tbuckley/cabot-search huggingface dataset:
AB1395 ISOTRETINOIN AND INFLAMMATORY LOW BACK PAIN; BEWARE!
Authors: S. S. Koca, F. Albayrak, B. Kisacik
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Oral isotretinoin is a commonly used treatment agent for acne vulgaris. In recent years, musculoskeletal side effects have become more common. <h3>Objectives:</h3> In this study, we aimed to share real life data about our patients who developed inflammatory low back pain due to isotretinoin use and presented to our rheumatology outpatient clinic. <h3>Methods:</h3> In this multicenter study, a total of 59 patients who developed inflammatory low back pain after isotretinoin use were included. Demographic, clinical and radiologic characteristics of the patients were obtained retrospectively from patient registration files. Approval for our study was obtained from the Ethics Committee of Firat University. <h3>Results:</h3> Of the patients included in the study, 47 (79.7%) were female and 12 (21.3%) were male. 55 (93.2%) patients used isotretinoin for acne vulgaris and 4 (6.8%) for comedones. The amount of isotretinoin use was 4693 mg (min:600 mg, max:10800 mg) and the duration of use was 5 months (±2.98). The mean follow-up period was 13.5 months. The complaints of 44 patients (76.3%) developed in the first three months. Pelvic radiographs of our patients showed grade 2 sacroilitis in 5 (8.5%) patients and grade 1 sacroilitis in 21 (35.6%) patients. Sacroiliac MRI revealed bilateral sacroilitis in 47 (79.7%) patients and unilateral sacroilitis in 10 (16.9%) patients. HLA-27 was negative in 43 (72.9%) patients, positive in 2 (3.4%) patients, and not analyzed in 14 (23.7%) patients. The mean baseline BASDAI score was 5.46 (±1.52) and the mean BASDAI score 3 months after discontinuation of NSAIDs and exercise was 2.46 (±1.90). 33 (55.9%) patients had normal follow-up MRI scans and 5 (8.5%) patients had chronic sacroilitis. During our follow-up, 5 patients were diagnosed with ankylosing spondylitis and 1 patient with SAPHO syndrome. <h3>Conclusion:</h3> Isotretinoin is an important treatment agent generally used for moderate to severe acne vulgaris. There are very few case-control reports of sacroilitis after isotretinoin use. In our study, patients with inflammatory low back pain and anamnesis of isotretinoin use were included and long-term results were shown. 6 patients were diagnosed with rheumatologic diseases in our follow-up and our study is important in this respect. In rheumatology practice, questioning isotretinoin use during history taking is important and should be taken into consideration. Large-scale studies with more cases are needed in this field. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> Thank you to all authors. <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1379 CUTANEOUS ROSAI-DORFMAN DISEASE: A SYSTEMATIC REVIEW AND REAPPRAISAL OF ITS TREATMENT AND PROGNOSIS
Authors: O. Dhrif, N. Litaiem, W. Lahmar, F. Fatnassi, M. Slouma, F. Zeglaoui
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Cutaneous involvement in Rosai Dorfman disease (CRDD) presents with a distinctive clinical presentation and prognosis, sufficient data is currently lacking regarding evidence-based treatment of CRDD. <h3>Objectives:</h3> This systematic review aims to provide a comprehensive overview of CRDD, focusing on treatment approaches and outcomes. <h3>Methods:</h3> PubMed and Scopus databases were searched for studies on CRDD from June 1st, 2013 to May 31st, 2023. Articles describing cases of CRDD confirmed with histological examination were eligible for inclusion. All interventions for CRDD were analyzed. The primary outcome measure was the response of cutaneous lesions to treatment including complete response (CR), partial response (PR), and no response. The secondary outcome measures were mortality rate, relapse rate, and the occurrence of adverse events related to CRDD treatment <h3>Results:</h3> Eighty-seven articles describing 118 CRDD cases were included. The mean age was 48.2±16.8 years. The sex ratio (F/M) was 1.53. Nodular (46.6%) erythematous (45.3%) lesions, located on the face (38.1%) were the most prevalent presentations. Associated hematological malignancies were noted in 8 (6.8%) cases. The reported treatment strategies, their outcomes and adverse events are outlined in Table 1. Surgical excision was the most prevalent intervention (51 cases) with CR in 48 cases. Systemic corticosteroids were used in 32 cases with 20 CR/PR, retinoids in 10 cases with 4 CR/PR, thalidomide in 9 cases with 5 CR/PR, methotrexate in 8 cases with 7 CR/PR while observation was