tbuckley/cabot-search huggingface dataset:
POS0722 HISTOPATHOLOGICAL ANALYSIS OF LUPUS NEPHRITIS INCORPORATING BANFF CRITERIA EMPHASIZES THE IMPORTANCE OF TUBULOINTERSTITIAL CHANGES FOR CREATININE AND PROTEINURIA AT 12 MONTHS AFTER RENAL BIOPSY
Authors: M. Plüß, S. Hakroush, N. Niebusch, B. Tampe, P. Korsten
Journal: Annals of the Rheumatic Diseases (2021)

Background: Lupus nephritis (LN) occurs in about 30-60% of patients with systemic lupus erythematosus (SLE). LN is associated with increased mortality. Currently, the diagnosis relies on histopathologic characteristics according to the ISN/RPS classification (1). This classification relies heavily on glomerular changes and may not accurately reflect all changes occurring in LN. For the description of transplanted kidney, the BANFF classification has been established which, in addition to glomerular changes, also incorporates tubular pathologies (2). Objectives: With the present study, we aim to describe histopathologic changes according to the BANFF classification in a single-center cohort of LN patients. Methods: We retrospectively recorded epidemiological, clinical and laboratory data of 58 patients with LN over a ten-year period. Histopathologic diagnoses according to ISN/RPS classification or the former WHO classification were also documented. We then re-analyzed representative kidney samples according to the BANFF classification and performed Spearman rank correlation for BANFF findings and creatinine at biopsy and 12 months as well as proteinuria at biopsy and at 12 months. Results: We analyzed 58 patients with LN. 9 were male, 49 were female. Median age was 38 (15-78) years. According to ISN/RPS, 3 had class I LN, 6 had class II, 14 had class III, 16 had class IV, 6 had class V, and 0 had class VI. Median eGFR at biopsy was 60 ml/min/1.73m2 (13-137). According to the BANFF classification, tubulointerstitial inflammation (ti) was associated with creatinine at 12 months. Proteinuria at 12 months was associated with interstitial fibrosis (ci) (Figure 1). Conclusion: In LN, the current ISN/RPS classification puts emphasis on glomerular changes. Nevertheless, for the long-term outcome, tubulointerstitial changes (tubulointerstitial inflammation and interstitial fibrosis) may at least be as important as glomerular changes. These findings have to be corroborated in larger cohorts with prespecified renal endpoints. References: [1]Weening et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. JASN 2004. [2]Jeong HY. Diagnosis of renal transplant rejection: Banff classification and beyond. Kidney Res Clin Pract 2020. Disclosure of Interests: Marlene Plüß: None declared, Samy Hakroush: None declared, Noah Niebusch: None declared, Björn Tampe: None declared, PETER KORSTEN Speakers bureau: Abbvie, Pfizer, Chugai, Sanofi, Boehringer-Ingelheim, GSK, Novartis, Consultant of: Abbvie, Pfizer, Chugai, Sanofi, Boehringer-Ingelheim, GSK, Novartis, Lilly, Gilead, Grant/research support from: GSK
Abstract 16646: Protective Effect of Isoflurane in an Experimental Model of Hemorrhagic Shock
Authors: Wangde Dai, Jianru Shi, Sharon Hale, Marie Csete, Juan Carreno, Robert A Kloner
Journal: Circulation (2017)

Background: Hemorrhagic shock is a leading cause of preventable death in young adults, both military and civilian. The volatile anesthetic isoflurane can protect (precondition) against cardiac repe...
POS1147 COSTS AND FACTORS AFFECTING HEALTH SERVICE UTILISATION IN PATIENTS WITH GOUT: A LONGITUDINAL, POPULATION-LEVEL LINKED DATA STUDY IN WESTERN AUSTRALIA
Authors: E. Kelty, J. Nossent, W. Raymond, P. Robinson, C. Hill, C. Inderjeeth, D. Preen, H. Keen
Journal: Annals of the Rheumatic Diseases (2021)

