tbuckley/cabot-search huggingface dataset:
AB0184 Diagnostic impact in the clinical setting of nailfold vieocapillaroscopy on connective diseases
Authors: C. Soleto, L. Torrens, J.C. Nieto González, Ana M. Anzola, Liz. Rocío Caballero Motta, Leticia. García, María Correyero. Plaza, D.D.D. González Benítez, Belén Serrano. Benavente, Julia Martínez. Barrio, Javier. López-Longo, Alfonso. Ariza, Indalecio Monteagudo. Sáez
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Nailfold video-capillaroscopy (NVC) is a non-invasive technique that allows visualisation of structure and distribution of capillaries at the nailfold level<sup>1</sup>, altered somehow in some connective diseases, specially in the Scleroderma (Scl) disease spectrum. The main indication of this technique is the investigation of Raynaud’s phenomenon (RF). <h3>Objectives</h3> Our objective is to investigate the diagnostic impact of NVC in the daily clinical practice. <h3>Methods</h3> The design is an observational, longitudinal, retrospective and descriptive study, which included patients with at least one NVC between June 2012 and December 2016 from our Rheumatology register of patients. We collected demographic data (age, gender, indication, autoantibodies, etc.), number of explorations performed and their result. We also collected in a dichotomist fashion if the NVC contributed in the diagnostic workup, between one consultation and the other after the NVC realisation. <h3>Results</h3> 437 patients were included with a total of 637 explorations. Of these 437 patients, 115 (24.1%) had a second NVC, 39 (8.2%) a third one, 9 (1.9%) a fourth and only two with a fifth NVC (both with diagnostic of Scl). We noticed a diagnostic change between the first consultation and the next one in 35 cases (5.49%). In 14/35 (40%) of these cases, the NVC played an important role in the diagnostic change, with changes in the NVC pattern, from normal or unspecific to Scl pattern (table 1). These changes, occurred after the first NVC in 10 patients (71.4%), 3 (21.4%) after the second, and 1 (7.1%) after the third exploration in addition of new disease manifestations, diagnostic tests and other image techniques. Of these 14 patients, 100% had positive ANA, 5 (35.7%) Anticentromere Antibodies (Ab), 1 (7.1%) anti-Ro Ab and 1 (7.1) Antiphospholipid Ab. <h3>Conclusions</h3> The NVC in our centre had a limited but important impact in the diagnostic process of connective diseases. This impact was specially relevant in patients diagnosed with Scleroderma. The probability of having a diagnostic change diminishes with successive explorations. <h3>Reference</h3> [1] Cutolo M, Pizzorni C, Secchi ME, Sulli A. Capillaroscopy. Best Pract Res Clin Rheumatol2008Dec;22(6):1093–108. <h3>Disclosure of Interest</h3> None declared
SAT0269 The effect of biologic disease-modifying antirheumatic drugs in targeting disease remission in axial spondyloarthritis (AXSPA): a systematic literature review
Authors: A.R. Cruz-Machado, S.R. Manica, J.L. Silva, F.M. Pimentel-Santos, J. Tavares-Costa, E. Vieira-Sousa
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The treat-to-target concept is currently recommended in axSpA management and remission is the main objective of treatment. Although consensual definitions of remission are lacking, most authors assume remission as a state of inactive disease or, alternatively, of low disease activity, as a near concept. In current practice, ASAS-Partial Remission (ASAS-PR) and ASDAS-Inactive Disease (ASDAS-ID) scores have gained wide acceptance as clinical remission-like definitions. <h3>Objectives</h3> In this review we assessed the efficacy of different biologic disease-modifying anti-rheumatic drugs (bDMARD) in achieving ASAS-PR or/and ASDAS-ID as remission-like primary outcomes. Data from randomised controlled trials (RCT) conducted in radiographic axSpA (r-axSpA) and non-radiographic axSpA (nr-axSpA) patients were included. <h3>Methods</h3> A systematic literature review was performed using the MEDLINE database (August 17 2017) with the filters "published in the last 10 years" and "humans". The PICO (P, population; I, intervention; C, comparison; O, outcome) concept was used to