decided in 10 cases with 6 CR/PR. Factors independently associated with the absence of response to treatment were facial involvement (OR=0.76, p=0.014), and cutaneous lesion size (OR=1.016, p=0.03). In view of the current evidence we proposed a management algorithm for CRDD in Figure 1. <h3>Conclusion:</h3> This systematic review shows distinctive clinical characteristics of CRDD and provides insights into the appropriate management of the disease. It allowed a proposal of a treatment algorithm that should be interpreted in the context of current evidence and would help practitioners in treating this rare disease. <b>REFERENCES: NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0208 IMMUNOPHENOTYPING PROFILES OF PERIPHERAL B CELLS IN ANTI-Jo-1 ANTIBODY-POSITIVE IDIOPATHIC INFLAMMATORY MYOPATHIES
Authors: M. Nakazawa, C. De Vries, K. Lodin, I. E. Lundberg, V. Malmström, C. Grönwall
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The idiopathic inflammatory myopathies (IIM) are characterized by inflammation of proximal skeletal muscles and skin. Anti-Jo-1 antibody is found most in about 30% of patients with IIM and often associated with interstitial lung disease and severe prognosis. B cells are likely to play an important role in pathogenesis in anti-Jo-1 antibody-positive IIM, however there are few reports about detailed immunophenotyping of B cell in anti-Jo-1 antibody-positive IIM. <h3>Objectives:</h3> The aim of this study was to understand immunological phenotyping profiles of peripheral B cells from the patients with anti-Jo-1 antibody-positive IIM by spectral flowcytometry. <h3>Methods:</h3> Enriched B cells from peripheral blood mononuclear cells from 7 patients with treatment-naive IIM, 6 patients with inactive IIM, 4 patients with active and treated IIM and 8 age- and sex-matched healthy donors were analyzed on spectral flowcytometry with a 24-marker panel. The dimensionality reduction and clustering analysis were applied to pre-gated CD19+ B cells. All 17 IIM patients were positive for anti-Jo-1 antibody. <h3>Results:</h3> Analyzing the composition of CD27-IgD+ naïve B cells and CD27+ memory B cells, the CD27+IgD- switched memory cells and the CD27+IgD+ unswitched memory B cells were significantly decreased in the active IIM patients compared to healthy controls (median: 3.4% vs 11.9%, p=0.01 and 1.3% vs 10.3%, p=0.006, respectively). When examining the expression of CD73, a key enzyme that converts ATP to adenosine, both MFI of CD73 on B cells and the frequency of CD73+ B cells were significantly lower from the patients with active IIM compared to healthy controls (median: 727 vs 1517, p=0.003 and 60.4% vs 79.0%, p=0.01, respectively), which was found both in CD27-IgD+ and CD27-IgD- B cells. Next, comparing the distribution of 10 clusters obtained by cluster analysis using FlowSOM, we found that the CD73- naïve B cell cluster was significantly increased in the patients with treatment-naïve IIM compared to healthy controls (median: 12.9% vs 4.5%, p=0.02). Overall, CD73-IgM+ naïve B cells were significantly increased in IIM patients with high disease activity compared to healthy controls (median: 19.2% vs 8.2% of naïve B cells, p=0.01). <h3>Conclusion:</h3> The expression of CD73 was significantly lower on peripheral B cells from the patients with IIM compared to healthy controls. This may lead to hyperactivation of B cells through ATP/adenosine pathway in pathogenesis of anti-Jo-1 antibody-positive IIM. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0821 RAYNAUD’S PHENOMENON IDENTIFIES A SUBSET OF PATIENTS WITH SJOGREN SYNDROME, INTERSTITIAL LUNG FIBROSIS, AND GREATER DISEASE ACTIVITY
Authors: R. Solans-Laqué, J. Mestre Torres, A. Valls Villalba, S. Bujan, L. Bisbe
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Raynaud phenomenon (RP) has been reported in 9 to 33% of patients with primary Sjögren (pSS) and has been linked to the presence of extraglandular (systemic) manifestations <h3>Objectives:</h3> We aimed to investigate the clinical characteristics of patients with pSS and RP and the relationships between RP and systemic involvement. <h3>Methods:</h3> Retrospective analysis of a wide cohort of pSS patients prospectively followed since 1994. Demographic, clinical, and serological data were compared between individuals with and without RP. Logistic regression analysis was used to identify risk factors. SPSS vs.29 was used for statistical analysis <h3>Results:</h3> RP was present in 121(26.8%) of 451 patients with pSS. Patients with RP were younger (54.39±16.7 vs. 56.04 ±14.1 years, p=0.002) and exhibited higher disease activity (ESSDAI 