tbuckley/cabot-search huggingface dataset:
POS0892 CLINICAL PREDICTIVE MODEL FOR INFECTION RISK IN CTD-ILD PATIENTS UNDERGOING CYCLOPHOSPHAMIDE PULSE THERAPY
Authors: D. Huang, Y. Liu
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Connective tissue disease-associated interstitial lung disease (CTD-ILD) presents a complex clinical scenario, often necessitating intensive therapeutic interventions such as cyclophosphamide pulse therapy. Despite its efficacy, the associated risk of infection remains a critical concern, prompting the need for a nuanced clinical predictive model. <h3>Objectives:</h3> The primary objective of this study is to construct a robust clinical predictive model that can effectively discern the infection risk in CTD-ILD patients receiving cyclophosphamide pulse therapy. Such a model holds promise for optimizing patient care and treatment outcomes. <h3>Methods:</h3> A retrospective analysis was conducted on 111 patients diagnosed with CTD-ILD who underwent cyclophosphamide pulse therapy. Comprehensive patient data, including demographic parameters, disease-specific characteristics, and treatment histories, were systematically collected. The analysis employed multivariate statistical methods to identify independent predictors of infection risk, leading to the development of a clinical predictive model. <h3>Results:</h3> A cohort of 111 confirmed CTD-ILD patients (mean age: 53.2±10.9 years; 72.1% female) was analyzed. During cyclophosphamide pulse therapy, 32 patients (28.8%) experienced infections, primarily concentrated in the initial three treatment cycles. The final model incorporated 6 key indicators (Oral glucocorticoids, GGT, carcinoembryonic antigen, CD4/CD8, lymphocyte, and C3), effectively discriminating between patients with and without infection events. The area under the receiver operating characteristic curve (AUC) for the model was 0.837 [95% confidence interval (CI) 0.749-0.925], indicating its high accuracy. <h3>Conclusion:</h3> This study successfully developed a predictive model for infection risk during cyclophosphamide pulse therapy in CTD-ILD patients. The model, comprising 6 significant indicators, demonstrated strong discriminatory capabilities, with an AUC of 0.837. Implementation of this model in clinical practice may enhance the identification of patients at higher risk of infection during treatment, allowing for timely intervention and improved patient management. Further validation studies are recommended to confirm the generalizability and reliability of the model across diverse patient populations. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0838 CAN SALIVARY CARCIOEMBRYONIC ANTIGEN BE USEFUL FOR THE DIAGNOSIS OF SJOGREN’S SYNDROME
Authors: I. Jeremic, M. Hadzi-Mihailovic, L. Pavlovic, Z. Bojic-Trbojevic, S. Golubovic
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Sjogren's syndrome is a relatively common autoimmune disease, especially in its early stages, and can have very nonspecific symptoms. Additionally, a large number of patients have a positive rheumatoid factor (RF), which can often misdirect the diagnosis towards rheumatoid arthritis. In RF-positive patients without anti-Ro antibodies, a biopsy of the minor salivary gland is often necessary for disease diagnosis, which is unacceptable for a significant number of patients. For this reason, new diagnostic markers that could differentiate Sjogren's syndrome from rheumatoid arthritis and individuals without autoimmune diseases could be very useful in clinical practice. Carcinoembryonic antigen (CEA) is a tumor marker secreted in certain inflammatory conditions. Unlike other autoimmune diseases, inflammation in Sjogren's syndrome is localized in the salivary glands, so our hypothesis was that CEA would be elevated in saliva. <h3>Objectives:</h3> The objective of this study was to examine whether patients diagnosed with Sjögren's syndrome exhibit elevated levels of carcinoembryonic antigen in their saliva. <h3>Methods:</h3> The study included 44 patients with Sjogren's syndrome, 45 patients with rheumatoid arthritis, 49 patients with osteoarthritis, and 21 healthy controls. Saliva samples were taken from all patients, and CEA was determined. Additionally, blood samples were taken from patients with Sjogren's syndrome for standard immunological analyses and inflammation parameters (anti-Ro antibodies, antinuclear antibodies, RF, erythrocyte sedimentation rate - ESR). <h3>Results:</h3> Patients with Sjogren's syndrome had significantly higher levels of salivary CEA (MED 1289 pg/mL) compared to patients with rheumatoid arthritis (MED 490 pg/mL), osteoarthritis (MED 346 pg/mL), and healthy controls (238 pg/mL). No statistically significant