tbuckley/cabot-search huggingface dataset:
POS1508-HPR IMPLEMENTATION PERSPECTIVES OF USING A DIGITAL PATIENT EDUCATION PROGRAMME IN CLINICAL PRACTICE
Authors: L. Raunsbæk Knudsen, K. Lomborg, E. M. Hauge, A. De Thurah
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The integration of telehealth interventions into clinical practice is frequently delayed, hindering the full adoption [1]. Previously, we developed a digital patient education programme for self-management in rheumatoid arthritis (RA) [2]. The programme design considered crucial factors to ensure the likelihood of success in clinical practice. Still, there is a need for a thorough and systematic evaluation of implementation perspectives. <h3>Objectives:</h3> To explore perspectives of implementation in using a digital patient education programme in clinical practice. <h3>Methods:</h3> The non-adoption, abandonment, scale-up, spread and sustainability (NASSS) framework [3] was used to evaluate the facilitators and challenges of implementing the digital patient education programme. We included a primary data set consisting of qualitative focus group discussions involving study nurses, rheumatologists, and leaders from rheumatology departments (n=10), who had participated in a randomised controlled trial examining the effectiveness of the digital PE programme. Data analysis was guided by a deductive content analysis approach. Further we included secondary data from earlier studies, comprising the programme development process, the effectiveness study, and a qualitative study exploring patients' perspectives of the programme. <h3>Results:</h3> Facilitators and challenges of importance to implementation of digital patient education were identified: <h3>Conclusion:</h3> The design and ease of use of the technology, the programme's effectiveness, its availability, and the potential to release healthcare resources may encourage the implementation of digital patient education. Challenges associated with implementing this mode of care pertains to the illness and the patient population, user adoption of the technology, and the organization of patient education. <h3>REFERENCES:</h3> [1] de Thurah A, et al. Ann Rheum Dis. 2022. [2] Knudsen LR, et al. PEC Innovation. 2022. [3] Greenhalgh T, et al. J Med Internet Res. 2017. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Line Raunsbæk Knudsen Phizer, Novartis, Eli Lilly, Kirsten Lomborg: None declared, Ellen-Margrethe Hauge Novo Nordic, Novartis, AbbVie, Sanofi, MSD, UCB, Novo Nordic Foundation, Galapagos, AbbVie, Roche, Novartis, Annette de Thurah: None declared.
OP0281 STATIN USE AND RISK OF TOTAL JOINT REPLACEMENT OF KNEE AND HIP OSTEOARTHRITIS PATIENTS: STUDY BASED ON THE FRENCH NATIONAL HEALTHCARE SYSTEM DATABASE
Authors: C. Roux, J. Bulsei, S. Ferrero, E. Fontas
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Potential beneficial effect of statin use on osteoarthritis progression is discussed. Some observational studies suggested that statin use might be associated with radiological worsening, others did not show any protective effect and few studies a protective effect. <h3>Objectives:</h3> The aim of our study was to assess the risk of total knee or hip replacement among patients treated by statin versus patients without statin treatment in the French population. <h3>Methods:</h3> We conducted a nationwide population based cohort study using the french national healthcare system database (SNDS). We included all patients starting a statin treatment in 2018 and still on treatment on a regular basis until december 2022 and 800,000 unexposed patients randomly selected from the entire French population. The primary endpoints, occurrence of knee or hip arthroplasty, were studied using Cox models adjusted for age, gender and comorbidities. In order to assess the uncertainty around the results, a propensity score matching was performed in a sensitivity analysis to create 2 groups of comparable patients. <h3>Results:</h3> The cohort included 274,801 patients treated with statins and 795,491 patients without statins, after removing patients who met exclusion criteria. Mean age 60.2 and 56.1 years, female 