tbuckley/cabot-search huggingface dataset:
POS0061 INTERCEPTION OF THE DEVELOPMENT OF RHEUMATOID ARTHRITIS BY A 1-YEAR COURSE OF METHOTREXATE IN ACPA-NEGATIVE ARTHRALGIA PATIENTS AT INCREASED RISK FOR RHEUMATOID ARTHRITIS: 4 YEAR RESULTS OF THE TREAT EARLIER TRIAL
Authors: Q. A. Dumoulin, D. I. Krijbolder, K. Visser, L. R. Lard, A. H. M. Van der Helm – van Mil
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Prevention of rheumatoid arthritis (RA) may go unnoticed in prevention trials that included many low-risk patients due to 'dilution' of a treatment-effect. The TREAT-EARLIER trial in clinically suspect arthralgia (CSA)-patients reported no treatment efficacy for intercepting ACPA-negative RA during 2-years follow-up. However, a large part of ACPA-negative CSA-patients are at low risk of developing RA. <h3>Objectives:</h3> We hypothesized that prevention of ACPA-negative RA can only be detected after stratifying for risk. Therefore, we studied the efficacy of a 1-year course of methotrexate on reducing RA development in ACPA-negative CSA-patients with increased risk of RA, using TREAT-EARLIER trial data, while taking advantage of 4-years follow-up. <h3>Methods:</h3> The TREAT-EARLIER trial included 182 ACPA-negative and 54 ACPA-positive CSA-patients with subclinical joint inflammation. Using a previously published prediction model, CSA-patients were grouped in low risk (&lt;25% predicted risk for RA development in 2-years), increased risk (25-70% predicted risk) and high risk (≥70% predicted risk).[1] Development of RA was studied during 4-years follow-up; treatment efficacy was determined per risk group. The severity of MRI-detected joint-inflammation, grip strength and physical functioning was studied in ACPA-negative patients per risk group. <h3>Results:</h3> Of ACPA-negative CSA-patients, 36% had increased and 64% had low risk. After 4-years in the ACPA-negative increased risk group, 29.0% of the placebo-arm developed RA compared to 8.6% of the treatment-arm (HR 0.27; 95%CI 0.07-0.99) (Figure 1A). In ACPA-negative low risk patients, there was no difference in RA development (9.5% vs 7.5%, HR 0.79; 95%CI 0.22-2.80) (Figure 1B). All ACPA-positive participants were at increased or high risk; despite initial delay of developing ACPA-positive RA, after 4-years there was no difference between placebo- and treatment-arm (52.2% vs 58.1%, HR 0.93; 95%CI 0.45-1.93). In ACPA-negative CSA-patients with increased risk, MRI-detected joint-inflammation, grip strength and physical functioning were persistently improved in the treatment-arm of patients with increased risk, but not in ACPA-negative CSA-patients with low risk. <h3>Conclusion:</h3> This is the first evidence to suggest that the development of ACPA-negative RA can be intercepted by a 1-year course of methotrexate in patients with CSA. <h3>REFERENCES:</h3> [1] Matthijssen, X.M.E., et al. Ann Rheum Dis, 2020. Legend figure 1. Kaplan-Meier curves for time to development of RA with 4-years follow-up duration. P-values are calculated by log-rank test. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0290 3D MODELING OF HIP DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA) IN POST-MENOPAUSAL WOMEN TREATED WITH ROMOSOZUMAB
Authors: G. Adami, A. Fassio, O. Viapiana, D. Gatti, M. Rossini
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Romosozumab, a sclerostin inhibitor, can increase bone mineral density (BMD) faster and to a higher extent than any other anti-osteoporotic drugs available. However, the precise effects on cortical and trabecular bone are not fully clarified. <h3>Objectives:</h3> To investigate the effect of romosozumab on three-dimensional QTC-like parameters of cortical and trabecular compartments of the proximal femur. <b>Table 1.</b> <h3>Methods:</h3> We conducted a 6-monhts prospective observational study on postmenopausal women treated with romosozumab. Image files of the hip DXA scans at baseline and after 6 months of romosozumab were transferred for DXA-based 3D modeling (3D-SHAPER v2.10.1, Galgo Medical, Spain). In brief, the software built a QCT-like 3D proximal femur model for each DXA image, based on a database of QCT scans from a reference population. Integral, cortical and trabecular vBMD (mg/cm<sup>3</sup>) were extracted. Other 3D-DXA measurements included: Cortical surface sBMD (mg/cm<sup>2</sup>), cortical BMC (g), cortical and trabular volume (cm<sup>3</sup>), cortical Thickness (mm), cross-sectional area (CSA, cm<sup>2</sup>) and cross-sectional moment of inertia (CSMI, cm<sup>4</sup>). <h3>Results:</h3> 19 post-menopausal women were included in the study. The increase in aBMD were paralleled by a significant increase in most trabecular parameters but not cortical parameters. <b>Figure 1</b> shows the 6-month % increase in 3D-DXA parameters and p-values adjusted with Holm-Šídák method. In synthesis (list not complete – see <b>Table 1</b> for absolute variations and <b>Figure 1</b> for % variations in X axis the % increase in the parameter and in Y axis the -log10 of the p value, the higher the more significant change): Trabecular vBMD Total (mg/cm3) increased from 74.82 to 83.56 (SE of difference 3,43, p 0.02), integral vBMD Total (mg/cm3) increased from 194.7 to 204.4 (SE of difference 3.79, p 0.02), CSA InterTroch (cm<sup>2</sup>) increased from 0.97 to 1.03 (SE of difference 0,02, p 0.01) and CSMI InterTroch (cm<sup>4</sup>) increased from 3.46 to 3.68 (SE of difference 0.09, p 0.02). <h3>Conclusion:</h3> Romosozumab increased most trabecular 3D-DXA parameters in 6 months. Cortical parameters did not change over time. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Giovanni Adami Theramex, UCB, Lilly, Galapagos, Fresenius Kabi, Amgen, BMS, Abiogen and Pfizer, Angelo Fassio: None declared, Ombretta Viapiana: None declared, Davide Gatti: None declared, Maurizio Rossini: None declared.
POS0330 ASSOCIATION OF A SNP IN VITAMIN D RECEPTOR GENE AND BONE MASS AMONG JAPANESE COMMUNITY-DWELLING MEN
Authors: S. Koto, K. Arima, H. Nakashima, S. Mizukami, N. Iwamoto, M. Tamai, T. Origuchi, A. Kawakami, K. Aoyagi
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Genetic polymorphisms on the vitamin D receptor (VDR) gene were reported to be associated with coronary artery disease, asthma, recurrent spontaneous abortion, sepsis and osteoporosis. <h3>Objectives:</h3> To investigate an association between single nucleotide polymorphisms (SNPs) in VDR gene and low bone mass among community-dwelling olders. <h3>Methods:</h3> This cross-sectional study was nested in the Nagasaki Islands Study, a prospective observational study in Japan. Participants who were 65-yeras old and older were recruited through health examinations of local residents. Calcaneal stiffness index was obtained from quantitative ultrasound measurements. Low bone mass was defined as participants with bone mass which was less than -2.5 of the T-score. Peripheral blood mononuclear cells were obtained from subjects. Genotyping was performed using fluorescent hydrolysis probes and LightCycler 480. Odds ratios were estimated by logistic regression adjusting for age, BMI, and other possible confounders. <h3>Results:</h3> Subjects were 830 community-dwelling residents (292 men with mean age of 74.2 years and 538 women with 73.9 years, respectively). The prevalence of low bone mass in men with CC, CA and AA genotype were 33.4%, 29.8% and 24.6%. The genetic polymorphism of the SNP (rs2189480) was associated with low bone mass in men. Men with CA and with CC were associated with low bone mass compared to men with AA after adjusting for age, BMI, alcohol consumption, exercise, smoking and comorbidity (OR 0.71, 95% CI 0.35-1.44, p = 0.34, for men with CA genotype, OR 0.48, 95% CI 0.23-1.00, p = 0.05, for men with AA genotype, respectively). <h3>Conclusion:</h3> The SNP in the VDR gene was associated with low bone mass in Japanese men. However, further studies taking into account the effect of vitamin D deficiency would be needed. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0004 TREND IN THE INCIDENCE OF RHEUMATOID ARTHRITIS IN KOREA FOR 11-YEARS (2006-2017)
Authors: Y. H. Cheon, H. Lee, Y. S. Suh, M. Kim, H. O. Kim, S. I. Lee
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease, characterized by joint damage. It occurs in approximately 0.3-1.0% of the worldwide population, with an annual incidence rate of 10-20 per 100,000 individuals. However, no incidence analyses have been conducted on Koreans beyond the year 2013. <h3>Objectives:</h3> This study aimed to calculate the incidence of rheumatoid arthritis and examine its trends using whole Korean NHIS claims data from 2007 to 2017. <h3>Methods:</h3> We used 16 years of Korean NHIS claims data from 01 January 2002 to 31 December 2017. Data from 2002 to 2006 (5years) were used as a washout period to define newly diagnosed RA patients. Patients were defined diagnostic RA who were diagnosed with