tbuckley/cabot-search huggingface dataset:
Survivorship Science at the NIH: Lessons Learned From Grants Funded in Fiscal Year 2016
Authors: Julia H Rowland, Lisa Gallicchio, Michelle Mollica, Nicole Saiontz, Angela L Falisi, Gina Tesauro
Journal: JNCI Journal of the National Cancer Institute (2018)

Federal investment in survivorship science has grown markedly since the National Cancer Institute's creation of the Office of Cancer Survivorship in 1996. To describe the nature of this research, provide a benchmark, and map new directions for the future, a portfolio analysis of National Institutes of Health-wide survivorship grants was undertaken for fiscal year 2016. Applying survivorship-relevant terms, a search was conducted using the National Institutes of Health Information for Management, Planning, Analysis and Coordination grants database. Grants identified were reviewed for inclusion and categorized by grant mechanism used, funding agency, and principal investigator characteristics. Trained pairs of coders classified each grant by focus and design (observational vs interventional), population studied, and outcomes examined. A total of 215 survivorship grants were identified; 7 were excluded for lack of fit and 2 for nonresearch focus. Forty-one (19.7%) representing training grants (n = 38) or conference grants (n = 3) were not coded. Of the remaining 165 grants, most (88.5%) were funded by the National Cancer Institute; used the large, investigator-initiated (R01) mechanism (66.7%); focused on adult survivors alone (84.2%), often breast cancer survivors (47.3%); were observational in nature (57.3%); and addressed a broad array of topics, including psychosocial and physiologic outcomes, health behaviors, patterns of care, and economic/employment outcomes. Grants were led by investigators from diverse backgrounds, 28.4% of whom were early in their career. Present funding patterns, many stable since 2006, point to the need to expand research to include different cancer sites, greater ethnoculturally diverse samples, and older (>65 years) as well as longer-term (>5 years) survivors and address effects of newer therapies.
Performance of Candidate Serum Biomarkers for Systemic Sclerosis–Associated Interstitial Lung Disease
Authors: Muriel Elhai, Anna Maria Hoffmann‐Vold, Jérôme Avouac, Sonia Pezet, Anne Cauvet, Agathe Leblond, Håvard Fretheim, Torhild Garen, Masataka Kuwana, Øyvind Molberg, Yannick Allanore
Journal: Arthritis & Rheumatology (2019)

Objective Interstitial lung disease ( ILD ) in systemic sclerosis ( SS c) runs a highly variable course, and prediction tools are highly desired. The aim of this study was to assess the diagnostic and prognostic performance of 4 candidate serum biomarkers for SS c‐associated ILD . Methods Serum samples from a combined cohort of SS c patients (from Paris, France and Oslo, Norway; n = 427) were analyzed by enzyme‐linked immunosorbent assay for concentrations of lung epithelial–derived surfactant protein D ( SP ‐D), Krebs von den Lungen 6 glycoprotein ( KL ‐6), CCL 18, and OX 40 ligand ( OX 40L). Lung fibrosis was measured by high‐resolution computed tomography and pulmonary function tests. Associations of these candidate biomarkers with baseline disease involvement and prediction of disease progression over time (mean ± SD follow‐up 3.2 ± 4.4 years) were investigated. Results In SS c patients at baseline, serum levels of KL ‐6 correlated with the forced vital capacity ( FVC ) (r = −0.317, P &lt; 0.001), diffusing capacity for carbon monoxide (r = −0.335, P &lt; 0.001), and extent of lung fibrosis (r = 0.551, P &lt; 0.001). In multivariate analyses, serum levels of KL ‐6 and SP ‐D, but not CCL 18 and OX 40L, were associated with lung fibrosis (odds ratio [ OR ] 2.41, 95% confidence interval [95% CI ] 1.43–4.07 [ P = 0.001] and OR 3.15, 95% CI 1.81–5.48 [ P &lt; 0.001], respectively). In SS c patients with ILD at baseline, longitudinal, multivariate analyses showed that CCL 18 serum levels were an independent predictor of a &gt;10% decrease in the FVC (hazard ratio [ HR ] 2.90, 95% CI 1.25–6.73; P = 0.014) and de novo development of extensive disease ( HR 3.71, 95% CI 1.02–13.52; P = 0.048). Matrix‐based logistic regression models for the diagnosis and prognosis of SS c‐associated ILD were constructed, and these models discriminated 3 groups of risk (mild, moderate, or high) for the diagnosis or worsening of lung fibrosis according to the serum levels of SP ‐D (for diagnosis) and serum levels of CCL 18 (for progression of disease). Conclusion These results show that SP ‐D is a relevant diagnostic biomarker for SS c‐associated ILD , whereas KL ‐6 could be used to assess the severity of lung fibrosis. CCL 18 appears to be a potential predictive marker for progression of ILD in SS c.
