tbuckley/cabot-search huggingface dataset:
Comment on Mathew et al. Therapeutic Lifestyle Changes Improve HDL Function by Inhibiting Myeloperoxidase-Mediated Oxidation in Patients With Metabolic Syndrome. Diabetes Care 2018;41:2431–2437
Authors: Michael Holzer, Gunther Marsche
Journal: Diabetes Care (2019)

We read with great interest the study by Mathew et al. (1) on the impact of therapeutic lifestyle changes on HDL function. We agree with the authors that lifestyle changes used as a therapeutic strategy is a widely understudied subject and further studies are warranted. However, we do have concerns about the quality and interpretation of the proteomic data sets of isolated HDL. Unfortunately, …
THU0233 Sick leave and its predictors in ankylosing spondylitis: long-term results from the outcome in ankylosing spondylitis international study
Authors: C. Webers, S. Ramiro, R. Landewé, D. van der Heijde, F. van den Bosch, M. Dougados, A. van Tubergen, A. Boonen
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Sick leave (SL) among patients with ankylosing spondylitis (AS) is a relevant outcome for individuals and for society. Disease related factors, contextual factors, but also SL itself may be risk factors for future adverse work outcome. To reveal predictors of SL over time, longitudinal studies are necessary. If SL itself is an independent predictor for further SL, this further underpins initiatives in clinical care to support worker participation. <h3>Objectives</h3> To investigate the occurrence of AS-related SL over 12 years and to explore which factors predict or explain SL. <h3>Methods</h3> Data from employed patients from the Outcome in Ankylosing Spondylitis International Study were used. At each visit, patients indicated the occurrence of SL (yes/no) in the previous inter-assessment period. Cox regressions were used to predict the hazard for a first episode of SL using baseline predictors. Generalised estimating equations (GEE) were used to investigate the association between SL and (time-lagged) predictors. To investigate whether SL predicts future SL, SL in the first year was included as covariate in a separate GEE analysis. Due to collinearity between ASDAS, BASDAI and BASFI, separate multivariable models were computed. <h3>Results</h3> 139 patients (76% males, mean [SD] age 38.7 [10.0] years) were at risk for SL during a mean (SD) period of 7.9 (3.9) years. Among the 88 patients (63%) who ever reported SL, 62 (70%) reported SL at more than 1 assessment. In separate multivariable Cox baseline predictors models, baseline ASDAS (HR 1.67 [95%CI 1.23–2.28]), BASDAI (HR 1.33 [95%CI 1.18–1.51]) and BASFI (HR 1.17 [95%CI 1.02–1.34]) were associated with increased hazard of SL, but only in male patients with a low level of education. In separate multivariable time-varying GEE models, 1 year time-lagged ASDAS (OR 1.48 [95%CI 1.07–2.03]), BASDAI (OR 1.31 [95%CI 1.15–1.49]) and BASFI (OR 1.31 [95%CI 1.16–1.47]) were associated with SL, but only in patients with a low level of education. Further adjustment for job type did not lead to different results, and job type itself was not significantly associated with SL. SL during the first year predicted SL over time (OR: 2.62–8.37 in different models, all p&lt;0.05), independently of educational level, disease activity or physical function. <h3>Conclusions</h3> Disease activity and physical function predict and explain variation in SL, but only in patients with a low level of education. Prior SL results in future SL, and SL should be considered an actionable factor for support to prevent future adverse work outcome. Research into which SL is beneficial with regard to recovery and which SL is a risk for work disability is needed. <h3>Disclosure of Interest</h3> None declared
Chemically Controlled, Immunosuppression-Resistant, Anti-Bcma CAR-T Cells for Treatment of Antibody-Mediated Autoimmunity
Authors: Sowndharya Rajavel, Cade E. Ito, Keith Abe, Valerie Guerrero, Gene I. Uenishi, Andrew M. Scharenberg, Gregory J. Cost
Journal: Blood (2018)
FRI0392 The relationship between salivary flow rates, oral health assessment and ultrasonographic scoring of the major salivary glands in sjogren syndrome