Background: Evidence suggests that gout is associated with high health care costs and that many inpatient admissions are preventable (1). Understanding the driver of health care costs will allow more targeted intervention. Objectives: To examine factors associated with high health service utilisation and cost in patients admitted to hospital with gout, using whole-population linked hospital, WA cancer registration, Emergency Department (ED) and death data (2). Methods: The study included patients (18 to 84 years) who had been admitted to hospital with a primary or co-diagnosis of gout for the first time between 1 Jan 02 and 31 Dec 09 Hospital costs were calculated per patient using DRG codes and ED costs were calculated from URG codes. Costs are presented in Australian dollars. Follow-up was completed at five years post their initial gout hospitalisation, at death, or at the 31th of December 2014. Both univariable and multivariable analysis was conducted for each patient characteristic. Independent variables were assessed for collinearity. Collinearity was assumed present where the correlation co-efficient was greater than 0.7. Results: 4,379 individuals were included. In the following five years, there was 22,222 ED attendances (median cost, $1826 per patient (IQR: $433 - $4,414)), and 58,920 hospital admissions, (median cost, $25,009 per patient (IQR: $6,844 - $60,535)). 4,059 (18.3%) ED attendances and 3,834 (6.5%) hospital admissions were potentially preventable. Gout was not a major driver of events, with 341 (1.5%) ED attendances and 620 (1.1%) hospital admissions coded with a primary diagnosis of gout. In the univariable analysis (Table 1), Aboriginality and smoking were associated with an increased number of both ED attendances and hospital admissions. Increased socio-economic status was associated with a reduction in ED attendances, however, this was not reflected in hospital admissions. Conclusion: Patients admitted to hospital with gout are highly likely to be re-admitted or attend ED in the following 5 years. Many of these contacts are preventable, but are usually driven by comorbidities rather than gout. References: [1]Loh K, . Intern Med J. 2020 Mar;50(3):386. [2] https://www.datalinkage-wa.org.au . Acknowledgements: The authors wish to thank the staff at the Western Australian Data Linkage Branch and the Hospital Morbidity Data Collection, and the Death Registrations and the Emergency Department Data Collection. Disclosure of Interests: None declared.
Immediate “Kangaroo Mother Care” and Survival of Infants with Low Birth Weight
Authors: Sugandha Arya, Helga Naburi, Kondwani Kawaza, Sam Newton, Chineme H Anyabolu, Nils Bergman, Suman P N Rao, Pratima Mittal, Evelyne Assenga, Luis Gadama, Roderick Larsen-Reindorf, Oluwafemi Kuti, Agnes Linnér, Sachiyo Yoshida, Nidhi Chopra, Matilda Ngarina, Ausbert T Msusa, Adwoa Boakye-Yiadom, Bankole P Kuti, Barak Morgan, Nicole Minckas, Jyotsna Suri, Robert Moshiro, Vincent Samuel, Naana Wireko-Brobby, Siren Rettedal, Harsh V Jaiswal, M Jeeva Sankar, Isaac Nyanor, Hiresh Tiwary, Pratima Anand, Alexander A Manu, Kashika Nagpal, Daniel Ansong, Isha Saini, Kailash C Aggarwal, Nitya Wadhwa, Rajiv Bahl, Bjorn Westrup, Ebunoluwa A Adejuyigbe, Gyikua Plange-Rhule, Queen Dube, Harish Chellani, Augustine Massawe
Journal: New England Journal of Medicine (2021)

“Kangaroo mother care,” a type of newborn care involving skin-to-skin contact with the mother or other caregiver, reduces mortality in infants with low birth weight (<2.0 kg) when initiated after stabilization, but the majority of deaths occur before stabilization. The safety and efficacy of kangaroo mother care initiated soon after birth among infants with low birth weight are uncertain.
AB0451 TO EVALUATE THE PREVALENCE OF INTERSTITIAL LUNG DISEASE (ILD) AND/OR PULMONARY ARTERIAL HYPERTENSION (PAH) IN PATIENTS AFFECTED BY SYSTEMIC SCLEROSIS (SSC) AND TO DETERMINE THE FACTORS ASSOCIATED WITH ILD
Authors: R. Ortega Castro, R. Mariscal-Ocaña, M. Rojas-Giménez, J. Calvo Gutierrez, A. Escudero Contreras, C. López-Medina
Journal: Annals of the Rheumatic Diseases (2021)