ICD-10 code (M05 and M06). Those who had only diagnostic code without prescribed RA drugs (DMARDs) were excluded from the prevalent RA patients. we set the 5-year period prior to 2006 as a disease-free period. <h3>Results:</h3> From 2007 to 2017, the incidence rate of RA was 35 to 43 per 100,000 individuals <b>(Figure 1(a</b>)). The female-to-male ratio was approximately 3 to 3.5 <b>(Figure 1(b</b>)). Notably, the sex-standardized incidence rate was highest in the 60-69 age group, but it gradually declined, resulting in a reversal in 2017, with the highest incidence rate observed in the 50-59 age group (50-59 age group of 78.7/100,000, 60-69 age group of 76.8/100,000) <b>(Figure 1(c</b>)). Moreover, the incidence of elderly-onset RA (EORA) in individuals aged over 60 exhibited a decreasing trend during the study period (60-69 age group of -6.45, 95% CI=-8.27 to -4.62, <i>p</i>&lt;0.001, ≥70 age group of -6.09, 95% CI=-7.66 to -4.53, <i>p</i>&lt;0.001) <b>(Table 1).</b> <h3>Conclusion:</h3> This study is the first to analyze the incidence trend RA over an 11-year period. There were notable changes in age-specific incidence rates. The incidence rate in the 60-69 age group gradually decreased, resulting in the highest incidence rate observed in the 50-59 age group in 2017. Additionally, there was a decreasing trend in the incidence of elderly-onset RA (EORA). <h3>REFERENCES:</h3> [1] Kim H, Sung Y-K. Epidemiology of rheumatoid arthritis in Korea. Journal of Rheumatic Diseases. 2021;28(2):60-7. [2] Sung Y-K, Cho S-K, Choi C-B, Bae S-C. Prevalence and incidence of rheumatoid arthritis in South Korea. Rheumatology international. 2013;33:1525-32. [3] Sung Y-K, Cho S-K, Choi C-B, Park S-Y, Shim J, Ahn JK, et al., editors. Korean Observational Study Network for Arthritis (KORONA): establishment of a prospective multicenter cohort for rheumatoid arthritis in South Korea. Seminars in arthritis and rheumatism; 2012: Elsevier. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0405 TAPERING csDMARD OR TNFi FIRST: IS THE RISK OF FLARES DIFFERENT FOR ACPA-POSITIVE OR ACPA-NEGATIVE RHEUMATOID ARTHRITIS?
Authors: J. W. Heutz, A. E. M. Looijen, A. H. M. Van der Helm – van Mil, P. H. P. De Jong, E. Van Mulligen
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> In well-controlled rheumatoid arthritis (RA) tapering of DMARDs can be considered. According to the EULAR guidelines glucocorticoids should be tapered first, followed by biological (b)DMARDs or conventional synthetic (cs)DMARDs. In patients using both bDMARDs and csDMARDs, the order of tapering – bDMARD first versus csDMARD first – does not matter from a perspective of clinical outcomes and costs. Nevertheless, other factors might also be relevant for the choice of tapering order. The presence of anti-citrullinated protein antibodies (ACPA) is associated with a higher risk of flare. Therefore, we hypothesized that the efficacy of different tapering orders might be different for ACPA-positive than for ACPA-negative RA patients. <h3>Objectives:</h3> To determine whether there is a difference in risk of flare between a tapering TNFi-first versus a tapering csDMARD-first strategy in groups of ACPA-positive and ACPA-negative RA patients with well-controlled disease using both a TNFi and a csDMARD. <h3>Methods:</h3> Data from the TARA trial were used. The TARA trial was a multicentre, randomized-controlled trial in established RA patients with a well-controlled disease (DAS44≤2.4 and SJC≤1) for at least 6 months, which was achieved with both a csDMARD and TNFi. Patients were randomized to either gradually tapering their csDMARD (mostly methotrexate) in the first year, followed by gradually tapering their TNFi (mostly etanercept or adalimumab) in the second year, or vice versa. In ACPA-positive and ACPA-negative RA patients we compared flare free survival percentages over two years between both tapering strategies. A flare was defined as a DAS44&gt;2.4 and/or SJC&gt;1. <h3>Results:</h3> Of the 135 included ACPA-positive patients, 66 tapered their TNFi first and 69 tapered their csDMARD first. The cumulative flare free survival over 2 years was similar for the two tapering strategies in this group (33% and 35%, HR 1.2, 95% CI 0.8-1.8, Figure 1). Of the 53 ACPA-negative patients, 29 tapered their TNFi first and 24 tapered their csDMARD first. The cumulative flare free survival over 2 years was similar for the two tapering strategies (39% and 36%, HR 0.9, 95% CI 0.5-1.9, respectively, Figure 1). <h3>Conclusion:</h3> In ACPA-positive and in ACPA-negative RA, the efficacy of TNFi-first versus a csDMARD first tapering strategy is similar with regard to the risk of flare. This suggests that ACPA status might not aid in the choice of tapering strategy at initiation of DMARD tapering when patients use both a TNFi and a csDMARD. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0296 RADIOFREQUENCY ECHOGRAPHIC MULTI-SPECTROMETRY (REMS) AND DXA FOR THE EVALUATION OF BONE MINERAL DENSITY IN AXIAL SPONDYLOARTHRITIS