Authors: Y. Yalçınkaya, G. Mumcu, Z. Erturk, A.U. Unal, P. Atagunduz, H. Direskeneli, N. Inanc
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Salivary flow rates (SFR) and oral health were known to be frequently impaired in Sjogren's syndrome (SjS) due to chronic inflammation and destruction of the salivary glands. Ultrasonography (USG) of major salivary glands (SG-USG) is a non-invasive widely used tool to evaluate salivary glands in SjS. <h3>Objectives</h3> The aim of the study was to assess the relationships between SFRs, oral health and USG changes of major salivary glands in patients with primary SjS. <h3>Methods</h3> Fifty-nine SjS patients (F/M:57/2) with the mean age of 52.2±11.5 years. The duration of follow-up period of 9.±7.1 years fulfilling ACR-EULAR classification criteria (2002) were included. Major salivary glands (bilateral parotis and submandibular glands) were scored according to two different scoring systems which are Hocevar A.(0–48) and Milic VD. (0–12). Oral health was assessed by indices. Measurements of whole unstimulated and stimulated SFRs were carried out in patients between 9 a.m. and 10 a.m in the morning. Oral health related quality of life (OHRQoL) as a patient reported outcome measure was evaluated by using Oral health impact profile (OHIP-14). High scores indicated poor OHRQoL status. Pathologic findings in oral health (GM) and USG images (NI) were evaluated by two authors as double-blind. <h3>Results</h3> Unstimulated SFR (0,2±0,2 ml/min) was correlated with stimulated SFR (1,1±0,7 ml/min) in the whole group (r=0,8 p=0.000). Moderate correlations were seen between unstimulated and stimulated whole SFRs and scores of hypoechogenic areas in bilateral parotid and submandibular glands (p&lt;0.05). Scores of Hocevar, Milic and OHIP-14 were found to be poor in patients with unstimulated SFR ≤0,1 ml/minute compared to those of others (p&lt;0.05) (table 1). In addition, the number of extracted teeth (8,6±7,5) was correlated with the number of carious teeth (r=-0,3, p=0.036). <h3>Conclusions</h3> Unstimulated and stimulated SFRs were found correlated with the structural changes of major salivary glands. Tooth loss and poor OHRQoL were shown in patients due to reduced salivary outputs. USG images of salivary glands could give insight to physicians about oral health and OHRQoL as outcome measure in patients with SjS. <h3>Disclosure of Interest</h3> None declared
AB1221 The association between synovitis in the foot on joint ultrasonography and clinical parameters in patients with rheumatoid arthritis
Authors: T. Kashiwagura, M. Kobayashi, M. Urayama, N. Konishi, T. Aizawa, H. Itoh, Y. Sugimura, H. Aonuma, T. Kawano, T. Sakuraba, N. Miyakoshi, Y. Shimada
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Treatment of rheumatoid arthritis (RA) has improved dramatically with the widespread use of biological disease-modifying antirheumatic drugs. In this context, the number of RA patients who undergo orthopaedic surgery is reportedly decreasing. However, the number of RA patients who undergo foot surgery is increasing. Joint ultrasonography has been used for early diagnosis and disease activity assessment in RA, allowing visualisation of synovitis. However, few detailed studies or evaluations of clinical parameters related to synovitis in the foot have been performed. <h3>Objectives</h3> This study investigated the association between synovitis in the foot as observed on joint ultrasonography and the degree of disability on the health assessment questionnaire (HAQ) in RA patients. <h3>Methods</h3> The study included 79 outpatients (101 feet) with RA. Patients who had undergone surgery were excluded. The mean age was 66.0 years (24–92 years), and the mean disease duration was 13 years and 5 months (ranging from 1 month to 49 years). Joint ultrasonography was performed by the same examiner using the same diagnostic instrument in the same room. Synovitis was defined as a power Doppler score of ≥Grade 1. The scanning sites were forefoot (metatarsophalangeal joints of toes 1–5), metatarsus (calcaneocuboid and talonavicular joints), and hindfoot (talocrural and subtalar