tbuckley/cabot-search huggingface dataset:
Clinical and financial burden of mental health (MH) conditions in patients (pts) with low-grade non-Hodgkin lymphoma (LG-NHL).
Authors: Keri Yang, Kaitlyn Esselman, Po-Ya Chuang, Wesley Furnback, Asher Alban Akmal Chanan-Khan
Journal: Journal of Clinical Oncology (2024)

7072 Background: LG-NHL is mostly incurable, imposing a prolong impact of cancer care burden for pts. This study aimed to quantify the burden of MH conditions in pts with newly diagnosed chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), follicular lymphoma (FL), mantle cell lymphoma (MCL), Waldenström macroglobulinemia (WM), or marginal cell lymphoma (MZL). Methods: A retrospective study was conducted using Optum Clinformatics Data Mart to identify pts ≥18 years with ≥1 new diagnosis for CLL, FL, MCL, WM, or MZL from 6/2016-6/2022 (index period). Pts were required to be continuously enrolled for 60 days pre- and 365 days post-index date, defined as the date of first cancer diagnosis. Incidence and prevalence of MH conditions of interest (anxiety, depression, stress reaction/adjustment disorder, insomnia, post-traumatic stress disorder [PTSD]) were categorized based on if diagnoses were post- or pre-index date. All-cause healthcare resource utilization (HCRU) and costs were measured during the 1-yr follow-up period. Results: Approximately half of newly diagnosed 36,054 LG-NHL pts (CLL/SLL=48.0%; FL=52.7%; MCL=57.2%; WM=50.5%; MZL=52.5%) had either an incident (19.4-25.7%) or prevalent (28.6-32.1%) MH condition diagnosis following their cancer diagnosis (Table). There were no significant demographic differences in pts with and without MH conditions. LG-NHL pts suffered most from anxiety (30.9-38.2%) and depression (27.5-31.9%), followed by insomnia (16-23.1%), stress (10.3-13.5%), and PTSD (1.4-1.9%). Median time from cancer diagnosis to onset of a MH condition was 334 days for CLL/SLL, 301 for FL, 248 for MCL, 351 for WM, and 328 for MZL. LG-NHL pts with an identifiable MH diagnosis had significantly higher costs and HCRU compared to those without; for example, in CLL/SLL pts with MH diagnosis, outpatient visits were 1.4 times higher, inpatient admissions 3.0 times higher, and costs 2.1 times higher than those without (all P=0.0001). HCRU and cost increases were also observed in MCL, FL, WM, and MZL pts with MH diagnosis. Conclusions: This real-world study uncovered a high proportion of LG-NHL patients suffer from MH conditions, incurring higher financial burden than those without. With advancements in new treatments, there remains unmet need of MH burden in these pts. [Table: see text]
OP0278-PARE ‘THE HUT OF MARE’ – 185 DAYS IN A TREEHOUSE FOR JIA
Authors: J. Geukens, N. Caeyers, V. De Pourcq
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> In 2022 little Niene (11 today) gets the diagnosis of JIA. A big shock for the active family of five, who needs to learn all about this disease and its impact on not only Niene, but the whole family. Big sister Mare (13 today) soon felt she needed to do something to support her sister. Inspired by a book, she decided to build a treehouse in the garden and live in it for six months to raise awareness and funding for JIA. <h3>Objectives:</h3> To raise awareness for JIA. To raise funding for ORKA, the Flemish organisation for parents with children with JIA. <h3>Methods:</h3> The family started building the treehouse beginning of January 2023. They used recycled materials to make the whole thing also eco-friendly. With some creativity and the help of generous donators for the materials, the cabin was finished just in time for Mare to move in on the 16<sup>th</sup> of April. The cabin contained a bed and a desk. Mare allowed herself only in the house for eating and washing. Sleeping, studying and free time were spent in the treehouse. Belgian press was alerted and immediately jumped on the inspiring story. Mare got radio-, TV- and newspaper coverage right away. This led to a nice financial boost for the project from the start. Apart from living in the treehouse, Mare also sold self-grown plants such as tomatoes, homemade cookies, homemade earrings and had family and friends in her cabin or garden for a sleepover in exchange for a financial gift. On Sunday 15<sup>th</sup> of October ORKA, the Flemish organisation for parents