tbuckley/cabot-search huggingface dataset:
AB0274 METHOTREXATE INTOLERANCE IN MOROCCAN RHEUMATOID ARTHRITIS PATIENTS
Authors: M. Mahroug, H. Azzouzi, H. Boutaibi, O. Lamkhanat, I. Linda
Journal: Annals of the Rheumatic Diseases (2021)

Background: Methotrexate intolerance is a principal reason for treatment discontinuation, hence the interest in a more in-depth study. Objectives: We aimed to study the prevalence of methotrexate gastrointestinal intolerance and determine its associated factors in rheumatoid arthritis (RA) patients. Methods: We designed a cross-sectional study on our RA patients recruited in January 2021 at our rheumatology department. Methotrexate Intolerance Severity Score (MISS) [1], previously validated in juvenile idiopathic arthritis patients, was used to determine methotrexate (MTX) intolerance prevalence in RA patients. The MISS consisted of four domains: abdominal pain, nausea, vomiting, and behavioral symptoms, occurring before (anticipatory), after, and when thinking of MTX (associative). MTX intolerance was defined as six or more points on the MISS. Our statistical analysis was based on a descriptive study and logistic regression with SPSS20. Results: We included 102 RA patients with a mean age of 51.60 ± 14.33 years, Women were predominant (93.1%). The mean disease duration was 14.86 ± 9.78 years, with a mean methotrexate use duration of 7.42 ± 6.44 years. The mean dose of methotrexate was 12.13 ± 9.06 mg per week. The prevalence of methotrexate intolerance was 55.9%, and seventy-six patients (74.5 %) experienced at least one gastrointestinal symptom during MTX treatment. After MTX administration, the most prevalent gastrointestinal symptom was nausea (93% of the intolerant patient), whereas abdominal pain occurred in 73.7% and vomiting in 57.9%. These symptoms were also prevalent before and when thinking of MTX. Anticipatory nausea was reported in 45.6% and associative nausea in 54.5% of the cases, abdominal pain occurred anticipatory in 22.8% and associative in 42.1 %, anticipatory vomiting was the least prevalent, affecting 8.8 %. Behavioral symptoms affected 87.7% of intolerant patients, with restlessness being the most prominent symptom in 71.9% of them. Among the intolerant patients, 45 patients (79%) took parenteral MTX, and 12 (21.1%) took methotrexate orally. In comparison, young patients (49.11 ± 14.95 years) were more intolerant to MTX than old (54.76 ± 13 years, p = 0.048) ones. However, in univariate logistic regression analysis, we did not find any significant association between methotrexate administration route, dose, duration, and digestive intolerance. Conclusion: Methotrexate intolerance was highly prevalent in our RA population. These results strengthen the idea that early detection of MTX intolerance may avoid effective treatment discontinuation, especially in younger patients. References: [1]Bulatović M, Heijstek MW, Verkaaik M, van Dijkhuizen EH, Armbrust W, Hoppenreijs EP et al. High prevalence of methotrexate intolerance in juvenile idiopathic arthritis: development and validation of a methotrexate intolerance severity score. Arthritis Rheum. 2011 Jul; 63(7):2007-13. Disclosure of Interests: None declared
POS0879 CLINICAL FEATURES, PROGNOSTIC FACTORS, AND OUTCOME OF ANTI-MDA5 POSITIVE DERMATOMYOSITIS WITH RAPIDLY PROGRESSIVE INTERSTITIAL LUNG DISEASE: A MULTICENTER STUDY OF 238 PATIENTS
Authors: L. Xu, L. Wang, C. LV, W. Tan
Journal: Annals of the Rheumatic Diseases (2021)