41.9 % and 51.9 %, diabetis 24.0 % and 7.7 %, cardiovascular comorbidities 33.0 % and 7.0 % respectively. During follow-up 5,788 and 9,928 knee replacement and 5,347 and 10,170 hip replacement occured in the statin and non statin group, respectively. Risk of knee or hip replacement for the statin group versus non statin group was significantly higher: knee replacement HR 1.49 [1.44; 1.55] (p&lt;0.0001); hip replacement HR 1.39 [1.34; 1.44] (p&lt;0.0001). The results were confirmed by sensitivity analysis. <h3>Conclusion:</h3> This study showed that statin use is associated in a increased significant risk of knee and hip replacement. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0855 POLYAUTOIMMUNITY AND MULTIPLE AUTOIMMUNE SYNDROME IN SYSTEMIC SCLEROSIS
Authors: M. Retuerto-Guerrero, C. Moriano, C. Sieiro Santos, I. González, I. González Fernández, C. Díez, C. Álvarez Castro, P. Pérez-García, J. Ordas Martínez, P. Baenas González, E. Diez Álvarez
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Polyautoimmunity (PA) is defined as the presence of more than one well-defined autoimmune disease (AD) in a single patient. When three or more autoimmune diseases coexist, this condition is called multiple autoimmune syndrome (MAS). Polyautoimmunity is not well characterized in systemic sclerosis (SSc). <h3>Objectives:</h3> We aim to describe the prevalence of polyautoimmunity and the multiple autoimmune syndrome in a Spanish cohort of patients with systemic sclerosis. <h3>Methods:</h3> Observational, analytical and cross-sectional monocenter study. We included 92 patients with diagnosis of SSc according to modified ACR-EULAR 2013 criteria. Demographic, clinical and immunological data were collected. Continuous variables were compared by Student's or Mann Whitney's T test, and categorical variables by Chi2 test or Fisher's exact test. <h3>Results:</h3> The study population comprised 92 patients with SSc (73% female) with a mean age at inclusion of 65±13.6 years (Table 1). Polyautoimmunity was present in 44 patients (48%) and Multiple autoimmune syndrome was present in 15 patients (16%). The most frequent rheumatics ADs were Sjögren´s syndrome (21/44) and Systemic lupus erythematosus (8/44). The most frequent non-rheumatic ADs were Primary biliary cirrhosis (4/44) and Lichen planus (4/44) (Table 2). Patients with polyautoimmunity had a higher frequency of treatment with antimalarias (p=0.004), and a higher number of positive antibodies (p&lt;0.001). The subjects with MAS have higher rates of anti-SSA than total of patients with PA (p=0.02). Polyautoimmunity does not increase the risk of cancer. <h3>Conclusion:</h3> Patients with systemic sclerosis and polyautoimmunity do not have a more aggressive phenotype, however, given the high prevalence of coexisting autoimmune diseases, it is important to diagnose other possible autoimmune diseases in these patients.<b>REFERENCES: NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0002 RECLASSIFICATION OF PATIENTS WITH ANTIPHOSPHOLIPID SYNDROME ACCORDING TO THE 2023 ACR/EULAR CLASSIFICATION CRITERIA: A DESCRIPTIVE STUDY OF A MONOCENTRIC COHORT
Authors: L. Rapino, S. Truglia, S. Mancuso, E. Balbinot, C. Alessandri, F. Ceccarelli, F. R. Spinelli, F. Conti
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The new classification criteria for antiphospholipid antibody syndrome (APS) have introduced many novelties, such as the presence of an entry criterion, the use of a scoring system, the introduction of previously "extra-criteria" manifestations, the weighting of thrombotic events according to thromboembolic and cardiovascular risk factors and the redefinition of obstetric APS (OAPS). <h3>Objectives:</h3> The aim of this study is to apply the latest classification criteria to a monocentric cohort of patients with diagnosis of APS and to compare it with the previous criteria. <h3>Methods:</h3> We retrospectively collected data from patients with clinical diagnosis of APS from the Lupus Clinic of Sapienza University of Rome and applied the new classification criteria and the previous 2006 "Sapporo" criteria. <h3>Results:</h3> In our cohort of 165 APS patients, 139 could be