Background: Systemic sclerosis (SSc) is a chronic autoimmune disease that carries significant mortality. Despite diagnostic and therapeutic advances in recent years, there is still a significant percentage of patients who do not present a complete clinical response, with the associated increase in morbidity and mortality. Specifically, pulmonary disease is frequent and entails a poor prognosis, with interstitial lung disease (ILD) and pulmonary hypertension (PAH) being the two most important complications, the first and second cause of mortality, respectively. Objectives: To evaluate the prevalence of ILD and/or PAH in patients affected by SSc and to determine the factors associated with ILD. Methods: Cross-sectional observational study of 102 patients diagnosed with SSc (Limited, Diffuse, SSc without scleroderma or Pre-scleroderma), treated between 1975 and 2020 at the Reina Sofia University Hospital in Cordoba. A descriptive study of the cohort was carried out and factors independently associated with ILD were evaluated using a multiple logistic regression model. Results: 102 patients were included, 87.3% of these were female with an average age of 50.8 (14) years. There were 20 deaths (19.8%), from which 55% died because of SSc and the main reason was ILD and/or PAH. Respiratory complications (as ILD or as PAH) were present in 59 patients (57.8%), of whom 52 were diagnosed with ILD (90.4% with a pattern of non-specific interstitial pneumonia) and 25 PAH, whose mean pulmonary artery systolic pressure was 47.16 (18.54) mmHg. Anti-topoisomerase I antibodies were positive in 34.6% of patients who developed ILD, while anticentromere antibodies were more frequent in SSc without interstitial lung disease (80%). Independent factors associated with ILD were type of SSc, proximal skin involvement, anticentromere antibodies, current treatment with corticoids and the death. Conclusion: Just over half of the patients with SSc have lung disease (as ILD or as PAH). The main risk factors associated with ILD are proximal skin involvement and treatment with glucocorticoids, probably in the context of more severe forms that require more treatment. Anticentromere antibodies are more prevalent in patients with Limited SSc and their expression decreases the risk of developing ILD in these patients. References: [1]Orlandi M, Barsotti S, Lepri G, et al. Clin Exp Rheumatol 2018 Jul-Aug; 36 Suppl 113: 3-23 [2]Hao Y, Hudson M, Baron M, et al. Arthritis Rheumatol. 2017;69(5):1067-1077. [3]Furue M, Mitoma C, Mitoma H, et al. Immunol Res. 2017 Aug; 65: 790-7. [4]Nihtyanova SI, Schreiber BE, Ong VH, et al. Arthritis Rheumatol. 2014 Jun; 66: 1625-35. Disclosure of Interests: None declared.
AB0839 A STUDY OF SERUM COMPLEMENT AND SERUM CALPROTECTIN LEVEL IN SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: H. Goswami, S. Kakati
Journal: Annals of the Rheumatic Diseases (2021)

