tbuckley/cabot-search huggingface dataset:
AB1078 THE ASSOCIATION OF POST-TRAUMATIC STRESS DISORDER AND SLE: A SYSTEMATIC REVIEW
Authors: K. Parperis, M. Papachristodoulou, S. Psarelis, K. Voskarides, A. Chatzittofis
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Emerging evidence supports that post-traumatic stress disorder (PTSD) may increase the risk for the development of autoimmune diseases, such as SLE. PTSD may disrupt immune system functions, potentially increasing vulnerability to autoimmune diseases. <h3>Objectives:</h3> This systematic review aims to provide an overview of the existing literature and assess the impact of PTSD on the development of SLE. <h3>Methods:</h3> Following the PRISMA guidelines, we conducted a systematic review of the PubMed and Scopus databases from their inception up to December 2023. This review utilized the following search terms: "post-traumatic stress disorder" AND "SLE" OR "systemic lupus erythematosus". Only full-text original articles that investigated the relationship between PTSD and SLE were eligible. We excluded systematic and narrative reviews, case reports, and case series involving fewer than 10 patients from our analysis. <h3>Results:</h3> Out of the 22 articles that were identified, 7 were found to be relevant to our study question. Most of these articles consisted of prospective cohort studies (n=5), followed by one retrospective cohort and one case-control study as shown in Table 1. Among a total of 11,182 SLE patients, it was found that 1,243 (11%) had PTSD. A substantial proportion of these patients were female, and most studies took place in the US. All the studies indicated a positive connection between PTSD and SLE, with three showing at least a doubled risk for SLE in patients with PTSD. Depression and anxiety were prevalent comorbidities in SLE patients with a history of PTSD in 2 studies. <h3>Conclusion:</h3> The findings support the hypothesis that PTSD increases the risk of developing SLE. This relationship strengthens the need for further research to explore the underlying mechanisms linking PTSD with autoimmunity and to determine whether early recognition and effective treatment of PTSD could reduce the risk of developing SLE. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0950 DRUG SURVIVAL AND PREDICTOR FACTORS OF DISCONTINUATION IN AXIAL SPONDYLOARTHRITIS PATIENTS RECEIVING CERTOLIZUMAB AND SECUKINUMAB
Authors: E. Atalar, H. E. Konak, P. Akyüz Dağli, B. Özdemir Ulusoy, Ö. Karakaş, K. Orhan, R. Kocak Ulucaköy, E. Kayacan Erdoğan, S. C. Güven, O. Küçükşahin, İ. Dogan, H. Babaoglu, Y. Maraş, S. Erten, A. Omma, B. Armagan
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Drug survival is important for demonstrating the effectiveness of treatment in patients with axial spondyloarthritis (axSpA) in real life. <h3>Objectives:</h3> This study examines the drug survival rates and factors influencing discontinuation of two such agents, certolizumab and secukinumab, in AxSpA patients. <h3>Methods:</h3> The single-center retrospective cohort study included patients treated with certolizumab (n=239) and secukinumab (n=64) among axSpA patients followed up at the rheumatology clinic. Clinical, laboratory and imaging findings, treatment duration and reasons for discontinuation were meticulously evaluated. The primary outcome assessed was drug survival rate, defined as the duration until treatment discontinuation, switching to another biologic or targeted synthetic DMARD (bDMARD or tsDMARD), or temporary interruption. Drug survival was analyzed using Kaplan-Meier analysis and predictive factors associated with drug discontinuation were analyzed using multivariable Cox regression analysis. <h3>Results:</h3> The 12-month drug survival rates were comparable for both drugs (76% for secukinumab and 73% for certolizumab, p=0.641) (Figure 1). The frequency of female gender, peripheral arthritis and inflammatory bowel disease was higher in patients who discontinued certolizumab treatment than in those who continued treatment. The frequency of male gender was higher in patients who discontinued secukinumab treatment than in those who continued treatment. The multivariable Cox regression showed in table and female sex was independently associated with a lower risk of certolizumab discontinuation (HR: 0.634, %95 CI: 0.41-0.97, p=0.036) and with a higher risk of secukinumab discontinuation (HR: 2.77, %95 CI: 1.18-6.49, p=0.018). <h3>Conclusion:</h3> Our data showed that drug survival of certolizumab and secukinumab was similar in patients with AxSpA. Notably, gender differences in drug discontinuation were observed, with females showing divergent retention patterns for the two drugs. These findings highlight the need for gender-specific considerations in AxSpA treatment strategies. Further multicenter, prospective studies are warranted to validate these findings and refine treatment strategies in AxSpA. <h3>REFERENCES:</h3> <b>NIL.