7.99 vs. 6.27, p=0.037) than those without. The mean follow-up was similar in patients with and without RP (10.98±8.5 vs. 9.73±8.4 years, p=0.084). The prevalence of lung involvement, especially interstitial lung disease, was significantly higher in pSS patients with RP (50.4% vs. 33.6%, p=0.002, and 23.1% vs. 10.3%, p&lt;0.001, respectively). Similarly, the prevalence of liver involvement, especially biliary cirrhosis, was significantly related to the presence of RP (17.3% vs. 5.7%, p=&lt;0.001, and 11.5% vs. 3.3%, p=0.002). Patients with pSS and RP had significantly more frequent leukopenia (p=0.035), hypergammaglobulinemia (p&lt;0.001), positive cryoglobulins (p=0.013), and hypocomplementemia C4 (p=0.008) than those without (Table 1). Anti-centromere antibodies (ACA) were positive in 9.9% of patients with RP compared to those without (2.5% (p&lt;0.001). Multivariate analysis identified interstitial lung disease (OR 1.9, 95%CI 1.1-3, p=0.030), primary biliary cirrhosis (OR 3.1, 95%CI 1.3-7.3, p=0.009), hypergammaglobulinemia (OR 1.8, 95%CI 1.1-2.8, p=0.011) and positive cryoglobulins (OR 1.8, 95%CI 1.05-3.03, p=0.33) as independent risk factors for RP. <h3>Conclusion:</h3> The presence of RP defines a subset of pSS patients with increased lung involvement and greater disease activity, suggesting that RP has a clinical and prognostic value in pSS patients <h3>REFERENCES:</h3> [1] Garcií-Carrasco M, et al. Raynaud's phenomenon in primary Sjogren's syndrome. Prevalence and clinical characteristics in a series of 320 patients. <i>J Rheumatol</i> 2002; 29:726-730. [2] Lin W et al. Clinical features and risk factors of Raynaud's phenomenon in primary Sjögren's syndrome. <i>Clin Rheumatol</i> 2021; 40: 4081-87. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1420 THE EFFECT OF MANUAL THERAPY ON PAIN, MUSCLE ACTIVITY AND JAW FUNCTION IN TEMPOROMANDIBULAR JOINT DYSFUNCTION WITH MYOFASCIAL ORIGIN
Authors: K. Ateş, D. Karagozoglu Coskunsu
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Temporomandibular disorders (TMD) is a heterogeneous musculoskeletal and neuromuscular disorder involving the temporomandibular joint structures and surrounding muscular system and bone components, and is classified as intra-articular and extra-articular. Rheumatoid arthritis and juvenile idiopathic arthritis affect the temporomandibular joint, and fibromyalgia syndrome causes TMDs of extra-articular origin. Patients with fibromyalgia and myofascial pain syndrome are seen with lower mouth opening and higher pain levels than healthy individuals and are more affected by craniomandibular disorders. <h3>Objectives:</h3> To examine the effectiveness of the manual therapy in treatment of patients with temporomandibular joint (TMJ) dysfunction of myofascial origin <h3>Methods:</h3> Thirty-eight patients were randomized manual therapy (MTG) and control groups (CG) (n=1:1). While MTG received 1 session/weekX4 weeks (4 sessions in total) manual therapy including 40 minutes of intraoral-extraoral myofascial release, trigger point inhibition, TMJ and suboccipital mobilizations, no treatment was applied to CG. At baseline and at the end of the 4th week, rest and activity pain with visual analogue scale (VAS-rest and VAS-activity), muscle activity of right/left anterior temporalis (rightAT, leftAT) and right/left masseter (rightM, leftM) at rest and during activity with surface electromyography (sEMG) and functional status with Jaw Functional Limitation Scale-8 (JFLS-8) were evaluated. <h3>Results:</h3> Seventeen patients in MTG (mean age: 29.58±10.20) and 17 patients in CG (mean age: 31.648±0.47) completed the study. At the end of 4th week, a decrease in VAS-resting and VAS-activity of MTG (p&lt;0.001; p&lt;0.001) and increase in VAS-activity in CG (p=0.021) were found. A significant difference was found in leftM-rest, rightAT-rest, leftAT-rest and rightM-activity, leftM-activity, rightAT-activity, leftAT-activity sEMG measurements of MTG (p=0.011, p=0.039, p=0.028, p=0.022, p=0.025, p=0.001, p=0.028, respectively). At the end of four weeks, a significant difference was found between the groups in favor of MTG in VAS-resting and VAS-activity (p&lt;0.001; p&lt;0.001), right-M-activity yEMG measurement (p=0.013) and JFLS-8 (p&lt;0.001). <h3>Conclusion:</h3> In patients with myofascial-related TMJ dysfunction, manual therapy applied to the TMJ, chewing muscles and cervical region affects the activities of the chewing muscles, reduces pain and increases functionality. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1443 CONSISTENT SAFETY PROFILE OF SECUKINUMAB IN PATIENTS WITH PSORIASIS, PSORIATIC ARTHRITIS AND AXIAL SPONDYLOARTHRITIS: UPDATE ON THE DATA FROM POOLED CLINICAL TRIALS