Background: Serum calprotectin, also known as MRP8/14 or S100A8/A9, has gained attention in recent years as a candidate biomarker in inflammatory diseases like SLE. 1 Proteins of the complement pathway (serum C3 and C4) are linked to the pathogenesis of SLE and their levels have been measured as a means to assess the disease activity. 2 Objectives: [1]To study the relation of serum complement and serum calprotectin levels to disease activity in SLE [2]To study the relation between serum complement and serum calprotectin level in SLE Methods: Our study was a hospital based observational study conducted in a tertiary care centre in North-East India during the period of June 2019 to May 2020. A total of 102 patients of SLE were taken up for the study. Disease activity was assessed using SLEDAI-2K scores and serum calprotectin level was measured by ELISA. Serum C3 level was assessed by Nephelometric and C4 level by Turbidimetric immunoassay. The statistical significance was fixed at 5% level of significance (p&lt;0.05) for all analysis. Results: Our study found a predominantly female population (Female: Male ratio 24.5: 1) with majority of the patients (49.02%) in the 30-39 years age group. Higher calprotectin levels were seen in patients with higher disease activity (SLEDAI) and this relation was statistically significant (r=0.84, p&lt;0.001). There was significant negative correlation between disease activity (SLEDAI) and serum C3 (r=-0.35, p&lt;0.001) and serum C4 (r=-0.4, p&lt;0.001) level. There was a significant negative correlation between complement levels and serum calprotectin levels (r=-0.53, p&lt;0.001). Conclusion: We found a significant positive correlation between serum calprotectin level and disease activity with a significant negative correlation between complement level and disease activity in SLE patients. There was a significant negative correlation between serum complement and serum calprotectin levels. These findings suggest serum calprotectin levels could be a substantial addition in the existing diagnostic array of tools in assessing lupus disease activity. References: [1]García-Arias M, Pascual-Salcedo D, Ramiro S, Ueberschlag ME, Jermann TM, Cara C, et al. Calprotectin in rheumatoid arthritis: Association with disease activity in a cross-sectional and a longitudinal cohort. Mol Diagnosis Ther. 2013;17(1):49–56. [2]Walport MJ. Complement and systemic lupus erythematosus. Arthritis Res. 2002;4(Suppl 3):S279-293. Disclosure of Interests: None declared
EULAR recommendations for intra-articular therapies
Authors: Jacqueline Uson, Sebastián Cruz Rodriguez-García, Raul Castellanos-Moreira, Terence W O'Neill, Michael Doherty, Mikael Boesen, Hemant Pandit, Ingrid Möller Parera, Valentina Vardanyan, Lene Terslev, Willm Uwe Kampen, Maria-Antonietta D'Agostino, Francis Berenbaum, Elena Nikiphorou, Irene A Pitsillidou, Jenny de la Torre-Aboki, Loreto Carmona, Esperanza Naredo
Journal: Annals of the Rheumatic Diseases (2021)

To establish evidence-based recommendations to guide health professionals using intra-articular therapies (IAT) in adult patients with peripheral arthropathies.
Lazertinib: First Approval
Authors: Sohita Dhillon
Journal: Drugs (2021)

Lazertinib (LECLAZA®) is an oral, third-generation, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) being developed by Yuhan and Janssen Biotech for the treatment of non-small cell lung cancer (NSCLC). It is a brain-penetrant, irreversible EGFR-TKI that targets the T790M mutation and activating EGFR mutations Ex19del and L858R, while sparing wild type-EGFR. In January 2021, lazertinib received its first approval for the treatment of patients with EGFR T790M mutation-positive locally advanced or metastatic NSCLC who have previously received EGFR-TKI therapy. This article summarizes the milestones in the development of lazertinib leading to this first approval.
Clinical Excellence Awards are not fit for purpose
Authors: Fraz A Mir
Journal: BMJ (2021)

Essex and colleagues shine a long overdue spotlight on the Clinical Excellence Awards (CEA) scheme.1 There is no doubt in my mind that the scheme is iniquitous, opaque, and akin to medicine’s own version of cronyism. Vested interests and the risk of antagonising influential leaders in the profession mean that the BMA and royal colleges remain unwilling to grasp …
POS0191 THE VALUE OF MIR-20B, MIR-22, MIR-26A, MIR-125B AND MIR-221 IN RHEUMATOID ARTHRITIS
Authors: M. Ciesla, B. Kolarz, M. Majdan, M. Dryglewska
Journal: Annals of the Rheumatic Diseases (2021)

