tbuckley/cabot-search huggingface dataset:
AB0701 DRUG SURVIVAL ON FIRST BIOLOGIC THERAPY AMONG ELDERLY-ONSET RHEUMATOID ARTHRITIS PATEINTS COMPARED TO YOUNG-ONSET PATIENTS: A POPULATION-BASED COHORT STUDY
Authors: H. Jeries, R. Daood, B. Hijazi, A. Golan-Cohen, I. Green, E. Merzon, M. E. Naffa, F. Hassan
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory joint disease leading to joint destruction. Patients can be divided according to the age of onset, and classified as elderly-onset (&gt;60 years old) or young-onset (&lt;60 years old). Elderly-onset patients are underrepresented in clinical trials, and treatment strategies in these patients is based on extrapolation of the recommendations for young-onset patients. Current treatment guidelines do not stipulate any preference regarding the biologic that should be used first in elderly-onset patients. <h3>Objectives:</h3> This study aims to compare the drug survival times on first biologic disease modifying anti rheumatic drugs (bDMARDs) between elderly-onset and young-onset patients. <h3>Methods:</h3> This is a retrospective cohort study based on the electronic medical records of Leumit healthcare services. We collected all data of RA patients between the years 2000-2017. RA patients were identified according to ICD-9 code 714, in addition to one of the following criteria: 1) being positive for RF or ACPA, 2) diagnosis made by a rheumatologist or, 3) at least a single purchase of conventional synthetic disease modifying anti rheumatic drug (csDMARD). Patients' demographics, comorbidities, laboratory parameters and medications' purchase data were collected. RA patients were divided into elderly-onset and young-onset and were compared according to the drug survival times on the first biologic therapy. <h3>Results:</h3> The final cohort included 3814 RA patients, 2807 (73.6%) were young-onset RA patients. Overall, bDMARDs were used more often among young-onset patients compared to elderly-onset (16.9% vs. 7.8%, p &lt;0.001). Etanercept was associated with the longest drug survival time on first biologic among young-onset patients, and adalimumab and infliximab were associated with the longest drug survival times among elderly-onset patients. No differences were observed in drug survival times on the first bDMARD between elderly-onset and young-onset, except for abatacept and golimumab. <h3>Conclusion:</h3> Elderly-onset RA patients are treated with biologics at a lesser extent than young-onset patients, but no differences were observed in drug survival times on first bDMARD between the two groups. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0711 ASSESSMENT OF RHEUMATOID ARTHRITIS PATIENTS’ ADHERENCE TO TREATMENT AND RELATED FACTORS
Authors: A. Ben Salem, M. Brahem, O. Jomaa, R. Sarraj, M. Ardhaoui, M. Younes
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Low therapeutic compliance is one of the main causes of therapeutic failure in rheumatoid arthritis (RA). <h3>Objectives:</h3> Our study aimed to measure adherence to treatment among patients suffering from RA and assess the associated factors. <h3>Methods:</h3> This is a cross-sectional study conducted among patients suffering from RA diagnosed based on ACR/EULAR 2010 criteria. Disease Activity Score-28, Visual Analog Scale for pain (VAS pain) and functional disability (HAQ) were assessed. Socio-demographic characteristics and medication types in RA were determined. A questionnaire was used to measure adherence using the 8-item Morisky's scale. A general score of less than 8 defined low adherence to treatment. <h3>Results:</h3> A total of 65 RA patients were enrolled with a female predominance of 92.3 %. The median age was 54.2 ±12 years [24-80] and the mean duration of disease was 12.6 ± 7.7 years [6 months- 37]. The average DAS 28 was 3.1 ± 1.2 [1.1-6.3]. The VAS pain and HAQ scores were respectively 19.5 ± 21 [0-90 mm] and 0.7± 0.5 [0-2] on average. CsDMARDs; corticosteroids and biotherapy were prescribed in 100%; 87.7% and 15.4 % of cases respectively. According to Morisky's scale, low adherence was observed in 27% of cases (n=17). Statistical analysis showed that the low adherence to treatment was associated with severe activity stage (p=0.004) and higher VAS pain (p=0.006). However, no correlation was found between low adherence and the following parameters: age (p=0.8); gender (p=0.6); HAQ level (p=0.9); socioeconomic level (p=0.7) and intellectual level (p=0.1). <h3>Conclusion:</h3> Our study reveals a low adherence in 27 % of cases with significant association with pain and severe activity. So, it's necessary to act on these parameters to increase treatment adherence. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0705 PAIN AND CATASTROPHIZING IN PATIENTS WITH RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL STUDY
Authors: M. Brahem, A. Ben Salem, O. Jomaa, R. Sarraj, M. Ardhaoui, B. Jebali, M. Younes
