tbuckley/cabot-search huggingface dataset:
POS1453-PARE SCREENING AND LINKAGE TO PSYCHIATRIC SERVICES FOR DEPRESSION AND ANXIETY IN SLE PATIENTS- A CROSS-SECTIONAL STUDY FROM A TERTIARY CARE CENTER IN SOUTH INDIA
Authors: R. S. Kodali, L. J. Salazar, R. Aithala, B. Pinto, V. Shobha
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Depression and anxiety disorders are one of the most common neuropsychiatric (NP) manifestations in Systemic Lupus Erythematosus (SLE) with prevalence varying from 2.1–78.6% and 2.9–84.9%, respectively [1]. Delay in detection of mental disorders has a significant negative impact on quality of life and disability in lupus patients. <h3>Objectives:</h3> 1) To estimate the prevalence of depression and anxiety disorders in SLE. 2) To estimate the rates of linkage to psychiatric services among SLE patients who screen positive for depression and/ or anxiety disorders 3) To examine medical and social factors associated with depression and anxiety disorders in SLE patients. <h3>Methods:</h3> We sampled consecutive SLE outpatients from March 2021 to July 2022. Socio-demographic and disease (clinical and laboratory) variables were captured. All patients were screened for anxiety (Generalized Anxiety Disorder Questionnaire -7 (GAD-7)) and depression (Patient Health Questionnaire -9 (PHQ-9)) with cut-off scores of ≥10 for both measures. <h3>Results:</h3> Out of 160 SLE patients included in the study, 42 (26.3%) screened positive for anxiety disorder and/ or depression. Specifically, 25 (15.6%) screened positive for both depression and anxiety disorder, 13 for depression only and 4 for anxiety disorder only. 31 (19.3%) reported thoughts of self-harm. All positive screens were counselled and referred to a psychiatrist for assessment, of which only 24 (57%) agreed to meet psychiatrist. Of the patients who met the psychiatrist, 20 (83.33%) received a clinical diagnosis (Figure 1). Lower socioeconomic status and the presence of NP event in the past were found to be significantly associated with a positive screen for depression and anxiety disorders respectively (Table 1). <h3>Conclusion:</h3> Depression and anxiety disorders are highly prevalent among SLE patients. Most patients who screen positive for depression and anxiety disorders receive a psychiatric diagnosis following clinical assessment. Linkage to psychiatric services is a significant barrier to comprehensive care in patients with SLE and comorbid depression and anxiety disorders. <h3>REFERENCES:</h3> [1] Moustafa AT, Moazzami M, Engel L, Bangert E, Hassanein M, Marzouk S, et al. Prevalence and metric of depression and anxiety in systemic lupus erythematosus: A systematic review and meta-analysis. Semin Arthritis Rheum. 2020;50(1):84. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0884 DIABETIC KETOACIDOSIS OUTCOMES IN INDIVIDUALS WITH AUTOIMMUNE RHEUMATIC DISEASE(ARDS) IN COMPARISON TO INDIVIDUALS WITHOUT ARDS: INSIGHTS FROM NATIONAL INPATIENT SAMPLE 2015-2019
Authors: V. Jelic, S. Piplani, G. Jelic, V. R. Bejugam, M. Sedaghati, S. Kong, P. Mogga, S. T. Kolli, P. K. Komminni, S. R. Goguri, N. Tanasijevic, M. Radulovic, M. Vukelic
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes mellitus (DM). Multimorbidity in Rheumatic Diseases(RDs) is well reported with many vital organs and systems often affected that complicates hospital care during acute illnesses. Understanding disease dynamics is vital to tailoring DKA management in patients with RDs in order to maximize patient outcomes. Outcomes of DKA in a patients with RDs is unknown. <h3>Objectives:</h3> We investigated the in-hospital outcomes of patients hospitalized for Diabetic ketoacidosis(DKA) and compared the same outcomes with patients who had DKA with underlying Rheumatologic Diseases. <h3>Methods:</h3> This is retrospective cohort study of a nationwide inpatient sample (NIS) database from 2015 to 2019. ICD-10 CM codes were used to identify adults (&gt;18 yrs) with RDs. The primary outcomes were rates of in-hospital mortality, length of stay, total charges, major bleeding and needs for use of pressors and mechanical ventilation. <h3>Results:</h3> In the study period there were 1,134,550 patients hospitalized for Diabetic Ketoacidosis(DKA) in the United States, 16225 patients had Diabetic Ketoacidosis with Rheumatologic Diseases(DKA+RDs). The prevalence of DKA+RDs was highest (p&lt;0.00001) among whites (68.32% vs. 57.25%) and smokers (40.72%). This group was in the higher income bracket (15.8% vs. 13.13% for $82000) and had insurance. Charlson Comorbidity Index showed higher number of comorbidities among DKA+RDs patients (p&lt; 0.00001) including hypertension, CHF, CKD, alcohol use, liver disease, COPD, and thyroid disease. Inpatient mortality was significantly higher for DKA+RDs group (1.16% in DKA+RDs vs 0.92% in DKA patients), hospitalizations were 0.51 days longer (95% CI: 1-4.32, p=0.0001) and with $6284 higher total charges (p = 0.0001). Hospital stay in this group was significantly more complicated by major bleeding (5.03% in DKA+RDs vs 4.72% in DKA group; p&lt;0.001) and intubation (4.05 in DKA+RDs vs 3.42% in DKA group; p&lt;0.024) but not concomitant infection or sepsis. <h3>Conclusion:</h3> We found increased death rates and in-hospital complications for patients with RDs that are admitted for DKA. This incurs longer length of stay and higher hospital charges. Our study has several limitations including potential confounders and biases. This underscores the need for future research to include outcomes of DKA in individual RDs as well as long term outcomes.REFERENCES: NIL. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0098 ANALYSIS OF SUSPECTED IMPLANT RELATED COMPLICATIONS WITH RAMAN SPECTROSCOPY REVEALS POLYMER AND TITANIUM DIOXIDE MICROPARTICLES IN SYNOVIAL FLUID
Authors: T. Niessink, J. Schoenmakers, M. Janssen, C. Otto, T. Jansen
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Due to mechanic stress, wear particles can be generated at the metal-to-metal interface of orthopedic implants [1]. These particles include polyethylene microplastics and titanium dioxide and can cause oxidative stress and cause inflammation through NLRP-3 dependent processes, comparable with monosodium urate crystals in gout [2]. Recognition and characterization of these particles can therefore be of clinical value in the treatment of implant related complications. <h3>Objectives:</h3> In this study we evaluate the microparticle content of synovial fluid from patients with suspected implant related complications using an integrated Raman spectroscope with an ordinary polarized light microscope. <h3>Methods:</h3> We retrieved 10 synovial fluid samples from patients with problematic prosthetic implants. In this study, only samples were chosen from patients who had a clinical suspicion of complications of their prosthetic joint (i.e., a painful, warm and/or swollen prosthetic joint). We analyzed the presence or absence and the nature of microparticles in the samples with iRPolM. <h3>Results:</h3> Table 1 shows the results of Raman spectroscopic analyses of the 10 included samples. Titanium dioxide particles were present in 90%, microplastics were present in 80% of the samples. Patients 1 till 7 were positive for bacteria after culture, indicating a microbial infection. All patients were positive for pro-inflammatory particles in their synovial fluid and there was no difference between patients with and without signs of bacterial infection. <h3>Conclusion:</h3> Raman spectroscopy can be of additional value to physicians in cases with problematic implants and swollen joints. Analysis demonstrates a ubiquitous presence of titanium dioxide and microplastics in the periprosthetic synovium. As these microparticles have been proven to be pro-inflammatory through NLRP-3 dependent processes, these patients might benefit from inflammasome-inhibitory therapies. Therefore, Raman spectroscopy can aid in the guidance on therapeutic options for non-microbial implant related complications. <h3>REFERENCES:</h3> [1] Yao, J.J., E.A. Lewallen, W.H. Trousdale, W. Xu, R. Thaler, C.G. Salib, et al., <i>Local Cellular Responses to Titanium Dioxide from Orthopedic Implants.</i> BioResearch open access, 2017. <b>6</b>(1): p. 94-103. [2] Ruiz, P.A., B. Morón, H.M. Becker, S. Lang, K. Atrott, M.R. Spalinger, et al., Titanium dioxide nanoparticles exacerbate DSS-induced colitis: role of the NLRP3 inflammasome. Gut, 2017. 66(7): p. 1216-1224. <h3>Acknowledgements:</h3> Jan Maarten van Dijk, Marjan Wouthuyzen-Bakker. <h3>Disclosure of Interests:</h3> Tom Niessink: None declared, Jorrit Schoenmakers: None declared, Matthijs Janssen Crystalytics B.V., Cees Otto Hybriscan Technologies B.V., Tim Jansen Crystalytics B.V.
