tbuckley/cabot-search huggingface dataset:
POS1017 ACHIEVING LLDAS-50 IS ASSOCIATED WITH LESS ORGAN DAMAGE AND BETTER QUALITY OF LIFE DURING 5-YEAR FOLLOW-UP IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: S. S. Lee, J. H. Kang, S. E. Choi, D. J. Park
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> <h3></h3> A lupus low disease activity state (LLDAS) is a pragmatic, realistic treatment goal, since remission in systemic lupus erythematosus (SLE) is extremely rare and usually temporary. Objectives: Because patients who have a longer LLDAS should have better clinical outcomes, we investigated the effect of achieving LLDAS for more than 50% of the follow-up period, the so-called LLDAS-50, on disease activity, damage, and quality of life in our Korean SLE cohort during a 5-year follow-up period. <h3>Methods:</h3> We evaluated 199 SLE patients from the Korean Lupus Network (KORNET) registry. Demographics, clinical manifestations, laboratory findings, disease activity, organ damage, and quality of life were assessed at enrollment, and then annually for 5 consecutive years. We divided the patients into two groups according to whether LLDAS-50 was achieved (LLDAS-50 and non-LLDAS-50 groups). Univariate and multivariate analyses were used to assess the association between LLDAS-50 and clinical outcomes in SLE patients. <h3>Results:</h3> Of the 199 patients, 140 (70.4%) were assigned to the LLDAS-50 group and 59 (29.6%) to the non-LLDAS-50 group. The LLDAS-50 group was less likely to have a malar rash (<i>p</i>=0.031), serositis (<i>p</i>=0.025), and anti-nRNP (<i>p</i>=0.005), anti-nucleosome (<i>p</i>=0.048), and anti-histone (<i>p</i>=0.002) antibodies. The mean PGA and Systemic Lupus Erythematosus Disease Activity Index during follow-up were significantly lower in the LLDAS-50 group (both <i>p</i>&lt;0.001). During follow-up, the SF-36 Mental Component Summary (MCS) scores improved significantly, and the SLICC damage index (SDI) scores increased less in the LLDAS-50 group (both <i>p</i>=0.006). In the multivariate analysis, LLDAS-50 was significantly associated with the SF-36 MCS (OR = 1.061, 95% CI: 1.019–1.105, <i>p</i>=0.004) and SDI (OR = 0.682, 95% CI: 0.518–0.898, <i>p</i>=0.006) after adjustment. <h3>Conclusion:</h3> Attaining LLDAS-50 was associated with less organ damage and a better quality of life during the 5-year follow-up. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1529 DIVERSE PREVALENCE OF ANTI-C1Q ANTIBODIES ACROSS AUTOIMMUNE AND OTHER CHRONIC DISEASES
Authors: Y. Jiang, Y. Liang, Q. Wei, J. Xie, Z. Wu, Z. Liao, J. Gu
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Anti-C1q antibodies, targeting the complement system component C1q, are majorly linked to autoimmune diseases. However, anti-C1q antibodies could be detected in other conditions. Detecting anti-C1q antibodies can be clinically relevant in assessing and understanding the immune responses in these diverse diseases. <h3>Objectives:</h3> This study aimed to assess anti-C1q antibody positivity in different diseases, including autoimmune diseases, infectious diseases and other chronic diseases. <h3>Methods:</h3> Anti-C1q antibodies were examined via ELISA (Yahuilong, China) with a normal range of ≤10 U/ml. The assessment was carried out by two experienced laboratory experts. <h3>Results:</h3> In the 20,132 samples examined in our hospital, we conducted an analysis of anti-C1q antibodies, identifying 995 participants with positive antibodies and a mean age of 31.3±15.0. The median value of anti-C1q antibodies was 19 (13, 29) U/ml. Notably, 78.8% of the positive samples belonged to systemic lupus erythematosus (SLE), followed by connective tissue diseases (CTD) at 4.3%, skin rash at 2.9%, and a smaller percentage in other categories such as hepatitis B Virus (HBV) infection (2.1%). Additionally, conditions like thrombocytopenia (1.9%), systemic sclerosis (SSC) (1.5%), chronic kidney disease (1.4%), rheumatoid arthritis (RA) (1.3%), and pneumonia (1.2%) exhibited varying degrees of association with positive anti-C1q antibodies. Autoimmune encephalitis, idiopathic inflammatory myopathy (IIM), antiphospholipid syndrome (APS), thyroiditis, osteoarthritis, and primary biliary cirrhosis (PBC) showed lower prevalence. Notably, 106 individuals with C1q levels above 50 IU/ml were observed, predominantly in SLE (75.5%), skin rash (5.7%), and CTD (2.8%), with smaller percentages in HBV infection, Sjögren's syndrome (SS), RA, SSC, chronic kidney disease, thrombocytopenia, IIM, cryptococcal meningitis and even ankylosing spondylitis (AS). <h3>Conclusion:</h3> These findings underscore the diverse prevalence of anti-C1q antibodies across various diseases, with SLE being the most prominent. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0226 GRANULOMATOSIS WITH POLYANGIITIS AND COURSE OF PREGNANCY - RESULTS FROM THE NATIONWIDE PREGNANCY REGISTER REVNATUS
