tbuckley/cabot-search huggingface dataset:
THU0476 Spontaneous vertebral fracturesafter denosumab discontinuation: a report of 6 cases
Authors: H. Florez, J. Ramírez, A. Monegal, N. Guañabens, P. Peris
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Denosumab (Dmab) is an antiresorptive treatment with demonstrated efficacy in osteoporosis. However, discontinuation of Dmab has been associated with rapid bone loss, and recently, the development of vertebral fractures (VF) in some patients. It is essential to identify the risk factors for these adverse events and follow its evolution. <h3>Objectives</h3> To analyse the clinical characteristics, parameters of bone metabolism and evolution of patients developing VF after Dmab discontinuation. <h3>Methods</h3> Six women with spontaneous VF after Dmab discontinuation were included (median age 66 years<sup>56–75</sup>). The clinical history, cause of osteoporosis, treatments received, fractures, Dmab treatment duration and discontinuation period were reviewed. Additionally, the clinical and densitometric evolution, and bone mineral parameters were also analysed after Dmab discontinuation. <h3>Results</h3> All the patients had postmenopausal osteoporosis, and one was receiving glucocorticoid treatment; 3/6 patients had previous fractures (2 VF and 1 calcaneus); 4/6 had previously received antiosteoporotic treatment (hormone replacement therapy, risedronate, alendronate, zoledronate [once or consecutively)] during 1–23 years. All had received Dmab for 24–53 months (median 37). The reasons for treatment discontinuation were: dental indication (1 patient), BMD improvement (T-score −1.2) (1 patient), poor adherence,<sup>1</sup> prescription problems and/or delay in administration.<sup>3</sup> The median bone mineral density T-scores prior to VF were −2.6 (-1.2/–4) at the lumbar spine and −3.0 (-0.6/–3.7) at the femoral neck. The mean time between the last Dmab dose and VF was 9.5 months,<sup>8–20</sup> with a median of 5 VFs/patient.<sup>2–8</sup> No patient showed 25-OH vitamin D&lt;20 ng/ml. After Dmab discontinuation, bone turnover markers increased (median increase +364% in PINP and +287% in NTx); one patient presented hypercalcaemia (Ca 11.3 mg/dL); and BMD decreased 1%–21% in the lumbar spine and 2%–6% in total hip at 8–19 months. After VF, 3 patients restarted Dmab, 1 received zoledronate and 2 alendronate. No new fractures occurred during follow-up. <h3>Conclusions</h3> Discontinuation of Dmab is associated with an increase in bone turnover markers and bone loss which can be associated with the development of spontaneous VF. Previous bisphosphonate therapy does not seem to decrease this risk. Further studies are needed to assess the optimal antiresorptive treatment and its duration after Dmab discontinuation. <h3>Disclosure of Interest</h3> None declared
AB0728 Nailfold capillaroscopy in systemic sclerosis – six years in review
Authors: A.C. Duarte, A. Cordeiro, M.J. Santos
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Microvascular dysfunction is a dynamic process that is crucial in systemic sclerosis'(SSc) pathogenesis. Nailfold capillaroscopy(NCP) is a rapid, non-invasive exam that illustrates the early capillary changes in SSc and monitor their evolution. It is extremely useful in clinical practice and has been recognised in 2013 ACR/EULAR classification criteria for SSc. <h3>Objectives</h3> Evaluate the prevalence and evolution of NCP scleroderma pattern in SSc patients and analyse possible associations with disease-phenotype. <h3>Methods</h3> NCP of SSc patients followed in our centre were reviewed; clinical and demographic features were collected. A descriptive analysis was performed and nonparametric tests compared patients with and without SSc pattern. <h3>Results</h3> In total, 70 out of 117 SSc patients had at least 1 NCP available during the last 6 years. Most of these patients(62.9%) had limited cutaneous SSc, 21.4% diffuse cutaneous SSc, 11.4% very early diagnosis SSc and 4.3% overlap syndromes; mean disease duration was 10.7±9.6 years. At the moment of the first NCP, 46 patients(39.4%) had a scleroderma pattern, 12 (10.3%) had non-specific(NS) NCP abnormalities and 12 had a normal NCP. During the 6 years follow-up, NCP changed in 5 patients as illustrated in figure 1. However, none had concomitant development/worsening of other clinical manifestations. At the end of the follow-up, 49 (70%) patients had a NCP scleroderma pattern. Early pattern was present in 13 (26.5%) patients, active pattern in 21 (42.9%), active/late pattern in 3 (6.1%) and late