</b> <b>Table 1.</b> Cox regression analysis of drug discontinuation of entire cohort, certolizumab and secukinumab in axial spondyloarthritis patients <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0866 COMPARISON BETWEEN CLINICAL AND IMMUNOLOGIC PROFILES IN SJOGREN’S SYNDROME PATIENTS WITH AND WITHOUT CHRONIC KIDNEY DISEASE
Authors: S. J. Moon, H. Son
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Primary Sjogren's syndrome (pSS) is a chronic, systemic autoimmune disorder characterized by lymphocytic infiltration of exocrine glands including salivary and lacrimal glands, affecting a female-to-male ratio of 9:1. Nephritis is one of the extra-glandular manifestations, occurring in up to 25% of pSS patients. However, previous studies that have determined the prevalence or clinical features of chronic kidney disease (CKD) in pSS patients are very scarce. <h3>Objectives:</h3> The purpose of this study is to compare the clinical, immunological, and laboratory characteristics of pSS patients whose renal function has decreased to CKD stage 3 or lower without a clear primary renal disease. <h3>Methods:</h3> We conducted a retrospective cohort study for pSS patients who visited Seoul St. Mary's Hospital between January 2000 and August 2023. Our study only included patients who were consistently followed up for over a year and had their renal function monitored on at least three occasions. We analyzed clinical and laboratory indices, the final renal function, and biopsy findings. Cases in which a clear renal disease, other than pSS, is identified as causing CKD are excluded from the pSS-CKD patients. <h3>Results:</h3> Among 2506 patients with incident pSS, 77 patients developed CKD and 9 patients developed ESRD. Median duration from pSS diagnosis to CKD development was 17 months. 1:1 age- and sex-matched propensity score was used to compare the two groups. The majority of patients were female (9:1). The mean age of pSS diagnosis is 60 ± 13 years. Diabetes and hypertension were more prevalent in CKD group compared with non-CKD group, whether the prevalence of dyslipidemia and metabolic syndrome did not differ. Clinical features such as BMI, and blood pressure did not differ between the two groups. The proportions of NSAID use during follow-up between the two groups were similar. SSDAI and ESSDAI score were significantly higher in CKD group compared to non-CKD group. 18 patients had undergone renal biopsy. Tubular interstitial nephritis is most common (5/18). <h3>Conclusion:</h3> The majority of pSS patients has remained normal renal function. Impaired renal function and comorbidity such as diabetes and hypertension could be a risk factor for CKD development in pSS patients, suggesting the need for regular renal function monitoring. <h3>REFERENCES:</h3> [1] Lin CY et al. Long-term renal prognosis among patients with primary Sjögren's syndrome and renal involvement: A nationwide matched cohort study. J Autoimmun. 2020 Sep:113:102483. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS1491-HPR WORK INSTABILITY AND ITS ASSOCIATED FACTORS AMONG PATIENTS WITH SPONDYLOARTHRITIS
