tbuckley/cabot-search huggingface dataset:
AB0166 CONTRIBUTION OF IMAGING IN INFECTIOUS SPONDYLODISCITIS IN THE CAP BON REGION OF TUNISIA
Authors: Y. Abid, I. Chaabane, S. Bachrouch, S. Wafa, K. Bouzaidi, R. Amri, Z. Alaya
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Infectious spondylodiscitis (IS) remains a diagnostic and therapeutic emergency that can impact a patient's vital and functional prognosis through various complications. The contribution of imaging in IS is fundamental. <h3>Objectives:</h3> The aim of our work is to describe the radiological aspects of IS in the Cap Bon region of Tunisia. <h3>Methods:</h3> This is a retrospective study carried out in the internal medicine department of the Mohamed Taher Maamouri University Hospital in Nabeul during the period from January 2018 to January 2023, grouping patients hospitalized for IS. <h3>Results:</h3> We identified 53 cases of IS over a 5-year period divided into 39 men and 14 women with a sex ratio M/F = 2.78. The mean age of the patients was 59.49 ± 11.71. 42 patients had pyogenic spondylodiscitis (79.24% of cases), 7 had tuberculous spondylodiscitis (13.2% of cases), and 4 had brucellian spondylodiscitis (7.5% of cases). Spinal radiographs were taken in only ten cases. They were pathological in seven cases, showing signs suggestive of IS: disc pinching in 6 cases, mirror-like erosions of the vertebral plates in 4 cases, effacement of the vertebral plates in 2 cases, and vertebral osteolysis in one case. Spinal CT scans were performed in 31 patients (58.49%). It was pathological in all cases, showing: effacement of the vertebral plates in 8 cases, mirrored erosions of plates in 6 cases, subchondral geodesia in 7 cases, vertebral osteolysis in 9 cases, disc pinching in 10 cases, disc void in 2 cases, paravertebral soft-tissue thickening in 11 cases, paravertebral abscess in 14 cases, epiduritis in 18 cases, and spinal cord compression in 6 cases. MRI was performed in 49 cases (92.45%). It showed pathological images of IS in all cases in which it was performed. The abnormalities observed were: T1 hyposignal of vertebral bodies in 31 cases (65.26%), T2 hypersignal of vertebral bodies in 31 cases (65.26%), disc pinching in 29 cases (59.18%), Gadolinium uptake in 32 cases (62.3%), soft tissue thickening in 22 cases (44.89%), paravertebral soft-tissue abscess in 13 cases (24.5%), epiduritis in 27 cases (55.1%), epidural abscess in 8 cases (16.32%), spinal cord compression in 13 cases (26.53%), posterior arch involvement in 2 cases (3.8%) and sacroiliac involvement in 2 cases (3.8%). <h3>Conclusion:</h3> MRI is the gold standard for the diagnosis of IS. It enables early diagnosis when even standard radiographs or CT scans are normal. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0243 ADDITION OF IMMUNOSUPPRESSIVE AGENTS AND/OR INTRAVENOUS IMMUNOGLOBULIN TO STEROIDS IN THE TREATMENT OF SUSAC SYNDROME: A NATIONAL COHORT STUDY
Authors: K. Sacre, A. Kachaner, T. Goulenok, C. Astoul, N. Delory, M. P. Chauveheid, T. Papo
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> No randomized controlled trial has been published or declared as ongoing in Susac syndrome (SuS). <h3>Objectives:</h3> We aimed to compare the efficacy of steroids alone or associated with immunosuppressive agents and/or intravenous immunoglobulin for the prevention of relapse in SuS. <h3>Methods:</h3> CarESS study is a prospective national cohort study that started in December 2011, including all consecutive patients with SuS referred to the French reference center. The CarESS study was designed with a follow-up including fundoscopy, audiometry, and brain MRI at 1, 3, 6, and 12 months after diagnosis and then annually for 5 years. The primary outcome was the first relapse defined by new clinical symptoms or signs and new abnormalities on retinal angiography, audiometry or brain MRI leading to treatment intensification. <h3>Results:</h3> Sixty-four patients were included in the study, with a median [IQR] age at diagnosis of 35 [25-40] years and a female ratio of 64%. Among them, 46 (72%) experienced at least one relapse with a median relapse-free survival time of 3.6 months. First-line treatment included steroids only for 40 patients, while 20 patients received a combination of steroids with immunosuppressive (IS) agents and/or intravenous immunoglobulin (IVIg). Comparison of relapse-free survival demonstrated no significant difference between the two treatment strategies. Evaluation of the treatment strategy after relapse in patients initially treated