SAT0164 Adverse drug reactions due to disease modifying drugs in patients with incident rheumatoid arthritis
Authors: Z. Rosales Rosado, D. D. Freites NÚÑEZ, C. Lajas Petisco, E. Pato Cour, León Mateos, L. Abásolo Alcázar
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> There is a well-known risk of developing adverse drug reactions (ADR) in rheumatology due, mainly, to the Disease Modifying Antirheumatic Drugs (DMARD) used. There is no doubt about their efficacy in Rheumatoid Arthritis (RA), but it is necessary to increase our knowledge of their ADR, especially those that lead to discontinuation <h3>Objectives:</h3> To describe the incidence and characteristics of ADR related with DMARD in patients with incident RA as well as the factors involved in their development <h3>Methods:</h3> Observational retrospective longitudinal study between April 15th 2007 and December 31st 2016. Inclusion criteria: patients diagnosed with RA between April 15th 2007 and June 31st 2011 followed until December 31st 2016 whom started any DMARD. Primary endpoint: development of an ADR that required discontinuation of the DMARD (moderate: discontinuation; severe: discontinuation with hospitalization or death). Co-variables: sociodemographic; clinical and therapy. Statistical analysis: incidence rates of discontinuation (IR) per 100 patient-years were estimated using survival techniques with their respective 95% confidence interval [CI]. Comparisons between associated factors were run by Cox bivariate and multivariate regression models. Results were expressed by hazard ratio (HR) and [CI] <h3>Results:</h3> We included 1054 courses of DMARD treatment in 405 patients (2277.9 patient-years). 78.3% were women with a mean age at diagnosis of 57±15 years. During follow-up, 16.3% of patients were taking biological DMARD, 73.3% were using monotherapy and 89% were taking corticoids. There were 369 ADR in 212 patients, 88.9% moderate. Gastrointestinal was the most frequent cause of ADR (26.3%), followed by infections (12.2%). IR are shown in table 1 and the multivariate analysis in table 2. Regarding type of DMARD, Abatacept had the highest risk of ADR development (HR:4.9[2.1–11.2]) compared to the other drugs followed by Gold (HR:1.6[1–2.6]) and Leflunomide (HR:1.4[1.1–1.9]). Methotrexate was the safest drug compared with the others (0.6[0.5–0.8]) <h3>Conclusions:</h3> The IR of ADRwas 16.2%, being similar in all age categories. Gastrointestinal was the main cause of ADR followed by infections. We have found differences in discontinuation rates among DMARD due to ADR, being Abatacept, Gold and Leflunomide the drugs with the highest risk. Methotrexate had a lower risk of ADR compared to other DMARD. Caution should be taken in patients receiving combined therapy and with certain comorbidities <h3>Disclosure of Interest:</h3> None declared
AB1250 Vaccination awareness and uptake in inflammatory arthritis patients
Authors: K. Murray, A. O’Rourke, C. Low, F. Young, E. Feeney, D.J. Veale
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Inflammatory arthritides (IA) increase infection risk. The Centre for Disease Control and Prevention recommends influenza vaccination for all adults and pneumococcal vaccine for &gt;65 years old and under 64 years receiving certain immunosuppressive therapies, including TNF inhibitors. <h3>Objectives</h3> We examined patients' knowledge, uptake and attitudes to influenza and pneumococcal vaccination and opportunities to increase vaccination rates in our IA clinic. <h3>Methods</h3> Patients attending the IA Clinic completed an anonymous 23 question worksheet recording demographic details, medical history, medications, knowledge about vaccinations, vaccination status, reasons for non-vaccination and availability and willingness to use smartphone for healthcare records. <h3>Results</h3> 329 patients completed the survey. Respondents were predominantly female (78%). 69% were &gt;50 years old. 82% had completed secondary education. 59% of patients had rheumatoid arthritis, 11% had psoriatic arthritis and 30% other conditions. 29% of patients were taking a biological DMARD, 27% using methotrexate and 19% oral steroids. 