with children with JIA, organised a wonderful closing event together with Mare and her family. Mare succeeded in living in the treehouse for six months! Again, the press covered the story on all possible channels. <h3>Results:</h3> As for awareness: Mare's action was spot on. The press loved the idea of this selfless deed of a 13 year old girl who wanted to do something for her little sister. Press coverage was huge on all channels. People in Flanders have certainly heard about JIA now! As for funding: The original goal was to raise 5000 euro. This soon showed to be too modest, so the hope was to raise 10 000 euro. Finally, Mare succeeded in raising almost 11 000 euro for ORKA. <h3>Conclusion:</h3> Mare's plan to live in a treehouse for six months was a brilliant way to draw attention of the general public to JIA and the impact the disease has on the child, but also the family, including brothers and sisters. Mare has given a big boost to ORKA, who will use the extra funding to inform parents of new JIA children, for the annual summer camp and for additional awareness campaigns. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0919 CLINICAL AND THERAPEUTIC STUDY OF VASCULO-BEHCET’S DISEASE: A MONOCENTRIC STUDY
Authors: B. Mayssa, H. Tounsi, W. Garbouj, S. Wafa, R. Amri
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Behçet's disease (BD) is a multi-systemic vasculitis characterized by attacks of acute inflammation. Vascular involvement is common in Behçet's disease, affecting up to 40% of patients according to the literature. <h3>Objectives:</h3> Our study aimed to determine the epidemiological, clinical, therapeutic and prognostic features of vascular involvement in patients with Behçet's disease. <h3>Methods:</h3> A Retrospective and descriptive study, was conducted within the internal medicine department of Taher Maamouri Hospital, between 2015 and 2023. All patients meeting the new MB classification criteria (International Criteria for Behçet's Disease: ICBD) and having a vascular involvement were included. <h3>Results:</h3> Among a cohort of 110 patients followed for Behcet disease, thirty-eight patients with angio-Behçet were included. The male to female ratio was 5.33. The mean age at onset of vascular involvement was 43.6 years. Vascular involvement had inaugurated the Behçet's disease in 68% of cases. The mean delay between the onset of vascular disease and the diagnosis of Behçet's disease was 7 months. Venous thrombosis was the most frequent vascular manifestation (71%). The mean age of patients at the onset of venous disease was 30.9 years. It was deep in 23 patients and associated with superficial thrombosis in four. The most frequent site was the lower limbs venous system, in 20 patients. Inferior vena caval thrombosis was noted in 6 patients. Budd-Chiari syndrome was diagnosed in three patients, and internal jugular vein thrombosis in one. Risk factors for venous thromboembolism were identified in five patients: obesity (n=3), varicose veins of the lower limbs (n=2). Arterial involvement occurred belatedly (mean age: 57) in 11 patients (28%). It was inaugural in 5 cases. It was associated with venous involvement in 5 cases. There were 7 cases of aneurysmal involvement and 7 cases of arterial occlusion. Aneurysmal involvement and arterial thrombosis were noted in three cases. The arterial thromboses were located mainly in the pulmonary arteries and in the arteries of the lower limbs. Myocardial infarction and stroke were noted in one case each. Three patients had arterial aneurysms in the pulmonary arteries, two in the aorta and one in the humeral artery. All patients were treated with corticosteroids and colchicine. An immunosuppressant was associated in 6 cases. Anticoagulation was prescribed in 27 patients. Two patients underwent surgical treatment. Twenty-four patients achieved prolonged remission. Recurrence of venous thrombosis was noted in 10 cases. Four patients were lost to follow-up. <h3>Conclusion:</h3> Vascular involvement in Behçet's disease is common, and is mainly represented by venous thrombosis. It can be a potentially life threatenig condition. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
Efficacy outcomes of treatments for double exposed chronic lymphocytic leukemia/small lymphocytic lymphoma: A systematic literature review.