Background: Micro-RNAs (miRNAs) are an endogenous small, single-stranded, non-coding RNAs with a 18-25 nucleotide long and have been reported as a potential extracellular biomarkers of various diseases. They mainly decrease the gene expression by inhibiting the translation or cause mRNA destabilization. Objectives: The aim of the study was to identify miRNAs whose plasma expression level is associated with RA prevalence and/or activity. Methods: A total of 74 unrelated individuals, 50 with RA and 24 in a control group were enrolled to the study. Real-time PCR was used to evaluate the plasma expression levels of 5 miRNAs: miR-20b, miR-22 miR-26a, miR-125b, miR-221. Results: We found the differences in four out of five evaluated miRs between RA and HC group – miR-26a, p&lt;0.0001; miR-125b, p &lt;0.0001; miR-20b p&lt;0.0001; miR-22, p=0.005. Graphical presentation of the results is shown in Figure 1. The logistic regression results showed that miR-22 (p=0.0003) and miR-26a (p=0.049) are the most important molecules distinguishing RA patients and healthy controls in the study. MiR-22 was positively correlated with ESR (r s =0.41), CRP (r s =0.49) and DAS28 (r s =0.33) and miR-26a was positively correlated with ESR (r s =0.49), CRP (r s =0.41), number of swelling joints (r s =0.43), number of painful joints (r s =0.74) and DAS28 (r s =0.63). Moreover, miR-22 expression was different between rheumatoid factor (RF) positive and RF negative patients (p=0.04). Conclusion: The results showed that miR-22 (p=0.0003) and miR-26a (p=0.049) may be the most useful in evaluated panel of miRs distinguishing RA patients and HCs. In this study we demonstrated for the first time that plasma concentration of miR-22 may be considered as a potential molecular marker of RA exacerbation. References: [1]Ouboussad, L., Hunt, L., Hensor, E.M.A. et al. Profiling microRNAs in individuals at risk of progression to rheumatoid arthritis. Arthritis Res Ther 2017 19, 288. [2]Churov AV, Oleinik EK, Knip M. MicroRNAs in rheumatoid arthritis: altered expression and diagnostic potential. Autoimmun Rev. 2015 14(11):1029-37. Figure 1. Diagrams from A to D show the expression levels of miR-22, miR-26a, miR-125b and miR-20b, respectively. The median values of expression have been connected by a line. Table 1. Spearman’s rank correlation between micro-RNA-22 and micro-RNA-26 and the clinical variables. miRs \ clinical variable Age Disease duration ESR CRP SJC TJC DAS-28 ACPA RF miR-22 0.09 -0.27 0.41 0.49 0.26 0.21 0.33 0.24 0.16 miR-26a 0.2 0.14 0.49 0.41 0.43 0.74 0.63 0.26 0.16 The significant correlations were bolded and indicated by red. Abbreviations: ACPA, anti-citrullinated protein antibodies; CRP, C-reactive protein; SJC, swollen joint count; TJC, tender joint count; DAS-28, disease activity score 28; ESR, erythrocyte sedimentation rate; RF, rheumatoid factor. Disclosure of Interests: None declared
AB0691 ANALYSIS OF SARS-COV-2 ANTIBODIES IN NON-COVID-19 PATIENTS: COMPARISON BETWEEN SYSTEMIC SCLEROSIS PATIENTS AND HEALTHY CONTROLS
Authors: L. Giardullo, C. Rotondo, A. Corrado, N. Maruotti, R. Colia, A. Altomare, E. Sanpaolo, D. Cici, F. P. Cantatore
Journal: Annals of the Rheumatic Diseases (2021)