Authors: Z. Syrine, R. Leila, S. Bouden, A. Ben Tekaya, R. Tekaya, I. Mahmoud, O. Saidane, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patients with spondyloarthritis often encounter challenges in maintaining employment due to the disease's impact on their work ability. <h3>Objectives:</h3> This study aimed to assess the relationship between disease activity, function, and the work instability. Then, to identify factors associated with moderate to high levels of work instability. <h3>Methods:</h3> A cross-sectional observational study was conducted. Demographic data (age, gender, educational level) and disease-related parameters (disease activity using BASDAI and ASDAS-CRP, CRP, VAS, functional ability with BASFI, extra articular manifestation) were collected Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HAD). We also assessed whether the patient assisted regularly to their checkups in the last year. Job characteristics and workplace adaptations were recorded. Work instability was evaluated using AS-WIS, with results categorized as low (less than 10), medium (10–17), and high (above 17). Statistical analysis was performed using SPSS26 with the Mann-Whitney U test, χ2 test, and Spearman's correlation. <h3>Results:</h3> The study included 41 patients (M/F sex ratio was 2.72) with a mean age of 39.34±12.58. Extra articular manifestations were present in 12 patients, including uveitis (16.7%), restrictive lung disease (25%), inflammatory bowel disease (33.3%), and psoriasis (25%). Disease parameters revealed a mean BASDAI of 3.08±1.6, ASDAS-CRP 2.53±1.13, and BASFI 4.18 [0.5-8.5]. Patients were under NSDAIDs in 24,1%, csDMARDS in 22,3%, and bDMARDs in 22%. Eleven patients (26,8%) had regular physical reeducation. Educational levels varied, with 31.8% having elementary education, 44% high school, and 24.4% university. The mean depression score was 5,74±1,9 and the mean anxiety score was 4,54±1,6. The mean AS-WIS score was 11,17 [2-18], Work instability was present in 58.8% of patients. Work instability was significantly associated with extra articular manifestations (p=0.004) and lower educational levels (p=0.013). Regular check-ups and physical reeducation were associated with work stability (p=0.04 and p=0.01, respectively). Significant correlations were observed between AS-WIS and disease parameters (BASDAI R=0.58;p&lt;0.001, ASDAS-CRP R=0.46;p=0,015, BASFI R=0.66;p&lt;0.001 and VAS R=0.70, p&lt;0.01). Finally, AS-WIS correlated with HAD with its two components A and D (R=0.52; p=0.001 and R=0.63;p&lt;0.001 respectively). <h3>Conclusion:</h3> Work instability in patients with spondyloarthritis is closely linked to disease activity, functional ability, and indicators of psychiatric comorbidity. Regular monitoring and physical reeducation appear to be associated with improved work stability. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1232 ECHOCARDIOGRAPHY FOR THE ASSESSMENT OF CARDIOVASCULAR BURDEN IN SYSTEMIC SCLEROSIS
Authors: D. Perretta, I. Sorriso, M. C. Visconti, C. Volpicelli, M. De Luca, C. Iandoli, C. Naclerio, C. Romano, F. Ciccia, G. Cuomo
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> despite recent advances in understanding the pathobiology of systemic sclerosis (SSc), cardio-vascular burden remains a challenge in daily practice. Echocardiography emerges as a valuable non-invasive technique extensively recommended for the screening, evaluation and monitoring of cardiac involvement (CI) in different SSc settings. <h3>Objectives:</h3> the main aim of this study was to evaluate the prevalence and the type of cardiac involvement (clinical/subclinical; primary/secondary) in SSc and to identify potential relation with disease subsets, activity and severity. <h3>Methods:</h3> cross-sectional study in 665 consecutive SSc (fulfilling 2013 ACR/EULAR classification, attending the outpatient rheumatology at least once. Patients were assessed according to a standardized protocol comprising demographics, SSc-related clinical and immunologic parameters, disease activity and severity; cardiac involvement (systolic and diastolic dysfunction, pericardial disease, myocardial ischemia, pulmonary hypertension, valve damage) was evaluated by 2D transthoracic Doppler-echocardiography (TTE). Statistical analysis was done in GraphPad Prism 8, p&lt;0.05. <h3>Results:</h3> CI was detected in 296 SSc (44,6%) patients with diffuse cutaneous (dcSSc) developing earlier CI compared with limited (lcSSc) (p&lt;0.05). Asymptomatic left ventricular dysfunction was described in 15,38%, while important decrease in ejection fraction (LVEF) (as low as 30%) in 6.15%, with a statistically significant negative correlation with disease duration and activity (p&lt;0.05). Diastolic dysfunction was registered in 46,15% SSc with a direct correlation with disease duration and age (p&lt;0.05) Myocardial fibrosis in a mosaic patchy distribution was reported in up one third SSc, while cardiomyopathy in limited cases. Mild pericardial