tbuckley/cabot-search huggingface dataset:
AB0870 EFFICACY OF ORAL STEROIDS FOR PERIPHERAL ARTHRITIS IN SPONDYLOARTHRITIS: A DOUBLE BLIND, PARALLEL GROUP, RANDOMISED CONTROL TRIAL
Authors: S. Jayaprakash, V. Dhir, B. Leishangthem, P. Saini, A. Khullar, G. Naidu, S. K. Sharma, S. Bhutungru, A. Sharma, S. Jain
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> There are studies showing efficacy of glucocorticoids in axial SpA. Although peripheral arthritis in SpA is responsive to intra-articular steroids, there are no studies on systemic glucocorticoids. <h3>Objectives:</h3> To study the efficacy of oral glucocorticoids over 24 weeks when using a fast-tapering regimen for peripheral arthritis in patients with spondyloarthritis. <h3>Methods:</h3> This pragmatic real-world double-blind randomised trial included patients who fulfilled either the axial or the peripheral SpA ASAS criteria who had 2 or more tender and swollen joints. They were randomized into placebo or glucocorticoid groups. The glucocorticoid group received a dose of 30 mg prednisolone in the first week with a fast tapering to reach a dose of 5 mg by 6 weeks, which was continued till 24 weeks. Treatment intensification was allowed in both arms including addition of cs DMARDs, intra-articular and intramuscular steroids (up to a maximum of 5 injections). Primary outcome measures was ACR 50 at week 24. Secondary outcome measures were change in BASDAI, ASDAS ESR, ASDAS CRP, MASES enthesitis score, Dactylitis severity score, ASAS NSAID index at 24weeks. <h3>Results:</h3> This study included 94 patients, who were randomized into placebo group and the glucocorticoid group. At 24 weeks, there was no statistically significant difference in ACR 50 between two groups <b>p 0.21</b> (Table 1 and Figure 1). Also, there was no significant difference between the groups in BASDAI, ASDAS, NSAID index and MASES. There was higher requirement of parenteral glucocorticoids in the placebo arm. Adverse effects were hyperglycaemia in 5 patients, new onset hypertension in two patients and stroke in 1 patient in the glucocorticoid group. Minor adverse effects included higher tendency to acne, facial puffiness in the glucocorticoid group. <h3>Conclusion:</h3> This is the first RCT to examine the efficacy of oral glucocorticoids in peripheral arthritis in SpA. Our study did not meet primary or secondary endpoints. An important outcome from our study is that peripheral arthritis in SpA can be effectively managed with cs DMARDS and parenteral steroids. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> Macleod Pharmaceuticals India who provided drugs and placebo free of cost. <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0820 CONTRIBUTION OF NAILFOLD VIDEOCAPILLAROSCOPY TO THE DIAGNOSIS OF CONNECTIVE TISSUE DISEASES IN PATIENTS WITHOUT RAYNAUD’S PHENOMENON
Authors: J. Caetano, M. Coimbra, M. Amaral, S. Oliveira, J. Delgado Alves
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Nailfold capillaroscopy (PC) is fundamental in the evaluation of RP, helping to differentiate between primary and secondary Raynaud's phenomenon (RP). However, the usefulness of this technique in patients with symptoms suggestive of a connective tissue disease (CTD) or positive antibodies, but without RP, has not been established. <h3>Objectives:</h3> To evaluate the utility of NVC for the diagnosis of CTD in patients without RP. <h3>Methods:</h3> Retrospective review of NVC performed in patients without RP and suspicion of a CTD, between 2010-2022. NVC from an age and sex-matched cohort control group with RP and a suspected CTD were selected, in a ratio of 1:1. Two NVC patterns were considered: SSc-pattern and non-scleroderma pattern (non-specific alterations or normal). Final diagnosis at follow-up were categorized as: SSc, other-CTD, no-CTD. Associations between final diagnosis, NVC patterns and characteristics of NVC defined by the EULAR Study Group on Microcirculation in Rheumatic Diseases were analyzed. <h3>Results:</h3> From a total of 1471 NVC performed in patients with a suspicion of a CTD, we identified 184 in individual patients without RP. For control group, 184 patients with RP were selected. A total of 368 patients were included, with a median follow-up time of 2.6 years (interquartile range 6.3). The SSc pattern was associated