Background: Previous study evidenced a cross-reactivity between Sars-Cov-2 antibodies and autoimmune tissue antigen involved in connective tissue diseases, as nuclear antigen (NA), extractable nuclear antigen (ENA), histone and collagen (1). No study has been published about the titer of Sars-Cov-2 antibodies in non-infected patients with autoimmune disease. Objectives: To evaluate the titer of SARS-CoV-2 antibodies in non-COVID-19 patients and compare it between systemic sclerosis (SSc) patients and healthy controls (HC). Methods: A total of 58 patients with SSc (who fulfilled ACR/EULAR 2013 SSc classification criteria) and 18 HC were enrolled. Sera of all participants were collected, and SARS-CoV-2 antibodies (IgG and IgM) were evaluated by means ELISA. In all participants swabs for SARS-CoV-2 by real-time reverse-transcriptase-polymerase-chain-reaction assay were reported negative. Demographic, clinical, and autoimmune serological characteristics of SSc patients were recorded. The normal distribution was assessed using the Shapiro–Wilk’s test. Exclusion criteria was previous or actual Sars-Cov-2 infection. Comparisons between study groups of patients were evaluated by the Student’s t-test or Mann – Whitney U-test as appropriate. The differences between categorial variables were assessed by Pearson chi-square or Fisher’s exact test, as opportune. Statistical significance was set at p ≤ 0.05. Results: We observed significant differences between SSc patients and HC in serum levels of Sars-Cov-2 antibodies (IgG: 1,4±2,1 AU/ml vs 0,36±0,19 AU/ml respectively (p=0,001); and IgM: 2,5±3,1 AU/ml vs 0,8±0,7 AU/ml (p=0,022)). In 5 SSc patients was found titer of Sars-Cov-2 antibodies (IgG) exceeding the cut-off, but the control of swabs for SARS-CoV-2 by real-time reverse-transcriptase-polymerase-chain-reaction assay were negative. No significative differences in Sars-Cov-2 autoantibodies titer were found in subgroup of SSc patients with or without ILD or PAH, limited or diffuse skin subset, and different autoantibodies profile. Furthermore, antibodies titer was not associated with different drugs (steroid, methotrexate, mofetil-mycophenolate and bosentan) in use. Conclusion: A cross mimicking between Sars-Cov-2 antibodies and antinuclear antibodies or anti ENA could be hypothesized. Further studies are necessary to unravel the reliability of Sars-Cov-2 antibodies detection in autoimmune disease. References: [1]Vojdani, A., Vojdani, E., &amp; Kharrazian, D. (2021). Reaction of human monoclonal antibodies to SARS-CoV-2 proteins with tissue antigens: Implications for autoimmune diseases. Frontiers in Immunology, 11, 3679 Disclosure of Interests: None declared
Impact of minimum unit pricing on alcohol purchases in Scotland and Wales: controlled interrupted time series analyses
Authors: Peter Anderson, Amy O'Donnell, Eileen Kaner, Eva Jané Llopis, Jakob Manthey, Jürgen Rehm
Journal: The Lancet Public Health (2021)

As a policy option to reduce consumption of alcohol and the harm it does, on May 1, 2018, Scotland introduced a minimum price of 50 British pence (p) per unit of alcohol (8 g) sold; Wales followed suit on March 2, 2020, with the same minimum unit price (MUP). We analysed household purchase data based on bar codes to assess the impact of these policy options in the medium term for Scotland and in the immediate term for Wales.For these location-controlled, interrupted time series regression analyses, the data source was Kantar WorldPanel's household shopping panel, which, at the time of our analysis, included 35 242 British households providing detailed information on 1·24 million separate alcohol purchases in 2015-18 and the first half of 2020. With no data exclusions, we analysed the impact of introducing MUP in Scotland, using purchases in northern England as control, and in Wales, using western England as control. The studied changes associated with MUP were price paid per gram of alcohol purchased, grams of alcohol purchased, and amount of money spent on alcohol.In Scotland, price increases and purchase decreases following the introduction of MUP in 2018 were maintained during the first half of 2020. The difference between Scotland and northern England in 2020 was a price increase of 0·741 p per gram (95% CI 0·724-0·759), a 7·6% increase, and a purchase decrease of 7·063 g per adult per household per day that an alcohol purchase was made (6·656-7·470), a 7·7% decrease. In Wales, the introduction of MUP led to similar results. The difference between Wales and western England was a price increase 0·841 of 0·841 p per gram (0·732-0·951), an 8·2% increase, and a purchase decrease of 7·052 g per adult per household per day that an alcohol purchase was made (6·463-7·640), an 8·6% decrease. For both Scotland and Wales, reductions in overall purchases of alcohol were largely restricted to households that bought the most alcohol. The introduction of MUP was not associated with an increased expenditure on alcohol by households that generally bought small amounts of alcohol and, in particular, those with low incomes. The changes were not affected by the introduction of COVID-19 confinement in the UK on March 26, 2020.The evidence base supporting the positive, targeted impact of MUP is strengthened by the comparable results for Scotland and Wales. The short-term impact of MUP in Scotland during 2018 is maintained during the first half of 2020. MUP is an effective alcohol policy option to reduce off-trade purchases of alcohol and should be widely considered.None.