Authors: A. Deodhar, I. B. Mc‎ Innes, X. Baraliakos, A. B. Gottlieb, U. Kiltz, S. Schreiber, B. G. Sahoo, W. Bao, L. Pricop, C. Gaillez, V. Dong, P. J. Mease
Journal: Annals of the Rheumatic Diseases (2024)
AB1416 THE EFFECT OF INFORMATION SOURCES ON BIOLOGICAL TREATMENTS IN RHEUMATOLOGY PATIENTS ON PATIENT’S ANXIETY LEVEL AND DRUG DECISION
Authors: P. Talu Erten, S. B. Kocaer
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Although biological therapies are frequently used in rheumatology practice, some potential side effects increase anxiety levels in patients. Information from various sources may positively or negatively affect this level of anxiety and the decision to approve the drug [1]. <h3>Objectives:</h3> In our study, we aimed to determine the effect of information sources about biological therapy on patients' treatment decisions and anxiety levels; and to determine patients' expectations in this regard. <h3>Methods:</h3> 91 patients aged 18-65 years using biological therapy for rheumatic disease were included in our study. Questions were asked about the sources of information about the biological therapy, the factors influencing positive and negative thinking about the therapy, the level of anxiety before and after the therapy for each side effect, and the preferred methods of education about the therapy (Figure 1). <h3>Results:</h3> At baseline and after treatment initiation, the mean overall anxiety score was 4.8±3.0, median 5.0 (IQR 2.0-7.0) and 2.75±1.8, median 2.0 (IQR 1.0-4.0), respectively (p&lt;0.00001). There was no correlation between anxiety level and age and education level. Anxiety levels for each side effect (cancer, drug duration, drug access concerns, tuberculosis, infection, self-injection, death, neurological side effects, and allergy anxieties) decreased statistically significantly after the initiation of treatment compared to pretreatment (p&lt;0.0001). The two most common causes of anxiety were cancer and uncertainty about how long the drugs would be used, which were significantly higher than other causes of anxiety (p=0.003) (Figure 2). <h3>Conclusion:</h3> In our study, side effect anxiety, which was high at the beginning of treatment, decreased significantly after starting treatment. We found that cancer is the primary cause of anxiety, that today's various sources of information are preferred by patients at a low rate, and that an effective dialogue with their physicians is the most critical factor in drug compliance [2,3]. <h3>REFERENCES:</h3> [1] Pehlivan, Yavuz, et al. "Patients' concerns regarding biological agents in rheumatology." International journal of rheumatic diseases 21.6 (2018). [2] Choi IA, Kim JH, Hae Chang S, et al. Patient perspectives on biological treatments for inflammatory arthritis: A multi-center study in Korea. Arch Rheumatol. 2021. [3] Sidiropoulos P, Bounas A, Athanassiou P, Koutsianas C, Petrikkou E, Kaltsonoudis E, Drosos A, Vassilopoulos D. Correlation of patient preferences to treatment outcomes in patients with rheumatoid arthritis treated with tumour necrosis factor inhibitors in Greece. Clin Rheumatol. 2020 Dec;39(12):3643-3652. DOI: 10.1007/s10067-020-05171-8. Epub 2020 May 26. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1391 IMMUNOPATHOLOGICAL MANIFESTATIONS OF INFECTIVE ENDOCARDITIS
Authors: G. Koilubaeva, G. Tarasova, A. Bolotbekova
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Infectious endocarditis has many immunopathological manifestations, both organ and laboratory, which can mimic inflammatory rheumatic diseases (RD), such as systemic vasculitis, rheumatoid/reactive arthritis, Still's disease, systemic lupus erythematosus, antiphospholipid syndrome, etc. It can be especially complex differential diagnosis with RD occurring with non-infectious endocarditis. Delay in diagnosis leads to delay in initiation of antibiotic therapy; on the other hand, misdiagnosis of RD and administration of immunosuppressive therapy can have catastrophic consequences for patients with active infection. <h3>Objectives:</h3> To study the immunopathological manifestations of infective endocarditis <h3>Methods:</h3> The study included 50 patients with infective endocarditis, 11 of them had an acute course, and 39 had a subacute course. <h3>Results:</h3> Damage to the musculoskeletal system was observed in 60% of patients: arthritis was detected in 20%, arthralgia in 38%, myalgia in 14%, tendinitis in 18% of patients. The duration of arthritis during antibiotic therapy was, on average, 7.5 + 4 days, arthralgia - 15 + 