tbuckley/cabot-search huggingface dataset:
Abstract 16398: Comparison of Major Bleeding Risk and Associated Costs Among Newly Anticoagulated Non-valvular Atrial Fibrillation Patients
Authors: Steven Deitelzweig, Amanda Bruno, Natalie Tate, Augustina Ogbonnaya, Manan Shah, Eileen Farrelly, Tasneem Lokhandwala, Kiran Gupta, Michael Eaddy
Journal: Circulation (2015)

Real-world evidence highlighting the risks and benefits of novel oral anticoagulants (NOCAs) is lacking. This study compared major and clinically relevant non-major (CRNM) bleeding risk and costs among non-valvular atrial fibrillation (NVAF) patients newly treated with apixaban, dabigatran, rivaroxaban, or warfarin. A retrospective analysis of NVAF patients newly treated with apixaban, dabigatran, rivaroxaban, or warfarin was conducted using PharMetrics Plus data from 1/ 2012 - 9/ 2014. Patients were indexed on the date of the first anticoagulant prescription, and were required to be ≥18 years old and have CHA 2 DS 2 -VASc score &gt; 0 and ≥ 1 month of follow-up. Patients were followed until discontinuation (≥30-day gap in treatment), treatment switch, end of continuous enrollment, 1 year post-index, or end of study. Major and CRNM bleeding, and bleeding-related costs were measured. Cox proportional hazards model was used to examine the association between anticoagulants and risk of bleeding and GLM was used to evaluate bleeding-related costs. The study included 24,573 NVAF patients; distributed as apixaban 11.7%, dabigatran 12.0%, rivaroxaban 36.7%, and warfarin 39.6%. Mean age was 64.4 and 66.5% were males. HAS-BLED and CHA 2 DS 2 -VASc scores averaged 2.0 and 2.7, respectively. After adjusting for differences in baseline characteristics, when compared to apixaban patients, rivaroxaban (HR: 1.5; P =0.0013) and warfarin (HR: 1.7; P &lt;0.0001) patients were more likely to have major bleeding, and dabigatran (HR: 1.3; P =0.0030), rivaroxaban (HR: 1.7; P &lt;0.0001), and warfarin (HR: 1.4; P &lt;0.0001) patients were more likely to have CRNM bleeding. Major bleeding risk was similar between apixaban and dabigatran patients. Major and CRNM bleeding costs, when compared to apixaban patients ($154 and $18), were significantly higher for dabigatran ($457; P &lt;0.0001 and $39; P &lt;0.0001), rivaroxaban ($420; P &lt;0.0001 and $61; P &lt;0.0001), and warfarin ($511; P &lt;0.0001 and $63; P &lt;0.0001) patients. Among anticoagulant-naive moderate-to-high risk NVAF patients encountered in real-world clinical setting, major bleeding was lower with apixaban compared to warfarin and rivaroxaban. Bleeding costs were lower with apixaban compared to alternative NOACs and warfarin.
AB0287 Decrease in 14–3–3eta protein levels is correlated with improvement of clinical disease activity in tofacitinib treated early rheumatoid arthritis patients
Authors: O. Shovman, B. Gilburd, A. Watad, H. Amital, P. Langevitz, N.L. Bragazzi, M. Adawi, D. Pérez, M. Blank, N.K. Biln, A. Marotta, Y. Shoenfeld
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> 14–3–3η protein is a proinflammatory mediator that may represent a novel diagnostic and prognostic biomarker for rheumatoid arthritis (RA). <h3>Objectives</h3> To assess the disease activity parameters and 14–3–3η protein concentrations in serum of early RA patients treated with Tofacitinib. <h3>Methods</h3> Paired serum samples from 35 previously non-treated early RA patients (disease onset less than 1 year) receiving Tofacitinib were obtained at baseline and 5 months after the initiation of treatment. Levels of 14–3–3η were measured by JOINT stat 14–3–3η ELISA test kits (Augurex Life Sciences Corp.). The cut-off was defined as 0.19 ng/ml. We investigated the correlation between changes in serum 14–3–3η concentrations and changes in clinical disease activity index (CDAI), simplified disease activity index (SDAI), Disease Activity Score (DAS) 4CRP and DAS4ESR. <h3>Results</h3> Increased concentrations of 14–3–3η were found in 57% of the patients at baseline and in 37% of the patients after 5 months of treatment. Mean ±SD baseline 14–3–3η concentrations [4.92±8.86 ng/ml] were significantly higher (p=0.005) than those found following treatment [1.97±4.59 ng/ml]. Statistically significant improvement (p&lt;0.001) of CDAI, SDAI, DAS4ESR and DAS4CRP was achieved after the 5 month of treatment. No correlation was found between absolute 14–3–3η concentrations and parameters of clinical disease activity at both time points. Decrease in 14–3–3η protein levels were highly correlated with improvement in DAS4ESR (r=0.50, p&lt;0.01) and moderately correlated with improvement in CDAI (r=0.32), SDAI (r=0.33), and DAS4CRP (r=0.46, p&lt;0.01). <h3>Conclusions</h3> The study demonstrates that decrease in 14–3–3η protein concentrations in RA patients treated with Tofacitinib is correlated with improvement of clinical disease activity parameters. 14–3–3η protein is a useful biomarker for monitoring Tofacitinib therapy. <h3>Disclosure of Interest</h3> O. Shovman: None declared, B. Gilburd: None declared, A. Watad: None declared, H. Amital: None declared, P. Langevitz: None declared, N. L. Bragazzi: None declared, M. Adawi: None declared, D. Pérez: None declared, M. Blank: None declared, N. K. Biln Employee of: Augurex Life Sciences Corp, A. Marotta Employee of: Augurex Life Sciences Corp, Y. Shoenfeld: None declared
Abstract 16641: Reduction of Phrenic Nerve Injury During Cryoballoon Ablation Using the Proximal Seal Method
Authors: Alexander Homer, Muhanad Al-Zubaidi, Roger Tseng, Kelly Dancanay, Wilber Su
Journal: Circulation (2015)