differences in CEA concentrations were found between healthy controls and RA patients, as well as patients with osteoarthritis. CEA levels were not correlated with ANA titer, erythrocyte sedimentation rate, concentration of anti-Ro antibodies, and RF. <h3>Conclusion:</h3> Patients with Sjogren's syndrome have significantly higher concentrations of CEA compared to healthy controls and patients with osteoarthritis and rheumatoid arthritis. CEA could be a useful laboratory parameter in the future for diagnosing Sjogren's syndrome. <h3>REFERENCES:</h3> [1] Shi L et al. Increases in tumor markers are associated with primary Sjögren's syndrome-associated interstitial lung disease. Ther Adv Chronic Dis. 2020 Jul 30:11:2040622320944802. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1132 TRANSCRIPTOME-BASED CHARACTERIZATION OF SEX-SPECIFIC PHENOTYPE ON SLE PATIENTS
Authors: A. Banos, M. Grigoriou, S. Papanikolaou, N. Malissovas, A. Filia, C. Nikolaou, G. K. Bertsias, D. Boumpas
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> A key feature of Systemic Lupus Erythematosus (SLE) is the female predominance, as women present with this disease 9-fold more than men. In addition, the phenotype of the disease in each sex is quite distinct. Hormone impact, genetic distance, differential microbiome and epigenetic mechanisms are thought to be the main reasons for this sex bias. Yet, the details of the pathophysiological mechanisms that lead to the emergence of this trait of the disease are poorly studied. <h3>Objectives:</h3> To elucidate the molecular characteristics that differentiate the female from male lupus, using transcriptome analysis on whole blood from a large cohort of SLE patients. <h3>Methods:</h3> We mapped through RNA-seq the transcriptomes of 95 female healthy, 11 male healthy, 235 SLE female and 46 SLE male individuals. RNA libraries were prepared using the Illumina Truseq kit. Paired-end 67 bp mRNA-sequencing was performed on the Illumina HiSeq4000. FastQC software assessed quality. Raw reads were aligned to the human (hg38 version) genome using STAR V.2.6 algorithm. Gene quantification was performed using HTSeq. Differential expression analysis of human data was conducted using clusterProfiler package. Enrichment and network analyses were performed using gProfiler2. |log2 Fold Change|&gt; 0.58 and adjusted p-value &lt; 0.05 were utilized as thresholds for list of DEGs. <h3>Results:</h3> We curated lists of differentially expressed genes (DEGs) as follows: 1296 DEGs in SLE versus healthy individuals (regardless of gender), 19 DEGs in female versus male healthy individuals and finally 37 DEGs in female versus male SLE individuals. Of note, two genes of interests stand out in the comparison of transcriptomes between SLE female versus SLE male individuals, as NEBL gene (cardiac-muscle specific gene) is downregulated, while RPL10P6 gene (a pseudogene-residing in a neighborhood of enhancer like non-coding RNAs) is expressed higher in SLE females compared to SLE males. Molecular pathways altered specifically on SLE female transcriptomes include the Cohesin Complex (demarcation of the boundaries of active and inactive chromatin) as well as the MLL4 complex (an epigenetic regulator acting as histone methyltransferase). In addition, Xist gene expression is markedly upregulated in SLE females. <h3>Conclusion:</h3> According to our findings, chromatin reorganization through epigenetic switches seems to be a major contributor of the SLE sex bias. Though research is still needed towards the genetic component and other epigenetic layers (DNA methylation, non-coding genome), the elucidation of sexual dimorphism in SLE will boost efforts towards personalized therapy. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1718 ULTRASONOGRAPHIC EVALUATION OF MAJOR SALIVARY GLANDS IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS: A COMPARATIVE CASE SERIES
Authors: A. Moshrif, M. M. S. Younis, L. Allam, M. A. Ali
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease in childhood. Impaired salivary gland function has been previously reported in children with JIA. <h3>Objectives:</h3> To explore the possible subclinical affection of major salivary glands in pediatric patients with JIA by means of musculoskeletal Ultrasound (US) and to correlate the findings with disease activity and inflammatory indices. <h3>Methods:</h3> We conducted a cross-sectional study including 28 children diagnosed as JIA according to ILAR criteria and 20 healthy controls. Full history taking, general and local examination of the affected joints and US assessment of major salivary glands were done for both groups. <h3>Results:</h3> Ages of participants ranged from 5 to 16 