perform the analysis according to: Patients – adults (&gt;18 years old) with r-axSpA or nr-axSpA; Intervention – any bDMARD regardless of formulation or duration; Comparison – placebo and/or any different drug; Outcomes: ASAS-PR and ASDAS-ID. <h3>Results</h3> After screening 557 references (after de-duplication), 7 RCTs fulfilled the inclusion criteria, all concerning tumour necrosis factor inhibitors (TNFi) bDMARDs – table 1. ASAS-PR was the most commonly used remission-like definition- in 6 of the 7 trials, 1 of those as a composed measure with a magnetic resonance score. Despite different baseline populations (including r-axSpA and nr-axSpA), all these trials provide evidence of TNFi efficacy in achieving remission. The proportion of patients achieving ASAS-PR and ASDAS-ID varied between 33%–61.9% and 27.3%–55%, respectively, with a minimum and maximum follow-up periods of 28 to 254 weeks for ASAS-PR and 24 weeks to 5 years for ASDAS-ID. <h3>Conclusions</h3> Clinical trials addressing remission-like concepts as primary outcomes are scarce. ASAS-PR score was the most commonly used remission outcome. Depending on the studies, between one third to one half of patients treated with TNFi achieved ASAS-PR or ASDAS-ID. Considering nowadays aimed treatment targets, these data raise the unmet need for improved treatment options and strategies, that favour optimised remissions rates in axSpA patients. <h3>References</h3> [1] Braun2008. [2] Davis2008. [3] Sieper2011. [4] Sieper2012. [5] Song2012. [6] Sieper2013. [7] van Heijde2014. [8] van Heijde2016. [9] Smolen2017. <h3>Disclosure of Interest</h3> None declared
Ofatumumab Is Active and Safe in Patients with Relapsed/Refractory Splenic Marginal Zone Lymphoma (SMZL): Results from the Interim Analysis of an Italian Multicenter Phase 2 Study (MORE trial)
Authors: Lydia Scarfo, Silvia Ferrari, Annamaria Maria Frustaci, Monica Tani, Samantha Pozzi, Eloise Scarano, Maria Colia, Pamela Ranghetti, Maurilio Ponzoni, Paola Ronchi, Andres JM Ferreri, Paolo Ghia
Journal: Blood (2018)
Biophysicochemical Motifs in T-cell Receptor Sequences Distinguish Repertoires from Tumor-Infiltrating Lymphocyte and Adjacent Healthy Tissue
Authors: Jared Ostmeyer, Scott Christley, Inimary T. Toby, Lindsay G. Cowell
Journal: Cancer Research (2019)

Abstract Immune repertoire deep sequencing allows comprehensive characterization of antigen receptor–encoding genes in a lymphocyte population. We hypothesized that this method could enable a novel approach to diagnose disease by identifying antigen receptor sequence patterns associated with clinical phenotypes. In this study, we developed statistical classifiers of T-cell receptor (TCR) repertoires that distinguish tumor tissue from patient-matched healthy tissue of the same organ. The basis of both classifiers was a biophysicochemical motif in the complementarity determining region 3 (CDR3) of TCRβ chains. To develop each classifier, we extracted 4-mers from every TCRβ CDR3 and represented each 4-mer using biophysicochemical features of its amino acid sequence combined with quantification of 4-mer (or receptor) abundance. This representation was scored using a logistic regression model. Unlike typical logistic regression, the classifier is fitted and validated under the requirement that at least 1 positively labeled 4-mer appears in every tumor repertoire and no positively labeled 4-mers appear in healthy tissue repertoires. We applied our method to publicly available data in which tumor and adjacent healthy tissue were collected from each patient. Using a patient-holdout cross-validation, our method achieved classification accuracy of 93% and 94% for colorectal and breast cancer, respectively. The parameter values for each classifier revealed distinct biophysicochemical properties for tumor-associated 4-mers within each cancer type. We propose that such motifs might be used to develop novel immune-based cancer screening assays. Significance: This study presents a novel computational approach to identify T-cell repertoire differences between normal and tumor tissue. See related commentary by Zoete and Coukos, p. 1299
AB1419-HPR Clinic of pregnancy and rheumatic diseases: epidemiologic characterisation