Authors: B. Jakobsen, H. Koksvik, T. T. Pedersen, M. Wallenius
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Granulomatosis with polyangiitis (GPA) is a rare autoimmune disease that cause inflammation of blood vessels that may lead to manifestations from several organ systems. Pulmonal and renal involvement may indicate serious disease. Most previous reports on pregnancies in GPA are based on retrospective collected data and smaller case reports. <h3>Objectives:</h3> To describe the course of pregnancy in patients with GPA. <h3>Methods:</h3> We prospectively collected data on pregnancy outcome in women with GPA through the nationwide Norwegian quality registry on pregnancy and rheumatic diseases (RevNatus) from 2008 – 2023. All women were diagnosed with ICD-10 code M31.3. 35 pregnancies in 25 women were recorded. <h3>Results:</h3> Mean maternal age at birth was 30 years (SD = 5.0). Mean disease duration was eight years (SD = 6.0). Median Vasculitis Damage Index (VDI) at inclusion was 0 (range 0 – 5). 44 % had previous treatment with cyclophosphamide, and 67 % with rituximab. One patient had hypertension, one had metabolic disease, one had psychiatric disease and one had severe renal disease as comorbidity. Four pregnancies were not planned. We recorded one stillbirth and one spontaneous abortion in pregnancy week 10. Mean gestational age at delivery was 39 weeks (range 33-42). Mean birth weight was 3461 gram (SD = 661.9). Three women experienced preeclampsia, but no HELLP was recorded. 24 (73 %) had vaginal deliveries and 9 (27 %) had caesarean section (6 was acute and 3 was planned). 20 (57 %) women used azathioprine in pregnancy and 15 (43 %) used prednisolone in doses from 2,5 – 15 mg per day. In addition, one patient received rituximab in 1<sup>st</sup> trimester, and one patient received immunoglobulin in 1<sup>st</sup> and 2<sup>nd</sup> trimester. 14 (45 %) women used acetylsalicylic acid in pregnancy. Due to different and multiple scoring points during pregnancy, we present median of the highest reported values for Birmingham Vasculitis Activity Score (BVAS), CRP, and patient global health, patient pain and patient fatigue on visual analogue scale (VAS) in Table 1. <b>Table 1.</b> <h3>Conclusion:</h3> Most patients with GPA in this cohort had a favourable course and outcome of pregnancy and most pregnancies were planned. GPA is a very heterogeneous disease, and the women in our cohort had low disease activity. Larger cohorts representing the heterogeneity are needed to study the course and outcome of pregnancies in GPA. <h3>REFERENCES:</h3> [1] Gatto M, Iaccarino L, Canova M, Zen M, Nalotto L, Ramonda R, Punzi L, Doria A. Pregnancy and vasculitis: a systematic review of the literature. Autoimmun Rev. 2012 May;11(6-7):A447-59. doi: 10.1016/j.autrev.2011.11.019. Epub 2011 Dec 3. PMID: 22155197. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1606-HPR IS RADIOGRAPHIC OSTEOPENIA A VALID INDICATION FOR BONE DENSITOMETRY
Authors: N. Powrie, E. Mclernon, K. Stansfield, A. Ismail