Background: Anti-melanoma differentiation-associated gene 5 positive dermatomyositis (anti-MDA5 + DM) is typically amyopathic and associated with a life-threatening, therapy-resistant, rapidly progressive interstitial lung disease (RP-ILD). Objectives: The present study aims to characterize the prognostic factors and long-term outcome of MDA5 + DM -associated RP-ILD. Methods: A multicenter retrospective study was performed across ten tertiary hospitals in China between January 1, 2018 to December 31, 2019. Results: A total of 238 patients (170 women) with MDA5 + DM enrolled into this retrospective clinical study. The mean age was 53.0 ± 12.2 years. The median follow-up duration was 6.3 ± 12.2 months. Of those 238 anti-MDA5+ patients, ILD is commonly observed in 213 patients, and RP-ILD occurred in 35.29% (84/213) of these patients (RP-ILD defined as progressive dyspnea occurs within 1 month after the onset of respiratory symptoms, and chest radiography or pulmonary function test show progressive interstitial abnormalities). The mortality rate of RP-ILD patients within the 6 months was 58.3% (49/84) in our cohort. Death peaked the first three months after diagnosis, occupying 84.8% (39/46) of died RP-ILD patients. Cox univariate proportional hazard analysis showed that age, gender, disease duration, abnormal laboratory features (LDH, CK, ESR and CRP), anti-Ro52 autoantibody and anti-MDA5 grade were related to the risk of occurrence of RP-ILD in patients with MDA5 + DM. The Cox proportional hazards model identified the disease duration [odds ratio (OR) 0.81 (95% CI 0.68, 0.96), P=0.016] as a protective factor, and anti-Ro52 autoantibody [OR 5.82 (95% CI 1.72, 19.73), P=0.005] as independent risk factors for the occurrence of RP-ILD in MDA5 + DM patients. The 6-month all-cause mortality rate of RP-ILD patients was 58.3% (49/84). Conclusion: Combined with anti-Ro52 in Myositis-specific antibodies was associated with the occurrence and long-term mortality in MDA5 + DM -associated RP-ILD patients. The results suggest poor overall survival among patients with MDA5 + DM -associated RP-ILD. Survival during the first 6 months is crucial for long-term survival. Early recognition and prompt treatment of this high-risk group of MDA5 + DM -associated RP-ILD patients are therefore important. Disclosure of Interests: None declared
Transient receptor potential canonical 5 mediates inflammatory mechanical and spontaneous pain in mice
Authors: Katelyn E. Sadler, Francie Moehring, Stephanie I. Shiers, Lauren J. Laskowski, Alexander R. Mikesell, Zakary R. Plautz, Allison N. Brezinski, Christina M. Mecca, Gregory Dussor, Theodore J. Price, John D. McCorvy, Cheryl L. Stucky
Journal: Science Translational Medicine (2021)

Tactile and spontaneous pains are poorly managed symptoms of inflammatory and neuropathic injury. Here, we found that transient receptor potential canonical 5 (TRPC5) is a chief contributor to both of these sensations in multiple rodent pain models. Use of TRPC5 knockout mice and inhibitors revealed that TRPC5 selectively contributes to the mechanical hypersensitivity associated with CFA injection, skin incision, chemotherapy induced peripheral neuropathy, sickle cell disease, and migraine, all of which were characterized by elevated concentrations of lysophosphatidylcholine (LPC). Accordingly, exogenous application of LPC induced TRPC5-dependent behavioral mechanical allodynia, neuronal mechanical hypersensitivity, and spontaneous pain in naïve mice. Lastly, we found that 75% of human sensory neurons express
A National Goal to Advance Health Equity Through Value-Based Payment
Authors: Joshua M. Liao, Risa J. Lavizzo-Mourey, Amol S. Navathe
Journal: JAMA (2021)

This Viewpoint proposes payment reforms to incentivize health equity, including setting of national goals, equity audits of payment models independent of quality and cost, and creation of a payment equity learning and action network to guide the work of achieving payment equity goals.