Authors: I Perez Onofre, C.M. Skinner Taylor, L. Perez Barboza, D.A. Galarza Delgado, J.A. Soria Lopez, N.E. Rubio Perez
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Pregnancy in women with Rheumatic Diseases (RD) is of high risk and requires a close communication between the rheumatologist, obstetrician, and all other specialists involved.It may have an effect on the natural history of autoimmune disease, a phenomenon that is particularly relevant in Systemic Lupus Erythematous (SLE) and Rheumatoid Arthritis (RA). Additionally, there are consequences that autoimmune disease may yield throughout the course of conception and gestation. <h3>Objectives</h3> To describe the epidemiological characteristics of patients seen at the Clinic of Pregnancy and Rheumatic Diseases (Clínica de Embarazo y Enfermedades Reumáticas, CEER) located in the Jose E. Gonzalez University Hospital in Mexico. <h3>Methods</h3> We conducted a descriptive transversal study of a cohort of 50 adult patients that attended CEER; which were categorised within three consultation groups (reproductive age, with a present or future desire to become pregnant, pregnant or in postpartum period). All patients were evaluated by the Maternal-Fetal Medicine and Rheumatology department. CEER was created in, August 2017 and provided medical follow up for newly pregnant patients, those already pregnant, and patients in the immediate postpartum period. Epidemiological data was collected. <h3>Results</h3> Of the 50 patients, 8 (16%) with a present or future desire to become pregnant, 24 (48%) pregnant, just only one presented gestational diabetes; and 18 (36%) were in the immediate postpartum period. The median age was 32 years (<i>SD=6.16</i>). The 18 births were live births obtained by caesarean section, 8 (55.8%) were pre-term (<i>&lt;37</i> WG) and none presented eclampsia or preeclampsia. Of the patients, 22 (44%) had a diagnosis of RA, 10 (20%) had SLE, 10 (20%) had Antiphospholipid Syndrome, and the remaining 8 (16%) had other diagnoses (table 1). Only 18 (36%) had previous abortions. <h3>Conclusions</h3> The evaluation of patients with RD requires a close follow-up, which is why the population of reproductive age with RD must be seen early on. Considering that our results revealed a high percentage of preterm live births medical attention must be provided from the preconception to the postpartum period. <h3>References</h3> [1] Ching Soh May, Nelson-Piercy Catherine, High Risk pregnancy and the rheumatologist. Rheumatology. 2015;54(4): 572–587 [2] Alvarez-Nemegyei J. Cervantes-Diaz MT, Avila-zapata F, et al. Desenlace obstétrico antes y después del inicio de la artritis reumatoide. Rev Mex Imss2011;49:599–604 <h3>Disclosure of Interest</h3> None declared
FRI0010 Prediction of radiographic progression in patients with rheumatoid arthritis by both magnetic resonance imaging and ultrasound
Authors: A. Takatani, M. Tamai, N. Ohki, Y. Nakashima, Y. Endou, S. Tsuji, T. Shimizu, M. Umeda, S. Fukui, R. Sumiyoshi, A. Nishino, T. Koga, S. Kawashiri, N. Iwamoto, T. Igawa, K. Ichinose, K. Arima, H. Nakamura, T. Origuchi, S. Sato, M. Uetani, A. Kawakami
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Magnetic resonance imaging (MRI) and ultrasound (US) are both useful modality to monitor disease status of RA whereas combination analysis of disease course by both modalities are quite few. <h3>Objectives</h3> To clarify the predictors of radiographic progression in patients with RA examined by both MRI and US. <h3>Methods</h3> Thirty-three patients with active RA, managed with a treat-to-target strategy and checked disease activity score every three months along with examination of both MRI and US, were enrolled from June 2010 to June 2016 and observed for 12 months. US of wrist and finger joints was examined every three months, MRI and radiograph were done every six months. US were evaluated by synovitis score of semi-quantitative manner by gray-scale (GS) and power Doppler (PD) proposed from EULAR. In MRI, synovitis, bone oedema and bone erosion were assessed by the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system (RAMRIS). Radiographic bone