with steroids only did not differ between patients who did or did not receive IS agents and/or IVIg as a second-line treatment (HR = 2.13 [0.4 - 10.8], p=0.36). <h3>Conclusion:</h3> Within this national prospective cohort, patients with SuS did not appear to experience more relapses when treated with steroids only. The lack of difference may however, to some extent, be attributed to a more severe phenotype of patients treated with steroids and immunosuppressive agents at diagnosis. Kaplan-Meier curves of the survival without first relapse among patients who did (steroids + IS and/or IVIg) or did not (steroids) receive IS agents and/or IVIg in addition to steroids. P value was calculated with a Cox proportional hazard model. The model was adjusted on age, sex, center and presence of encephalopathy at diagnosis. Patients who did not received either steroids, IS agents or IVIg at disease onset (n=4) were excluded from the analysis. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0213 THE CARDIOVASCULAR RISK OF JAK INHIBITORS IN TREATING RHEUMATIC DISEASES
Authors: A. Kwan, E. Ingrid, M. Jiang, K. Lim
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The cardiovascular safety of JAK inhibitors (JAKi) remains a contentious topic, as evidenced by the ORAL surveillance study, which found JAKi use not non-inferior to biologic therapy for major adverse cardiovascular events (MACE) in older rheumatoid arthritis patients with cardiovascular risk factor. Generalising these findings is challenging due to patient and JAKi characteristics. This narrative review aimed to clarify JAKi's cardiovascular risk by summarising relevant literature. <h3>Objectives:</h3> This narrative review aimed to clarify JAKi's cardiovascular risk by summarising relevant literature. <h3>Methods:</h3> A search of The Cochrane Library and Ovid MEDLINE from inception to 2023 using keywords related to JAKi, rheumatic disease, and MACE was performed. English language studies of adults with autoimmune inflammatory arthritis who received JAKi and mentioned descriptive MACE or explored the potential role of JAKi in the pathophysiology of cardiovascular disease were included. <h3>Results:</h3> 95 articles met inclusion criteria. Factors like smoking history, advanced age, and cardiovascular disease history were associated with increased MACE. However, JAKi class, dose, combination therapy, patient ethnicity and rheumatic disease type didn't strongly alter cardiovascular risk. <h3>Conclusion:</h3> Intrinsic JAKi features (class and dose) showed no robust association with MACE. However, JAKi might contribute to MACE in patients with advanced age, smoking status, and cardiovascular history. Long-term, large population studies are needed to better characterise the cardiovascular risk of JAKi. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Alexander Kwan: None declared, Elvina Ingrid: None declared, Matthew Jiang: None declared, Keith Lim Janssen Pharmaceuticals research grant.
AB0183 CARDIAC EFFECTS OF THE ARTHRITIS/HEART FAILURE COMORBIDITY
Authors: T. C. Tønnessen, M. S. Ahmed, A. O. Melleby, T. Ueland, E. K. S. Espe, L. Zhang, H. Attramadal, I. Sjaastad, L. E. Vinge
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patients with rheumatoid arthritis face an elevated risk of developing heart failure (HF), but the cardiac prerequisites and disease mechanisms are unknown. <h3>Objectives:</h3> This study employed experimental models of chronic arthritis and HF to explore the cardiac effects of arthritis-induced chronic inflammation on HF development. <h3>Methods:</h3> Rheumatoid arthritis-like phenotype was induced by delayed-type hypersensitivity arthritis (DTHA) in male BALB/c mice (n=29). Control mice received vehicle injections (n=29). The DTHA protocol includes 1) immunization towards methylated bovine serum albumin (mBSA) 2) intravenous injection of mixed anti-collagen II antibodies, and finally 3) release of local arthritis by hind-leg subcutaneous mBSA injection. Three days after induction of arthritis, the mice in both the DTHA group and controls were randomized to HF surgery (n=16 in both groups) or sham surgery (n=13 in both groups). HF was induced via thoracotomy and placement of a constricting o-ring around the ascending aorta. Step 2 and 3 of the DTHA protocol were repeated weekly for 8 consecutive weeks to uphold inflammation. Cardiac magnetic resonance imaging (MRI) was performed 12 and 54 days after surgery, with subsequent euthanization and harvesting of blood and tissue. <h3>Results:</h3> We found evidence of