AB0767 SEVERE BREAST ULCERATION IN BEHÇET’S DISEASE TREATED WITH CYCLOPHOSPHAMIDE: A CASE REPORT
Authors: E. Ball, D. Okane, C. Mccourt, M. Mccarron, C. Riddell
Journal: Annals of the Rheumatic Diseases (2021)

Background: Behcet’s disease is a systemic autoimmune vasculitis that typically involves mucocutaneous surfaces, the eyes and the skin with varying manifestations. Skin ulceration often secondary to pathergy is a common feature. Objectives: To raise awareness of breast ulceration as a clinical manifestation in Behcet’s disease. Methods: We report a case of complex Bechet’s disease associated with severe refractory breast ulceration successfully treated with cyclophosphamide. Results: A 27 year old female patient presented to the rheumatology department with a non-healing lesion on her face secondary to a cat scratch. She reported previous episodes of ulceration usually as a result of minor trauma such as IV cannulation, as well as a two year history of severe oral and genital ulceration. She had also been diagnosed with ‘colitis’ requiring iliocaecal resection two years prior to presentation. Previous treatments for her bowel included azathioprine, infliximab, adalimumab and vedolizumab. Over the next three years she developed recurrent eye involvement in the form of scleritis with ongoing oral and genital ulceration. Further treatment under our care included ustekinumab, entanercept, benepali, certolizumab and tacrolimus with background prednisolone. She then developed a small area of broken skin on her left breast which continued to extend and ulcerate despite treatment with IV steroids. Tissue biopsy showed deep focal vasculitis with intravascular thrombi. Anticoagulation was commenced and she was treated with tocilizumab IV for 3 months with no clinical improvement. Involvement extended to include 80 percent of the breast surface and the nipple self-amputated. Due to the severity and extent of the ulceration which was extremely painful and distressing, she was given 3 months of IV cyclophosphamide at a dose of 15mg/kg every 2-3 weeks. The ulceration showed rapid clinical improvement (see Figure 1). Figure 1. Breast ulceration before and after 3 months of cyclophosphamide treatment Conclusion: Involvement of the breast in systemic vasculitides (such as GPA or PAN) has been reported, although usually manifesting as a palpable mass with diagnosis on biopsy 1 . Similar presentations in Behcet’s disease have been recognised 2 , although much less commonly. Our case demonstrates that severe breast ulceration can be a clinical manifestation of this condition and can be refractory to usual therapies. References: [1]Ren J, Liu J, Su J, Zhang J, Zhao J. Systemic vasculitis involving the breast: a case report and literature review. Rheumatol Int. 2019 Aug;39(8):1447-1455 [2]Soleto MJ, Marcos L. Behçet’s disease involving the breast. Eur Radiol. 2002 Dec;12 Suppl 3:S98-S100. doi: 10.1007/s00330-002-1420-4. Disclosure of Interests: None declared
Systemic Blockade of Clever-1 Elicits Lymphocyte Activation Alongside Checkpoint Molecule Downregulation in Patients with Solid Tumors: Results from a Phase I/II Clinical Trial
Authors: Reetta Virtakoivu, Jenna H. Rannikko, Miro Viitala, Felix Vaura, Akira Takeda, Tapio Lönnberg, Jussi Koivunen, Panu Jaakkola, Annika Pasanen, Shishir Shetty, Maja J.A. de Jonge, Debbie Robbrecht, Yuk Ting Ma, Tanja Skyttä, Anna Minchom, Sirpa Jalkanen, Matti K. Karvonen, Jami Mandelin, Petri Bono, Maija Hollmén
Journal: Clinical Cancer Research (2021)

Macrophages are critical in driving an immunosuppressive tumor microenvironment that counteracts the efficacy of T-cell-targeting therapies. Thus, agents able to reprogram macrophages toward a proinflammatory state hold promise as novel immunotherapies for solid cancers. Inhibition of the macrophage scavenger receptor Clever-1 has shown benefit in inducing CD8