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Pain catastrophizing is the tendency to perseverate on one's pain and imagine its worst possible outcome. It is suspected of being involved in the maintenance and persistence of chronic pain in rheumatoid arthritis (RA). <h3>Objectives:</h3> This study aimed to determine the frequency of catastrophizing and its associated factors. <h3>Methods:</h3> This was a cross-sectional study of patients with RA over a 3-month period. We collected clinical parameters including disease activity (DAS 28) and Visual Analog Scale for pain (VAS pain). We assessed catastrophizing using the Pain Catastrophizing Scale (PCS) questionnaire. The total score was calculated, along with 3 sub-scores corresponding to pain amplification (items 6,7 and 13), rumination (items 8 to 11), and feelings of helplessness (items 1 to 5 and 12). A score of 30 or more represents a high level of pain catastrophizing. <h3>Results:</h3> A total of 65 patients were included: 60 females and 5 males (sex-ratio M/F: 0.08) with an average age of 54.1 ±12 [24-80 years]. The mean duration of RA was 12.6 years ± 7.7 [6 months-37 years]. Rheumatoid factor (RF) was positive in 44 Patients (72.1% of cases). Anti-citrullinated peptide antibody (ACPA) was positive in 47 patients (79.7 %). 54 patients (83.1%) had radiological impairments and 32 (49.2%) had specific RA deformities of RA. The average disease activity score (DAS28-VS) and (DAS28-CRP) were 3.1±1.2 [1.1-6.3] and 2.5 ± 1 [1 – 5.2] respectively. The average HAQ was 0.7 ± 0.5 [0-2]. Based on the PCS questionnaire, 27 patients (43.5%) had a high level of catastrophizing (PCS ≥ 30) with a mean PSC of 19.3 ± 12.4 [0-44]. A significant association was found between the presence of pain catastrophizing and high disease activity (p=0.02), higher HAQ levels (p=0.05), and higher VAS (p=0.04). On the other hand, no association was found between pain catastrophizing and age (p=0,8) nor post-menopausal status (p=0.1). <h3>Conclusion:</h3> These high PCS scores encourage the systematic removal of catastrophizing in patients with RA to treat this distortion of perception using cognitive-behavioral approaches. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1331 THE CARBON FOOTPRINT OF ADALIMUMAB BIOSIMILARS THROUGH THEIR LIFE CYCLE
Authors: I. Moninot, A. Fontana, E. Feurer, M. Q. Le, P. J. Cottinet, R. Chapurlat
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> We are experiencing climate change, a portion of which is anthropogenic, meaning it is caused by human activities. In developed countries, the impact of healthcare systems on the environment is sizeable (roughly 8% of the carbon footprint). So, it is essential to incorporate a medico-ecological approach into our practices and prescriptions. In rheumatology, there are now numerous biosimilars for the same biological DMARD. We are questioning whether there might be a medico-ecological argument to prescribe one over the other. <h3>Objectives:</h3> The objective of this study was to evaluate the carbon footprint (eqCO2) of the different ADALIMUMAB 40mg pens and compare them. We focused solely on the container, excluding the active ingredient. The pen and its packaging were taken into account. We also studied 2 syringes. <h3>Methods:</h3> In this descriptive study, we have analyzed the life cycle of materials. The original drug and its eight 40mg biosimilars were analyzed. The Ansys Granta EduPack® software was used following the "eco-audit" method proposed by Ashby. The resulting emissions correspond to the entire lifespan of the different elements: from material extraction to their disposal, including production and transportation. We have also assessed the amount of water needed for manufacturing and recyclable proportions. <h3>Results:</h3> We have measured differences in terms of carbon emissions among the biosimilars. The one with the greatest impact represents almost +40% equivalent of Co2 more than the one with the lowest impact. We have observed that one injection by syringe represents 2 to 3 times fewer emissions than a pen. There is significant variability in water quantity that is necessary, ranging from a single unit to six times as much; there are disparities in recyclable content, as shown in Figure 1 below. A year of treatment using an ADALIMUMAB pen for one patient represents at least 8.6 equivalent kgCO2 (excluding the active ingredient). In France, in 2022, the greenhouse emissions related to 40mg ADALIMUMAB pens represent 482 514 kgeCO2, the equivalent of 3 million kilometers by plane. <h3>Conclusion:</h3> In conclusion, there are disparities in carbon emissions among different ADALIMUMAB biosimilars. Comparatively, the syringe halves the emissions compared to the pen. Our results will help both manufacturers and prescribers decarbonize healthcare. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Inès Moninot: None declared, AURELIE FONTANA: None declared, Elodie Feurer: None declared, Minh-Quyen Le: None declared, Pierre-Jean Cottinet: None declared, Roland Chapurlat Fresenius-Kabi, Abbvie, BMS, Lilly, Galapagos, Medac, Nordic, Novartis, UCB.