Introduction: Cryoballoon has been effectiveness in treating atrial fibrillation; however it has also been associated with phrenic nerve injury during right-sided pulmonary vein ablation. The use of a proximal seal method would be able to mechanically increase the distance between the cryoballoon and the phrenic nerve and thereby reduce the incidence of phrenic nerve. However, the significance of this maneuver has not been objectively evaluated. Methods: Single center experience of cryoballoon ablation using Arctic Front Advance cryoballoon was reviewed. Incidence of phrenic nerve involvement was collected and binned into transient paralysis with recovery during the case, transient paralysis with recovery prior to discharge, or paralysis greater than 24 hours. Results were compared to historical data of phrenic nerve injury in STOP-AF trial where the proximal seal technique was not utilized. Result: 512 cases of cryoballoon ablation were reviewed from a single center where proximal seal method was used. 14 of 512 patients (2.7%) were identified to have phrenic nerve involvement-- 10 of 14 (71%) patients phrenic nerve recovered during the procedure, 3 of 14 (21%) patients phrenic nerve recovered prior to discharge, and 1 of 14 (7%) patient had prolonged phrenic nerve injury greater than 24 hours. Compared to historic data without proximal seal method, phrenic injury rate of 11.2% was reported in the STOP-AF trial. Conclusion: Phrenic nerve injury is a serious complication of cryoballoon ablation and representing a significant adverse outcome in STOP AF Trial. Utilizing the proximal seal method demonstrated significantly less phrenic nerve injury. Further studies are required to better understand the mechanisms of phrenic injury and improve the safety of cryoballoon ablation.
OP0226 Risk of hospitalised infection and initiation of abatacept versus tnf inhibitors among patients with rheumatoid arthritis: a propensity score-matched cohort study
Authors: S.K. Chen, K.P. Liao, J. Liu, S.C. Kim
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rheumatoid arthritis (RA) patients receiving biologic therapy are at an increased risk of infection. TNF inhibitors (TNFi) and abatacept are used similarly in RA as the first line biologic. Few studies conducted a head-to-head comparison of infection risk specific to different types of biologics used in a real-world setting. <h3>Objectives</h3> To evaluate the risk of hospitalised infection among RA patients who initiate abatacept versus TNFi. <h3>Methods</h3> We identified RA patients aged ≥18 years with ≥2 RA diagnoses separated by 7–365 days using insurance claims data from Truven MarketScan database (2005–2015). New users of abatacept or TNFi (adalimumab, etanercept, certolizumab, golimumab, and infliximab) were included. To balance RA duration or severity between the groups, we excluded patients who previously used rituximab, tocilizumab or tofacitinib. We also excluded patients with malignancy, dialysis, HIV/AIDS, or organ transplantation. The primary outcome was a composite endpoint of hospitalised infection including bacterial, viral or opportunistic infection. Secondary outcomes were bacterial infection, herpes zoster, and infections affecting different organ systems. To control for over 50 baseline confounders, we performed 1:1 propensity score (PS) matching. We estimated incidence rate (IR) and hazard ratio (HR) with 95% confidence interval (CI) of risk of hospitalised infection. <h3>Results</h3> We included 11,248 PS-matched pairs of abatacept and TNFi initiators with median age of 56 years. 