Authors: Mohammed Zuber, Sreelatha Akkala, Azeem Ahmad, Lorenzo Villa Zapata
Journal: Journal of Clinical Oncology (2024)

e19019 Background: Bruton's tyrosine kinase inhibitors (BTKis) and the B-cell lymphoma 2 inhibitor (BCL2i) venetoclax have improved outcomes and achieved durable remission in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL) in both first-line and relapsed/refractory settings. Despite advances in treatment with these targeted agents, some CLL/SLL patients remain incurable. Notably, patients who fail to respond to both BTKis and venetoclax, termed 'double-exposed,' often exhibit poor outcomes. Data on treatment efficacy for this subgroup is limited. This study systematically reviews treatments and their efficacy outcomes in double-exposed CLL/SLL patients. Methods: A comprehensive search was conducted across MEDLINE/PubMed, Embase, and Web of Science databases from inception to November 2023, using relevant keywords and MeSH terms. The search focused on identifying studies reporting treatments and efficacy outcomes in double-exposed CLL/SLL patients, irrespective of discontinuation reasons. Key efficacy outcomes included progression-free survival (PFS), overall survival (OS), and overall response rate (ORR). Results: From 3942 retrieved articles, 12 publications covering 8 unique studies (4 clinical trials and 4 observational studies) were included. The median patient age ranged from 60-69 years in clinical trials to 56-76 years in observational studies. Two clinical trials reported PFS, with pirtobrutinib-treated patients showing a median PFS of 16.8 months (95% CI, 13.2-18.7) and lisocabtagene maraleucel-treated patients demonstrating a median PFS of 13 months (95% CI,2.8-not reached). BELLWAVE-001 was the sole study reporting a median OS of 10.1 months (95%CI, 7.4-15.9) in nemtabrutinib-treated patients. ORR varied, with 58% in nemtabrutinib-treated patients and 80% in those receiving lisocabtagene maraleucel. In the four observational studies, PFS ranged from 3 months (chemoimmunotherapy) to 12 months (BTKis), and ORR ranged from 31.8% (chemoimmunotherapy) to 85.7% (CAR T-cell therapy). Conclusions: This study underscores the scarcity of clinical data addressing efficacy outcomes in double-exposed CLL/SLL patients. Treatments like pirtobrutinib and CAR-T cell therapy show promise for this group. However, the limited treatment options and efficacy data following failure on BTKis and venetoclax highlight a significant unmet medical need. Further research is necessary to comprehensively understand efficacy outcomes in the double-exposed CLL/SLL population.
AB1666-PARE THE LIPID PROFILE AND SCREENING FOR HEPATIC STEATOSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS UNDERGOING METHOTREXATE THERAPY
Authors: I. Elaroussi, S. Zniber, A. Mougui, I. El Bouchti
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) promotes disruption of the lipid profile and leads to quantitative and qualitative abnormalities of lipoproteins. The causality link of certain medications used for RA treatment has been the focus of several studies, which have demonstrated the neutral or beneficial effect of methotrexate on lipid parameters, in contrast to the exacerbating role of glucocorticoids. <h3>Objectives:</h3> The aim of our study is to assess parameters of lipid metabolism and screen for hepatic steatosis using the HSI score in patients with rheumatoid arthritis treated with methotrexate. <h3>Methods:</h3> Retrospective descriptive and cross-sectional study including patients with rheumatoid arthritis (RA) according to the ACR/EULAR 2010 criteria treated with methotrexate alone. Data on lipid profile, transaminase levels, and body mass index (BMI) were collected. Hepatic steatosis was screened using the HSI score: HSI = 8 × (ALT/AST) + BMI + 2 (if type 2 diabetes) + 2 (if female). <h3>Results:</h3> We identified 69 patients. The average age was 53 years, with a clear female predominance at 91.3%. The average duration of rheumatoid arthritis was 7.74 years. The average duration of methotrexate treatment was 3.97 years. Dyslipidemia was found in 33 patients, with hypertriglyceridemia in 14 patients, hypercholesterolemia in 13 patients, and mixed dyslipidemia in 6 patients. The HSI score was calculated for 60 patients, representing 86.9%. A score &lt;30 was found in 37 patients, a score between 30 and 36 in 7 patients, and a score &gt;36 in 25 patients, or 36.2%. A statistically significant correlation was found between the HSI score and the type of dyslipidemia (p=0.006, r=2). <h3>Conclusion:</h3> Dyslipidemia was present in almost half of the cases, and hepatic steatosis was found in one-third of our patients with rheumatoid arthritis, exclusively under methotrexate treatment. The correlation between the HSI score and the lipid profile was significant. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
Safety and feasibility of outpatient CAR-T therapy: A single center analysis.