52% knew some rheumatological conditions increase infection risk. 54% knew some rheumatological medications can increase infection risk. 66% knew influenza vaccination was recommended, most commonly via their general physician (GP) (70%). 50% of patients were up to date with their 'flu' vaccination, mainly (75%) via their GP. Reasons for non-vaccination included lack of awareness (45%) and fear of side effects (25%). 29% knew pneumococcal vaccination may be indicated, 78% of whom were informed by their GP. 33% of patients were up to date with their pneumococcal vaccine. 80% cited lack of awareness for non-vaccination. 70% of patients had smart phone access. 74% of these were willing to use this for their healthcare record and reminders re vaccination. <h3>Conclusions</h3> These data show low awareness amongst IA patients of the risk of immunosuppression associated with their disease and treatments and the need for regular vaccinations. Mobile technology may help increase vaccination rates. <h3>Disclosure of Interest</h3> None declared
Abstract 20169: The Role of Pathological Strain on Pulmonary Vein Endothelial Cells
Authors: Rachel Vanderlaan, Yaqin Fu, Nitin Rai, Yanting Wang, Christopher Caldarone
Journal: Circulation (2017)

Introduction: Clinical evidence suggests that high pulmonary blood flow states or local flow disturbances could play a role in the progression of pulmonary vein stenosis (PVS); however, it has not ...
Gut Colonization with Carbapenem Resistant Enterobacteriaceae(CRE) Leads to More Chemotherapy Inerruptions and Higher Mortality in Patients with Acute Leukemias Receiving Remission Induction Chemotherapy
Authors: Sweta Kothari, Rishi Dhawan, Mukul Aggarwal, Tulika Seth, Sarita Rath, Manoranjan Mahapatra
Journal: Blood (2018)
Abstract MP16: Trends in Statin Utilization Among Adults With Severe Peripheral Artery Disease Including Critical Limb Ischemia in an Integrated Healthcare Delivery System
Authors: Kristi Reynolds, Katie Mues, Lei Qian, Songyue Chen, Teresa N Harrison, Jin-Wen Y Hsu, Kiran J Philip, Keri L Monda, Stephanie Reading, Somjot Brar
Journal: Circulation (2018)

Background: Studies have demonstrated benefit of statin therapy in patients with peripheral artery disease (PAD). However, use of statins in patients with PAD has been found to be suboptimal. We examined trends in statin use and discontinuation among adults with severe PAD including critical limb ischemia (CLI) from 2002-2015. Methods: Using electronic health record data from a large, integrated healthcare delivery system, we identified patients aged ≥40 yrs with incident severe PAD/CLI and 12 months of prior continuous coverage of health and drug benefits. Statin intensity was defined at first prescription fill. Discontinuation of statin therapy was defined as the first 90-day gap in treatment within 1 yr after diagnosis. Results: We identified 11,059 patients with incident severe PAD/CLI from 2002-2015. Mean (SD) age was 69 (11.3) yrs, 40% were female, 54% were White, 23% Hispanic, 16% Black and 4% Asian/Pacific Islander. Statin use in the yr before diagnosis increased from 50% in 2002 to 66% in 2015. Overall, 60% (n=6578) were on a statin in the yr before diagnosis. Of these patients, 18%, 54% and 28% were receiving high, moderate and low intensity statins, respectively. The proportion of patients on high intensity statins increased from 7.3% in 2002 to 41.9% in 2015 while the proportion on low intensity statins decreased (Figure). Of the 40% (n=4481) who were not on a statin in the yr before diagnosis, 13.5% (n=607) newly initiated statin therapy within 1 month after diagnosis. The proportion of patients with no statin use increased with increasing LDL-C, while the percentage with any statin use decreased (Figure). Following diagnosis of PAD/CLI, 13% discontinued statin therapy within 1 yr. Conclusions: Use of statins and high intensity statins increased from 2002-2015 among a population of patients with severe PAD including CLI. However, a substantial proportion remained untreated with statins, representing a significant treatment gap in this population at high risk for cardiovascular events and adverse limb outcomes.