effusion was observed in 24,61 % patients more frequent in dcSSc (p&lt;0.05), while cardiac tamponade in only one case. Valvular disease was uncommon in SSc, reported only in 2,2% (mitral valve prolapse). Abnormal systolic pressure in pulmonary artery (sPAP) was found in 14,89% SSc, particularly in lcSSc, associated right atrial (15,1%) or ventricular (20.2%) enlargement. Anticentromere positivity, older age at first non RP symptom, digital ulcer, and severe joint involvement were associated with high sPAP (&lt;0.05). <h3>Conclusion:</h3> Patients with SSc (diffuse or limited) are at increased risk of developing either clinical or subclinical cardiovascular manifestations as demonstrated by echocardiographic studies. A systematic TTE assessment is routinely recommended for the screening and monitoring of cardiac events. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0861 RECLASSIFICATION OF OVERLAP SYNDROME OF PRIMARY SJÖGREN SYNDROME WITH ANCA-ASSOCIATED VASCULITIS ACCORDING TO THE NEW 2022 CLASSIFICATION CRITERIA FOR VASCULITIS
Authors: J. W. Ha, S. W. Lee
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic vasculitis is one of the most frequent extra-glandular manifestations in patients with Primary Sjögren syndrome (pSS), and further, small vessel vasculitis, particularly cryoglobulinaemic vasculitis is known as the most common vasculitis in patients with pSS <h3>Objectives:</h3> This study applied the 2022 American College of Rheumatology/European Alliance of Association for Rheumatology (ACR/EULAR) criteria for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) to patients with pSS accompanied by signs and symptoms suggestive of small- and medium-vessel vasculitis and investigated the overall frequency of and the major contributing factors to the reclassification of overlap syndrome of pSS with AAV (OS-pSS-AAV). <h3>Methods:</h3> This study included 116 patients with pSS according to the inclusion criteria, and defined signs and symptoms suggestive of small- or medium-vessel vasculitides as lung parenchymal lesions supporting AAV, peripheral neuropathy, and suspected renal vasculitis. The classification could be made when the total scores for microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) are 5 points or more, and that for eosinophilic GPA (EGPA) is 6 points or more. <h3>Results:</h3> The median age of the patients was 56.0 years, and 87.1% were women. Ninety-five, 12, and 37 patients had lung parenchymal lesions supporting AAV, peripheral neuropathy, and suspected renal vasculitis. According to the 2022 ACR/EULAR criteria for AAV, 35 of 116 (30.2%) patients were reclassified as having OS-pSS-AAV. Among these 35 patients, four were reclassified as having both OS-pSS-MPA and OS-pSS- GPA, whereas, one as having both OS-pSS-MPA and OS-pSS-EGPA simultaneously. The major contributing factor to the reclassification of OS-pSS-AAV was ANCA positivity. <h3>Conclusion:</h3> The overall frequency of the reclassification of OS-pSS-AAV was 30.2% in pSS patients accompanied by signs and symptoms suggestive of small- and medium-vessel vasculitis. Its likelihood increased according to ANCA positivity. <h3>REFERENCES:</h3> [1] Argyropoulou OD, Tzioufas AG. Common and rare forms of vasculitis associated with Sjögren's syndrome. Curr Opin Rheumatol 2020;32:21-8. [2] Scofield RH. Vasculitis in Sjögren's Syndrome. Curr Rheumatol Rep 2011;13:482-8. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1268 SUBCLINICAL ATHEROSCLEROSIS AND LIPID PROFILE IN PATIENTS WITH WEGENER’S GRANULOMATOSIS: A META-ANALYSIS
Authors: R. Yadav
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Accelerated atherosclerosis and associated cardiovascular morbidity have been extensively studied in patients with rheumatic diseases like rheumatoid arthritis, systemic lupus erythematosus, and Sjogren's syndrome. However, the risk of subclinical atherosclerosis and lipid profiles in patients with Wegener's Granulomatosis (WG) have not been elucidated well. <h3>Objectives:</h3> To perform a systematic review and meta-analysis to examine whether WG is associated with an increased carotid intima-media thickness (CIMT; a surrogate marker for atherosclerosis) when compared with healthy control subjects. We further aimed to compare the lipid profiles among the WG patients and the healthy controls. <h3>Methods:</h3> Studies