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> 'Osteopenia', is a common finding on skeletal radiographs ("Radiographic osteopenia"), and a common indication for Bone Densitometry. Studies have shown osteoporosis on DXA is common in those with radiographic osteopenia. However a significant proportion of patients are not osteoporotic. NICE recommendations are that bone densitometry is not routinely performed without first performing a fracture risk assessment using FRAX. <h3>Objectives:</h3> We sought to determine the proportion of patients with radiographic osteopenia, who would be diagnosed with osteoporosis on DXA, and whether the DXA scan alters treatment decision in patients with radiographic osteopenia and low pre-BMD FRAX probabilities. <h3>Methods:</h3> DXA scan reports between 01/08/21 and 28/02/22 were extracted from the radiology information system (n=2997). Those containing the phrase 'radiographic osteopenia' were selected (n=436, 15%). Those with other strong indications for DXA were excluded, leaving 190 reports; a further 4 were excluded where FRAX was unavailable (n=186). The following data was collected or calculated; WHO diagnosis based on lowest T-score; FRAX probability with and without BMD; whether DXA was indicated using FRAX without BMD, Whether treatment was indicated using FRAX with BMD. We aimed to investigate; 1.The proportion of patients with osteoporosis, based on their DXA as per WHO criteria; 2. The proportion of patients, in whom FRAX without BMD would not indicate a DXA, who would be eligible for treatment if DXA was performed. <h3>Results:</h3> 28% of patients had Osteoporosis, 47% Low Bone Density (Densitometric Osteopenia), and 25% in the normal range, on their DXA scan. Using FRAX without BMD included, DXA was not indicated in 118/186 (63%) of patients. Of these 19/118(16%) had fracture risk high enough to consider osteoporosis treatment if the DXA scan was subsequently performed anyway. <h3>Conclusion:</h3> 16% of patients with radiographic osteopenia, but with FRAX probabilities not high enough for a DXA to be indicated, would have be eligible for osteoporosis treatment if the DXA was performed anyway and FRAX recalculated with BMD included. It is therefore felt that 'radiographic osteopenia' remains a valid indication for bone densitometry. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0325-PARE BURDEN OF ILLNESS ON PEOPLE LIVING WITH ANCA-ASSOCIATED VASCULITIS
Authors: D. Densmore, M. De Belder, J. Brahmbhatt
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patients living with AAV are profoundly impacted by their illness. Limited awareness and understanding of AAV by both HCPs and patients typically results in misdiagnosis or delayed diagnosis, increasing the likelihood of delayed access to appropriate care and more severe disease. <h3>Objectives:</h3> Understand the burden of illness on people living with ANCA-Associated Vasculitis (AAV) and how those experiences impact their perceptions, preferences, and decision making around treatment options. <h3>Methods:</h3> Two structured patient advisory panels were conducted with five patients and one caregiver in August and October 2023. Additional insights were collected during in-depth interviews with six additional patients globally. <h3>Results:</h3> Most patient interviewees and panelists received their diagnosis when in crisis during an emergency room or hospital visit. Symptoms range from: extreme muscle weakness, severe fatigue, shortness of breath, cognitive impairment, and coughing up blood, all of which can be debilitating. Adding to the burden of illness are the significant side effects patients experience from their medications, including potential drug-drug interactions from treatments meant to manage comorbidities. Even in remission, the majority of patient panelists and interviewees experience significant symptoms, which diminish their quality of life. Universally described as "horrific," one patient panelist remarked that she would probably only get answers, "When they do the autopsy." <h3>Conclusion:</h3> ANCA-Associated Vasculitis is a rare disease that devastates the lives and wellbeing of most people living with it. The patient panelists and interviewees provided new insights that clearly illustrate the profound impact of AAV on the quality of their lives. More research into the burden of illness is needed to understand areas of improvement in the care continuum with the objective to improve health outcomes and lessen the emotional and physical toll AAV takes on a person's life. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> Vasculitis Foundation, Vasculitis International, Vasculitis Ireland, and APACS. <h3>Disclosure of Interests:</h3> Devra Densmore I own 15 shares of argenx stock., I am currently a consultant for argenx., Maya De Belder: None declared, Janki Brahmbhatt: None declared.