classified according to Sapporo criteria, while 106 patients fulfilled the new classification criteria. Among the 33 patients that could not be reclassified by the new criteria, 21 patients did not meet clinical domains (8 thrombotic APS patients did not reach enough points due to a high thromboembolic/cardiovascular risk and 13 OAPS patients due to the presence of poliabortivity or fetal death alone), while 18 lacked laboratory domains due to only IgM aPL positivity (Graph 1). <h3>Conclusion:</h3> In our cohort, the application of the new APS classification criteria identifies a smaller number of patients compared to the previous ones, confirming the reduced sensitivity of the former. The new criteria may lead to the exclusion of patients with specific clinical and laboratory characteristics, that require larger studies to be assessed. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0013 ATTAINMENT OF CLINICAL REMISSION IN RHEUMATOID ARTHRITIS: COMPREHENSIVE ANALYSIS OF CONTRIBUTING FACTORS
Authors: H. Zouaki, H. Elhani, L. Taoubane, N. Elouardi, A. Majjad, E. A. Houda, E. K. Elmarbouh, H. Toufik, A. Bezza
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) poses a persistent challenge marked by chronic joint inflammation and progressive damage. The pinnacle of therapeutic success in RA lies in achieving clinical remission, indicative of both symptom alleviation and profound inflammatory quiescence. <h3>Objectives:</h3> The paramount therapeutic objective in managing rheumatoid arthritis (RA) is the attainment of clinical remission, characterized by a profound absence of inflammatory signs and symptoms. This study aimed to meticulously evaluate the prevalence of remission in RA patients and rigorously identify potential predictive factors influencing this clinically significant outcome. <h3>Methods:</h3> Employing a meticulously structured cross-sectional and descriptive methodology, this investigation encompassed the entire spectrum of adult patients diagnosed with RA, strictly adhering to the rigorous ACR/EULAR 2010 criteria. The study was conducted at the Rheumatology Department of HMIMV-Rabat over a meticulously monitored 12-month period. Clinical remission was meticulously defined as the achievement of a Disease Activity Score (DAS28) less than 2.6, with an exhaustive analysis of potential predictive factors influencing remission. <h3>Results:</h3> A meticulous inclusion of 194 patients divulged a significant preponderance of females (80.92%), with an average age of 56.60 ± 10.8 years. A detailed exploration of their medical history revealed an average disease duration of 8.4 ± 7.29 years. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies were detected in 62.9% and 66.5% of patients, respectively. The calculated mean DAS28 CRP was 4.48. Erosive manifestations of RA were identified in 71.1% of patients. Background treatments comprised methotrexate in 91.8%, sulfasalazine in 45.3%, leflunomide in 27.9%, and synthetic disease-modifying antirheumatic drugs in 12.6%. Corticosteroids were prescribed in 90.7% of patients. A meticulous examination of the data revealed remission in 35% of patients. Multivariate analysis further elucidated that both conventional background treatments and biologics were significantly associated with achieving remission. <h3>Conclusion:</h3> Within this meticulously scrutinized cohort, the attainment of remission in RA at the one-year follow-up was discerned in 35% of patients. These compelling findings underscore the pivotal role of therapeutic interventions, specifically the administration of conventional background treatments and biologics, in effectively steering patients toward the coveted state of clinical remission in the management of rheumatoid arthritis. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0965 PREVALENCE AND ASSOCIATED FACTORS OF FIBROMYALGIA IN SPONDYLOARTHRITIS PATIENTS
Authors: O. Jomaa, W. Khelif, A. Ben Salem, M. Brahem, M. Ardhaoui, A. Sboui, M. Younes