joints, peroneal tendon, posterior tibial tendon). The presence or absence of synovitis was evaluated at each site, and the association with the HAQ score was examined. <h3>Results</h3> Synovitis was detected in the forefoot of 40 feet (39.6%), in the metatarsus of 34 feet (33.7%), and in the hindfoot of 63 feet (62.4%). Patients with synovitis in the forefoot (PD+: 0.41±0.1, PD-: 0.80±0.1, p=0.018) and hindfoot (PD+: 0.52±0.1, PD-: 0.86±0.1, p=0.043) had significantly lower HAQ scores. <h3>Conclusions</h3> Given that assessment of foot impairment is not included in the disease activity index for RA, there may be a delay in diagnosis of foot lesions. Our results showed that patients with synovitis in the forefoot and rearfoot had lower HAQ scores (disability measure), suggesting that increased physical activity may be associated with increasing incidence of synovitis in the foot. The ability of RA patients to perform activities of daily living may have improved with advances in pharmacotherapy, leading to increased physical stimulation, resulting in an increased incidence of synovitis of the foot. <h3>References</h3> [1] Brown AK. Arthtitis Rheum58(10); 2958–67: 2008 [2] Wakefield RJ. Ann Rheum Dis63; 382–5: 2004 <h3>Disclosure of Interest</h3> None declared
SAT0747-HPR The impact of non-persistence on the direct and indirect costs in patients treated with subcutaneous tumour necrosis factor-alpha inhibitors in germany
Authors: K. Ziegelbauer, M. Hübinger, S. Dombrowski, K. Kostev, M. Friedrichs, H. Friedel, S. Kachroo
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> No recent data is available about the association between non-persistence with subcutaneous TNFi and costs in Germany. <h3>Objectives</h3> The goal of the present study was to estimate the direct and indirect treatment costs in immune-mediated rheumatic disease (IMRD) patients initiating treatment with a subcutaneous biologic agent based on treatment persistence. <h3>Methods</h3> This is a retrospective cohort study based on the German statutory health insurance funds database. Patients aged ≥18 with a diagnosis of ankylosing spondylitis, psoriatic arthritis, or rheumatoid arthritis treated with subcutaneous TNF-alpha blockers (sc-TNFis) were included. Persistence was estimated as the duration of time from sc-TNFis therapy initiation to discontinuation, which was defined as at least 60 days without therapy. We performed 1:1 matching based on a propensity score that was constructed as the conditional probability of being persistent as a function of age, gender, index year, physician specialty, and Charlson comorbidity index. Finally, the differences in direct costs, indirect costs, and services between the matched pairs were estimated using the Wilcoxon test. <h3>Results</h3> After 1:1 matching, 678 persistent and 678 non-persistent patients were available for cost analyses. Both cohorts were similar in terms of age, gender, year of therapy initiation, CCI, and indication. Using a two-year time period, the costs for office based visits per patient were €2319 in the persistent cohort, as compared to €3094 in the non-persistent cohort (p&lt;0.001). Co-medication costs were €2828 in the persistent cohort, as compared to €5498 in the non-persistent cohort (p&lt;0.001), hospitalisation costs were €3551 in persistent cohort, as compared to €5890 in non-persistent patients, and sick leave costs were €717 in persistent cohort, as compared to €1241 in non-persistent patients. <h3>Conclusions</h3> The results of this study indicate that persistence with SC-TNFis treatment can be associated with several cost offsets for IMRD patients. For healthcare providers/payers, these findings reinforce the value of persistence, given the additional economic burden associated with non-persistent patients. <h3>Disclosure of Interest</h3> K. Ziegelbauer: None declared, M. Hübinger: None declared, S. Dombrowski: None declared, K. Kostev: None declared, M. Friedrichs: None declared, H. Friedel: None declared, S. Kachroo Employee of: Merch and Co
AB0687 Does anti-glomerular basement membrane (ANTI-GBM) antibody positivity correlate with relapse in patients with anti-gbm disease?