fluctuating, yet sustained local and systemic inflammation after induction of experimental arthritis, and clear development of HF after surgery. Mice with both arthritis and HF exhibited significantly increased mortality compared to the HF group without arthritis (p=0.04). Increased levels of brain natriuretic peptide (BNP) in cardiac tissue (p=0.03), suggests worsening of HF as cause of this observation. However, no significant functional differences were detected on cardiac MRI. <h3>Conclusion:</h3> Chronic systemic inflammation mediated by limb-restricted arthritis increased mortality in mice with HF induced by aortic constriction. Even though statistically significant increments of BNP were found, the cause of observed increased mortality remains elusive, as no functional differences could be found on MRI. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> The authors wish to thank Merete Høyem for expert technical assistance. <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1432 DISTINCT IMMUNOLOGICAL SIGNATURES OF AIIRD PATIENTS FROM IMMUNOPHENOTYPING ANALYSIS
Authors: K. J. Park, Y. N. Cho, H. M. Jin, H. J. Jung, H. M. Jeong, S. E. Choi, J. H. Kang, D. J. Park, T. J. Kim, S. S. Lee, Y. W. Park
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Autoimmune inflammatory rheumatic diseases (AIIRDs) are systemic conditions marked by immune responses against self-antigens, exhibiting diverse clinical manifestations and heterogeneous pathophysiology among patients. Despite this variability, the lack of personalized diagnostics and therapies remains a challenge. Immunophenotyping has been widely used among various experimental methods, offering dynamic and quantitative insight into the immunological status of individual patients. <h3>Objectives:</h3> We aimed to analyze the overall immune profiles of patients with SLE, RA, Axial SpA, and Gout, the major diseases of AIIRDs using immunophenotyping. <h3>Methods:</h3> The study enrolled 14 patients each with SLE, RA, Axial SpA, and 8 with gout, who met recent ACR/EULAR or ASAS criteria for each disease. Twelve healthy volunteers served as controls. Immunophenotyping of peripheral blood mononuclear cells from both AIIRD patients and healthy controls was conducted using flow cytometry. The panel covered circulating B cells, T cells, dendritic cells, NK cells, NKT cells, MAIT cells, and activation markers such as CD69, PD-1, LAG-3, and Annexin V. <h3>Results:</h3> In the analysis of innate and innate-like lymphocytes, Axial SpA and RA patients exhibited a decrease in MAIT cell numbers compared to healthy controls (HCs), while both MAIT and NKT cells were reduced in SLE patients. CD69 expression on MAIT, NKT, and NK cells was elevated in AIIRDs patients compared to HCs, indicating activation of these cells in the AIIRDs condition. Furthermore, CD4+CD69 effector memory cells increased, and Tregs decreased in AIIRDs patients compared to HCs. These findings, combined with the diminished CD86 expression in plasmacytoid dendritic cells in AIIRDs, suggested a regulatory function decrease due to reduced pDC-Treg interaction in AIIRDs patients. <h3>Conclusion:</h3> Despite limited clinical data and small patient samples, AIIRD patients exhibit distinct immunologic patterns compared to the healthy population. Further analysis, especially through the application of clustering and regression models, could reveal more detailed immune signatures of these patients and facilitate a more personalized approach to diagnosing and treating AIIRD patients. <h3>REFERENCES:</h3> <b>NIL.</b> <b>Table 1.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0152 HOW CAN WE IMPROVE THE FIBROMYALGIA PATIENT’S JOURNEY? IDEAS FOR IMPLEMENTATION
Authors: T. Oton, J. Rivera, O. D. Messina, D. G. Fernández-Ávila, M. Robles San Roman, L. Carmona
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Following a detailed study about the needs of fibromyalgia (FM) patients throughout their disease process [1] in Argentina, Colombia, and Mexico, we decided to establish an implementation plan to improve patients' experience. <h3>Objectives:</h3> To prioritize problems to tackle and define action plans to improve the experience of people with FM. <h3>Methods:</h3> A mixed methods study was conducted, including quantitative and qualitative methodology. The quantitative part consisted of a survey of people with FM and dedicated professionals in the three Latin American countries. The qualitative component consisted of three nominal group meetings (one per country) to develop