Authors: Noha Soror, Olivia Davis, Adolfo Diaz, Silas Day, Michael Machiorlatti, Manu Pandey, Sami Ibrahimi, Mohamad Osama Khawandanah, Jennifer Holter, Adam Steven Asch, Taha Al-Juhaishi
Journal: Journal of Clinical Oncology (2024)

e19005 Background: Chimeric Antigen Receptor modified R Cell Immunotherapy (CAR-T) cell products have revolutionized the landscape of treatment of relapsed and refractory (R/R) B-cell malignancies and multiple myeloma. Yet, these therapies emerged with their own challenges, Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are the most common and serious adverse events. The model of CAR-T cell therapy in the University of Oklahoma is unique as it is designated as an outpatient therapy. Little is known regarding risk factors for hospitalization after CAR-T therapy. Methods: This is a retrospective analysis of all consecutive adult patients who had CAR-T therapy from 9/1/2019 through 9/30/2023 at the University of Oklahoma Health Sciences Center (OUHSC). Inclusion criteria were adult patients with hematologic malignancies who received an FDA approved CAR-T therapy. Exclusion criteria included patients who were younger than 18 at the time of infusion, those who received cellular therapy for solid tumors and those who received investigational CAR-T cell products. Descriptive statistics were created for continuous and categorical variables. Chi-Square analysis and independent samples t-tests were used to measure association with hospital admission and treatment response. Logistic regression was used to explore associations for all covariates with each outcome. SAS 9.4 was used to perform all analysis. An alpha of 0.05 was used to determine significance. Results: A total of 118 patients received outpatient CAR-T/Cellular therapy at OUHSC during the study period with 78 patients meeting the inclusion criteria. The mean age at time of infusion was 58.6 (range=18-85) with most being male (n=46, 59.0%), White (n=63, 80.8%), and overweight/obese (n=50, 64.1%). The majority of patients received anti CD19 CAR-T (n=64, 82.1%) while 18.0% received anti BCMA products. CRS grade 0,1 occurred in 79.5% of patients (n=62) and 79.2% of patients were hospitalized within 30 days after CAR-T therapy (Median day of admission post CAR-T=5.5). Of patients who were hospitalized 26% had grades 2-4 CRS. Complete remission was achieved in 54.7% of patients. We compared the hospitalized and non-hospitalized patients across multiple characteristics, there was no association or predictors of hospitalization found. Albumin was the only predictor for CR. Conclusions: Our study provides data for safety and feasibility of outpatient CAR-T therapy despite potential risks for hospitalization. There are no clear predictors for hospitalizations after CAR-T therapy except for the development of CRS and ICAN. Higher baseline (pre-CAR-T) serum Albumin level was associated with higher odds of achieving CR.
AB1542-HPR SEVERITY AND IMPACT OF DIGESTIVE INVOLVEMENT ON SYSTEMIC SCLEROSIS: A CROSS-SECTIONAL STUDY
Authors: L. Cano-Garcia, R. Redondo-Rodriguez, S. Manrique-Arija, A. Garcia Studer, F. Ortiz Marquez, N. Mena-Vázquez
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> <h3>Objectives:</h3> To describe the severity and impact of gastrointestinal involvement in patients with systemic sclerosis (SSc) and identify associated factors. <h3>Methods:</h3> Noncontrolled cross-sectional study of patients with SSc (2013 ACR/EULAR criteria). The main variables were severity of gastrointestinal involvement according to the University of California, Los Angeles Scleroderma Clinical Trials Consortium Gastrointestinal Tract 2.0 instrument (UCLA SCTC GIT 2.0) and dysphagia according to the Eating Assessment Tool-10 (EAT-10). We evaluated reflux, distension, diarrhea, fecal soilage, constipation, emotional well-being, and social functioning, as well as dysphagia. Clinical and epidemiological data were collected using the Mini Nutritional Assessment Short Form (MNA-SF) and the EuroQol-5D-3L. Multivariate models were constructed to analyze factors associated with gastrointestinal involvement and dysphagia. <h3>Results:</h3> Of the 75 patients with SSc included, 58.7% had moderate, severe, or very severe reflux, 57.4% had constipation according to UCLA SCTC GIT 2.0, and 49.7% had abdominal distension. Gastrointestinal symptoms interfered significantly with social functioning (42.7%) and emotional well-being (40.0%). Dysphagia (EAT-10 ≥3) was recorded in 52% of patients, poor nutrition in 30.7%, and clear malnutrition requiring a nutritional intervention in 5.3%. Multivariate adjustment revealed an association between severity of gastrointestinal symptoms according to the mRSS (β=0.249; p=0.002) and VAS-EQ-5D-3L (β=–0.302; p=0.001), whereas presence of dysphagia was associated with the mRSS (OR=2.794; p=0.015), VAS-EQ-5D-3L (OR=0.950; p=0.005), and malnutrition (MNA-SF ≤7; OR=3.920; p=0.041). <h3>Conclusion:</h3> Patients with SSc frequently present severe gastrointestinal symptoms. These are associated with poor quality of life, more severe skin involvement, and malnutrition. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1670-PARE ELEVATION OF ANTI-CCP ANTIBODY LEVELS IS A FACTOR IN GOOD RESPONSE TO RITUXIMAB IN RHEUMATOID ARTHRITIS