Dynamics of minimal residual disease in patients with multiple myeloma on continuous lenalidomide maintenance: a single-arm, single-centre, phase 2 trial
Authors: Benjamin Diamond, Neha Korde, Alexander M Lesokhin, Eric L Smith, Urvi Shah, Sham Mailankody, Malin Hultcrantz, Hani Hassoun, Sydney X Lu, Carlyn Tan, Even H Rustad, Francesco Maura, Kylee Maclachlan, Tim Peterson, Andriy Derkach, Sean Devlin, Heather J Landau, Michael Scordo, David J Chung, Gunjan L Shah, Oscar Lahoud, Katie Thoren, Kazunori Murata, Lakshmi Ramanathan, Maria E Arcila, Caleb Ho, Mikhail Roshal, Ahmet Dogan, Sergio A Giralt, Ola Landgren
Journal: The Lancet Haematology (2021)
Hybrid Poly(AMPS‐CS)‐Au Microneedle Arrays to Enrich Metabolites from Skin for Early Disease Diagnosis
Authors: Yuyin Tang, Su Li, Linyu Hu, Xuetong Sun, Bei Zhang, Wenwen Ji, Lijuan Ma, Wenhui Qian, An Kang, Dong Zhu
Journal: Advanced Healthcare Materials (2021)

Abstract Recently, some metabolites in skin interstitial fluid (SIF) have become emerging re×sources for early disease diagnosis. However, their low level in SIF and difficulty to sampling are the biggest obstacle to further potential application. Here, a swellable microneedle array patch (MNAP) with high mechanical strength is presented, and the rapid enrichment of positively charged metabolites is achieved. The MNAP is fabricated by poly (chondroitin sulfate‐acrylamido‐2‐methylpropane sulfonic acid)‐gold nanoparticles (GNPs) composites via a micro‐molding. The negatively charged copolymer hydrogel not only enrich positively charged metabolites, but also provide swellable capacity. The in situ synthesis of GNPs in the process of copolymerization make the GNPs cross‐link to the hydrogel, which further enhance the MNAP mechanical strength and enrichment efficiency for positively charged metabolites. By using the MNAP, around 5 mg SIF in 10 min from the high fat/cholecalciferol/methimazole‐induced atherogenesis rat is extracted and 23 metabolites including 13 quaternary ammonium cationic compounds can be detected and quantified by using a LC‐QTOF‐MS. Dysregulated L‐carnitine and choline metabolism are discovered a week earlier in the SIF than in the serum, achieving early diagnosis of the metabolism syndrome disease. This MNAP also helps users complete home sampling for early disease diagnosis and monitoring.
POS0166 ASSOCIATION OF TRABECULAR BONE SCORE AND FAT DISTRIBUTION IN MOROCCAN RHEUMATOID ARTHRITIS PATIENTS
Authors: H. Azzouzi, O. Lamkhanat, I. Linda
Journal: Annals of the Rheumatic Diseases (2021)

Background: The association between body composition and bone microarchitecture reflected by trabecular bone score (TBS) has been studied lately (1). In rheumatoid arthritis (RA), this association, especially with fat mass, needs further confirmation. Objectives: The purpose of the present work was to study the association of TBS with fat distribution in RA. Methods: We designed a cross-sectional study of patients with RA diagnosis according to ACR-EULAR 2010 classification recruited from first January 2021. Those with prior cancer, hyperparathyroidism, hyperthyroidism, diabetes, chronic kidney disease, cirrhosis, and a body mass index (BMI) of more than 36kg/m 2 were excluded. TBS, total body fat mass (BFM), and its distribution (gynoid (GFM), android (AFM), visceral (VFM), limbs (LFM), trunk (TFM)) were measured with Dual-energy X-ray absorptiometry (Hologic). Clinical data and laboratory tests of the same day of the DXA scan were analyzed. The associations between TBS, BFM, and its distribution were studied by correlations and multiple linear regressions using SPSS 20. Results: Sixty-nine patients were included. Their