tbuckley/cabot-search huggingface dataset:
AB0766 GLOBAL PREVALENCE OF OSTEOPOROSIS IN RHEUMATOID ARTHRITIS: SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: K. Almutairi, C. Inderjeeth, D. Preen, H. Keen, E. Luu, J. Nossent
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Osteoporosis is a commonly co-existing comorbidity and well-documented extra-articular manifestation in patients with rheumatoid arthritis (RA), which is more prevalent than in the general population [1]. However, there is limited data on the prevalence of osteoporosis and associated risk factors in RA. <h3>Objectives:</h3> The study aims to estimate the global prevalence of osteoporosis in RA patients, identify associated risk factors, and determine high-risk RA patients who require preventive osteoporosis treatment. <h3>Methods:</h3> We searched several databases (MEDLINE, Scopus, ProQuest Central, Web of Science, EMBASE, CINAHL, and Google Scholar) to estimate the global prevalence of osteoporosis in RA populations. We also evaluated the influence of geographical location, prevalence methods, and diagnostic criteria on prevalence estimates from 1980 to 2023. <h3>Results:</h3> We included 29 studies involving 31,473 RA patients with osteoporosis out of 130,989 RA populations. The global prevalence of osteoporosis in RA was estimated at 21.5% (95% confidence interval 16.5-27.0), with a prediction interval of 1.4% - 56.1% (Figure 1). The point-prevalence of osteoporosis was 19.2% (95% CI 13.3-25.8), while the period-prevalence was 27.1% (95% CI 18.9-36.3). The highest pooled prevalence of osteoporosis was observed in Asia (30.0%; 95% CI 22.1-38.6), while Europe (13.4%; 95% CI 8.9-18.7) and North America (13.3%; 95% CI 11.0-15.9) had lower estimates. Factors influencing osteoporosis prevalence included continents, prevalence methods, and diagnostic osteoporosis criteria. The World Health Organization (WHO) osteoporosis criteria exhibited greater consistency in prevalence estimates in RA populations, regardless of demographic characteristics. <h3>Conclusion:</h3> The estimated global point- and period-prevalence of osteoporosis in RA were 19.2% and 27.1%, respectively. Higher prevalence rates observed in Asia may be influenced by restricted healthcare access or variations in risk environments, highlighting the significance of the WHO criteria in predicting and guiding preventive treatment. <h3>REFERENCES:</h3> [1] Hauser B, Riches PL, Wilson JF, Horne AE, Ralston SH (2014) Prevalence and clinical prediction of osteoporosis in a contemporary cohort of patients with rheumatoid arthritis. Rheumatology 53(10):1759-1766 <h3>Acknowledgements:</h3> The authors thank the Australian Rheumatology Association, and Arthritis &amp; Osteoporosis in WA for their financial support. <h3>Disclosure of Interests:</h3> Khalid Almutairi: None declared, Charles Inderjeeth AbbVie outside of the submitted work, David Preen: None declared, Helen Keen AbbVie, Cornerstones, Roche, and Pfizer outside of the submitted work, Emily Luu: None declared, Johannes Nossent: None declared.
AB0108 ELEVATED RISK OF VALVULAR HEART DISEASE IN PATIENTS WITH GOUT: A POPULATION-BASED COHORT STUDY
Authors: J. S. Yun, S. M. Jung
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Gout has been widely associated with cardiovascular health, but its relationship with incident valvular heart disease (VHD) remains uncertain. <h3>Objectives:</h3> To investigate the association between gout and VHD, and further explore the role of weight management within this context. <h3>Methods:</h3> We identified 10,930 patients with gout from the UK Biobank Cohort based on the combination of self-report and/or hospital diagnostic codes. The risk of VHD associated with gout was assessed in the overall populations and across subgroups with differing metabolic profiles. To examine the impact of obesity on the incident VHD, the relative risk of VHD were analyzed based on body mass index and waist circumference. <h3>Results:</h3> The incidence rate of VHD was significantly higher in patients with gout than in participants without gout (Hazard ratio 2.53, 95% confidence interval 2.35-2.71). While a positive correlation was observed between SUA level and VHD risk in the general population, the significant higher incidence of VHD was observed only in patients with SUA levels higher than 10 mg/dL among gout population. The elevated risk of VHD associated with gout remained consistently across subgroups with differing metabolic profiles. The impact of obesity on the incident VHD was notable among gout patients with SUA below 9.0 mg/dL, but less pronounced in those with SUA exceeding 9.0 mg/dL. <h3>Conclusion:</h3> This finding suggests a significant association between gout and VHD, emphasizing the need for screening and preventive efforts in patients with gout to mitigate the risk of VHD. <h3>REFERENCES:</h3> [1] Messika-Zeitoun D, Baumgartner H, Burwash IG, Vahanian A, Bax J, Pibarot P<i>, et al.