Authors: A. Fassio, F. Pollastri, C. Benini, I. Galvagni, C. Dartizio, D. Gatti, M. Rossini, O. Viapiana, G. Adami
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Osteoporosis and bone loss represent a significant complication in axial spondyloarthritis (axSpA) [1]. Radiofrequency Echographic Multi-Spectrometry (REMS) is a novel technique already validated in assessing Bone Mineral Density (BMD) in post-menopausal osteoporosis [2]. It is characterized by its agile machinery and the absence of ionizing radiation. Additionally, REMS is robust against artifacts, which are known to affect Dual-energy X-ray Absorptiometry (DXA), especially at the lumbar spine (LS) - including aortic calcifications and osteophytes [3]. <h3>Objectives:</h3> The aim of this real-life, cross-sectional, explorative study was to compare REMS with DXA in assessing BMD in patients affected by axSpA. <h3>Methods:</h3> LS and femur scans were acquired using both techniques, including LS latero-lateral (LL) DXA scans. ANOVA for repeated measures was utilized to compare the differences in T-scores among DXA anteroposterior (AP), LL, and REMS scans at the LS, as well as between DXA and REMS T-scores at the total hip (TH) and femoral neck (FN). The correlation between the T-scores at the hip site was assessed using Pearson's correlation coefficient. <h3>Results:</h3> A total of 55 patients were enrolled (see Table 1). No significant differences were found between the BMD T-scores measured through DXA or REMS at the femur. At the lumbar spine, the DXA AP mean T-score was significantly higher than those obtained through LL DXA and REMS (Figure 1). A strong positive correlation was observed between the T-scores obtained with the two techniques, both at the TH (r=0.80, p &lt;0.01) and FN (r=0.77, p &lt;0.01). <h3>Conclusion:</h3> Our findings indicate a notable concordance between DXA and REMS in assessing T-scores at the femoral sites in SpA patients. Particularly at the LS, REMS may offer more precise BMD measurements in this distinct patient group, where DXA assessments are potentially confounded by the presence of syndesmophytes <h3>REFERENCES:</h3> [1] Yan F, Wu L, Lang J, Huang Z (2024) Bone density and fracture risk factors in ankylosing spondylitis: a meta-analysis. Osteoporos Int 35:25–40. https://doi.org/10.1007/s00198-023-06925-1 [2] Adami G, Arioli G, Bianchi G, et al (2020) Radiofrequency echographic multi spectrometry for the prediction of incident fragility fractures: A 5-year follow-up study. Bone 134:115297. https://doi.org/10.1016/j.bone.2020.115297 [3] Fitzgerald G, Anachebe T, McCarroll K, O'Shea F (2020) Measuring bone density in axial spondyloarthropathy: Time to turn things on their side? Int J Rheum Dis 23:358–366. https://doi.org/10.1111/1756-185X.13765 <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0153 EFFECTIVENESS OF YOGA ON DEPRESSION AND ANXIETY IN PATIENTS WITH CHRONIC PRIMARY PAIN: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: J. Rai, A. Pathak, R. Singh, N. Rai, G. C. Bhatt
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> CPP is defined as a prolonged pain with significant emotional distress (anxiety, depression, anger, etc.) and/or severe functional disability (interference in daily life including sleep, work, or taking part in social activities), and is not explained better by any other alternative diagnosis. The cumulative effect of all this leads to deterioration of Health-related quality of life (HRQOL).