pattern in 12 (24.5%). When comparing patients with and without scleroderma specific patterns (table 1), the presence of scleroderma pattern was associated with the presence of current/previous digital ulcers(OR 1.49 95% CI 1.17–1.92). However, this difference was not confirmed between the different scleroderma patterns. Regarding, major organ involvement, although there were no statistical differences between both groups, patients with scleroderma pattern had a higher prevalence of oesophageal involvement. <h3>Conclusions</h3> This study demonstrates how NCP can illustrate the dynamic vascular damage in SSc. In our data, a NCP scleroderma pattern was significantly associated with a higher number of digital ulcers and these patients had a higher percentage of oesophageal involvement. In daily clinical practice, NCP is useful not only for corroborating SSc diagnosis, but also for monitoring endothelial injury and potential macrovascular/systemic damage. Although our sample is too small to demonstrate possible associations between specific NCP alterations and internal organ involvement, some studies have already identify NCP patterns as predictive factors for organ damage. <h3>Disclosure of Interest</h3> None declared
Novel auristatin E-based albumin-binding prodrugs with superior anticancer efficacy in vivo compared to the parent compound
Authors: Lara Pes, Stephan David Koester, Johannes Pall Magnusson, Serghei Chercheja, Federico Medda, Khalid Abu Ajaj, Didier Rognan, Steffen Daum, Friederike Inga Nollmann, Javier Garcia Fernandez, Patricia Perez Galan, Heidi-Kristin Walter, Anna Warnecke, Felix Kratz
Journal: Journal of Controlled Release (2019)
Imputation-based analysis of MICA alleles in the susceptibility to ankylosing spondylitis
Authors: Xiaodong Zhou, John D Reveille
Journal: Annals of the Rheumatic Diseases (2019)

A recent study has raised new questions about the independent association of MICA alleles with ankylosing spondylitis (AS).1 This letter highlights some important issues to be discussed in response to this article.

The authors used imputation to genotype MICA and HLA-B27 in patients with AS and controls of European ancestry. The results appeared discordant with the previous report that showed a strong and human leukocyte antigen (HLA)-B27 independent association between MICA*007:01 and AS in US and Chinese cohorts.2 A common finding was a significant high rate of MICA*007 in patient with AS. The …
AB1265 Loss of specialty medical care for elderly rheumatoid arthritis patients who discharged from hospital
Authors: S. Mizuki, F. Sagawa, D. Hiraoka, K. Yoshida, H. Ikeuchi, K. Oryoji
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> As the ageing of the population progresses, the proportion of the population over the age of 65 reaches 27.3% in 2016, in Japan. Even elderly rheumatoid arthritis (RA) patients often require immunosuppressive agents or biological disease modifying antirheumatic drugs (DMARDs) due to their high disease activity. Therefore, they need to continuously receive treatment by specialty rheumatologists. Due to the deterioration of the ability of daily living activities, some patients may drop out of specialty medical care. In recent years, the age of RA patients who need to be hospitalised has also increased. However, it is unclear whether elderly patients discharged from the hospital are able to continue receiving specialty medical care. <h3>Objectives</h3> To clarify whether a patient who has been discharged from a rheumatology specialty hospital can continue receiving rheumatology specialty medical care. <h3>Methods</h3> RA patients who discharged from our rheumatology unit from January 1, 2016 to December 31, 2016, were included. We investigated the backgrounds and outcomes of those patients retrospectively. We compared the background characteristics of patients who are receiving treatment by specialty rheumatologists at the final follow-up (specialty group) and those who are not (non-specialty group). For the statistical analysis, a chi-squared test and Student's t-test were used. <h3>Results</h3> We identified 147 patients. The mean ±SD age of patients at discharge was 72.2±9.1 years and 74.8% was female. The reasons for hospitalisation were 87 patients (59.2%) for treatment of RA and 60 (40.8%) for treatment of complications (sepsis, fracture and so on). After discharge, 134 patients (91.1%) had returned to follow up in our department for RA treatment. The remaining 13 patients were treated at other hospitals, five of whom were treated by a primary care physician who was not