</i> Unmet needs in valvular heart disease. <i>Eur Heart J</i> 2023;<b>44</b>:1862-73. [2] Feig DI, Kang DH, Johnson RJ. Uric acid and cardiovascular risk. <i>N Engl J Med</i> 2008;<b>359</b>:1811-21. [3] Lazzeroni D, Bini M, Camaiora U, Castiglioni P, Moderato L, Bosi D<i>, et al.</i> Serum uric acid level predicts adverse outcomes after myocardial revascularization or cardiac valve surgery. <i>Eur J Prev Cardiol</i> 2018;<b>25</b>:119-26. [4] Muiesan ML, Salvetti M, Virdis A, Masi S, Casiglia E, Tikhonoff V<i>, et al.</i> Serum uric acid, predicts heart failure in a large Italian cohort: search for a cut-off value the URic acid Right for heArt Health study. <i>J Hypertens</i> 2021;<b>39</b>:62-9. [5] Choi HK, McCormick N, Yokose C. Excess comorbidities in gout: the causal paradigm and pleiotropic approaches to care. <i>Nat Rev Rheumatol</i> 2022;<b>18</b>:97-111. <h3>Acknowledgements:</h3> This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (Grant Number: 2022R1F1A1072279). <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0780 LOW-DOSE IL-2 AMELIORATED PERIPHERAL ARTHRITIS AND INTESTINAL INFLAMMATION IN COLLAGEN-INDUCED ARTHRITIS (CIA) MICE
Authors: C. Wang, L. Cheng
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) is a progressive and aggressive autoimmune disease causing swelling, pain, degeneration and loss of function in joints. The pathogenesis of RA has not been fully elucidated. Low-dose Interleukin 2 (IL-2) can promote the proliferation of Treg cells, control inflammatory responses, and maintain immune tolerance in multiple systems, including the joints and the gut. <h3>Objectives:</h3> To elucidate the pathogenesis of RA and to explore new effective treatment methods is the focus of current research. In this study, we investigated the effects of low-dose IL-2 on intestinal inflammation in CIA mice. <h3>Methods:</h3> We first evaluated joint inflammation in mice. Next, The expression of intestinal inflammatory factors IL-17A and TNF-α, tight junction proteins ZO-1 and Claudin-1, and apoptosis related proteins Bax and Bcl-2 were evaluated. <h3>Results:</h3> Compared with the model group, low-dose IL-2 treatment significantly improved walking impairment and reduced joint inflammation in CIA mice. Low-dose IL-2 treatment reduced intestinal inflammation, repaired the intestinal mucosal barrier, and inhibited intestinal epithelial cell apoptosis in CIA mice. <h3>Conclusion:</h3> Low-dose IL-2 significantly reduced joint inflammation and intestinal inflammation in CIA mice and is a promising therapeutic modality for the treatment of RA. <h3>REFERENCES:</h3> [1] Möller B.; Kollert F.; Sculean A.Villiger P. M. Infectious Triggers in Periodontitis and the Gut in Rheumatoid Arthritis (RA): A Complex Story About Association and Causality. Front Immunol. 2020; 11, 1108. [2] Chahal S.; Biln N.Clarke B. Patient Perspectives on a Digital Mobile Health Application for RA. Open Access Rheumatol. 2021; 13, 63-71. [3] Croia C.; Bursi R.; Sutera D.; Petrelli F.; Alunno A.Puxeddu I. One year in review 2019: pathogenesis of rheu-matoid arthritis. Clin Exp Rheumatol. 2019; 37, 347-357. [4] McDermott G.; Gill R.; Gagne S.; Byrne S.; Huang W.; Wang X.; Prisco L. C.; Zaccardelli A.; Martin L. W.; Masto L.; Kronzer V. L.; Shadick N.; Dellaripa P. F.; Doyle T. J.Sparks J. A. Demographic, Lifestyle, and Serologic Risk Factors for Rheumatoid Arthritis (RA)-associated Bronchiectasis: Role of RA-related Autoantibodies. J Rheumatol. 2022; 49, 672-679. [5] Klatzmann D.Abbas A. K. The promise of low-dose interleukin-2 therapy for autoimmune and inflammatory diseases. Nat Rev Immunol. 2015; 15, 283-294. [6] Wu Y.; Tian Z.Wei H. Developmental and Functional Control of Natural Killer Cells by Cytokines. Front Immunol. 2017; 8, 930. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0759 USING MACHINE LEARNING TO PREDICT SUSTAINED REMISSION IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH BIOLOGIC THERAPIES