Authors: S. Zniber, I. Elaroussi, A. Mougui, I. El Bouchti
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> In rheumatoid arthritis (RA), there is variability in the clinical response to targeted treatments, particularly biological treatments. It has been shown that rituximab (RTX): a monoclonal antibody, directed against B lymphocytes, is effective to treat patients with RA resistant to conventional disease-modifying treatments (c DMARDs). RTX could have a greater action in anti-CCP+ RA than in anti-CCP− RA. <h3>Objectives:</h3> The objective of this study is to demonstrate that the titer of anti-CCP antibodies has an impact on the response to RTX at M6 in patients with active RA. <h3>Methods:</h3> This is a cross-sectional study including RA patients treated with RTX. The primary endpoint was the reduction in DAS28 greater than 1.2 at 6 months (M6). The secondary endpoints were a good response and remission according to EULAR criteria. <h3>Results:</h3> Eighty patients were included with a clear female predominance of 92.5%. The mean age was 45.3 ±13.05 years. The average duration of disease progression was 11.55 ±7.86 years. The average anti-CCP antibody level was 374.87 ± 642.10. The average DAS-28 before and after the introduction of rituximab was 5.79 ± 1.35 and 4.34 ± 1.14, respectively. The average corticosteroid dose was 10.97 ± 5.05 mg/day. The average duration of corticosteroid therapy was 10.33 ± 6.74 years. The average sedimentation rate and average CRP were respectively 35.71 ± 23.86 mm/H. and 20.18 ±20.01 mg/L. the average pain VAS was 6.95±1.33. A decrease in DAS28 &gt; 1.2 was observed in 45% of patients. In multivariate analysis, an anti-CCP level &gt; 500 U/ml was more frequently associated with a reduction DAS28 &gt; 1.2, EULAR remission (2.38, p=0.048). Thus, a high level of anti-CCP was also predictive of a very significant decrease in NAD (p = 0.031) and NAG (p = 0.0049) at M6. <h3>Conclusion:</h3> A high level of anti-CCP antibodies is predictive of the response to RTX during RA. Rituximab is a therapeutic prospect that could be used in many autoimmune diseases and in particular in RA. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1727 SERUM AND RENAL JANUS KINAS 3 EXPRESSION IN JUVENILE SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: N. Osman, E. Sayed, A. Badwy, E. Magdy, D. El-Ghoneimy
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Imbalance between pro and anti-inflammatory cytokines is an important feature in the pathogenesis of juvenile systemic lupus erythematosus (JSLE). Janus kinases (JAKs) play an important role in the regulation of action of these cytokines. Dysregulation of JAK pathway has been implicated in the pathogenesis of JSLE. <h3>Objectives:</h3> Evaluate JAK3 expression in serum of JSLE patients with active disease in comparison to age-and gender-matched healthy controls, as well as JAK 3 expression in renal tissue in patients with biopsy proven Lupus nephritis (LN) <h3>Methods:</h3> Forty-six children and adolescents with active JSLE were recruited from the Pediatric Rheumatology Unit at Assiut university Children hospital. The patients were evaluated clinically and SLE flare was measured using SLE disease activity index (SLEDAI). In addition to routine and immunological laboratory work up, serum JAK3 expression was measured using polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA). Renal JAK 3 expression was done for 26 patients with clinical and laboratory features of LN where renal biopsy was done. <h3>Results:</h3> The mean (SD) age of the studied patients was 12.2 (2.4) years, they were 34 females (74%) and 12 males (26%). Serum JAK3 expression both by ELISA and PCR were significantly higher among pateints as compared to the control group (p&lt;0.000). Also, serum and renal JAK 3 expression both by PCR and ELISA were significantly positively correlated with anti-double stranded DNA and SLEDAI and significantly negatively correlated with serum complement 3 (p &lt;0.000) Renal JAK 3 expression was significantly positively correlated with 24 hours urinary proteins and urinary RBCs (p&lt;0.000) Both serum and renal JAK 3 expression were comparable between patients with proliferative LN and those with non-proliferative LN. <h3>Conclusion:</h3> JAK 3 seems to have a major role in the pathogenesis of JSLE and strongly related with SLE flare and therefore use of JAK-3inhibitors could represent a targeted therapy of juvenile SLE. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>