Authors: N. Droz, A. Katz, J. Sedor, R. Hajj-Ali
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Anti-GBM disease is characterised by rapidly progressive glomerular nephritis with or without pulmonary haemorrhage. It is usually monophasic in nature and disease severity correlates with antibody titer. The disease is mediated by pathogenic antibodies directed against the non-collagenous region of the α3 chain of type IV collagen. Despite the known pathogenicity of anti-GBM antibodies, and the correlation of disease severity with their titers, there is conflicting reports on whether anti-GBM antibody positivity correlates with disease relapse on long term follow up. <h3>Objectives</h3> To assess for correlation of anti-GBM antibody positivity and disease relapse in patients with anti-GBM disease. <h3>Methods</h3> Patients seen in one single academic centre between 1997 and 2017 were initially screened for the presence of anti-GBM disease by ICD 9/10 code for anti-GBM disease or Goodpasture's syndrome. 435 patients were identified. Patients were then included in the study if the diagnosis was confirmed by a board certified rheumatologist or nephrologist at our institution and had positive anti-GBM antibodies and/or biopsy results consistent with a diagnosis of anti-GBM disease. The primary endpoint of this study was anti-GBM antibody positivity at the time of relapse. All charts were reviewed for baseline demographics, clinical manifestations, anti-GBM antibody and anti-neutrophil cytoplasmic antibody (ANCA) positivity at the time of initial presentation; these were compared between those with relapsing and non-relapsing disease. Results were analysed using a two tailed standard t-test. These same characteristics were also examined the relapsing cohort at the time of relapse. <h3>Results</h3> 40 patients were confirmed as having anti-GBM disease at our institution. Mean follow up from disease onset to the date of last follow up was 56.2 months. 8 patients had relapsing disease and 32 patients had non-relapsing disease. Baseline characteristics and clinical manifestations were similar between groups (table 1). Patients with relapsing disease had a statistically higher incidence of ANCA co-positivity as compared to non-relapsing patients (62.5% vs. 21.7% respectively p value- 0.03). In patients with relapsing disease, only 14.7% (1/7 tested patients) had positive anti-GBM antibodies at the time of their relapse. <h3>Conclusions</h3> In this study, anti-GBM positivity did not correlate with disease relapse in patients with anti-GBM disease. Patients with relapsing disease had a higher incidence of ANCA positivity, consistent with previous investigations. In patients with newly diagnosed anti-GBM disease, ANCAs should be obtained to assess for the risk of relapse. Larger studies are needed to validate our results. <h3>Disclosure of Interest</h3> None declared
Usefulness of <sup>18</sup>F‐Labeled Fluorodeoxyglucose–Positron Emission Tomography for the Diagnosis of Lymphoma in Primary Sjögren's Syndrome
Authors: Jérémy Keraen, Estelle Blanc, Florent L. Besson, Véronique Leguern, Céline Meyer, Julien Henry, Rakiba Belkhir, Gaétane Nocturne, Xavier Mariette, Raphaèle Seror
Journal: Arthritis & Rheumatology (2019)

The usefulness of positron emission tomography-computed tomography (PET-CT) with 18 F-labeled fluorodeoxyglucose (18 F-FDG) for the diagnosis of lymphoma in patients with primary Sjögren's syndrome (SS) is unclear, since the abnormalities it reveals may be due to systemic manifestations of SS. This study was undertaken to compare 18 F-FDG-PET-CT in patients with primary SS with lymphoma and those without lymphoma in order to identify patterns associated with lymphoma.A retrospective study was conducted in 2 centers and included patients who met the American College of Rheumatology/European League Against