evaluating the lipid profiles and the relationship between WG and CIMT were systematically searched in the PubMed, Google Scholar and EMBASE databases from inception to January 2024. The overall mean differences (MD) and 95% confidence interval (CI) of CIMT and lipid profiles between WG patients and control groups were calculated by fixed-effects or random-effect model analysis using Revman 5.1 software. The between-study heterogeneity of effect size was quantified using the Q statistic and I<sup>2</sup>. <h3>Results:</h3> A total of 242 patients from five studies were reviewed in this analysis. There was no significant difference in CIMT between WG and control groups. [MD=0.02, CI= -0.01-0.05, I<sup>2</sup>=0%, P value =0.18] (Figure 1) Similarly, there was no significant differences in total cholesterol [MD=0.04, CI= -0.18-0.26, I<sup>2</sup>=0%, P value =0.74], low density lipoprotein [MD=-0.07, CI= -0.42-0.28, I<sup>2</sup>=64%, P value =0.71] and high-density lipoprotein [MD=-0.07, CI= -0.16-0.03, I<sup>2</sup>=0%, P value =0.15] between WG and control groups. However, triglyceride level was significantly higher in WG patients as compared to healthy controls. [MD=0.40, CI= 0.19-0.61, I<sup>2</sup>=39%, P value =0.0001] (Figure 2). <h3>Conclusion:</h3> This study suggests that WG is not associated with subclinical atherosclerosis and deranged lipid profile. Further studies need to be conducted to prove the correlation of subclinical atherosclerosis in WG patients.<b>REFERENCES: NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0906 RISK OF ACUTE MYOCARDIAL INFARCTION AND ISCHEMIC STROKE IN ADULTS WITH ANKYLOSING SPONDYLITIS: A POPULATION-BASED STUDY
Authors: D. Karacabeyli, J. A. Aviña-Zubieta, N. Lu, H. Xie, D. Lacaille
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Several studies on the risks of fatal and non-fatal acute myocardial infarction (AMI) and stroke in adults with ankylosing spondylitis (AS) have been performed, but results (including subgroup analyses on age and sex) have been conflicting. <h3>Objectives:</h3> 1.To evaluate the risks of incident AMI and ischemic stroke in adults with newly diagnosed AS compared to matched general population controls. 2.To assess for differences in risk based on age and sex. <h3>Methods:</h3> We performed a population-based incident cohort study assessing risk of AMI and ischemic stroke among adults with AS compared to general population controls using administrative health data from British Columbia in a universal health care system. Data included diagnostic codes from physician visits and hospitalizations, all pharmacy-dispensed medications, and vital statistics. All incident cases with AS onset from January 1, 1997 to December 31, 2017, were identified based on ≥2 physician visits or hospitalizations with ICD9/10 codes 720.*/M45 and a run-in period of 7 years. General population controls without inflammatory arthritis were matched 2:1 on age, sex, and year of cohort entry. Individuals with prior AMI or stroke were excluded. Cohorts were followed until December 31, 2022, for occurrence of fatal or non-fatal AMI or ischemic stroke (defined by ICD9/10 codes in any position in hospital data or vital statistics). Cox proportional hazard regression models with propensity score overlap weighting (adjusting for potential confounders measured at baseline) and competing risk of death due to other causes were used to estimate hazard ratios (HRs) and 95% confidence intervals. <h3>Results:</h3> The cohort included 13,841 incident AS cases (52.6% males, mean age: 46.0) and 26,751 controls. Mean follow-up was 11.6 years. Risks of AMI and ischemic stroke were significantly higher in AS: weighted adjusted HRs for MI and stroke were 1.29 [1.18-1.42] and 1.16 [1.06-1.27], respectively (Table 1, Figure 1). The largest increases in risk were observed in females for both outcomes, in adults ≥50 years old for AMI, and in adults &lt;50 for ischemic stroke (Table 1). <h3>Conclusion:</h3> AS is associated with an increased risk of AMI and ischemic stroke, particularly among females. These findings highlight the importance of detecting and managing traditional cardiovascular risk factors as well as controlling disease activity to prevent systemic complications of inflammation like AMI and stroke. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>