AB1325 FIVE-YEAR OUTCOMES OF 150 PATIENTS WHO HAD BEEN CLASSIFIED AS POLYMYALGIA RHEUMATICA ACCORDING TO THE 2012 EULAR/ACR CLASSIFICATION CRITERIA
Authors: A. Ueno, M. Yamamura
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The diagnosis of polymyalgia rheumatica (PMR) requires the exclusion of many inflammatory illnesses with arthralgia and myalgia in older people. <h3>Objectives:</h3> To determine long-term clinical outcomes after PMR diagnosis. <h3>Methods:</h3> The diagnosis of PMR had been made according to the provisional 2012 EULAR/ACR classification criteria during April 2012 – March 2016. A total of 150 patients (82 males; mean 73.6 y.o. at onset) were retrospectively followed-up. <h3>Results:</h3> 125 patients had started with glucocorticoids (GC), but 63 patients relapsed at median 9 month followed by increased GC, methotrexate (MTX; n=43) + tocilizumab (n=11). At five years, 93 patients (64%) were cured, but 32 patients were still receiving low-dose GC (n=28) and MTX (n=11). During 5 years, adverse effects requiring hospitalization included fragility fracture (n=15), infections (n=11), malignancy (&gt; 2 years after PMR) (n=8), vascular events (n=7), and other conditions (n=13). On the other hand, 25 patients had been changed diagnoses from PMR to solid tumors (&lt; 2 years after PMR, mostly simultaneously; n=8), rheumatoid arthritis (n=3), hematologic diseases (n=2), vasculitis (n=2), other arthritides (n=6), and others (interstitial pneumonia, Still's disease, etc.; n=4). Patients with PMR showed higher erythrocyte sedimentation rates and matrix metalloproteinase levels at baseline, as compared with mimics. <h3>Conclusion:</h3> The 2012 EULAR/ACR classification criteria may be useful for the diagnosis for PMR, but caution must be required for mimics. To reduce GC-related side effects, approval of new drugs such as IL-6 inhibitors will be awaited. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1314 SAFETY AND EFFICACY OF LONG-TERM TOCILIZUMAB IN A COHORT OF PATIENTS WITH GIANT CELL ARTERITIS: AN ITALIAN MONOCENTRIC RETROSPECTIVE STUDY
Authors: E. Conticini, R. Terribili, S. Grazzini, P. Falsetti, C. M. Fabiani, G. Biasi, L. Cantarini, B. Frediani
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Tocilizumab (TCZ) is the only biologic drug approved for the treatment of giant cell arteritis (GCA), having clinical trials and real-life studies proved its efficacy and safety. However, optimal duration of the treatment has yet to be determined, being its early interruption associated with an increased risk of relapse. Conversely, prolonged schemes of therapy may rise safety concerns. <h3>Objectives:</h3> The aim of the study was to evaluate the incidence of adverse events (AEs) and remission/relapse rate in a cohort of GCA patients treated with TCZ and an accelerated steroid tapering scheme, followed for 24 months. <h3>Methods:</h3> We retrospectively included patients referring to our clinic from January 2019 to November 2021 who were diagnosed with GCA and started subcutaneous TCZ treatment (162 mg/week). They also received up to 62,5 mg prednisone (PDN), tapered following an accelerated six-month scheme (Table 1). All patients underwent influenza and pneumococcal and, upon available in Italy, recombinant zoster vaccination. <h3>Results:</h3> We collected 38 patients, with a mean age of 76,4 years, treated for an average of 22,3 months. AEs occurred in 12 (32%) subjects, and only one episode of serious event was reported; 7 (18%) patients permanently discontinued TCZ. At the end of follow-up, all the patients continuing treatment showed clinical remission, and only 15% continued to require the administration of GCs (&lt;5 mg PDN equivalent on average). We registered 3 (7,8%) minor relapses under TCZ, after an average of 15 months. No major relapses were reported. <h3>Conclusion:</h3> Our data, coming from one of the few studies covering an extended period of treatment of almost 2 years with TCZ in GCA, support the evidence of a safe and effective long-term use of anti-IL6R agents, especially when combined with low cumulative GCs doses. The occurrence of AEs after &gt;1 year of treatment, instead of within the first six months of treatment as previously reported, possibly suggests a smaller effect of TCZ in their determination, compared to other contributing factors. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1301 HISTOPATHOLOGICAL PATTERNS IN INFLAMMATORY AORTIC BIOPSIES FROM A SERIES OF 44 PATIENTS WITH AORTIC ANEURYSM OR AORTIC DISSECTION
Authors: A. Martín-Gutiérrez, J. Loricera, J. M. Gómez-Ortega, A. Ucelay, C. Secada-Gómez, F. López-Gutiérrez, R. Blanco
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The mechanisms underlying the pathogenesis of aortic aneurysms and aortic dissections remain not fully clear. However, inflammation has been considered as a central player in the development of these conditions. On the other hand, different inflammatory histological patterns may exist in the context of these pathologies. <h3>Objectives:</h3> To perform a comparative study of the different inflammatory patterns observed in patients undergoing surgery for aortic aneurysm or aortic dissection. <h3>Methods:</h3> We reviewed aortic biopsies from patients who had undergone cardiovascular surgery from February 2022 to December 2023 from a referral centre. Biopsies were analysed by an expert pathologist. The inflammatory pattern was defined by the presence of inflammation in any of the aortic layers. Based on the inflammatory findings, aortic biopsies were classified into 4 categories: <b>a</b>) vasa vasorum inflammation, <b>b</b>) periaortic fibrosis, <b>c</b>) vasa vasorum inflammation with periaortic fibrosis and <b>d</b>) inflammation of the intimal, medial o adventitial layer without others histological findings. <h3>Results:</h3> We present 44 patients (11 female/33 male) with a mean age of 65.2±10.1 years who underwent surgery for aortic aneurysm or aortic dissection, in whom inflammatory histological findings were observed. The main features of the patients are summarized in Figure 1. The histological samples corresponded to: thoracic aortic aneurysm (n=38; 86.4%), abdominal aortic aneurysm (n=2; 9.1%), and aortic dissection without previous aneurysm (n=4; 4.5%). The inflammatory patterns observed were: vasa vasorum involvement (n=8; 14%); periaortic fibrosis (n=6; 10.5%); vasa vasorum involvement and periaortic fibrosis (n=13; 22.8%); and no involvement of the above (n=30; 52.6%). Patients with vasa vasorum involvement were more likely to smoke than those with other patterns. (41.2 vs. 100%; p= 0077). The only patient with GCA had both vasa vasorum involvement and periaortic fibrosis. <h3>Conclusion:</h3> In the present study, we found no significant differences in the features of patients with different inflammatory histological patterns. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Adrián Martín-Gutiérrez: None declared, Javier Loricera Roche, Galápagos, Novartis, UCB Pharma, MSD, Celgene, Astra Zeneca, and Grünenthal, Janssen, Abbvie, Roche, Novartis, MSD, UCB Pharma, Celgene, Lilly, Pfizer, Galápagos, Jose María Gómez-Ortega: None declared, Ander Ucelay: None declared, Carmen Secada-Gómez: None declared, Fernando López-Gutiérrez Janssen, Abbvie, Roche, Novartis, MSD, UCB Pharma, Celgene, Lilly, Pfizer, Galápagos, Ricardo Blanco AbbVie, Pfizer, Roche, GSK, Lilly, UCB, Bristol-Myers, Novartis, Janssen, UCB and MSD, AbbVie, MSD, and Roche.