mean age was 49.86 ± 14.33 years, mean DAS28CRP was 2.56 ± 1.27, and mean disease duration was 14.84 ± 10.99 years. Sixty-two (89.9%) were women, with 30 (48.4%) had menopause. The mean BMI was 26.46 ± 5.26 kg/m 2 , and 41 patients were obese (59.4%). In the Pearson correlation analysis, TBS was associated with BFM (p = 0.04), AFM (p = 0.001), TFM (p = 0.007), and VFM (p &lt; 0.0001). However, there was no correlation with LFM (p = 0.262), and GFM (p = 0.469). At multivariate analysis, only VFM (p = 0.005, β = - 0.355, 95%IC [- 0.0002; - 0.00004]), and AFM (p = 0.02, β = - 0.395, 95%IC [- 0.00007; - 0.000006]) were associated with TBS, when adjusted on age, menopause, disease duration, disease duration under treatment, lumbar BMD, BMI, HAQ, CRP, and triglycerides level. Conclusion: In RA patients, TBS was negatively associated with visceral and android fat mass. This result may explain the intriguing coexistence of high BMD and vertebral fractures in RA obese patients. References: [1]Lv S, Zhang A, Di W, et al. Assessment of Fat distribution and Bone quality with Trabecular Bone Score (TBS) in Healthy Chinese Men. Sci Rep . 2016; 6:24935. Published 2016 Apr 26. doi: 10.1038/srep24935. Disclosure of Interests: None declared
Clinical integration of machine learning for curative-intent radiation treatment of patients with prostate cancer
Authors: Chris McIntosh, Leigh Conroy, Michael C. Tjong, Tim Craig, Andrew Bayley, Charles Catton, Mary Gospodarowicz, Joelle Helou, Naghmeh Isfahanian, Vickie Kong, Tony Lam, Srinivas Raman, Padraig Warde, Peter Chung, Alejandro Berlin, Thomas G. Purdie
Journal: Nature Medicine (2021)
POS1471-HPR EVALUATION OF THE EFFECTIVENESS OF MOBILE APP-BASED EXERCISES PROGRAMME IN PATIENTS WITH NECK PAIN: THE RANDOMIZED CONTROLLED TRIAL
Authors: L. Beyaztaş, E. Tonga
Journal: Annals of the Rheumatic Diseases (2021)

Background: Mobile health applications are frequently used to increase exercise adherence in patients with musculoskeletal problems. However, the usability of these health mobile applications mostly has not been proven. In our previous study, the usability of the mobile app, which includes postural correction and neck spinal stabilization exercises, has been proven. (M.U-NeckExercise application) Objectives: The aim of this study is to evaluate the effectiveness of the mobile application-based home exercise program for patients with chronic neck pain. Methods: 60 people with chronic neck pain were participated in the our study. They were randomized into two groups. The first group (n:30) received home exercises via the novel mobile app, and the second group (n:30) received the same home exercises via the brochure. The exercise program consisted of neck and thoracic postural correction and neck spinal stabilization exercises. Participants has been requested to do the exercises 3 days in a week for 6 weeks. Participants’ pain levels were assessed by using the Visual Analogue Scale (VAS), their neck-related functional limitations were evaluated by Neck Pain and Disability Index (BADI). Exercise adherence was meausered with a ratio of total participated sessions compared with the target defined by patient activation monitor and exercise adherance questionnaire. Targeted participation were %60 of total sessions. Results: In both groups, the improvement in VAS and BADI scores was statistically significant (p&lt;0.05). It was found that the pain parameters of VAS score decreased statistically more in the mobile application-based exercise group (p&lt;0.05). While there was no statistically significant difference between the groups in the BADI score, the effect size results was higher in the mobile app group (effect size= 0.411). Our exercise commitment target in the mobile app group was an average