erosion and joint space narrowing (JSN) were scored by Genant-modified Sharp Score (GSS). Radiographic progression was defined as delta radiographic score &gt;0.5. Multivariate analysis was employed to clarify independent predictors for radiographic progression at 12 month. <h3>Results</h3> Thirteen patients were treated with methotrexate monotherapy and eighteen were received combination of methotrexate and biologics. Three were given biologic monotherapy. Median of age was 57.0 years and that of disease duration was 9 months. Female was 84.8%, positive rate of RF was 87.1% and that of ACPA was 79.3%. DAS28-CRP was 4.20, total GS score 6.0, total PD score 4.0, MRI synovitis score 6.0, MRI bone oedema score 3.0, MRI bone erosion score 3.0, and GSS score 1.0 at baseline. Radiographic progression was found in 12 patients. Multivariate analysis revealed that high MRI bone oedema score at baseline, high MRI bone oedema score and PD ≧ grade 2 articular synovitis at any joints at 6 month were associated with radiographic progression at 12 months. Clinical indices of DAS28-CRP at any point did not predict radiographic progression compared with MRI or US. <h3>Conclusions</h3> During treat-to-target strategy, the presence of MRI bone oedema as well as PD ≧ grade 2 articular synovitis are found to be important to predict radiographic outcome in active RA patients. These imaging indices may be more sensitive to monitor radiographic progression as compared with clinical indices. <h3>Disclosure of Interest</h3> None declared
Effect of tacrolimus on skin microbiome in atopic dermatitis
Authors: Jongkonnee Wongpiyabovorn, Wipasiri Soonthornchai, Alisa Wilantho, Matanee Palasuk, Sunchai Payungporn, Pimpayoi Sodsai, Withaya Poomipak, Sinee Weschawalit, Kriangsak Ruchusatsawat, George S. Baillie, Nattiya Hirankarn, Naraporn Somboonna
Journal: Allergy (2019)

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Delayed ischaemic contracture onset by empagliflozin associates with NHE1 inhibition and is dependent on insulin in isolated mouse hearts
Authors: Laween Uthman, Rianne Nederlof, Otto Eerbeek, Antonius Baartscheer, Cees Schumacher, Ninée Buchholtz, Markus W Hollmann, Ruben Coronel, Nina C Weber, Coert J Zuurbier
Journal: Cardiovascular Research (2019)

Sodium glucose cotransporter 2 (SGLT2) inhibitors have sodium-hydrogen exchanger (NHE) inhibition properties in isolated cardiomyocytes, but it is unknown whether these properties extend to the intact heart during ischaemia-reperfusion (IR) conditions. NHE inhibitors as Cariporide delay time to onset of contracture (TOC) during ischaemia and reduce IR injury. We hypothesized that, in the ex vivo heart, Empagliflozin (Empa) mimics Cariporide during IR by delaying TOC and reducing IR injury. To facilitate translation to in vivo conditions with insulin present, effects were examined in the absence and presence of insulin.Isolated C57Bl/6NCrl mouse hearts were subjected to 25 min I and 120 min R without and with 50 mU/L insulin. Without insulin, Empa and Cari delayed TOC by 100 and 129 s, respectively, yet only Cariporide reduced IR injury [infarct size (mean ± SEM in %) from 51 ± 6 to 34 ± 5]. Empa did not delay TOC in the presence of the NHE1 inhibitor Eniporide. Insulin perfusion increased tissue glycogen content at baseline (from 2 ± 2 µmol to 42 ± 1 µmol glycosyl units/g heart dry weight), amplified G6P and lactate accumulation at end-ischaemia, thereby decreased mtHKII and exacerbated IR injury. Under these conditions, Empa (1 µM) and Cariporide (10 µM) were without effect on TOC and IR injury. Empa and Cariporide both inhibited NHE activity, in isolated cardiomyocytes, independent of insulin.In the absence of insulin, Empa and Cariporide strongly delayed the time to onset of contracture during ischaemia. In the presence of insulin, both Empa and Cari were without effect on IR, possibly because of severe ischaemic acidification. Insulin exacerbates IR injury through increased glycogen depletion during ischaemia and consequently mtHKII dissociation. The data suggest that also in the ex vivo intact heart Empa exerts direct cardiac effects by inhibiting NHE during ischaemia, but not during reperfusion.