with the diagnosis of SSc in both groups (p&lt;0.01). Non-specific NVC was associated with the diagnosis of other-CTD in patients with RP (p&lt;0.01), but not in those without RP (p=0.07). Specificity and negative predictive value (NPV) of SSc pattern were high in both groups (without RP: specificity 99.4%, NPV 98.9%; with RP: specificity 97.1%, NPV 93.1%). These values were lower for NVC with non-specific alterations and the diagnosis of other-CTD, although they were similar between groups with and without RP (without RP: specificity 61.9%, NPV 67.3%; with RP: specificity 61.5%, NPV 63.4%). The NVC analysis of patients with a SSc NVC pattern and without RP showed more abnormal shapes than those from patients with RP (p&lt;0.01). In patients with other-CTD, those without RP also had more abnormal shapes (p&lt;0.01) and a reduced capillary density (p=0.03). <h3>Conclusion:</h3> NVC can be useful in the approach of patients without RP and with a suspected CTD, mainly in the diagnosis of SSc. The role of NVC for the assessment of other CTD in patients without RP should be studied in future prospective studies. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0583 PROGNOSTIC NUTRITIONAL INDEX CORRELATES WITH DISEASE ACTIVITY SCORE AFTER METHOTREXATE INITIATION IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: I. Yoshii
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Methotrexate (MTX) is an anchor drug in treating rheumatoid arthritis (RA). The clinical effects after administration are confirmed and sustained. However, no parameters that predict clinical effectiveness have been suggested. The prognostic nutritional index (PNI) focuses on prognosis indicators for patients with malignant tumors after surgery. Recently, this index has been given attention regarding serious infections and osteoporotic fractures in patients with RA. <h3>Objectives:</h3> In this study, we approached the utility and validity of the prognostic nutritional index (PNI) as an indicator for prognosis prediction after MTX initiation using real-world clinical cases. <h3>Methods:</h3> Patients with RA who have not initiated MTX (baseline) but started treatment with MTX from baseline from July 2014 to October 2022 were picked up in the study. Patient's gender, age, disease duration of RA, anti-citrullinated polypeptide antibodies (ACPA), rheumatoid factor (RF), disease activity score using C-reactive protein (DAS28-CRP), Health Assessment Questionnaire Disability Index (HAQ-DI), pain score using a visual analog scale (PS-VAS), Sharp/van der Heijde score (SHS), PNI, estimated glomerular filtration ratio (eGFR), blood hemoglobin level (HGB), blood platelet count (PLT), matrix metalloproteinase-3 (MMP-3) were monitored every 3 months after baseline. Associations between the PNI at baseline and DAS28-CRP and its change (cDAS28) every 3 months from the baseline to 1 year after were evaluated using linear regression analysis. Associations between cDAS28s every 3 months and PNI and DAS28-CRP at the baseline were examined using multivariate linear regression analysis. Associations between the PNI and the other parameters at baseline and associations between DAS28-CRP and the other parameters at baseline were evaluated using linear regression analysis. Receiver operating characteristic analysis (ROC) for the PNI at baseline was performed according to the remission of DAS28-CRP at 1 year. <h3>Results:</h3> A total of 692 patients, 192 males, and 500 females, were studied. There is a significant correlation between PNI and DAS28-CRP at baseline and every moment after baseline. cDAS28 at every moment also correlated significantly with PNI and DAS28-CRP at baseline. At baseline, PNI significantly correlated with HAQ-DI, PS-VAS, eGFR, HGB, PLT, MMP-3, and DASA28-CRP. DAS28-CRP significantly correlated with the female gender, HAQ-DI, PS-VAS, PLT, MMP-3, and PNI. The ROC revealed PNI &gt; 44.21 as a significant cutoff index with 0.582 of the area under the curve. <h3>Conclusion:</h3> PNI at baseline could be an indicator for predicting a short-term disease activity prognosis after MTX administration. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0934 PHYSICAL ACTIVITY INSIGHTS WITH THE GLOBAL PHYSICAL ACTIVITY QUESTIONNAIRE (GPAQ) IN SPONDYLOARTHRITIS
Authors: A. Ben Salem, O. Jomaa, M. Brahem, W. Khelif, M. Younes