of 10.5 sessions. The target session number has been reached 11.25 sessions. Conclusion: It has been observed that the mobile application-based exercise program is effective in reducing pain and increasing exercise adherence in people with chronic neck pain. The findings support M.U-NeckExercise-App could be recommended to health professionals for exercise prescription in patients with cronic neck pain. References: [1]Tonga E, Can M, Polat MG (2019). ”SAT0730-HPR development and design of smartphone application for postural alignment of cervical and thoracic spine for young adults.” Annals of the Rheumatic Diseases, 78,2. [2]Voth, E. C., Oelke, N. D., &amp; Jung, M. E. (2016). A theory-based exercise app to enhance exercise adherence: a pilot study. JMIR mHealth and uHealth, 4(2), e62. Variable Group X±SS z p Post-Exercise VAS Value (0-10 cm) Mobile app 2,90 ± 2,04 -3,272 **0,001 Brochure 4,63 ± 1,69 Post-Exercise BADI Value Mobile app 38,86±12,38 0,031 0,861 Brochure 32,23±12,35 Disclosure of Interests: None declared
AB0546 5 YEARS FOLLOW-UP OF PSORIATIC ARTHRITIS PATIENTS TREATED ACCORDING TREAT-TO-TARGET STRATEGY. PRELIMINARY RESULTS
Authors: P. Tremaskina, E. Loginova, T. Korotaeva, S. Glukhova, A. Lila
Journal: Annals of the Rheumatic Diseases (2021)

Background: The concept of treat to target (T2T) in psoriatic arthritis (PsA) has been established recently and already shown its benefits [1]. But the long-term outcomes of the T2T have not been studied yet. Objectives: To study 5 years (yrs) follow-up of PsA patients (pts) treated according to T2T strategy at the early stage. Methods: 35 (M/F–17/18) PsA pts fulfilling CASPAR criteria, who were treated according to T2T strategy at the early stage (PsA duration≤2 yrs) within 24 months (mos) were analyzed. At the time of evaluation mean age is 42.7±11.2 yrs, median (Me) PsA duration 72 [60;95] mos, psoriasis duration 120 [88;180] mos. All pts underwent standard clinical examinations of PsA before started T2T therapy and at follow-up. Within 24 mos of T2T strategy all pts were taking Methotrexate (MTX) monotherapy in increasing dose up to 25 mg/wk and 18 out of 35 (51%) pts received MTX in combination with iTNF. When T2T study was stopped all pts were treated according to standard care with NSAIDs, bDMARDs, MTX, tsDMARDs based on PsA activity and physician decision. The number of pts achieved minimal disease activity (MDA, 5 of 7) and remission by DAPSA (≤4)/low disease activity (LDA)≤14) at the 24 mos of T2T strategy and at 5 yrs follow-up were calculated. The results are presented in the form of mean values, median, upper and lower quartiles. Results: Me duration of follow-up is 68 [53.5;81.5] mos. At 24 mos Me DAPSA 3.48 [0.45;21.76], remission by DAPSA (REM-DAPSA) were seen in 20 out of 35 (57%) pts, LDA-DAPSA in 4 (12%) pts, moderate activity (MoA) by DAPSA in 6 (17%) pts and high disease activity by DAPSA (HDA-DAPSA) in 5 (14%) pts. MDA was noted in 21 out of 35 (60%) pts. At 5 yrs Me DAPSA 7.4 [2.22;13.87], REM-DAPSA was noted in 12 (34%) pts, LDA-DAPSA in 14 (40%), MoA-DAPSA in 5 (14%), HDA-DAPSA in 4 (12%) pts. MDA was observed in 17 of 35 pts (49%). Among 20 pts who had REM-DAPSA at 24 mos only 6 pts (30%) remained in remission at 5 yrs follow-up and 12 out of 21 pts (57.14%) remained in MDA status. Conclusion: In early PsA pts remission and MDA are achievable goal of T2T strategy. But most pts lost remission/MDA after this strategy was changed to a standard care, despite being in remission/MDA status before change of therapy. Further investigations of the long-term outcomes of T2T strategy in PsA, including radiographic outcomes are needed. References: [1]Coates LC, Moverley AR, McParland L, et al. Lancet 2015; 386: 2489–98. Disclosure of Interests: None declared.