12 days. 3 patients had persistent long-term arthralgia (up to 3 months), with the infectious process already stopped. Organ pathology: nephritis was diagnosed in 28%, pericarditis in 18%, vasculitis in 18%, myocarditis in 12% of patients. Nephritis was more often observed with staphylococcal infection than with streptococcal infection (56% and 9%, respectively), p = 0.04, and also more often with the acute course of the disease, compared with subacute (57% and 23%, respectively). Myocarditis and pericarditis were also more common in acute compared with subacute (29% and 9%; 43% and 14%, respectively). In 88% of patients, immunological disorders were detected during laboratory testing: positive RF in 72%, increased a-DNA in 57%, ANA in 36% (in low and medium titers), cryoglobudins in 44% of patients (including high (+4) – in 23%). Hypergammaglobulinemia was recorded in 58% of patients. Patients with nephritis had positive ANA, cryoglobulinemia, and high RF significantly more often than others, p&lt;0.05. With the development of myocarditis, positive ANAs were more often detected (50% and 30%, respectively). <h3>Conclusion:</h3> Infective endocarditis has many symptoms, clinical and laboratory, overlapping with RD, which can lead to diagnostic errors. Infective endocarditis should always be considered in the differential diagnosis of RD, especially those occurring with endocarditis. Blood cultures for sterility, ECHO-CG, and PET-CT are often necessary for a correct diagnosis. If a patient with infective endocarditis has a positive RF, ANA and cryoglobulins, then the risk of developing glomerulonephritis is very high. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1438 CYTOKINE LEVELS IN COLOMBIAN FEMALE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND RHEUMATOID ARTHRITIS AND THEIR CORRELATION WITH BLOOD AND CLINICAL PARAMETERS
Authors: N. Duarte, L. S. Rodriguez, K. Segura, C. Tovar, S. Cacciatore, J. M. Bello-Gualtero, O. Gómez, S. Amado, D. G. Fernández-Ávila, M. C. Romero, S. Pulido
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are systemic and heterogeneous autoimmune pathologies with a worldwide distribution that affects mainly women. The abnormal biological activity of cytokines and their imbalance are implicated in the development of Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). The Colombian population has high levels of ethnic admixture between African, Native American, and European ancestral populations. Therefore, it is important to characterize the cytokine profile in this admixed population in the search for disease biomarkers. <h3>Objectives:</h3> This study aimed to evaluate the plasma cytokine levels in a group of Colombian women with RA and SLE and to explore the cytokine correlation network with blood and clinical parameters. <h3>Methods:</h3> A cytokine/chemokine magnetic bead-based panel was used to quantify in plasma samples the concentration of 17 cytokines. Kruskal-Wallis along with Dunn's test allowed us to compare the cytokine levels between the groups. We assessed their predictive value through receiver operating characteristic (ROC) analysis and 10-fold cross-validation of a partial least squares (PLS) model. We calculated the correlation between the levels of the cytokines and the blood and clinical parameters with Spearman's correlation. <h3>Results:</h3> We quantified the cytokine concentrations of 77 Colombian women, including 24 SLE patients, 24 RA patients, and 29 age- and BMI-matched healthy controls. We found two correlation clusters in RA: GM-CSF, CX3CL1 and IL-12p70, and the leukocytes including lymphocytes and neutrophils, and the other one with IL-12p70, IL-17A, IL-2, TNF-α and VEGF correlated with CRP (Figure 2a). All these cytokines were statistically significant, and GM-CSF, CX3CL1 and TNF-α also had the greatest AUC (area under the ROC curve) (Figure 1a). In SLE there were no correlation clusters, but we found that the PLS model with the 10-cross fold validation had an accuracy of 81,8% and that MCP-1 is significantly increased in these patients but also is correlated with ESR and CRP (Figure 2b). <h3>Conclusion:</h3> The cytokines significantly increased in RA and SLE and showing a correlation with blood parameters of inflammation and activation of the immune response currently used in the clinical setting, can be more reliable markers of both RA and SLE. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> Our sincere gratitude is extended to the RA and SLE patients and to the healthy controls subjects who agreed to participate in this study. <h3>Disclosure of Interests:</h3> <b>None declared.</b>