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Spondyloarthritis (SpA) is a chronic inflammatory condition that may result in structural damage, functional impairment, and reduced autonomy. <h3>Objectives:</h3> This study aims to assess the level of physical activity in SpA patients and identify associated factors. <h3>Methods:</h3> In this cross-sectional study of SpA patients, we gathered socio-demographic information, clinical data including disease activity scores (ASDAS, BASDAI), Visual Analog Scale for pain (VAS pain), and functional impact (BASFI). Physical activity was measured using the Global Physical Activity Questionnaire (GPAQ), and the intensity was determined through metabolic equivalent task (MET) calculations in minutes per week (min/week) assigning a coefficient of 8 for intense effort and a coefficient of 4 for moderate effort and walking. <h3>Results:</h3> The study comprised 45 SpA patients with a mean age of 44.4 ± 15 years [22-82]. The average disease duration was 10 ± 8.3 years [3 months-40], with a sex ratio (M/F) of 1.2. Mean BMI was 25.1 ± 3.4 kg/m<sup>2</sup> [17-31]. Disease activity was found in 44.7% (ASAS-CRP≥ 2.1 and/or DASDAI ≥ 40/100) and/or 57.7%, respectively. The mean BASFI was 37 ± 2 [6-71]. The Median of MET was 420 min/week [240-1160]. 45.2 % had moderate to intensive levels of total physical activity, defined as MET≥600 min/week and 54.8% had limited level of physical activity. A significant association was found between MET and disease duration (p=0.02). No statistically significant differences were observed in MET based on age, gender, BMI, disease activity or radiological impairment. <h3>Conclusion:</h3> Our study showed that 54.8% of SpA patients had limited physical activity. Disease durationwas significantly associated with more impaired MET. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0860 DESCRIPTION OF THE CLINICAL, HISTOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL CHARACTERISTICS OF PATIENTS WITH SICCA SYNDROME WITH MINOR SALIVARY GLAND BIOPSY AND FOCUS SCORE ≥1
Authors: A. Lamos, S. Rivadeneira, J. P. Castañeda-Gonzalez, A. Escobar, A. M. Arredondo-González, J. Cajamarca-Baron, H. Cubides, J. F. Polo Nieto, C. Ibañez, G. S. Rodríguez-Vargas, R. Parra-Medina, J. J. Capasso, A. Rojas-Villarraga
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> There is no standardization of minor salivary gland biopsy (MSGB) in patients with Sjögren's syndrome (SS) for accurate interpretation of immunohistochemistry (IHC) related findings. IHC could characterize the phenotype of lymphocytes present in an MSGB and be useful in defining prognosis. <h3>Objectives:</h3> The aim was to describe the histopathologic and IHC variables in patients with sicca syndrome and MSGB with focus score (FS) ≥1. <h3>Methods:</h3> Retrospective observational study of patients with sicca syndrome. Clinical, histopathological and IHC characteristics of MSGB were described using red (CD8 T cells) and brown (CD4 T cells) chromogen-based staining. CD20:CD3 and CD4:CD8 markers were obtained using Easy Scan Pro 6 -MOTIC® and QuPath® software. Descriptive statistics: qualitative variables (Chi2 or Fischer's exact test) and quantitative variables (according to normality <h3>Results:</h3> 28 patients with sicca syndrome and MSGB with FS ≥1 were analyzed; 16 patients had SS (8 with polyautoimmunity) and 12 without SS, of which 5 had only sicca syndrome without defined disease and 7 had autoimmune rheumatic diseases other than SS. The presence of atrophy was significantly greater in autoimmune diseases other than SS and in SS cases with polyautoimmunity (p&lt;0.05). All samples were positive for the 4 IHC biomarkers (Figure 1). When patients with SS and other autoimmune diseases were compared with respect to MSGB and IHC findings, the majority presented CD20:CD3 ratios ≤ 2:1 as well as CD4:CD8 ratios ≤ 2:1, with no statistically significant differences between the two groups (Table 1). <h3>Conclusions:</h3> Histopathological and IHC findings were analyzed in Colombian MSGB patients with sicca symptoms, mainly diagnosed with SS. Regarding IHC, the ratios were mainly CD20:CD3 ≤ 2:1, as well as CD4:CD8 ≤ 2:1. A higher frequency of glandular atrophy was found in patients with SS and polyautoimmunity, as well as in patients with other autoimmune diseases. These findings are novel in the Latin American population and may serve to better define the subphenotypes according to biopsy. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0919 ASSESSMENT OF HEARING LOSS AND ITS ASSOCIATED FACTORS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS
Authors: M. L. Ladehesa-Pineda, D. Ruiz-Vilchez, M. Á. Puche-Larrubia, J. Castellano Curado, L. Rodríguez Pérez, A. Escudero Contreras, E. Collantes-Estevez, C. López-Medina
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Spondyloarthritis (SpA) is characterised by both musculoskeletal and extramusculoskeletal involvement. Hearing loss appears to be the most frequently associated manifestation within the otolaryngological clinic. Previous evidence supports a higher prevalence of hearing loss in axial SpA (axSpA) patients than in the general population, manifesting in up to 42% of these patients. <h3>Objectives:</h3> To verify the existence of a higher prevalence of hearing loss in patients with axSpA compared to the general population. Secondarily, to characterize the predominant type of hearing loss and to detect possible factors associated with it. <h3>Methods:</h3> A cross-sectional descriptive observational study was carried out including 55 consecutive axSpA patients from REGISPON-3 and evaluated by an Otorhinolaryngologist between January 2021 and February 2022 and 17 healthy controls (HC). Independent-samples t test, U of Mann Whitney and Chi squared were used to compare the prevalence of hearing loss (defined as the condition where any of the intensities necessary for the audition of a given tone is greater than 20 decibel) between axSpA and HC and to evaluate the association between hearing loss and disease characteristics in the axSpA subgroup. <h3>Results:</h3> Hearing loss was observed in 55 (78,6%) patients, of which 50 (90.9%) were sensorineural (Table 1). The prevalence of hearing loss was higher in the group of axSpA than in HC (78,6% vs. 52,9%, p&lt;0.05), despite no differences in age between groups. AxSpA patients with hypoacusis presented higher age, BMI, years of symptom duration and mSASSS versus those without hypoacusis (p&lt;0.05) (Table 2). <h3>Conclusion:</h3> Hearing loss is more frequent in patients with axSpA in comparison to healthy population, being bilateral sensorineural hearing loss the predominating type. Older age, longer symptom duration, higher BMI and radiographic damage are associated with the presence of hearing loss. <h3>REFERENCES:</h3> <b>NIL.</b> Note: Data are represented by mean (standard deviation (SD)) for quantitative variables and total (percentage) for qualitative variables. Abbreviations: axSpA, axial spondyloarthritis; db, decibel. *Significant differences versus healthy controls, p &lt; 0.05. **Significant differences versus healthy controls, p &lt; 0.01. <h3>Acknowledgements:</h3> The authors would like to acknowledge REGISPON-3 Working Group and all participant patients. <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0610 EARLY RHEUMATOID ARTHRITIS AND THYROID DYSFUNCTION: A 20-YEARS FOLLOW-UP STUDY IN BULGARIA
Authors: N. Staykova, D. Troev, M. Murdjeva, I. Yanakiev, V. Alimanska, S. Alimanska
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis is systemic autoimmune disease with progressive development leading to disabilities. The presence of thyroid autoantibodies and thyroid autoimmune disease has been known for more than six decades. The co-existence of thyroid autoimmune disease and RA may lead to more severe clinical manifestations and worse joint damage. <h3>Objectives:</h3> This study aims to evaluate the prevalence of antithyroid autoantibodies and their association with the presence or later appearance of autoimmune thyroid disease (ATD) in patients with early rheumatoid arthritis (RA), as well as to find a possible relationship between RA activity, thyroid disorder, and severity of radiographic joint changes at the onset and long-term tracing of RA patients. <h3>Methods:</h3> We observed 210 patients with early RA in the period from 2000 to 2021. We assessed 126 healthy controls for anti-thyroid antibodies. Al1 RA patients were examined at entry to the study and later at regular intervals in the course of 15 years for disease activity, the