83% were female. In the 1 year baseline period, 68% had any use of oral steroids and 55% used methotrexate. 18% had diabetes and 3% had hospitalised infection. Over the mean 2.3 year of followup, 1024 abatacept and 1,031 TNFi initiators were hospitalised for infection (table 1). The risk of any hospitalised infection was similar (HR 0.97, 95% CI: 0.89 to 1.06) between the two groups with the IR per 1000 person-years of 40.01 in abatacept and 41.21 in TNFi initiators. We found consistent results in the analyses of secondary outcomes. IR=events per 1000 person-years <h3>Conclusions</h3> In this large cohort of RA patients who used abatacept or TNFi as a first or second-line biologic agent, we found no difference in the risk of hospitalised infection between the two groups. <h3>Acknowledgements</h3> This study was funded by Bristol-Myers Squibb. <h3>Disclosure of Interest</h3> S. Chen: None declared, K. Liao: None declared, J. Liu: None declared, S. Kim Grant/research support from: Bristol-Myers Squibb, Roche, and Pfizer
SP0032 The patients’ perspective on delay in treatment
Authors: S. Makri
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Delay in early start of treatment could cause serious problems for the patient with an RMD such as unnecessary pain suffering, deformations, depression and even disability. Often patients visit Orthopaedic doctors mainly out of ignorance. Often GPs delay for various reasons, referral to the specialist <h3>Objectives</h3> In order to achieve the goal of good quality of life, both and patient and the GP should be informed and educated so as to recognise early symptoms and seek immediate medical advice and treatment. <h3>Methods</h3> The use of Campaigns in the context of "Don't delay connect today "Slogan. Media appearances, with the aim of raising awareness amongst the public and patients are very useful. The use of mobile Clinique staffed by Health professionals, advising on how to recognise early symptoms, use of printed material to stress the importance of early diagnosis. Training of GPS and orthopaedics. Use of examples <h3>Results</h3> The patient, through education, realises the importance of early referral to a Rheumatologist for receiving personalised and effective treatment. <h3>Conclusions</h3> Early diagnosis and timely treatment allow the patient with RMDs to live a good quality life. Campaigning in this direction, through information and raising awareness, can empower the patient to seek help at the early stages of the disease. <h3>Disclosure of Interest</h3> None declared
Human “T <sub>H</sub> 9” cells are a subpopulation of PPAR-γ <sup>+</sup> T <sub>H</sub> 2 cells
Authors: Claire Micossé, Leonhard von Meyenn, Oliver Steck, Enja Kipfer, Christian Adam, Cedric Simillion, S. Morteza Seyed Jafari, Peter Olah, Nikhil Yawlkar, Dagmar Simon, Luca Borradori, Stefan Kuchen, Daniel Yerly, Bernhard Homey, Curdin Conrad, Berend Snijder, Marc Schmidt, Christoph Schlapbach
Journal: Science Immunology (2019)

