-CSF was negatively correlated with serum level of antibodies to Sm (r=−0.3) (p&lt;0.05). <h3>Conclusions</h3> These data suggest that the presence of ANA clusters may identify patients with distinct clinical subtypes and cytokine profiles and can reflecting different pathways of immune dysregulation in SLE. <h3>Disclosure of Interest</h3> None declared