presence of anti-thyroglobulin (anti-Tg) and anti-thyroid peroxidase (anti-TPO) antibodies. Erosion grade and joint space narrowing (JSN) of hands and feet were read. <h3>Results:</h3> At entry to the study, anti-Tg autoantibodies were found solely in 5% RA patients and anti-TPO antibodies were presented solely in 9,44% RA patients. Both antibodies were detected in 13,89% of RA patients'- significantly higher than the controls. In the beginning clinical and subclinical findings for ATD were more frequent in RA patients compared to controls. During the follow-up, RA patients showed statistically higher incidence of anti-Tg and anti-TPO serum antibodies. Erosions Sharp score, joint space narrowing (JSN) and total Sharp score compared between RA patients with and without thyroid disease showed no statistical difference in the severity of the radiographic joint damage at entry in the study and during follow-up. RA patients with thyroid disease had significantly higher JSN Sharp score in a 5 years duration of RA than the ones without thyroid disorder. <h3>Conclusion:</h3> RA patients are at risk for development of anti-Tg and anti-TPO antibodies. The presence of thyroid disease in early RA patients does not influence the course of RA clinical activity. RA patients with thyroid disease have more severe joint space narrowing. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0560 ALL-CAUSE AND CAUSE-SPECIFIC MORTALITY IN RHEUMATOID ARTHRITIS: A META-ANALYSIS
Authors: G. G. Sone, Y. H. Lee
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> One significant concern is the increased risk of mortality associated with rheumatoid arthritis (RA). Additionally, understanding the mortality patterns in patients with RA, including overall mortality and specific causes of death, is paramount for enhancing patient care and outcomes. <h3>Objectives:</h3> This study aimed to evaluate standardized mortality ratios (SMRs) for both all-cause and cause-specific mortality in patients with RA. <h3>Methods:</h3> We conducted an extensive search across the Medline, Embase, and Cochrane databases to identify studies investigating SMRs for all-cause and/or cause-specific mortality in patients with RA compared to the general population. Subsequently, we performed a comprehensive meta-analysis, examining SMRs across various categories, including all-cause, sex-specific, ethnicity-specific, and cause-specific SMRs in RA patients. <h3>Results:</h3> Our analysis encompassed seventeen studies, involving 486,098 patients with RA, among whom there were 63,988 reported deaths, meeting our inclusion criteria. Stratification by ethnicity revealed that the all-cause SMR was 1.575 (95% CI 1.207 – 1.943) in Caucasians and 1.355 (95% CI 1.140 – 1.569) in Asians. The sex-specific meta-analysis indicated pooled SMRs of 1.644 for women and 1.602 for men. Notably, RA patients exhibited an increased risk of mortality attributed to cardiovascular disease (CVD) (SMR 1.399, 95% CI: 0.972–1.706, p &lt; 0.001). And the SMRs for deaths from respiratory diseases, infections, malignancies, and cerebrovascular accidents (CVA) were 2.459 (95% CI 1.936 – 2.982, p &lt; 0.001), 0.984 (95% CI 0.873 – 1.096, p &lt; 0.001), and 1.156 (95% CI 0.890 – 1.422, p &lt; 0.001), respectively. However, no significant increase in SMR was observed for mortality due to malignancy. <h3>Conclusion:</h3> Patients with RA face a higher risk of death from various causes, irrespective of sex or ethnicity, with elevated mortality rates attributed to CVD, respiratory disease, infection, and CVA. However, the risk of death from malignancy in RA patients did not exhibit a notable increase. <h3>REFERENCES:</h3> [1] Dadoun S, Zeboulon-Ktorza N, Combescure C, Elhai M, Rozenberg S, Gossec L, et al. Mortality in rheumatoid arthritis over the last fifty years: systematic review and meta-analysis. Joint Bone Spine 2013;80:29-33. [2] Meune C, Touze E, Trinquart L, Allanore Y. Trends in cardiovascular mortality in patients with rheumatoid arthritis over 50 years: a systematic review and meta-analysis of cohort studies. Rheumatology 2009;48:1309-13. [3] Listing J, Gerhold K, Zink A. The risk of infections associated with rheumatoid arthritis, with its comorbidity and treatment. Rheumatology 2013;52:53-61. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>