THU0409 Management of systemic sclerosis (SSC) related digital ulcers (DU) in expert tertiary centres: results from the analysis of the multicentre observational real-life desscipher/eustar study
Authors: J. Blagojevic, G. Abignano, Y. Allanore, J. Avouac, L. Cometi, L. Czirják, C. Denton, O. Distler, M. Frerix, S. Guiducci, D. Huscher, V.K. Jaeger, V. Lóránd, B. Maurer, S. Nihtyanova, G. Riemekasten, E. Siegert, G. Valentini, S. Vettori, U.A. Walker, U. Müller-Ladner, F. Del Galdo, M. Matucci-Cerinic
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> In SSc, the management of DU is a real clinical challenge. It includes the use of vasoactive and vasodilating drugs, but no comparative studies between agents are available. DeSScipher was the first European multicentre observational study with the aim to decipher the optimal management of SSc. <h3>Objectives</h3> To assess in expert centres the current therapeutic strategy for the management of SSc related DU. <h3>Methods</h3> Baseline demographic and clinical characteristics of patients enrolled in the DeSScipher/EUSTAR ulcer study and detailed data regarding DU were analysed. <h3>Results</h3> There were 1823 patients enrolled in this study. 277 (15.2%) presented DU at the enrolment visit, 628 (34.4%) had previous DU and 918 (50.4%) had never experienced DU. Patients with DU (current or previous) were more frequently anti-Scl70 positive, had more frequently the diffuse cutaneous subset (40.8% vs 26.7% (p&lt;0.000)), gastro-esophageal symptoms (70% vs 63.4% (p=0.002)) and lung fibrosis on lung Rx or HRCT (65.7% vs 54% (p=0.001)) compared to patients without DU. There were no significant differences in the prevalence of pulmonary hypertension (7.3% patients with DU vs 5.3% patients without DU, p=0.87). Treatment of patients with and without DU is shown in table 1. Information on recurrent DU were available for 779 (86.1%) of patients with DU. Treatment of patients with and without recurrent DU is shown in table 2. <h3>Conclusions</h3> 90% of SSc patients were on vasodilating and/or vasoactive treatment regardless of the history/presence of DU. Recurrent DU were treated aggressively, using in 75% of cases Bosentan and Sildenafil combination therapy. Our data indicate frequent use of Sildenafil and Bosentan for DU management in specialised centres, especially for recurrent DU. <h3>Disclosure of Interest</h3> None declared
Inherited NUDT15 Variants Substantially Increased Infection and Related Medical Cost in Children with Acute Lymphoblastic Leukemia
Authors: Jiabi Qian, Chuang Jiang, Qian Wenji, Wenge Hao, Jiayi WANG, Yingyi He, Hua Jiang, Yin Ting Cheung, Hui Zhang
Journal: Blood (2018)
Abstract 16341: Trends of Inpatient Burden of Primary Pulmonary Hypertension in USA: Analysis of Nationwide Inpatient Sample Database From 2001-2012
Authors: Vidhu Anand, Thenappan Thenappan
Journal: Circulation (2015)

Background: Primary pulmonary hypertension (PPH) is a rare pulmonary vascular disease characterized by endothelial dysfunction and vascular remodeling of small pulmonary arteries, resulting in elevated pulmonary artery pressures. The cause of endothelial dysfunction is usually unknown. PPH is a progressive disease resulting in reduced cardiac output, right heart failure, and death. We aimed to evaluate the characteristics of hospitalizations for PPH in United States. Methods: We analyzed the National Inpatient Sample Database (NIS) for all subjects in which PPH (ICD code 416.0) was the principal discharge diagnosis from 2001-2012. Data is presented as mean ± SE. Results: In 2001, there were 3177 admissions with a principal discharge diagnosis of PPH as compared to 1345 in 2012 (p&lt;0.001) (Figure). Rate of discharge per 100,000 persons decreased significantly from 1.1 ± 0.1 to 0.4± 0.0 (p&lt;0.001). However, the mean length of stay (7.03±0.5 in 2001 vs 7.6±0.6 in 2001, p= 0.5) and in-patient mortality (7.75±1.07 % in 2001 vs 6.32±1.68 % in 2001, p= 0.47) has not changed significantly between 2001 and 2012. It is important to note that during this period the mean hospital charges increased by 269.8 % from $29507 per patient in 2001 to $79607 per patient in 2012 (p&lt;0.0001). In 2012, 68% of patients were between ages 45-84 years and 72.9% were females. Medicare was billed for about half the hospital stays in 2012 (49.4%). The routine discharges constituted about 62.45% of total discharges, followed by home health care (18.6%) and nursing home/ rehab (6.7%). Conclusion: The number of inpatient admissions and rate of discharge for primary pulmonary hypertension has decreased significantly over the last 13 years. The cost associated with these admissions has however increased substantially, even though there is no significant change in the duration of inpatient stay and inpatient mortality rates.
Revised Adult T-Cell Leukemia-Lymphoma International Consensus Meeting Report
Authors: Lucy B. Cook, Shigeo Fuji, Olivier Hermine, Ali Bazarbachi, Juan Carlos Ramos, Lee Ratner, Steve Horwitz, Paul Fields, Alina Tanase, Horia Bumbea, Kate Cwynarski, Graham Taylor, Thomas A. Waldmann, Achilea Bittencourt, Ambroise Marcais, Felipe Suarez, David Sibon, Adrienne Phillips, Matthew Lunning, Reza Farid, Yoshitaka Imaizumi, Ilseung Choi, Takashi Ishida, Kenji Ishitsuka, Takuya Fukushima, Kaoru Uchimaru, Akifumi Takaori-Kondo, Yoshiki Tokura, Atae Utsunomiya, Masao Matsuoka, Kunihiro Tsukasaki, Toshiki Watanabe
Journal: Journal of Clinical Oncology (2019)

Adult T-cell leukemia-lymphoma (ATL) is a distinct mature T-cell malignancy caused by chronic infection with human T-lymphotropic virus type 1 with diverse clinical features and prognosis. ATL remains a challenging disease as a result of its diverse clinical features, multidrug resistance of malignant cells, frequent large tumor burden, hypercalcemia, and/or frequent opportunistic infection. In 2009, we published a consensus report to define prognostic factors, clinical subclassifications, treatment strategies, and response criteria. The 2009 consensus report has become the standard reference for clinical trials in ATL and a guide for clinical management. Since the last consensus there has been progress in the understanding of the molecular pathophysiology of ATL and risk-adapted treatment approaches.Reflecting these advances, ATL researchers and clinicians joined together at the 18th International Conference on Human Retrovirology-Human T-Lymphotropic Virus and Related Retroviruses-in Tokyo, Japan, March, 2017, to review evidence for current clinical practice and to update the consensus with a new focus on the subtype classification of cutaneous ATL, CNS lesions in aggressive ATL, management of elderly or transplantation-ineligible patients, and treatment strategies that incorporate up-front allogeneic hematopoietic stem-cell transplantation and novel agents.As a result of lower-quality clinical evidence, a best practice approach was adopted and consensus statements agreed on by coauthors (> 90% agreement).This expert consensus highlights the need for additional clinical trials to develop novel standard therapies for the treatment of ATL.