FRI0135 Have prevalence of joint surgery decreased with the use of biotherapy in rheumatoid arthritis?
Authors: O. Saidane, M. Sellami, R. Barhoumi, A. Ben Tekaya, H. Ajlani, R. Tekaya, I. Mahmoud, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Biological response modifiers have greatly expanded therapeutic arsenal of rheumatoid arthritis (RA) leading to a better control of inflammation, a reduced long-term complications and a prevention of joint damage. <h3>Objectives</h3> Our objective was to assess the impact of use of biologics on joint surgery during RA. <h3>Methods</h3> This is a retrospective study including patients with RA according to American College of Rheumatology (1987) followed- over 15 years period [2000–2014]. We excluded patients who underwent joint surgery without direct relevance to RA. The significance level was set at 0.05. <h3>Results</h3> A total of 500 RA patients (422 women and 78 men) were enrolled in this period. The mean age was 53.3 years (21–83) and the mean disease duration was 12 years (2–40). Rheumatoid factor was positive in 71.4% cases. A high disease activity was noted at diagnosis with a mean disease activity score of 5.90±1.38. The mean Health Assessment Questionnaire index was 1.62 [0.2 à 3]. All patients received at least 2 conventional disease-modifying antirheumatic drugs, one of which was methotrexate. Twenty seven per cent of RA patients (135 patients) received biologics: 35 patients received Rituximab (7%) and 100 patients (20%) received anti TNF α (infliximab, etanercept and adalimumab in 10%, 6.8% and 3.2% respectively). The trend curve of biologics use showed a linear increase with spikes of use in 2008, 2011 and 2014. A surgical act was considered necessary in 59 cases (11.8%) mainly total knee arthroplasty (56%). The mean duration between the onset of RA and surgery was 7.02 (1–33). Patients who received biologics had less joint surgery without significant association (p=0.350). The joint surgery showed a decrease in the number of procedures from 2004, concomitantly with promoting biologics. <h3>Conclusions</h3> Our study concluded that joint surgery was less frequent in RA patients who received biologics without a significant association. <h3>Disclosure of Interest</h3> None declared
SP0070 What are gout guidelines good for ?
Authors: T. Bardin
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Guidelines aim to help physicians to make decisions in daily practice for an individual patient with a given condition. Guidelines should therefore be clear, easily readable and understandable by all physicians involved in disease care. They should also be as simple and brief as possible to be easily memorised by physicians, and this is a real challenge when guidelines aim at a full coverage of gout management. Most importantly, they cannot be taken as strict rules with legal implications. The final decisions concerning an individual patient remain in the hands of the responsible physician. Guideline methodology has improved over years but still varies across recently published works. Ad hoc committees regularly involve all specialities involved in the disease care, and in the case of gout, general practitioners, who take care of most gout patients are now included but their number vary. Patients are not always included, despite being the final target of guidelines. Conflicts of interest of participating physicians are taken into account to a varying extent. The guideline development process involves an evaluation of all evidence available at the time of writing. Treatment impact on outcome, and assessment of drug benefit ratios are unanimously considered as important in the elaboration of guidelines. Factors such as drug pricing, availability and local regulatory agency recommendations, for instance about reimbursement, also matter, as guidelines should be practical in order to help physicians, but are rarely taken into account in guidelines. There are several levels of evidence and the best ones, such as randomised placebo-controlled trials (RCT) or RCT meta-analyses are not available in all aspects of gout management. A large part of the published guidelines on the management of gout therefore relies on expert opinion, which remains fragile and may vary from one group to the other. The numerous guidelines presently available for gout management exhibit more or less striking differences, and this diversity does not help guidelines to reach their goal. In this regard, the major differences observed between the simple and short guidelines issued by the American College of Physicians and the usually more complicated recommendations from the Rheumatology societies are the most detrimental. Pursuing therapeutic research on gout management and improving guideline methodology appear as sine qua non conditions to reach consensus and improve gout management. <h3>Disclosure of Interest</h3> T. Bardin Consultant for: astraZeneka, ipsen menarini, novartis