The transcription factor PPAR-γ plays a vital role in the generation of IL-9–producing T H cells.
SP0076 Genomic dissection of immune-mediated disease: prognosis, vasculitis and eosinophils
Authors: K.G. Smith
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Modern medicine has developed by classifying disease into defined diagnostic categories on clinical grounds. Even within a specific clinical diagnostic category, however, the features of a disease and the clinical course it takes can vary greatly between individuals. I will examine two examples of how application of genomic technologies to patient cohorts has provided insight into disease behaviour. 1. A distinct biology underlying immune-mediated disease prognosis? This presentation will explore transcriptome data that defines a clinically useful prognostic biomarker in IBD, but also addresses the specific immunological mechanisms driving long-term outcome many immune-mediated diseases (including SLE and ANCA-associated vasculitis (AAV)), and the genetics that underpins this. Evidence will be presented suggesting that the biology underlying long-term disease outcome, or prognosis, is distinct from that driving specific diagnosis, and represent an under-investigated but clinically relevant aspect of disease pathogenesis. 2. Patient stratification in ANCA-associated vasculitis: GWAS highlights new disease entities. AAV has been defined using pathological criteria into granulomatosis with polyangiitis (GPA, formerly Wegener's), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA, or Churg-Strauss syndrome). GWAS studies performed by the European Vasculitis Genetics Consortium have revealed 4 genetically distinct syndromes within AAV – which are aligned with autoantibody specificity, and better align with clinical phenotype, patient outcome and treatment response than the traditional clinically-defined syndromes. GWAS can therefore be a tool for enhancing patient stratification, and revealing new insights into disease susceptibility and perhaps therapy. <h3>Disclosure of Interest</h3> None declared
FRI0293 Imbalance in circulating subsets of innate lymphoid cells is linked to disease activity and type i interferon signature in primary sjÖgren’s syndrome
Authors: S.L. Blokland, L.L. van den Hoogen, E.F. Leijten, A.A. Kruize, T.R. Radstake, J.A. van Roon
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Recent studies indicate an important role for innate lymphoid cells (ILCs) in the pathophysiology of rheumatic diseases. In rheumatoid arthritis and spondyloarthropathies elevated numbers of subsets of ILCs have been found at the site of inflammation producing cytokines including IFN-γ and IL-22 and in addition, group 3 ILC have been suggested to be involved in formation of ectopic lymphoid structures in rheumatic diseases, Shikhagaie Nat Rev Rheumatol 2017 Wenink A and R 2017). ILC3-like cells producing IL-22 have been found in the salivary glands of pSS patients. Ciccia ARD 2012 However, circulating ILC have not yet been studied in primary Sjögren's syndrome (pSS) and systemic lupus erythematosus (SLE). Furthermore, SLE and pSS are characterised by presence of a type I interferon (IFN) signature in a large proportion of the patients. Animal studies in HIV and asthma implicate type I IFN, produced by plasmacytoid dendritic cells (pDCs), to regulate the survival of group 2 and group 3 ILCs (ILC2 and ILC3) via increase of Fas (CD95) expression, rendering the ILC more susceptible to apoptosis, Maazi JACI 2017 , Zhang JCI 2015. Duerr Nat Immunol 2016 <h3>Objectives</h3> In this study, we explored for the first time the frequency and phenotype of circulating ILCs in pSS and SLE and their relation to the IFN signature. <h3>Methods</h3> Frequencies and phenotypes of ILC subsets and pDCs were assessed by flow cytometry in peripheral blood of patients with pSS (n=20), SLE (n=20) and healthy controls (n=17). Patients were stratified by the presence or absence of an IFN signature as assessed by RT-qPCR on peripheral blood mononuclear cells as previously described. Brkic ARD 2013 <h3>Results</h3> <b>Results</b> ILC1 numbers were increased in peripheral blood of patients with SLE as compared to healthy controls and in pSS patients ILC1 numbers correlated with disease activity (ESSDAI score), serum IgG levels and anti-SSB autoantibodies (all p&lt;0.05). Numbers of ILC1, ILC2 or ILC3 did not significantly differ between patients with SLE and pSS. However, patients with a high expression of the type I IFN signature had significantly decreased numbers of ILC2 and ILC3 (p=0.04 and p=0.02, respectively). The decrease of ILC2s and ILC3s was related to increased expression of Fas (CD95) on these cells in patients with a high type I IFN signature (both p=0.01). <h3>Conclusions</h3> Both in SLE and pSS, a type I IFN signature is related to reduced numbers of circulating ILC2s and ILC3s in association with increased Fas expression on these cells possibly rendering them more susceptible to Fas/FasL-dependent apoptosis at peripheral sites. <h3>Disclosure of Interest</h3> None declared
Show patients evidence for treatment “add-ons,” fertility clinics are told
Authors: Jacqui Wise
Journal: BMJ (2019)