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Fibromyalgia is a disease characterized by chronic widespread pain that can significantly impair the quality of life of patients with spondyloarthritis (SpA). <h3>Objectives:</h3> Our study aimed to determine the prevalence of fibromyalgia in a SpA population and to identify the factors associated with it. <h3>Methods:</h3> This is a cross-sectional study of patients with spondyloarthritis diagnosed according to ASAS 2009 criteria. Epidemiological and clinical characteristics, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP), and Bath ankylosing spondylitis functional index (BASFI) for the functional impact (BASFI were assessed for each patient. The First questionnaire, consisting of six questions each taking one point, is a screening questionnaire for fibromyalgia if at least a score of 5 out of 6 is obtained. <h3>Results:</h3> In this study, we enrolled 45 patients with a female/male ratio of 1.2. The mean age was 44.4 ±15 [22-82 years]. The mean duration of the disease was 10 ± 8.3 [3 months-40 years]. The socioeconomic level was poor in 34.1% of cases. SpA was axial in 56.8% (n=25); peripheral in 13.6% (n=16) and both in 29.5% (n=13). The mean BASFI and ASDAS were 37 ± 2 [6-71] and 2.8± 1 [1.2-5.3] respectively. The frequency of fibromyalgia was 11.1% (n=5) with a mean FiRST score of 1.94 ± 1.4 [0-5]. A significant association was found between the presence of fibromyalgia and high disease activity (ASDAS), (BASDAI); p=0.003), higher BASFI level (p= 0.001), higher Visual Analog Scale pain (p=0.007), C-Reactive Protein level (p=0.006) and erythrocyte sedimentation rate (ESR)(p=0.003). However, no association was noted between fibromyalgia based on age (p=0.3), duration of the disease (p=0.5) and Body Mass Index (BMI) (p=0.7). <h3>Conclusion:</h3> our study highlights that fibromyalgia is significantly associated with high disease activity and functional disability in spondyloarthritis patients. Consequently, implementing systematic screening for fibromyalgia in this context appears to be crucial for ensuring more effective and personalized care. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0018 ARTHROPLASTY RATES AND RISK IN FAMILIAL MEDITERRANEAN FEVER PATIENTS: A LARGE POPULATION-BASED STUDY
Authors: N. Ben-Shabat, L. Fisher, Y. S. Patt, M. Arow, N. Maixner, A. Watad, H. Amital, O. Gendelman
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Familial Mediterranean Fever (FMF) is a genetic disorder characterized by recurrent episodes of fever and inflammation in various organs, including joints. Traditionally, the arthritis of FMF has been considered relatively harmless. However, anecdotal evidence has suggested that it may contribute to long-term joint damage, which may necessitate surgical joint replacement. <h3>Objectives:</h3> This study aimed to investigate the rates of arthroplasty among FMF patients and compare it to the general population. <h3>Methods:</h3> The study used the electronic database of the largest healthcare organization in Israel to identify 9,769 FMF patients diagnosed between 2000 and 2016. A similar number of age-, gender-, and residency-matched controls were also identified. The rates of arthroplasty were compared between the two groups. A logistic regression model predicting the need for arthroplasty within the FMF group was formed to identify potential risk factors. <h3>Results:</h3> Of the 9,769 FMF patients, 114 (1.2%) underwent arthroplasty, compared to 64 (0.7%) of the control group [unadjusted odds ratio (OR)=1.79, 95% confidence interval (CI) 1.32-2.43; partially adjusted OR=1.97, 95% CI 1.40 to 2.77; fully adjusted OR=1.92, 95% CI 1.35-2.72]. Within the FMF cohort, those of North African origin had a significantly higher risk of arthroplasty (OR=6.89, 95% CI 5.09-9.33; p &lt; 0.001). <h3>Conclusion:</h3> FMF patients can experience long-term joint damage that may require arthroplasty. Although this complication is relatively uncommon in FMF patients, it occurs almost twice as frequently as compared to the general population. FMF patients of North African origin are at an even higher risk. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0015 DECIPHERING FIBROMYALGIA’S INTERPLAY IN RHEUMATOID ARTHRITIS: UNVEILING INSIGHTS FOR CLINICAL PRECISION
Authors: E. A. Houda, H. Elhani, L. Taoubane, A. Majjad, H. Toufiq, A. Bezza, N. Elouardi