Rheumatism 2016 criteria for primary SS and had undergone PET-CT. Two independent readers who were blinded with regard to lymphoma diagnosis analyzed PET-CT scans. Abnormalities were compared between patients with and those without lymphoma.Of the 45 patients included, 15 had lymphoma. Compared to patients without lymphoma, the mean size (P = 0.048) and maximum standardized uptake value (SUVmax) (P = 0.001) of the parotid glands were higher in patients with lymphoma. FDG uptake in the lymph nodes was observed in 53.3% of the patients with lymphoma and 43.3% of the patients without lymphoma, with no difference in the number of sites, uptake pattern, or mean SUVmax. Focal pulmonary uptake (nodules or condensations) was observed in 5 of the patients with lymphoma (33.3%) but only 1 patient without lymphoma (3.3%) (P = 0.01). Having an SUVmax in the parotid gland of ≥4.7 and/or the presence of focal pulmonary lesions was highly suggestive of lymphoma (sensitivity 80%, specificity 83.3%).Some systemic manifestations of primary SS (lymphadenopathy, pulmonary involvement, and salivary gland involvement) can be visualized by PET-CT. Involvement of the lymph nodes and parotid glands is commonly observed with a similar frequency in SS patients with and those without lymphoma. An SUVmax in the parotid glands of ≥4.7 and/or the presence of focal lung lesions are associated with the diagnosis of lymphoma.
FRI0436 Comparison of the 2017 eular/acr criteria with bohan and peter criteria for the classification of adult and juvenile idiopathic inflammatory myopathies
Authors: B. Pinto, R. Janardana, R. Nadig, A. Mahadevan, A. Bhatt, J.M. Raj, V. Shobha
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The 2017 EULAR/ACR classification criteria provide a validated scoring system for the classification of both adult and juvenile idiopathic inflammatory myopathies (IIM) with reasonable sensitivity and specificity. <h3>Objectives</h3> To assess the performance of the 2017 EULAR/ACR criteria<sup>1</sup> in retrospective cohort of IIM and compare with Bohan and Peter criteria.<sup>2,3</sup> <h3>Methods</h3> We conducted a retrospective study of all patients clinically diagnosed to have IIM in a tertiary care centre in the last ten years. Performance of both the criteria in the cohort was assessed and compared with clinical diagnosis. <h3>Results</h3> One hundred and seven patients were included in the study. Nine patients had juvenile onset. Clinical features are summarised in table 1. 80.4% of the patients were classified as probable/definite myositis using the Bohan and Peter criteria. 81.3% of the patients were classified as having probable/definite inflammatory myositis using the new criteria (score ≥5.5 without biopsy or ≥6.7 with biopsy). However the agreement between the two classification criteria was weak in our cohort (kappa-0.43). Complete details of muscle biopsy were available in 44 patients. In this subgroup 95.5% were classified by and Bohan and Peter and 84.1% by EULAR/ACR criteria. Both criterias performed poorly in patients without biopsy data and in polymyositis subset (table 2). <h3>Conclusions</h3> The new EULAR/ACR criteria did not perform better than Bohan and Peter criteria in our cohort. The new criteria are more time consuming and seem to be of limited utility in daily clinical practice. <h3>References</h3> [1] Lundberg IE, et al. European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Ann. Rheum. Dis. 2017;76:1955–1964. [2] Bohan A, Peter JB. Polymyositis and Dermatomyositis. N. Engl. J. Med. 1975;292:344–347. [3] Bohan A, Peter JB. Polymyositis and Dermatomyositis. N. Engl. J. Med. 1975;292:403–407. <h3>Disclosure of Interest</h3> None declared
THU0599 Evaluation of efficacy and safety of canakinumab in japanese patients with systemic juvenile idiopathic arthritis in phase iii clinical trial, composed predominantly of patients with prior use of tocilizumab