AB0845 INVESTIGATING PERIPHERAL MICROCIRCULATION IN JUVENILE SJÖGREN’S SYNDROME: A PILOT STUDY USING NAILFOLD VIDEOCAPILLAROSCOPY
Authors: M. Cutolo, A. Lercara, C. Malattia, E. Hysa, M. Gattorno, A. Cere, C. Lavarello, T. Vojinovic, E. Gotelli, S. Paolino, A. Sulli, C. Pizzorni, V. Smith
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Juvenile Sjögren's syndrome (jSjS) is a rare autoimmune disease, primarily marked by the involvement of exocrine glands and a range of systemic symptoms, including small vessel vasculitis and Raynaud's phenomenon (RP). <h3>Objectives:</h3> Our study focused on investigating the microvascular status in jSjS patients by nailfold videocapillaroscopy (NVC) correlating it with clinical and serological features. <h3>Methods:</h3> Clinical information was gathered from thirteen consecutive jSjS patients (11 females and 2 males). The average age was 16 ± 4 years and participants were diagnosed before 16 years of age (mean age at diagnosis 12 ± 3) according to the 2016 American College of Rheumatology/EULAR criteria for adult SjS [1]. Thirteen healthy controls (HCs) were age- and sex-matched. Clinical, laboratory, and instrumental data were collected, together with NVC examination. According to recently published standardised definitions in capillaroscopy, non-specific and specific NVC parameters were investigated [2]. These included capillary density, capillary dilations, giant capillaries, microhaemorrhages and abnormal shapes. Associations between NVC findings and clinical/serological features were explored and analysed using parametrical and non-parametrical tests. <h3>Results:</h3> RP was present in 8% of jSjS patients (Table 1). No specific NVC pattern for jSjS was identified, whereas the occurrence of abnormal capillary shapes were significantly greater in jSjS patients compared with HCs (p = 0.005, Figure 1). The reduction of capillary density correlated significantly with articular involvement, in particularly with arthralgias (p = 0.024). Microhaemorrhages correlated with lower C3 serum concentrations (p = 0.034). NVC abnormalities were not associated with SjS-specific instrumental tests (biopsy findings, imaging, Schirmer's test). <h3>Conclusion:</h3> The reduction of capillary density, as well as microhaemorrhages at NVC analysis, are significantly associated with some clinical aspects like articular involvement and serum biomarkers (C3 reduction). The NVC is suggested as safe and further analysis in jSjS patients. <h3>REFERENCES:</h3> [1] Shiboski et al. Arthritis Rheumatol 2018. [2] Smith V et al. Aut Rev 2020. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0624 NON-INVASIVE MEASUREMENT OF ENDOTHELIAL DYSFUNCTION (PERIFLUX) IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: S. Dans-Caballero, M. L. Ladehesa-Pineda, M. C. Ábalos-Aguilera, P. Ruiz Limón, C. Perez-Sanchez, A. Escudero-Contreras
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) is established as a systemic inflammatory disease that primarily affects joints but also entails a significant increase in cardiovascular morbidity and mortality. Despite numerous research, unmet needs persist in this field. Studies have demonstrated endothelial dysfunction as a precursor to atherosclerosis, thus stimulating the search for non-invasive methods for early detection. <h3>Objectives:</h3> To assess differences in clinical and serological characteristics based on endothelial dysfunction parameters in patients with rheumatoid arthritis. <h3>Methods:</h3> A cross-sectional study with 100 RA patients from Reina Sofía University Hospital in Córdoba analyzed clinical characteristics (gender, age, ultrasound presence of carotid plaque, smoking, etc.) and serological factors (total cholesterol, ACPA, rheumatoid factor, apolipoproteins A and B, etc.). The presence of endothelial dysfunction was evaluated using a Periflux 5010 Laser-Doppler, dividing patients into two groups (n=50) based on the median hyperemia area (1417.18). <h3>Results:</h3> The univariate analysis (Table 1) showed a lower median age in the group with a larger hyperemia area (53.23 (12.31) vs. 56.58 (12.09)), with no statistical significance (p = 0.31). Other clinical variables of interest (smoking, disease duration, diagnostic delay) did not reach the threshold of significance. Serological variables of interest in cardiovascular health, such as mean total cholesterol (201.97 (35.51); 191.67 (37.46)), mean LDL (123.23 (26.26); 114.24 (32.9)), or ApoA levels (157.5 (47.5); 151 (23)), showed a tendency to be higher in the group with lower hyperemia area, although not reaching significance. Parameters of endothelial dysfunction measured by Periflux, such as resting flow (RF) or peak flow (PF), were significantly lower in the group with a smaller hyperemia area (p &lt; 0.01; p = 0.04). In the multivariate analysis adjusted for ApoA levels, statistically significant differences persisted in PF (OR 1.15; 95% CI (1.08-1.27)), RF (OR 0.79; 95% CI (0.66-0.88)), and ACPA titer (OR 1.001; 95% CI (1.001-1.002)). <h3>Conclusion:</h3> Endothelial dysfunction evaluated with Periflux could be useful in clinical practice to stratify cardiovascular risk in RA patients, independent of classic parameters. The univariate analysis detected trends that did not reach the threshold of statistical significance, likely due to a small sample size. Nevertheless, additional cohorts are needed to validate the findings and determine their utility in clinical practice, combined with other well-known cardiovascular risk factors (CVRF). <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>