priorities-based action plans. <h3>Results:</h3> The survey was completed by 52 respondents, 37 (36%) of whom were women. Responses pointed to the lack of visibility, the lack of importance of pain as a symptom, and the lack of standardized disease management as the most significant difficulties with FM in their settings. The main reasons behind these problems were the limited knowledge and training of health professionals in FM, leading to contradictory messages and damaged trust, the lack of standardization in the management of FM, and the limited access to non-pharmacological treatments, which are crucial in FM. In the nominal group, action plans were decided collectively between professionals and patients. Table 1 summarises the priorities identified in the survey by country and the action plans designed to improve them. Many were related to various forms of health education and research. <h3>Conclusion:</h3> Professional and citizen education is considered the most efficient strategy and a primary target to avoid lack of visibility and damaged trust and foster standardization and access to non-pharmacological interventions in FM. <h3>REFERENCES:</h3> [1] Otón T MO, Fernández-Ávila DG, Robles San Román M, Mata D, Arguissain C, Galindo Guzmán JM, Pérez M, Carmona L, Grupo Fibrojourney Latam The patient journey of fibromyalgia in Latin America Reumatología Clínica. 2023. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0189 CHANGING SEASONS, CHANGING JOINTS: THE INFLUENCE OF SEASONAL VARIATIONS ON PROs IN PATIENTS WITH INFLAMMATORY ARTHRITIS
Authors: S. K. Gandhi, S. Pedro, K. Michaud
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Inflammatory Arthritides (IA) cause complex flares, partly explained by factors like diet, lifestyle, and medications, prompting speculation about the influence of seasonality. Studies suggest that winter and spring trigger most exacerbations, but findings are contentious due to symptom overlap with Seasonal Affective Disorder (SAD). It remains unclear whether seasons directly impact disease activity or through SAD-related symptoms. <h3>Objectives:</h3> To assess the seasonal variation in PROs in patients with IA. <h3>Methods:</h3> Study data came from adults in the Forward Databank registry diagnosed with IA (RA, SLE, PsA, AS). They provided biannual questionnaires with completed Patient Activity Score-II (PAS-II) scores from 1998 to 2023. PAS-II, averaging pain VAS, patient global VAS, and HAQ-II, was the primary outcome with season as the exposure. When HAQ-II was missing, HAQ-DI substituted for PAS-II imputation. Descriptive statistics characterized patients at baseline and by season, averaging patient-reported outcomes (PROs). Gaussian GEE models, with robust standard errors, assessed PAS-II and season association. Five models adjusted for demographics, clinical variables, other PROs (fatigue, sleep), comorbidities, and treatment. The best models were selected using the QIC criteria. <h3>Results:</h3> 47,052 total participants with IA contributed 406,215 observations with mean age of 58, males 19%, and RA 84% (Table 1). Mean values of PROs over the follow-up are presented in Table 1. Higher PROs, indicating worse disease, were more frequently observed in the spring and fall. Figure 1 illustrates the five models that assess the impact of seasonal variation on PAS-II scores. The QIC scores decrease as more variables are introduced, indicating the increasing strength of the correlation structure. No difference in PAS-II is seen between winter and summer. Spring and fall have the highest coefficients in Model 1, with a PAS-II 0.13 (95% CI 0.11 – 0.14) and 0.10 (95% CI 0.09 – 0.12) higher PAS-II than in the summer. This association continues till Model 4, but in Model 5, winter, spring, and fall had the same coefficient impact on PAS-II estimates, with about a 0.04 increase in PAS2 when compared to the summer. The important factors in predicting the seasonal variation of PAS-II scores are fatigue (Z-score 149), followed by sleep (Z-score of 74.86), education (Z-score of -34.91), MCS (Z-score -32.04), RD comorbidity index (Z score 27.02), IA duration (Z-score 21.53), employment (Z-score -22.45), and prednisone use (Z score 22.7). <h3>Conclusion:</h3> We identified a seasonal correlation with PROs, impacted by factors like fatigue and sleep. Future work will explore SAD and inflammation components, using varied outcomes and consider regional weather. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1352 MISUSE OF ORAL CORTICOSTEROIDS: KNOWLEDGE, ATTITUDES, AND PRACTICES (KAP) AMONG COMMUNITY PHARMACISTS IN MOROCCO