specialised for rheumatology. Overall, we compared 142 patients in the specialty group and 5 in the non-specialty group. The age, the use ratio of immunosuppressive agents/biological DMARDs/prednisolone and the dose of prednisolone in the specialty group and the non-specialty group were 71.9 and 79.0 years old (p=0.09), 50.0% and 20.0% (p=0.37), 29.6% and 20.0% (p=1.00), 78.7% and 80.0% (p=1.00), 6.5 and 5.6 mg/day (p=0.83), respectively. <h3>Conclusions</h3> In elderly RA patients, some patients drop out of RA specialty medical care. The background of such patients is not different from those of patients who are receiving treatment by specialty rheumatologists. In order to provide specialty medical care for RA patients throughout the community, a co-management medical collaboration system between specialty rheumatologists and primary care doctors should be established. <h3>Disclosure of Interest</h3> None declared
THU0312 Risk of infection in patients with psoriasis/psoriatic arthritis: a population-based study in the province of british columbia
Authors: J.A. Avina-Zubieta, A. Dominique, T.A. Simon, H. Tavakoli
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Psoriasis (PsO) is a chronic autoimmune disease of the skin with a third of patients (pts) also developing inflammatory arthritis (PsA), which can lead to joint destruction. Research suggests that pts with PsA have an increased risk of complications (e.g. cardiovascular disease). There are limited data on the risk of infections among pts with PsO/PsA. <h3>Objectives</h3> To assess the risk of mild and severe infections in pts with newly diagnosed PsO/PsA in a general population. <h3>Methods</h3> Using administrative health data from British Columbia (Canada) we developed an incident cohort of pts diagnosed with PsO/PsA between 1996 and 2013, with equal control pts matched on sex, age and calendar year. PsO/PsA cases were determined by: a) one International Classification of Diseases code (696.X) for PsO/PsA assessed by a rheumatologist or dermatologist; b)≥2 diagnostic codes for PsO/PsA,≥2 months apart in a 2 year period assessed by a non-rheumatologist or dermatologist; c)≥1 hospitalisation with a diagnostic code for PsO/PsA. Individuals with a history of HIV or tuberculosis were excluded. Outcomes were mild infections (requiring a physician visit and antibiotics) or serious infections (requiring hospitalisation). Adjusted risks of these infections were estimated using generalised estimating equation extensions of multivariate Poisson regression models. <h3>Results</h3> We identified 84 616 newly diagnosed pts with PsO/PsA (51.6% female; mean age 49.5 years [SD: 18.2]) who were matched with an equal non-PsO/PsA cohort. Pts with PsO/PsA had a higher risk of developing mild infections during follow-up, including HIV (2.6-fold) and mycosis (2-fold), compared with the general population. PsO/PsA also increased the risk of severe infections including <i>Chlamydia</i> (1.7-fold) and viral diseases with exanthema (2.6-fold) (table 1). P-Y=patient years <h3>Conclusions</h3> This large epidemiological study demonstrates that pts with PsO/PsA are at significantly higher risk of acquiring infections. The role of therapy for PsO/PsA on the risk of these infections needs to be evaluated. <h3>Acknowledgements</h3> This study received an unrestricted grant from Bristol-Myers Squibb for an investigator-initiated project in PsO/PsA. <h3>Disclosure of Interest</h3> J. A. Avina-Zubieta Grant/research support from: Bristol-Myers Squibb Company (BMS), A. Dominique Employee of: Bristol-Myers Squibb Company (BMS), T. Simon Employee of: Bristol-Myers Squibb Company (BMS), H. Tavakoli Grant/research support from: Bristol-Myers Squibb Company (BMS)
AB1183 Diagnostic value of salivary crp and il-6 in patients undergoing anti-tnf-alpha therapy for rheumatic disease
Authors: D. Sikorska, R. Rutkowski, A. Prymas, M. Mrall-Wechta, D. Bednarek-Hatlińska, A. Surdacka, W. Samborski, J. Witowski