years, with a mean of 11.04± 2.968 years 15 (31.25%) of them were males and 33 (68.75%) were females. According to Grey-scale score, there were 16 patients (57.1%) with normal parenchyma (grade 0), 4 patients (14.3%) with minimal change (grade 1), 2 patients (7.1%) with moderate change (grade 2), and 6 patients (21.4%) with severe change (grade 3) in JIA group. PD signal has been detected in the submandibular glands of only two patients with systemic onset JIA. No abnormality has been detected in the healthy control group. There was a statistically significant positive correlation between Grey-scale total score with ESR (r=0.694, P &lt; 0.001), juvenile arthritis disease activity score (JADAS) (r= 0.713, P &lt; 0.001), and parents' disease assessment (r= 0.678, P &lt; 0.003). <h3>Conclusion:</h3> Ultrasound detected subclinical salivary gland abnormalities are frequent in JIA patients and are associated with disease activity. However, further large scale studies are needed to support these preliminary results. <h3>REFERENCES:</h3> [1] Defabianis P, Garofalo F, Romano F. Salivary glands involvement: a new indicator of juvenile idiopathic oligoarticular arthritis (preliminary results). Rheumatology (Oxford). 2021 Sep 1;60(9):4379-4383. doi: 10.1093/rheumatology/keaa891. PMID: 33404649. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1422 SPINE TUBERCULOSIS: A SERIES OF 39 CASES
Authors: O. Farhat
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Pott's disease is still a major public health problem, particularly in developing countries. <h3>Objectives:</h3> Our aim was to describe the epidemiological, clinical, paraclinical and therapeutic features of tuberculous spondylodiscitis. <h3>Methods:</h3> This is a retrospective and descriptive study of cases of spine tuberculosis identified in a rheumatology department between 2000 and 2023. Diagnosis was based on bacteriological or anatomopathological evidence, or on a combination of arguments. <h3>Results:</h3> There were 39 patients, divided into 23 women and 16 men. The mean age was 55.69 years [25-83]. The average delay to diagnosis was 4,5 months. Initial signs were dominated by spinal pain (89,7%), which was inflammatory in 92% of cases, altered general condition (59%), fever (51,3%) and night sweats (33%). Neurological signs were present in 28,2% of cases. Biological inflammatory syndrome was present in 66,7% of cases. MRI was pathological in all cases, showing epiduritis in 64%, paravertebral abscesses in 30.8% and spinal cord compression in 17.9%. The lumbar region was most affected in 41% of cases. Multifocal involvement was observed in 15% cases. Tuberculin Skin Test was positive in 38.5% of cases. X-rays and thoracic CT scans revealed pulmonary involvement in 15.4% of cases. A spinal disc biopsy was performed in 71.8% of patients. Koch's bacillus was detected in 33% of cases. All patients received anti-tuberculosis treatment for an average of 12 months. Surgical treatment was indicated in 10.25% of cases. No deaths were reported during the course of the disease. <h3>Conclusion:</h3> Vertebral tuberculosis remains a fairly common pathology in our country. Diagnosis can be delayed by an insidious evolution and atypical signs, thereby increasing the risk of formidable complications, essentially neurological. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1363 ORBITAL INFLAMMATORY PSEUDOTUMORS: CLINICAL AND RADIOGRAPHIC CHARACTERISTICS: REPORTS OF 19 CASES
Authors: I. Arbaoui, Z. Aydi, I. Rachdi, M. Somai, R. Maamouri, B. Ben Dhaou, M. Cheour, F. Daoud, F. Boussema
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Orbital inflammatory pseudotumors (PTIO) are any inflammatory intra-orbital expansive process. <h3>Objectives:</h3> The objective of our work is to study the clinical and radiographic characteristics of PTIO in an internal medicine department. <h3>Methods:</h3> This is a retrospective study including patients being hospitalized in the internal medicine department between 2014 and 2023 and in whom the diagnosis of PTIO was made on clinical and radiological criteria. <h3>Results:</h3> Nineteen patients were included, with a mean age of 55 years (18–81).The symptomatology was dominated by exophthalmos in all the cases, it was associated with a decrease in visual acuity(n=13), eye pain in(n=7), eye redness(n=6), oculomotor paralysis(n=6),and palpebral oedema(n=4).The ophthalmologic examination noted the presence of conjunctival hyperemia(n=6), posterior nodular scleritis(n=3), episcleritis(n=1), ischemic retinal vasculitis(n=1),The extra ocular manifestations included: dry eye syndrome (n = 5), chronic sinusitis (n = 3), peripheral neuropathy (n = 2), presence of excavated lung