AB1645-PARE DISEASE FLARES IN PATIENTS WITH RHEUMATOID ARTHRITIS FOLLOWING COVID-19 BREAKTHROUGH INFECTION: RESULT FROM COVAD E-SURVEY STUDY
Authors: C. Sieiro Santos, J. P. Chen, E. Nikiphorou, C. W. Tseng, C. E. Toro-Gutierrez, A. L. Tan, A. Nune, E. Kadam, M. Kuwana, J. Day, S. Saha, T. Velikova, J. B. Lilleker, C. Vinicio Caballero, P. Sen, H. Chinoy, R. Aggarwal, V. Agarwal, L. Gupta, Y. M. Chen
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> COVID-19 has been suggested as a possible trigger of disease flares in patients with rheumatoid arthritis (RA). However, factors associated with disease flares remain unknown. <h3>Objectives:</h3> This study aimed to identify factors associated with disease flares in patients with RA following COVID-19. <h3>Methods:</h3> We selected patients with RA from an online e-survey data from the COVID-19 vaccination in autoimmune diseases (COVAD) study. Demographic data, patient-reported outcomes, comorbidities and pharmacologic treatment were extracted from the database. Disease flare-ups were derived from the e-survey database. Factors associated with disease flare-ups were determined by multivariate logistic regression analysis. <h3>Results:</h3> In total, 1928 patients with RA were extracted from the COVAD database. Younger age (odds ratio (OR): 0.98, 95% CI: 0.96 – 0.99, p&lt;0.001), ethnicity other than Asian, past history of tuberculosis (OR: 3.80, 95% CI: 1.12 – 12.94, p=0.033), treatment with methotrexate (OR: 2.55, 95% CI: 1.56 – 4.17, p&lt;0.001), poor global physical health (OR: 1.07, 95% CI: 1.00 –1.15, p=0.044) and mental health (OR: 0.91, 95% CI: 0.87 –0.95, p&lt;0.001) were independent factors associated disease flares in patients with RA. Table 1 represents factors associated with disease flare in patients with RA after COVID breakthrough infections and Figure 1 represents forest plots of symptoms of disease flare. <h3>Conclusion:</h3> Our study highlights important socio-demographic, clinical characteristics and mental health to be associated with flares in patients with RA. This finding may help determine relevant strategies to proactively manage RA patients at risk of flares. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> Myositis Association, Myositis India, Myositis UK, Myositis Support and Understanding, the Myositis Global Network, Deutsche Gesellschaft für Muskelkranke e.V. (DGM), Dutch and Swedish Myositis patient support groups, Cure JM, Cure IBM, Sjögren's India Foundation, Patients Engage, Scleroderma India, Lupus UK, Lupus Sweden, Emirates Arthritis Foundation, EULAR PARE, ArLAR research group, AAAA patient group, Myositis Association of Australia, APLAR myositis special interest group, Thai Rheumatism association, PANLAR, AFLAR NRAS, Anti-Synthetase Syndrome support group, and various other patient support groups and organizations. <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1665-PARE DRUG PERSISTENCE WITH THERAPY OF ADALIMUMAB BIOSIMILAR, MSB11022, IN RHEUMATOLOGIC DISEASES
Authors: S. Cheung, F. Kudaeva, P. Heidari, D. Truong
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Drug persistence is often used as a surrogate marker for control of disease activities in rheumatologic diseases (RDs). Patient support program (PSP), KabiCare, plays one of the key roles in patient education for drug persistence. <h3>Objectives:</h3> The objective of the project is to investigate drug persistence with adalimumab biosimilar, MSB11022, in RDs. <h3>Methods:</h3> Patients diagnosed with RDs were enrolled in KabiCare and administered at least one dose of the adalimumab biosimilar, MSB11022, between February 2021 and September 2023, were included. The database tracked medication initiation and cessation dates, disease classifications (rheumatoid arthritis [RA], psoriatic arthritis [PsA], and ankylosing spondylitis [AS]), as well as patient treatment categorizations (classified as either treatment-naïve to biologics or having switched from other biologics). The stop date denoted the moment KabiCare was notified about the discontinuation of medication. Patients continuing their medication were recorded until the maximum follow-up date of analysis, which was September 12, 2022, after which they were censored. KM (Kaplan-Meier) plot comparisons using log-rank tests were conducted to assess potential differences in medication persistence among various RDs, and between the treatment-naïve group and the switch group based on disease categories. <h3>Results:</h3> The study cohort included 2,882 patients, with 1,291 diagnosed with RA, 673 with PsA, and 918 with AS. Of these, 695 (53.8%) patients with RA, 268 (39.8%) with PsA, and 396 (43.1%) with AS were classified as treatment-naïve. KabiCare monitored patients for a median duration of 431 days (interquartile range: 176-618 days; maximum: 912 days). At 800 days (approximately 27 months) after the initiation of medication, there was a slight variance in the persistence probability among patients with RA, PsA, and AS (68.0%, 72.0%, and 71.5%, respectively; P=0.036). Comparatively, the persistence probability was notably higher in the switch group than in the naïve group across the three RDs groups (75.1% vs. 61.1%, P=0.0001 in RA; 73.7% vs. 69.3%, P=0.0034 in PsA; and 74.0% vs. 67.5%, P=0.0027 in AS). <h3>Conclusion:</h3> The evidence suggests that drug persistence of adalimumab biosimilar, MSB11022, was high in both treatment-naïve to biologics, or switched from other biologics groups at 27 months. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Sun Cheung Abbvie, Abbott, Fresenius Kabi Canada, Fatima Kudaeva Fresenius Kabi Canada, Pooneh Heidari Fresenius Kabi Canada,, Don Truong Fresenius Kabi Canada.