AB0974 CHARACTERISTICS OF AXIAL SPONDYLOARTHRITIS IN PATIENTS WITH ONSET CHRONIC LOW BACK PAIN AFTER AGE 45
Authors: F. Z. Y. Heddi, Z. Lamri, K. Khelif, A. Benammar, W. Zahdour
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The onset of axial spondyloarthritis (axSpA), as defined by the Assessment of SpondyloArthritis International Society (ASAS) criteria is unusual after the age of 45 years. However, axSpA can start after this age with a different phenotype than early-onset forms. <h3>Objectives:</h3> To assess the clinical, biological, and radiological characteristics of axSpA in patients with chronic low back pain at the onset age of older than 45 years. <h3>Methods:</h3> A single-center cross-sectional study included patients diagnosed with axSpA between 2018 and 2023. Patients were classified into two groups according to the age of onset of low back pain: late-onset (&gt;45 years) and early-onset (≤ 45 years). The clinical, biological, radiological, and therapy data of the two groups were compared. <h3>Results:</h3> A total of 167 patients (104 males, 63 females) were included, clinical characteristics are presented in Table 1. The onset of low back pain after the age of 45 years was observed in 16 patients (9.6%), they showed a shorter duration of disease (6.2±4.9 vs 12.2±9.5 years; p=0.01), a higher prevalence of psoriasis (56.2% vs 10.6%; p&lt;0.0001), higher scores of BASDAI (7.1±3.5 vs 4.2±2.0; p=0.02), ASDAS (4.5±1.2 vs 3.4±1.0; p=0.02) and BASFI (7.9±3.5 vs 4.5±2.5; p=0.01), a lower radiographic sacroiliitis (62.5% vs 83.2%; p=0.002), a higher prevalence of fibromyalgia (12.5% vs 1.3%; p=0.04) and less use of NSAIDs (64.3% vs 91.2%; p=0.01). No significant differences were found according to sex, family history of spondyloarthritis, inflammatory markers (ESR/CRP), HLA B27 positivity, and the use of TNF inhibitors. Logistic regression analysis confirmed that late-onset low back pain was associated with a shorter duration of disease (OR=0.89, CI 95%: 0.81-0.98), fibromyalgia (OR=0.94, CI 95%: 0.01-0.72), psoriasis (OR=0.1, CI 95%: 0.03-0.28), higher BASDAI (OR=1.5, CI 95%: 1.05-2.22), ASDAS (OR=2.63, CI 95%: 1.12-6.19) and BASFI (OR=1.88, CI 95%: 1.08-3.28) and less use of NSAIDs (OR=5.7, CI 95%: 1.65-19.90). <h3>Conclusion:</h3> Our study showed that almost 10% of the patients with axSpA had late-onset chronic low back pain. Moreover, they had a shorter duration of disease, higher frequency of psoriasis and fibromyalgia, higher disease activity, and worse functional severity. Therefore, it is essential to define and validate diagnostic criteria for individuals with onset low back pain after age 45. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0125 GOUT PATIENTS WITH CHRONIC KIDNEY DISEASE REQUIRE LOWER FEBUXOSTAT DOSES TO ACHIEVE TARGET SERUM URATE LEVELS: RESULTS FROM THE ULTRA REGISTRY
Authors: Y. J. Oh, J. W. Hur, M. K. Lim, K. W. Moon, K. Shin, C. N. Son
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Chronic kidney disease (CKD) is frequently observed in patients with gout due to impaired excretion of serum urate (SU). Febuxostat is a xanthine oxidase inhibitor developed as an alternative to allopurinol for treating hyperuricemia in patients with gout. Febuxostat was approved without dose adjustment for patients with mild-to-moderate renal impairment (estimated glomerular filtration rate [eGFR] of 30 to 90 mL/min/1.73m2). <h3>Objectives:</h3> The aim of this study was to determine the febuxostat dose requirement in gout patients with CKD who achieve target SU levels. <h3>Methods:</h3> This study performed on patients enrolled in Urate Lowering TheRApy in gout (ULTRA) registry. The ULTRA registry is an established cohort that prospectively enrolls Korean patients with gout treated in multiple centers nationwide since September 2021. A total of 342 gout patients were enrolled in this registry and 95 patients who followed up for one year were analyzed in this study. Study subjects were categorized into normal and CKD group by the estimated glomerular filtration rate as a 60 ml/min/1.73m<sup>2</sup>. The dose of febuxostat or allopurinol in patients who achieved the SU target (&lt; 6 mg/dL) was defined as the average daily dosage at the time of SU target achievement. <h3>Results:</h3> Seventy-one (74.7%) patients and twenty-four (25.3%) patients were allocated into normal and CKD group. Febuxostat was used in 65.2% of normal and 77.3% of CKD group. The rate of patients who achieved SU target was 67.6% in normal and 66.7% in CKD group (P=1.0). Although the mean febuxostat dose at baseline was not different among the patients with achieved SU target at one year (41.8 ± 14.5 mg <i>vs</i>. 