mass (n = 1), nodular pachymeningitis (n = 1) and clinical signs of hyperthyroidism (n = 1). The realization of an orbito-cephalic magnetic resonance imaging allowed a diagnostic orientation by objectifying exophthalmos in all cases, fatty infiltration (n = 17), oculomotor muscle infiltration (n = 15), enhancement of the optic nerve sheath (n = 5), dacryoadenitis (n = 5), and nodular scleral thickening (n = 4) and pansinusien thickening (n = 3). The orbital biopsy was done in seven cases showing non-specific inflammatory signs in five cases and allowing the diagnosis of B lymphoma in one case. The aetiologies found: granulomatous polyangiitis (n = 3), primary sjogren syndrome (n = 2), Basedow disease (n = 1) and orbital lymphoma (n = 1), PTIO was idiopathic in twelve cases. <h3>Conclusion:</h3> Orbital pseudotumor is a benign intraorbital process confined to the orbit but extra orbital involvement can occur. Clinically, orbital pseudotumor has been categorized as myositis, dacryoadenitis, or associated with several ocular damage, Diagnosis is based on careful history, magnetic resonance imaging (MRI) studies which may also provide prognostic information. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
OP0157 CCL2-CCR2 AXIS MEDIATES DECIDUAL MONOCYTE/MACROPHAGE INFILTRATION AND INFLAMMATION IN OBSTETRIC ANTIPHOSPHOLIPID SYNDROME
Authors: R. Gao, C. Lu, L. Qin
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Obstetric antiphospholipid syndrome (OAPS) is an autoimmune disorder associated with pathologic pregnancy. Decidual inflammation was found to be a critical pathogenesis of OAPS, but the characteristic and regulator was unrevealed. We found significant monocyte/macrophage infiltration in decidua of OAPS patients before, as well as the overexpression of CCL2, which were related to decidual inflammation. However, the detail effect of CCL2-CCR2 axis in OAPS was unclear. <h3>Objectives:</h3> To investigate the effect and mechanism of CCL2-CCR2 axis in decidual monocyte/macrophage infiltration and inflammation among OAPS. <h3>Methods:</h3> The first-trimester decidua and peripheral blood samples from OAPS patients and healthy controls who matched for age and gestational weeks were collected, and pregnant mice were injected with mouse-anti human ß2 glycoprotein I (ß2GPI) monoclonal antibody to induce OAPS. The expressions of CCL2 and CCR2 in decidua and peripheral blood were detected by immunohistochemistry, enzyme-linked immunosorbent assay and flow cytometry. Transwell was used to detect the chemotaxis of primary decidual cells to THP-1 cell line. The monocyte/macrophage infiltration and inflammation of blocking CCL2-CCR2 signaling in OAPS mice was investigated by bindarit, a CCL2 inhibitor, and RS504393, a CCR2 antagonist. The main source and distribution of decidual CCL2 were explored by immunofluorescence staining. <h3>Results:</h3> The CCL2 levels in decidua and serum, and the expressions of CCR2 on decidual macrophages and peripheral monocytes, were significantly higher in both OAPS patients and mice than controls. A higher proportion of decidual macrophage and lower proportion of monocytes were observed in both OAPS patients and mice compared to controls. Also, we validated the positive correlations between decidual CCL2 levels, CCR2 levels in decidual macrophage and the proportion of decidual macrophage. The primary decidual cells from OAPS patients recruited more THP-1 cells than those from controls in vitro, and after bindarit stimulating and RS504393 blocking, this chemotactic effect was inhibited. OAPS mice that received bindarit and RS504393 treatment also presented less decidual monocyte/macrophage infiltration, less inflammatory cytokines, such as TNF-α, IFN-γ and IL-1ß, in decidua, and lower embryo absorption rate. Decidual macrophages and vascular endothelial cells were the main source of CCL2, and CCL2 was mainly distributed in the decidual interstitium and surface of vascular vessels in OAPS. <h3>Conclusion:</h3> The CCL2-CCR2 axis mediates monocyte/macrophage infiltration from peripheral blood to decidua, and subsequent inflammation, among OAPS. We provide a new insight into the mechanism and therapeutic target for OAPS. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1390 BARICITINIB FOR THE TREATMENT OF RELAPSING POLYCHONDRITIS: A COHORT STUDY
Authors: Z. Zhang, Y. Wang