Patients undergoing fertility treatment should be given far more information about treatment “add-ons” and should only be offered them if there is good evidence that they are safe and effective, according to the UK fertility regulator.1

The Human Fertilisation and Embryology Authority (HFEA) and 10 leading professional and patient fertility groups agreed a consensus statement after growing concern that patients are being frequently offered, and charged for, optional extras to their treatment which claim to improve their chances of having a healthy baby. These additional therapies and techniques include genetic tests, drugs, surgery, and equipment.

The statement says: “Offered responsibly, they can be a sign of healthy innovation in the fertility sector. However, there is currently no conclusive evidence that any of the add-ons increase the chance of a pregnancy or live birth.”

The matter was raised in …
SAT0638 Ultrasonografhy the prevalence of monosidium urate crystal deposition in patients with calcium pyrophosphate deposition disease: association with laboratory, radiographic parameters and microscopy of synovial fluid
Authors: M. Eliseev, R. Osipyants, S. Vladimirov, K. Ilinykh, A. Smirnov
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> An association between gout and chondrocalcinosis is well known. Our objectives were to first, to determine by ultrasonography (US) the prevalence of monosodium urate (MSU) crystal deposition in patients (pts) with calcium pyrophosphate deposition disease (CPPD) and second, to investigate the relationship between serum urate (SU), synovial fluid (SF) examination, radiographic and US findings. <h3>Methods</h3> Eighty five pts (52% – men) with CPPD disease [McCarty criteria; median age 58.5 (range 50.5–65) years] were enrolled. SU levels were obtained during the follow-up period. US examination (Logiq 9, GE, 9 MHz probe) was performed by one sonographer, blind to clinical and laboratory data. Hyaline cartilages of the knees, II-V metacarpophalangeal and I metatarsophalangeal joints were evaluated for the "double contour" (DC) sign as evidence of MSU crystal deposition.<sup>1,2</sup> SF analyses under polarised microscopy were obtained at each time of US assessment. X-ray of knee joints was performed in all pts. We assessed joint space narrowing, osteophytes, presence of osteosclerosis and cyst in the tibiofemoral (TF) and patellofemoral (PF) compartments, radiographic evidence of knee osteoarthritis (OA, Kellgren and Lawrence (KL) criteria grade ≥2 in the medial and/or lateral TF compartment). <h3>Results</h3> 44% (38/85) pts had PFOA, 19% (16/85) had TFOA and combined PFOA and TFOA in 10.5% (9/85). Thirty-five of 85 (41%) pts had a SU level of &gt;6 mg/dl [7.9 (7.7–8.3) mg/dl]. Among them 60% (21/35) were performed US assessment of the joints. The prevalence of the DC sign was found in at least one articular site in 17 of 21 (81%) cases. SU levels were positively correlated with presence of the DC sign in joints (Spearman's r=0.532, p&lt;0.05), PFOA (r=0.291, p&lt;0.05). The MSU crystals from SF aspirates were received in 4 of 17 (23.5%) cases. <h3>Conclusions</h3> This study confirmed that the US DC sign in joints significantly correlate with a SU level and may be of use as a non-invasive tool in reflecting changes of uricemia in pts with crystal-associated synovitis. Hyperuricemia in pts with CPPD was associated with PFOA disease pattern. <h3>References</h3> [1] Filippucci E, et al. Ultrasound imaging for the rheumatologist XXV. Sonographic assessment of the knee in patients with gout and calcium pyrophosphate deposition disease. Clin Exp Rheumatol2010;40:309–15. [2] Filippucci E, et al. Ultrasound imaging for the rheumatologist XXXVI. Sonographic assessment of the foot in gout patients. Clin Exp Rheumatol2011;29:901–5. <h3>Disclosure of Interest</h3> None declared
Mood disorders in dermatology consultations
Authors: F.J. Dalgard, Å. Svensson, U. Gieler, L. Tomas‐Aragones, L. Lien, F. Poot, G.B.E. Jemec, L. Misery, C. Szabo, D. Linder, F. Sampogna, A.W.M. Evers, J. Anders Halvorsen, F. Balieva, J. Szepietowski, A. Lvov, S.E. Marron, I.K. Alturnay, A.Y. Finlay, S.S. Salek, J. Kupfer
Journal: British Journal of Dermatology (2018)
Sarecycline: First Global Approval
Authors: Emma D. Deeks
Journal: Drugs (2019)

Sarecycline (Seysara™) is an oral, once-daily, tetracycline-class drug for which a tablet formulation is approved in the USA for the treatment of inflammatory lesions of non-nodular moderate to severe acne vulgaris in patients aged ≥ 9 years. The drug was developed by Paratek and Allergen and later acquired by Almirall S.A. (a Barcelona-based pharmaceutical company focused on medical dermatology). Sarceycline tablets were approved in early October 2018 and are planned to be available for patients in January 2019. Sarecycline capsules have also been studied in the USA, but no recent reports of development have been identified for this formulation. There are currently no clinical trials underway assessing sarecycline in rosacea. This article summarizes the milestones in the development of sarecycline leading to this first approval for the treatment of inflammatory lesions of non-nodular moderate to severe acne vulgaris.
Radiotherapy Priming Chimeric Antigen Receptor T Cell Therapy Is a Safe and Promising Approach in Relapsed/Refractory Diffuse Large B Cell Lymphoma Patients with High Tumor Burden
Authors: Changju Qu, Nana Ping, Qian Wu, Liqing Kang, Fan Xia, Lei Yu, Depei Wu, Zhengming Jin
Journal: Blood (2018)
New Evidence for Shared Risk Architecture of Mental Disorders
Authors: Steven E. Hyman
Journal: JAMA Psychiatry (2019)

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