POS1104 SERUM C-REACTIVE PROTEIN LEVELS CAN PREDICT ORGAN DAMAGE WITHIN 2 YEARS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS WHO MEET LUPUS LOW DISEASE ACTIVITY STATE
Authors: T. Nakajima, A. Onishi, H. Onizawa, M. Shirakashi, R. Hiwa, H. Tsuji, K. Kitagori, S. Akizuki, R. Nakashima, H. Yoshifuji, M. Tanaka, A. Takatani, T. Onishi, T. Kida, Y. Miyawaki, T. Shimizu, H. Kajiyama, R. Yoshimi, Y. Matsuo, Y. Shimojima, S. Sato, S. Ohno, M. Fujiwara, N. Yajima, K. E. Sada, A. Morinobu
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> C-reactive protein (CRP), one of the inflammatory markers, has been previously reported to be relatively low in systemic lupus erythematosus (SLE) patients, except in the presence of specific organ involvement such as serositis [1]. By contrast, CRP is a predictor of atherosclerotic diseases [2], which may be caused by SLE itself or medications for SLE and are frequently complicated with SLE as organ damage. However, it is unclear whether CRP predicts Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) progression in inactive SLE. <h3>Objectives:</h3> This study aimed to examine the association between CRP levels and organ damage in SLE patients with low disease activity. <h3>Methods:</h3> This multi-center, retrospective observational study used Lupus Registry of Nationwide Institutions (LUNA) cohort database. SLE patients who met Lupus Low Disease Activity State (LLDAS) at registration were divided into two groups: those with serum CRP levels ≥ 0.07 mg/dL (high CRP group) or &lt; 0.07 mg/dL (low CRP group) both at registration and in the first year. The cutoff for CRP levels was determined as the median value in patients who met LLDAS. SDI progression was defined when the score increased ≥1. <h3>Results:</h3> Among 106 SLE patients who met LLDAS, 55 were in a high CRP group and 51 were in a low CRP group. In the high CRP group, patients were older (median: 56.8 vs. 41.6, p = 0.002), had higher body mass index (median: 22.6 vs. 20.3, p &lt; 0.001), and had higher SDI scores (median: 1 vs. 0, p = 0.03) at registration. Log-rank test showed that the probability of SDI progression within 2 years was significantly higher in the high CRP group (p = 0.007) (Figure 1). Furthermore, Cox proportional hazard model showed that high CRP group was significantly associated with SDI progression when adjusted for age, SLE disease activity index scores, and SDI scores at baseline (HR: 2.72, 95% CI: 1.06-6.99, p = 0.04) (Table 1). <h3>Conclusion:</h3> CRP levels were associated with SDI progression within 2 years in LLDAS patients. Even in patients with inactive SLE, positive CRP levels may suggest the necessity to modify treatment for SLE or atherosclerotic risk factors. <h3>REFERENCES:</h3> [1] M Aringer. J Autoimmun. 2020: 110: 102374. [2] J Danesh, et al. N Engl J Med. 2004; 350(14): 1387-97. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS1160 CLINICAL CHARACTERISTICS AND RESPONSE TO STANDARD-OF-CARE IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS WITH OR WITHOUT ANTI-RIBONUCLEOPROTEIN (RNP) ANTIBODIES
Authors: R. Kandane-Rathnayake, R. Koelmeyer, S. Oon, S. O’neill, F. Goldblatt, M. Rischmueller, A. Hennessey, Y. Oh, S. Khetan, T. Tsai, D. Ranganathan, A. Jullion, T. Shisha, M. Nikpour, E. Morand, A. Hoi
Journal: Annals of the Rheumatic Diseases (2024)