42.4 ± 19.9 mg in normal and CKD group, P=0.914), after one year the febuxostat dose in CKD group was significantly lower than that in normal group (40.0 ± 18.2 mg <i>vs</i>. 53.7 ± 19.8 mg, P=0.015). <h3>Conclusion:</h3> Among patients who achieved SU target, those with CKD required a lower febuxostat dose to achieve the target SU level compared to patients with normal kidney function. <h3>REFERENCES:</h3> [1] Moon KW, el al. The aftermath of urate-lowering TheRApy in gout (ULTRA) registry: The first prospective observational multicenter cohort of Korean patients with gout. Int. J. Rheum. Dis. 2023;26:1015–1018. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0045 THE RELEVANCE OF DAS28-GGT IN CARDIOVASCULAR RISK PREDICTION AMONG PATIENTS WITH RHEUMATOID ARTHRITIS: FINDINGS FROM A DESCRIPTIVE CROSS-SECTIONAL STUDY
Authors: H. Elhani, A. Majjad, L. Taoubane, N. El Ouardi, H. Toufik, A. Bezza
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patients afflicted with rheumatoid arthritis (RA) face an elevated risk of cardiovascular diseases (CVD). Previous studies have indicated that high levels of gamma-glutamyl transpeptidase (GGT) in the blood are associated with an increased risk of CVD. This investigation seeks to assess whether DAS28-GGT can serve as a predictor for cardiovascular risk in RA patients. <h3>Objectives:</h3> This study aims to explore the potential of DAS28-GGT as a predictor for cardiovascular risk in rheumatoid arthritis patients, contributing valuable insights into the relationship between disease activity, GGT levels, and cardiovascular health. <h3>Methods:</h3> We conducted a descriptive cross-sectional study involving RA patients (according to ACR/EULAR 2010 criteria) who were monitored for a minimum of 1 year. Sociodemographic parameters and RA characteristics, including DAS28-CRP activity score, GGT levels, and cardiovascular risk (CVR) assessed by the Framingham cardiovascular risk score, were evaluated. DAS28-GGT was calculated at baseline using the formula: 0.56VNSD-28 + 0.28VNSG-28 + 2*|n(yGT)+0.014*VAS. <h3>Results:</h3> A total of 100 patients, with an average age of 51±11 years, were included. The mean disease duration was 7.67±6.8 years. Rheumatoid factors and ACPAs were positive in 51% and 56% of patients, respectively. The mean DAS28-CRP was 4.2±1.75. GGT levels ranged from 9 to 279 U/L, with a mean value of 34±21 U/L, and the average DAS28-GGT was 7.45±2.06. In our cohort, 28% of patients exhibited a high CV risk, defined by a Framingham cardiovascular risk score exceeding 10%. Additionally, DAS28-GGT showed a significant correlation with patient age (r=0.61; p&lt;0.001) and Framingham risk score (r=0.52, p&lt;0.001). <h3>Conclusion:</h3> This study underscores the importance of assessing cardiovascular comorbidities in RA patients and suggests the potential utility of DAS28-GGT as a predictor for cardiovascular risk. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
OP0010 EVALUATION OF THE RISK OF PSORIATIC ARTHRITIS IN PATIENTS WITH PSORIASIS UNDERGOING BIOLOGICAL TREATMENT. GLOBAL POPULATION STUDY (TRINETX)
Authors: B. Joven-Ibáñez, R. Rivera, G. Hernandez, C. García-Donoso, J. L. Pablos Álvarez