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Saliva has been increasingly used as a diagnostic medium for disease detection and monitoring. Since saliva contains many of mediators of inflammation, collagen breakdown and/or bone remodelling, they may be of potential use for the rheumatic disease monitoring.<sup>1, 2</sup> <h3>Objectives</h3> The aim of this pilot study was to investigate whether and how well salivary concentrations of CRP and IL-6 correlate with those in serum and with the clinical course of a rheumatic disease. <h3>Methods</h3> The nineteen consenting patients with rheumatoid arthritis or ankylosing spondylitis, newly scheduled for anti-TNFα therapy, were analysed. CRP and IL-6 were measured with high-sensitivity immunoassays before and after 12 weeks of anti-TNFα therapy, according to standard regimens. Disease activity and oral health parameters were also assessed. <h3>Results</h3> The patients' baseline characteristics were summarised in Table 1. The treatment resulted in a significant improvement in the clinical status and standard biochemical parameters in the majority of patients (table 2). Concentrations of CRP in saliva correlated significantly with those in serum (R=0.62; p&lt;0.001) and decreased markedly after successful response to treatment (n=15) (1.7±0. 2.2 mg/L vs. 0.8±1.4 mg/L; p&lt;0.001). In patients with a limited or no response to treatment (n=4) salivary CRP levels increased (0.4±0.8 mg/L vs. 2.6±2.4 mg/L; p=0.250). In contrast to CRP, the salivary concentrations of IL-6 did not change significantly over the course of therapy and they did not correlate with serum IL-6 concentrations. Salivary levels of neither CRP nor IL-6 corresponded to parameters of oral health and hygiene. <h3>Conclusions</h3> These data indicate, that salivary CRP but not IL-6 could be of potential use for monitoring the rheumatic disease activity. <h3>References</h3> [1] Buczko P, Zalewska A, Szarmach I. Saliva and oxidative stress in oral cavity and in some systemic disorders. Journal of physiology and pharmacology: an official journal of the Polish Physiological Society. 2015;66(1):3–9. [2] Mirrielees J, Crofford LJ, Lin Y, Kryscio RJ, Dawson DR, 3rd, Ebersole JL, et al. Rheumatoid arthritis and salivary biomarkers of periodontal disease. Journal of clinical periodontology. 2010;37(12):1068–74. <h3>Disclosure of Interest</h3> None declared
<i>Notes from the Field:</i>Respiratory Syncytial Virus Infections in a Neonatal Intensive Care Unit — Louisiana, December 2017
Authors: Erica J. Washington, Erica Billig Rose, Gayle E. Langley, Julie P. Hand, Isaac Benowitz, Susan I. Gerber, Andrea L. Salinas, Ashley L. Terry, Julius L. Tonzel, Theresa M. Sokol, Andrew T. Smith, Gillian J. Richardson
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

In December 2017, the Louisiana Department of Health was notified of seven cases of respiratory syncytial virus infection at a five-unit, 84-bed neonatal intensive care unit that included 66 individual infant rooms.
AB1356 Age peculiarities of bone mineral density in young female with juvenile idiopathic arthritis
Authors: V. Povoroznyuk, M. Dzhus
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Objectives</h3> <b>Aim:</b> to study the bone mineral density (BMD) in young adult females with juvenile idiopathic arthritis (JIA) depending on the age. <h3>Methods</h3> 99 females aged 19–39 (40 patients with JIA and 59 practically healthy persons) were examined. All surveyed were divided into 2 groups by age: I group–20–29 years old and II group–30–39 years old. The age of disease onset, delay in diagnosis, disease duration, ILAR-variant of JIA, BMD, T-score and Z-score were estimated. <h3>Results</h3> The onset of JIA was at the age of 11.16±4.34 years, delayed diagnosis–23.52±21.37 months, the disease duration–11.9±9,4 years, persistent oligoarthritis was detected in 25% of patients, RF-negative polyarthritis–in 22.5%, extended oligoarthritis–in 10%, RF-positive polyarthritis–in 10%, systemic-onset JIA–in 12.5%, enthesitis-related JIA–in 15%, undifferentiated arthritis–in 2,5%, psoriatic arthritis–in 2,5% of patients. BMD (p&lt;0.000001) in the lumbar spine (LS) were lower in female with JIA than in healthy people. Femoral neck (FN) BMD (p&lt;0.000001), total body (TB) BMD (p&lt;0.000001) were lower in patients with JIA than in healthy people. The BMD was significantly lower at the LS (p&lt;0.001) and at the TB (p&lt;0.01) in both groups, and at the FN (p&lt;0.001) in patients aged 20–29 years in comparison with healthy group. Z-score&lt;-2 SD in young females was detected in 40% of patients in the LS, in 25% of patients in the FN, in 35% of patients in the TB and 52.5% of patients in ultradistal forearm, and T-score &lt;−2.5–in 2.5% in LS, 2.5%–FN, 37.5%–TB, 22.5%–ultradistal forearm. Osteopenia by T-score at the LS was found in 42.5%, of the FN–42.5%, TB–37.6%, ultradistal forearm–22.5% of patients. <h3>Conclusions</h3> The presence of JIA in childhood had negative effects on the formation of peak bone mass and BMD at young female. <h3>Disclosure of Interest</h3> None declared
Decrease of methicillin resistance in Staphylococcus aureus in nosocomial infections in Germany–a prospective analysis over 10 years