FRI0498 Comparative study of the treatment of refractory cystoid macular oedema to conventional immunosuppressive therapy: tocilizumab vs anti-tnf. multicenter study of 59 patients
Authors: J.L. Martín-Varillas, V. Calvo-Río, R. Demetrio-Pablo, B. Atienza-Mateo, J. Loricera, M.V. Hernández, A. Adán, M. Mesquida, S. Insua, J.M. Herreras, O. Maíz, A. Blanco, M. Gandía, D. Díaz, L. Martínez, E. Valls, G. Díaz, M. Díaz, I. Calvo, I. Torre, A. Atanes, L. Linares, M. Hernández, E. Beltrán, M. Cordero, E. Aurrecoechea, F.F. Hernández, R. Almodovar, Ó. Ruiz, F. Jiménez, J.M. Nolla, C. Modesto, M.A. González-Gay, R. Blanco
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Cystoid macular oedema (CME) is the most serious complication of uveitis. This potentially severe complication may lead to irreversible visual loss.<sup><b>1–2</b></sup> <h3>Objectives</h3> To compare efficacy and safety of Tocilizumab (TCZ) vs. Anti-TNF-α drugs in patients with refractory CME to conventional immunosuppressant (IS). <h3>Methods</h3> Multicenter study of patients with refractory CME to treatment with glucocorticoids and at least 1 conventional IS. The main objective was the improvement of macular thickness. Secondary objectives were the enhancement in best corrected visual acuity (BCVA) and the degree of ocular inflammatory activity. <h3>Results</h3> 59 patients/112 affected eyes. Causes of uveitis were: Behçet's disease (n=41), Birdshot's retinochoroidopathy (n=4), Juvenile Idiopathic Arthritis (n=9), Sarcoidosis (n=1) and idiopathic (n=4). No significant differences were observed at baseline in both groups (TCZ vs Anti-TNF-α) in sex (♂/♀; 8/17 vs. 15/19), mean age (35.6±18.9 vs 40.0±9.1), BCVA (0.40±0.31 vs. 0.48±0.31), Tyndall (1 [0–1] vs. 1 [0–2]), vitritis (1 [0–2] vs. 1 [0–3]) and macular thickness (431.8±165.9 vs. 397.1±138.1) (table 1). 25 patients were treated with TCZ as follows: 8 mg/kg/4 weeks (n=24) and 162 mg sc/2 weeks (n=1). Anti-TNF-α therapy was used in the remaining 34 as follows: IFX (n=12) (5 mg/kg 0, 2 y 6 weeks and every 4–8 weeks) and ADA (n=22) (40 mg/sc/2 weeks). We observed a rapid and sustained improvement in macular thickness after 1 year follow-up in both groups, without objectifying significant differences between them. In the same way, secondary ocular parameters also improved (table 1). <h3>Conclusions</h3> TCZ and Anti-TNF-α are effective in the treatment of CME refractory to conventional therapy. <h3>References</h3> [1] Calvo-Río V, Blanco R, Beltrán E, et al. Anti-TNF-alfa therapy in patients with refractory uveitis due to Behçet's disease: a 1-year-follow-up study of 124 patients. Rheumatol. 2014;53(12):2223–31. [2] Calvo-Río V, Blanco R, Santos-Gómez M, et al. Efficacy of anti-il6-receptor tocilizumab in refractory cystoid macular edema of Birdshot retinochoroidopathy report of two cases and literature review. Ocul Immunol Inflamm. 2017;25(5):604–609. <h3>Disclosure of Interest</h3> None declared