Authors: L ’heri, H. Rkain, F. Kronbi, N. Benzine, I. Bensaghir, S. Farih, T. Latifa, N. Hajjaj-Hassouni, F. Allali
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Corticosteroids are commonly prescribed for a range of conditions, but their usage can lead to significant side effects. The increase in self-medication practices raises the potential for corticosteroid misuse. Community pharmacists, playing a crucial role in medication distribution, can actively contribute to preventing misuse. <h3>Objectives:</h3> The aim of this study was to assess the knowledge, attitudes and practices of community pharmacists in Morocco regarding the misuse of oral corticosteroids. <h3>Methods:</h3> This is a cross-sectional study carried out among Moroccan pharmacists who were included according to their availability and accessibility. The survey was conducted using a validated and pilot-tested Google Forms questionnaire using a Likert scale of 1 to 5, providing information on the sociodemographic data of pharmacists, their knowledge, attitudes and practices in dispensing oral corticosteroid therapy. <h3>Results:</h3> A total of 101 pharmacists, with an average age of 43.86 ± 12 years and an average professional experience of 17 ± 11 years, participated in the survey. 54.5% of the participants were female. The results of our KAP study are presented in Table 1. <h3>Conclusion:</h3> This study highlights the high prevalence of misuse of oral corticosteroids in Morocco. The associated factors are multiple, which means that a multidisciplinary approach is needed to combat misuse. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1148 EXPLORING PRSS23 AS A NOVEL THERAPY TARGET FOR SKIN FIBROSIS IN SYSTEMIC SCLEROSIS
Authors: R. Mu, X. Yuan, L. Lishuang, D. Xu
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> <b>Systemic Sclerosis (SSc) is an autoimmune disease characterized by fibrosis in skin and internal organs, significantly impacting patients' lives. A key feature of SSc, skin fibrosis, is central to the disease's progression and prognosis. Despite ongoing research, the complex pathophysiology of SSc is not fully understood. In this context, Serine Protease 23 (PRSS23) has emerged as a noteworthy molecule. Recent RNA-seq findings indicate its upregulation in the fibrotic skin tissues of SSc patients, suggesting a crucial role in fibrogenesis. Investigating PRSS23's functions could reveal new insights into SSc's pathology and offer avenues for novel treatments.</b> <h3>Objectives:</h3> <b>This study aims to identify the expression of PRSS23 in skin fibrosis associated with SSc and to investigate the potential of PRSS23 as a novel therapeutic target for this condition.</b> <h3>Methods:</h3> <b>We analyze the GSE58095 database to assess PRSS23 expression levels and their correlation with the modified Rodnan skin score (mRSS). Immunohistochemistry analysis of PRSS23 expression in skin tissues of SSc patients and healthy individuals, complemented by evaluating PRSS23 levels in extracted fibroblasts (n=6). Knockdown of PRSS23 in fibroblasts derived from SSc patient skin tissues, followed by stimulation with transforming growth factor-β (TGF-β), and subsequent assessment of ECM-related gene expression (n=3). Intradermal injection of PRSS23 siRNA for the treatment of bleomycin (BLM)-induced skin fibrosis (n=6).</b> <h3>Results:</h3> <b>In the GSE58095 dataset, PRSS23 levels in SSc patient skin tissues were elevated compared to healthy controls (p&lt;0.001) and positively associated with mRSS scores (R=0.4096, p=0.0014). Further experiments confirm that expression levels of PRSS23 are elevated in the skin tissues and primary fibroblasts of SSc patients, when compared with those in healthy controls. Finally, we discovered that PRSS23 knockdown can inhibit the expression of collagen I, collagen III, fibronectin in skin fibroblasts of SSc patients and improve collagen deposition, skin thickening, and collagen fber alignment in the BLM-induced skin fibrosis model (Figure1).</b> <h3>Conclusion:</h3> <b>Utilizing clinical samples, this study reveals elevated PRSS23 expression in the skin tissues of SSc patients. Importantly, targeting PRSS23 has been shown to suppress ECM-related gene expression in fibroblasts and alleviate BLM-induced skin fibrosis. This significant finding could open new therapeutic pathways for fibrosis treatment and deepen researchers' understanding of fibrotic mechanisms.</b> <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>