Authors: T.S. Kramer, C. Schröder, M. Behnke, S.J. Aghdassi, C. Geffers, P. Gastmeier, C. Remschmidt
Journal: Journal of Infection (2019)
AB0878 Comparison of clinical features in patients with psoriatic arthritis and patients with spondyloarthritis with inflammatory bowel disease
Authors: M. Uematsu, K. Inui, T. Okano, Y. Yamada, K. Mandai, Y. Sugikoka, K. Mamoto, T. Koike, H. Nakamura
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Spondyloarthritis (SpA) is one of the representative comorbidity in patients with psoriasis (PsO) and inflammatory bowel disease (IBD) disease. However, the difference of clinical features between SpA due to PsO (PsA) and SpA due to IBD (IBD-SpA) are unclear. <h3>Objectives</h3> The purpose of this study is to compare the clinical features between patients with PsA and IBD-SpA. <h3>Methods</h3> Overall, 192 patients with PsO and 37 patients with IBD were included in this cross-sectional study. Clinical classification of PsA and IBD-SpA were performed according to the CASPAR<sup>1</sup> criteria and ASAS criteria.<sup>2</sup> Disease activity (DAS28-CRP), C-reactive protein (CRP), matrix metalloproteinase-3 (MMP-3), anti-cyclic citrullinated peptide antibody (ACPA), rheumatoid factor (RF), biologic disease modifying anti-rheumatic drugs (bDMARDs) use, and proportion of peripheral and axial disease were evaluated in patients with PsA and IBD-SpA. <h3>Results</h3> In this analysis, 74 patients were classified as PsA, 65 patients as PsO, 17 patients as IBD-SpA and 20 patients as IBD. The mean age was 56.0±14.7 years in PsA, 44.7±10.9 years in IBD-SpA (p=0.003). The mean BMI was 24.2±4.5 kg/m<sup>2</sup> in PsA, 23.3±7.2 kg/m<sup>2</sup> in IBD-SpA (p=0.18). DAS28-CRP was 3.26±1.26 in PsA, 4.02±1.5 in IBD-SpA (p=0.12). Axial SpA was observed in 4 (5.4%) in PsA, 5 (29.4%) in IBD-SpA (p=0.01). Biologics were used in 29 (39.2%) patients in PsA, 13 (76.5%) patients in IBD-SpA (p=0.007). Proportion of seropositive ratio was not significant in this two groups. <h3>Conclusions</h3> The clinical features between patients with PsA and IBD-SpA were compared. The patient with IBD-SpA was younger than patient with PsA and the prevalence of axial disease was more frequent in IBD-SpA. <h3>References</h3> [1] Taylor W, Gladman D, Helliwell P, et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum. 2006;54:2665–73. [2] Rudwaleit M, van der Heijde D, Landewé R, et al. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis. 2011;70:25–31. <h3>Acknowledgements</h3> We wish to thank Tomoko Nakatsuka for clinical assistant. <h3>Disclosure of Interest</h3> None declared
Progression Free Survival below 12 Months Following Stem Cell Transplant Is a Hallmark of High-Risk Myeloma Which Is Associated with Inferior Overall Survival — Data from the Ukmrc Myeloma XI Trial
Authors: Ceri A Bygrave, Charlotte Pawlyn, Faith E. Davies, David Cairns, Alina Striha, Anna Hockaday, Andrea Paterson, John R Jones, Bhuvan Kishore, Mamta Garg, Cathy Williams, Kamaraj Karunanithi, Jindriska Lindsay, Matthew W Jenner, Gordon Cook, Mark T Drayson, Roger G. Owen, Nigel H Russel, Walter M Gregory, Gareth J. Morgan, Graham Jackson, Martin Kaiser
Journal: Blood (2018)
Brain and Salivary Gland Tumors and Mobile Phone Use: Evaluating the Evidence from Various Epidemiological Study Designs
Authors: Martin Röösli, Susanna Lagorio, Minouk J. Schoemaker, Joachim Schüz, Maria Feychting
Journal: Annual Review of Public Health (2019)

Mobile phones (MPs) are the most relevant source of radiofrequency electromagnetic field (RF-EMF) exposure to the brain and the salivary gland. Whether this exposure implies a cancer risk has been addressed in several case-control and few cohort studies. A meta-analysis of these studies does not show increased risks for meningioma, pituitary, and salivary gland tumors. For glioma and acoustic neuroma, the results are heterogeneous, with few case-control studies reporting substantially increased risks. However, these elevated risks are not coherent with observed incidence time trends, which are considered informative for this specific topic owing to the steep increase in MP use, the availability of virtually complete cancer registry data from many countries, and the limited number of known competing environmental risk factors. In conclusion, epidemiological studies do not suggest increased brain or salivary gland tumor risk with MP use, although some uncertainty remains regarding long latency periods (&gt;15 years), rare brain tumor subtypes, and MP usage during childhood.