Authors: S. Takei, R. Hara, H. Umebayashi, N. Iwata, T. Imagawa, M. Shimizu, M. Tomiita, N. Seko, T. Kitawaki, G. Wang, S. Yokota
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Systemic juvenile idiopathic arthritis (SJIA) is a distinct form of juvenile idiopathic arthritis (JIA), accounting for approximately 4% to 17% of JIA<sup>1</sup>. In Japan, a higher frequency of SJIA, 41.7% of JIA<sup>2</sup> has been reported compared to Europe and United States. Tocilizumab (TCZ) is the only approved biologic for SJIA treatment in Japan. However, some patients (pts) demonstrate persistently high disease activity and/or drug intolerabiliy. Therefore, new treatment options are required. Here, we evaluated the efficacy and safety of canakinumab (CAN), a human anti-interleukin-1ß monoclonal antibody, in Japanese SJIA pts. <h3>Objectives</h3> To report the results of a 28 week (Wk) interim whole analysis of Phase III data (NCT02396212) of CAN, and the subgroup analysis of pts with or without prior use of TCZ. <h3>Methods</h3> Patients (age ≥2-&lt;20 years) received open-labelled CAN 4 mg/kg (max 300 mg) every 4Wks (q4w) subqutaneously (s.c.). The primary objective was to evaluate the proportion of pts who achieved 30% improvement from baseline of adapted ACR Paediatric criteria (aACR 30) at Wk8 and who achieved corticosteroid tapering at Wk28. Steroid reduction was allowed from Wk8. We also analysed the data with or without prior use of TCZ. <h3>Results</h3> The trial enrolled 19 pts who had insufficient response to prior treatment; the majority (15/19, 78.9%) had received TCZ (table 1). Of the 19 pts, 3 discontinued CAN due to lack of efficacy or adverse events (AE) by Wk28 and 16 completed the assessment of Wk28. All pts (19/19) achieved aACR 30/50/70 at Wk8 (figure 1). Overall, 73.7% (14/19) pts achieved corticosteroid tapering at Wk28 and 2 pts (10.5%) achieved "steroid free". Of 15 pts with prior use of TCZ, 12 pts (80.0%) achieved aACR 100 at Wk8 and 11 pts (73.7%) achieved corticosteroid tapering (26.3%, 5/19). Serious AE (SAE) was seen in 41.1% (8/19) pts, and the most frequent SAE was JIA (flare or worsening of SJIA, 21.1%, 4/19). One macrophage activation syndrome (MAS) but no death was reported. <h3>Conclusions</h3> CAN 4 mg/kg q4w s.c. provided improvement in disease activity and a redution of oral steroid dose in Japanese SJIA pts, including those who were not well-controlled with TCZ. No new safety concerns were reported. <h3>References</h3> [1] Ravelli A, Martini. Lancet2007; 369(9563):767–78. [2] Takei S, et al. Annual Report on children with chronic refractory diseases from the Japanese Ministry of Health, Labor and Welfare2008;102–13. <h3>Disclosure of Interest</h3> None declared
Endoscopic removal of two long iron rods impacted in the stomach
Authors: Liansong Ye, Xianhui Zeng, Xuli Wang, Chuanjun Tang, Jiang Du, Yuhang Zhang, Bing Hu
Journal: Endoscopy (2019)

A 20-year-old man was referred for left epigastralgia, with a history of eating barbecued food and alcoholic intoxication 2 days earlier. On physical examination, he had abdominal tension and tenderness, without obvious rebound pain. Abdominal imaging revealed two long rods (17 cm and 13 cm) in the stomach, without signs of perforation or other conditions ([Fig. 1]). Upper endoscopy revealed that the proximal ends of the iron rods were impacted in the gastric body ([Fig. 2 a]), while the distal ends were impacted in the gastric antrum ([Fig. 2 b]). We used endoscopic grasping forceps to gently grip the proximal ends of the rods and remove them as we withdrew the endoscope ([Fig. 3], [Video 1]). There was no perforation, and only surrounding mucosal hyperemia and edema were noted. The patient’s symptoms disappeared, and he was discharged from our hospital on the same day.