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Biological treatments are very effective in the control of psoriasis but there are no conclusive data regarding the prevention of psoriatic arthritis (PsA). <h3>Objectives:</h3> To compare the incidence of PsA between patients receiving first- or second-line biological treatment for psoriasis. <h3>Methods:</h3> Retrospective study based on electronic history data included in Trinetx, a global network of electronic records of 199,875,420 patients. Patients with psoriasis without PsA who had started first-line biological treatment with TNF inhibitor (iTNF), iIL12-23, iIL17 and iIL23. The incidence of APs was compared in the different cohorts at 5 years (relative risk, RR) and throughout the follow-up in those 5 years (Hazard ratio, HR) using the 1st line iTNF population as a comparator. To perform the analysis, the cohorts were matched by propensity score matching and adjusted for different known risk factors for PsA (time since the onset of psoriasis, sex, nail psoriasis, obesity, alcohol or tobacco abuse, previous conventional treatments). <h3>Results:</h3> 1,101,000 were identified with psoriasis, without PsA (869,000), who started iTNF (23,610), iIL12-23 (5,820), iIL17 (5,270) and iIL23 (5,640). After adjusting for the different factors, we can compare a population of 5080 iIL12-23, 4280 iIL17 and 4850 iIL23 patients with respect to iTNF, of which 320, 390 and 200 developed PsA respectively. The risk of developing PsA in 1st line was 37% lower with iIL12-23 [RR -4.5 (6.29-10.82) HR 0.631 (0.550-0.725)] and 39% lower with iIL-23 [RR -6.8 (4.12-10.92); HR 0.6804 (0.511, 0.714)] at 5 years. In the 2nd line, the risk was 32% lower with iIL-12/23 [RR -2.59 (6.46-9.05) HR 0.680 (0.550-0.841)] and 31% lower with iIL23 at 3 years [RR -3.37 (5.61-8.98) HR 0.690 (0.472-1.002)] versus an anti-TNF in the 1st line. iIL-23, both in 1st [HR 0.524 (0.437; 0.628)] and 2nd line [HR 0.529 (0.367; 0.761)], present a 47% lower probability of developing PsA than antiIL-17 at 5 and 3 years <h3>Conclusion:</h3> Big data analysis offers an opportunity to obtain information on the efficiency of drugs in real life. This is the first study to analyze the incidence of PsA in matched, adjusted cohorts with a 5-year follow-up. According to these data, iIL12-23 and iIL23 reduce the incidence of PsA compared to iTNF and iIL17, both in naïve and bio-experienced patients. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Beatriz Joven-Ibáñez Abbvie, Novartis, Lilly, Abbvie, Janssen, UCB, Amgen, UCB, Janssen, Abbvie, BMS, Janssen, Raquel Rivera Abbvie, Almirall, Amgen, Boehringer, BMS, Janssen, Lilly, Novartis, Leo Pharma, UCB, Abbvie, Amgen, Boehringer, BMS, DICE, Janssen, Lilly, Novartis, Pfizer, UCB, Gema Hernandez: None declared, Carmen García-Donoso: None declared, José Luis Pablos Álvarez: None declared.
AB0968 ULTRASONOGRAPHIC DYNAMIC EVALUATION OF INTERCOSTAL DISTANCE IN PATIENTS WITH RADIOGRAPHIC AXIAL SPONDYLOARTHROPATHY: A COMPARATIVE CASE SERIES
Authors: A. Moshrif, A. Hamed, M. Hassanien, A. Allam
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> limited chest expansion is a main feature of radiographic axial SpA. <h3>Objectives:</h3> We aimed to perform a dynamic evaluation of chest movement by ultrasound and to correlate our findings with other disease parameters. <h3>Methods:</h3> thirty one patients and eleven controls were involved in this cross-sectional study. Intercostal distance has been measured in the left mid-clavicular (MCL), mid-axillary (MAL), and paraspinal (PSL) lines during maximal inspiration and expiration in the fourth intercostal space. The mean differences and percent changes were compared between controls and patients with correlation of the measurements to disease activity and functional indices. <h3>Results:</h3> the mean age of patients was 34.5, SD±3.53 and 68.7% were females. There was a statistically significant mean difference between patients and controls in all the three lines of measurements; MCL (0.65 SD= ±0.212 Vs 8.5 SD ±2.82, with p = 0.003 and median % change=45.5), MAL (1.2 SD±0.424 Vs 5.3 SD ± 0.283, p = 0.001 and median % change=30.6), and PSL (2.35 SD ± 1.62 Vs 4 SD±0, p= 0.003 and median % change=30.5). Mean differences of MCL and MAL were found correlating with patients age (r=0.61, p=0.04), disease duration (r=0.68, p=0.02), BASMI (r=0.72, p=0.001), and BASFI (r=0.62, p=0.03). <h3>Conclusion:</h3> ultrasonographic intercostal distance is an easy to measure dynamic indicator on limited chest mobility in patients with radiographic axial SpA. More large scale studies are needed to support our findings and to define cutoff values for the proposed measurements. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>