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) stands as the most prevalent chronic inflammatory rheumatic disease, with pain being a pivotal parameter assessed in various scoring systems employed for disease activity measurement. Fibromyalgia, on the other hand, is characterized by chronic widespread pain. <h3>Objectives:</h3> To discern the specific impact of fibromyalgia on rheumatoid arthritis by thoroughly examining its prevalence within the rheumatoid arthritis population, identifying significant correlations, and defining customized assessment strategies for optimal clinical management. <h3>Methods:</h3> We conducted a cross-sectional and descriptive study encompassing all adult patients diagnosed with RA according to the ACR/EULAR 2010 criteria over a 12-month period. Sociodemographic characteristics, diverse disease assessment scores, the FiRST questionnaire, and various diagnostic and therapeutic aspects were documented for each patient. <h3>Results:</h3> Data were collected from 194 patients, with an average age of 56.60 ± 10.8 years, predominantly female with a female-to-male ratio of 9.5. The prevalence of fibromyalgia in the RA patient population was 38.1%, with a mean FiRST score of 3.85 ± 1.82. In multivariate analysis, the only statistically significant association with fibromyalgia was found to be the number of painful joints. <h3>Conclusion:</h3> Our study underscores the substantial prevalence of fibromyalgia within our RA patient cohort. The evaluation of RA should consider the presence or absence of concomitant fibromyalgia to mitigate therapeutic escalation. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1336 IMPROVING INFLUENZA VACCINATION RATES AND METHOTREXATE WITHHOLDING IN PATIENTS WITH RHEUMATOID ARTHRITIS: AN EDUCATIONAL INTERVENTION
Authors: H. Martin, C. Barrett, L. Young, Y. Oh
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patients with rheumatoid arthritis (RA) are at an increased risk of influenza infection and adverse outcomes independent of their treatment. Continuing methotrexate following vaccination impairs immunogenicity, but withholding methotrexate for one or more weeks following vaccination improves immunogenicity. ARA and ACR guidelines recommend patients with stable disease withhold methotrexate 2 weeks post influenza vaccine. It is unclear if patients are aware of or completing this practice. <h3>Objectives:</h3> To assess patients' awareness of the increased risk of influenza, knowledge of withholding methotrexate and the proportion of patients who were vaccinated in 2022 and withheld. Additionally, we aimed to determine if an educational handout informing patients of the benefits of withholding leads to increased rates of temporary withholding and the overall influenza vaccination rate in 2023. We also assessed rates of disease activity and fear of vaccination and influenza. <h3>Methods:</h3> We conducted a cross-sectional study surveying patients before and after the influenza season in 2023. Patients with RA prescribed methotrexate were recruited from a rheumatology clinic in Australia in June and July 2023 and given a handout at recruitment. The primary outcome was the change in temporary withholding in 2023 and change in total vaccination rate. <h3>Results:</h3> 177 patients completed the initial survey, with a mean age of 62.3 years and 71% female. 57% reported being aware of the increased risk of adverse outcomes with influenza infection. In 2022, 78% were vaccinated, with 3.3% of patients withheld methotrexate post-vaccination. In 2023, 92% were vaccinated against influenza, with 11% withholding (P&lt;0.007). Two of 14 that withheld reported increases in disease activity, consistent with previous data. <h3>Conclusion:</h3> The provision of a handout increased both rates of withholding of methotrexate and overall vaccination rates against influenza. The large proportion of patients &gt;65 years may have influenced the findings. <h3>REFERENCES:</h3> <b>NIL.</b> <b>Table 1.</b> Patient characteristics <b>Table 2.</b> Vaccination outcomes 2022 and 2023 <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>