[1-4] <h3>Objectives:</h3> This review aims to summarize evidence on the effectiveness of different forms of yoga in individuals with chronic primary pain. <h3>Methods:</h3> Search engines like PubMed, Ovid (SP), Cinahl, and Cochrane were used to identify papers published till 31 October 2023. Randomized control trials (RCTs) having either a passive control group or an active control group were included in this review for primary and secondary aims, respectively. Depression and anxiety were primary outcome measures, and pain, quality of life, adherence, and adverse event were considered secondary outcomes. Standardized mean difference (SMD) or mean difference (MD) with a 95% confidence interval (CI) were evaluated for each outcome. <h3>Results:</h3> This meta-analysis included seven randomized control trials with 539 patients of chronic primary pain. Yoga had a positive effect on depression(SMD -1.54, 95% CI -2.47 to -0.61; participants = 407; studies = 7; I<sup>2</sup> = 94%), anxiety(SMD -1.56, 95% CI -2.51 to -0.61; participants = 407; studies = 7; I<sup>2</sup> = 94%), pain (MD -1.56, 95% CI -2.30 to -0.82; participants = 225; studies = 4; I<sup>2</sup> = 86%) and quality of life of CPP patients (SMD -1.26, 95% CI -2.49 to -0.04; participants = 232; studies = 4; I<sup>2</sup> = 94%). <h3>Conclusion:</h3> Yoga is effective in improving depression, anxiety, pain as well as quality of life in patients with chronic primary pain. The practice of meditation only does not have any effect on the considered outcomes. <h3>REFERENCES:</h3> [1] Park J, Hughes AK. Nonpharmacological Approaches to the Management of Chronic Pain in Community-Dwelling Older Adults: A Review of Empirical Evidence. J Am Geriatr Soc 2012;60(3):555–568; doi: 10.1111/j.1532-5415.2011.03846.x. [2] Leadley RM, Armstrong N, Reid KJ, et al. Healthy Aging in Relation to Chronic Pain and Quality of Life in Europe. Pain Pract 2014;14(6):547–558; doi: 10.1111/papr.12125. [3] Moore RA, Wiffen PJ, Derry S, et al. Gabapentin for chronic neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev 2014;2017(3); doi: 10.1002/14651858.CD007938.pub3. [4] Nicholas M, Vlaeyen JWS, Rief W, et al. The IASP Classification of Chronic Pain for ICD-11: Chronic Primary Pain. Pain 2019;160(1):28–37; doi: 10.1097/j.pain.0000000000001390. <h3>Acknowledgements:</h3> Thank you al the author and Eular 2024. <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0150 DO BIOLOGICAL THERAPIES HAVE ANY EFFECT ON NEUROPATHIC PAIN IN RHEUMATOID ARTHRITIS? WHAT ARE THE RELATED FACTORS?
Authors: M. E. Ergin, G. Kimyon, B. Kara, M. Akkan
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Biological therapies like anti-TNF-α (tumor necrosis factor) used in the treatment of RA are effective medicines in controlling the disease activity and reducing pain. However bDMARDs and tsDMARDs have been shown to decrease chronic pain in RA, however with which mechanisms this happens and via which nociceptive, neuropathic or nociplastic pathways they demonstrate efficacy could not have been explained. <h3>Objectives:</h3> The objective of our study is to investigate the frequency of neuropathic pain in patients with rheumatoid arthritis (RA) who are receivers and non-receivers of biological treatment. Secondary objective of our study is to set forth the neuropathic pain-related factors in RA. <h3>Methods:</h3> Our study is a sectional case-control study which measures the frequency of neuropathic pain using painDETECT in patients with RA being monitored in our rheumatology outpatient clinic and in the control group. In addition, along with the demographic data of the patients, DAS28-CRP, VAS pain, VAS fatigue, Beck depression index, Beck anxiety index, HAQ and RA quality of life index were used. <h3>Results:</h3> 105 patients with RA (60 biological, 45 conventional treatment) and 106 healthy control group participants were enrolled in the study. According to painDETECT, neuropathic pain was n:15 (7.1%), n:9 (4.3%) and n:13 (6.2%) in groups who were bDMARD receivers, non-receivers and control group, respectively. There was no statistical difference between groups who were bDMARD receivers and non-receivers (p&gt;0.005). There was a moderate positive correlation between painDETECT and RA duration (r=0.363), VAS pain score (r=0.594), VAS fatigue score (r=0.589), DAS28-CRP score (r=0.489), Beck depression index (r=0.402), Beck anxiety index (r=0.606), Erythrocyte Sedimentation Rate (ESR) value (r=0.226) and tender joint count (TJC) (r=0.367) (p&lt;0.05). <h3>Conclusion:</h3> Neuropathic pain is commonly observed in RA patients and treatment with bDMARD did not change the frequency of neuropathic pain. A positive correlation was observed between neuropathic pain and RA disease duration, DAS28-CRP, VAS pain, VAS fatigue, Beck depression index, Beck anxiety index, ESR and TJC. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>