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> This pilot study aims to evaluate the effectiveness and safety of baricitinib in relapsing polychondritis (RP) patients. <h3>Objectives:</h3> Aim of this case report was to show efficacy of baricitinib in a patients with relapsing polychondritis. <h3>Methods:</h3> A single-center, cohort analysis was performed to enroll RP patients who received baricitinib (2 mg per day) along with glucocorticoids (GC) and immunosuppressants. Efficacy assessment and side effects were recorded. <h3>Results:</h3> 16 patients (12 males) were included with a mean follow-up of 12.7 ± 4.3 months. At 3 months of follow-up, 80.5% of patients achieved a complete response and the proportion increased to 90.2% at the one year follow up visit. During the follow-up, ESR (p &lt; 0.01) and hsCRP (p &lt; 0.0001) decreased significantly, as well as the relapsing polychondritis disease activity index (RPDAI) (p &lt; 0.01). In addition, baricitinib showed a GCs-sparing effect. No serious adverse events were noted. <h3>Conclusion:</h3> Our study suggests that baricitinib is well-tolerated and effective in treating relapsing polychondritis patients. <h3>REFERENCES:</h3> [1] Meshkov AD, Novikov PI, Zhilyaev EV, et al. Tofacitinib in steroid-dependent relapsing polychondritis. <i>Ann Rheum Dis</i> 2019;78:e72–e72. DOI:10.1136/annrheumdis-2018-213554. [2] Moulis G, Pugnet G, Costedoat-Chalumeau N, <i>et al.</i> Efficacy and safety of biologics in relapsing polychondritis: a French national multicentre study. <i>Ann Rheum Dis</i> 2018;77:1172–8. DOI:10.1136/annrheumdis-2017-212705. [3] Rednic S, Damian L, Talarico R, <i>et al.</i> Relapsing polychondritis: state of the art on clinical practice guidelines. <i>RMD Open</i> 2018;4:e000788. DOI:10.1136/rmdopen-2018-000788. [4] Yoshida T, Yoshifuji H, Shirakashi M, et al. Risk factors for the recurrence of relapsing polychondritis. Arthritis Res Ther 2022;24:127. DOI:10.1186/s13075-022-02810-0. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1436 TO WHAT EXTENT IS THERE A HALO EFFECT ON CLASS PRESCRIBING ACROSS KEY RHEUMATOLOGY INDICATIONS (RA, PsA AND axSpa)?
Authors: S. Brown, J. Godfrey, M. Hollis, R. Samuels, M. I. Tanase
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> In the field of rheumatology, there are five primary classes of advanced therapy treatments that are crucial for addressing key indications. These include TNFi, JAKi, IL6i, CD80i, and CD20i. Should a treatment response not be sustained with csDMARDs like methotrexate, it is recommended by the EULAR guidelines to consider the utilization of advanced therapies for patients. However, it is important to take into account specific risk factors when using Janus Kinase inhibitors (JAKi). <h3>Objectives:</h3> The purpose of this was study was to evaluate whether physicians utilize JAKi treatment at similar levels for the rheumatology indications of Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA), and Axial Spondyloarthritis (axSpA). We aimed to determine if there is a halo effect, whereby the use of JAKi in one indication influences its usage in another, and if this relationship has evolved over time. <h3>Methods:</h3> In Q4 of 2023, 228 Rheumatologists from France, Italy, Germany, Spain, and the UK contributed approximately 3420 anonymous patient record forms for individuals receiving advanced therapy. These forms consisted of 1600 records for RA patients, 912 for PsA patients, and an additional 912 for axSpA patients, all of which were collected through the Therapy Watch Rheumatology survey by Research Partnership. Informed consent from physicians was obtained. Where relevant, statistical comparisons were performed using t-test. <h3>Results:</h3> 35% of physicians reported exclusive use of JAKi for RA treatment, while 44% prescribe JAKi for RA in combination with either PsA, axSpA, or both. Very few physicians prescribe JAKi to PsA or axSpA patients, indicating a halo effect originating from RA use. 18% of physicians do not report JAKi use in any indication across EU5. In Germany, 7.3% physicians did not report JAKi use in any indication in Q2 2022, rising to 19.6% in Q4 2023. The percentage of physicians not using JAKi in the treatment of RA has increased from 15.4% in Q1 2022 to 21.9% in Q4 2023. On the other hand, the prescribing of JAKi for PsA and axSpA is significantly lower than in RA, but remains relatively stable. <h3>Conclusion:</h3> Our findings reveal a halo effect when it comes to the use of JAKi in RA, which extends to its usage in PsA and axSpA. Very few physicians prescribe JAKi solely for PsA or axSpA patients. Our data confirms that the utilization of JAKi in PsA and axSpA patients is typically linked to its usage by physicians in RA. However, there is a growing trend among physicians who have stopped prescribing JAKi for RA following the PRAC guidance announcements. At this point, our data suggests that this change has not had a ripple effect on the prescribing of JAKi for PsA and axSpA. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>