Authors: F. Z. Aharrane, F. E. Abourazzak, T. Fatima Zahrae, A. Amar, I. Hmamouchi, I. El Bouchti, Z. Baba, F. Allali, R. Bahiri, A. Bezza, A. El Maghraoui, I. Ghozlani, H. Hassikou, T. Harzy, I. Linda, S. Janani, R. Niamane, R. Abouqal
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Sustained remission is the primary therapeutic goal for patients with rheumatoid arthritis (RA). Although several studies have identified factors associated with treatment response in rheumatoid arthritis (RA), there are no precise predictive models for sustained remission in patients treated with biologic therapies. <h3>Objectives:</h3> Evaluating the performance of machine learning to predict short-term sustained remission in rheumatoid arthritis patients under biological disease modifying antireumatic drugs (bDMARDS). <h3>Methods:</h3> We included patients with rheumatoid arthritis, who started biological disease modifying antireumatic drugs, from the Moroccan registry of biological therapies, with a follow-up of at least 1 year and an evaluation in at least two consecutive visits with an interval of 6 months. Sustained remission was defined as DAS28 &lt; 2.6 on two consecutive visits. Demographic and clinical characteristics were collected at treatment baseline, 6-month, and 12-month follow-up. Four different machine-learning algorithms, namely, logistic regression, Random Forest, K Nearest Neighbors and AdaBoost, were trained and validated to predict remission at 12 months. The algorithms performance was then compared by assessing accuracy, precision and recall. <h3>Results:</h3> We included 130 patients (88.5% female); mean age ± SD was 51.52 ± 10.86 years. 38 patients (29.2%) achieved sustained remission. The set of variables used to train the algorithms included initial DAS 28, rheumatoid factor and anti-citrullinated peptides antibodies positivity, Health Assessment Questionnaire-Disability Index, type and number of biotherapies, Methotrexate use, as well as several clinical features. Adaboost showed the best performance (accuracy, 75%; precision, 75%; recall, 100%), outperforming Random Forest (accuracy, 57%; precision, 75%; recall, 60%), K-nearest neighbors (accuracy, 57%; precision, 33%; recall, 100%) and logistic regression (accuracy, 29%; precision, 33%; recall, 25%). <h3>Conclusion:</h3> Machine-learning models can be used to predict sustained remission in rheumatoid arthritis patients on biotherapy. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0768 ANTI-CITRULLINATED PROTEIN ANTIBODIES AND CERVICAL SPINE INVOLVEMENT IN RHEUMATOID ARTHRITIS
Authors: S. Moukhane, I. El Mezouar, N. Akasbi, I. Mahfoudi, T. Harzy
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis is the most common inflammatory rheumatism. Cervical spine involvement in rheumatoid arthritis is a frequent and potentially serious complication. <h3>Objectives:</h3> The objective of our study is to investigate the correlation between cervical spine involvement in RA and anti-citrullinated protein antibodies (ACPA). <h3>Methods:</h3> Our work is a retrospective descriptive and analytical study involving patients followed in our department for RA meeting the ACR 1987 and/or ACR/EULAR criteria over a period from January 2020 to December 2023. We collected deographic, clinical, radiological, and therapeutic data and studied the correlation between cervical spine involvement in RA and ACPA. <h3>Results:</h3> A total of 437 patients were included. The mean age was 58.68 ± 12.44 years with a female predominance: 85.8% females and 14.2% males. Diabetes was present in 19.1%, and hypertension in 16%. The average duration of RA was 14.7 ± 7.591 years. The mean rheumatoid factor (RF) was 170.25 ± 283.02, and the mean ACPA was 230.50 ± 435.99. In our study, we had two groups: The first group without cervical involvement (55.4% of cases) with a mean onset age of 43.29 ± 14.05, a mean diagnosis delay of 37.18 ± 44.91 months, RF positive in 84.1%, ACPA positive in 65.8%, mean DAS28 CRP was 5.01 ± 1.45, and HAQ &gt;0.5 in 74.9%. The second group with cervical involvement (44.66% of cases) had a mean disease onset age of 44.34 ± 12.59 (P=0.420), a diagnosis delay of 52.12 ± 71.56 months (P=0.009), RF positive in 83% of cases (P=0.795), ACPA positive in 61.8% (P=0.414), mean DAS28 CRP was 5.71± 3.31 (P=0.004), and HAQ &gt; 0.5 in 76.8% (P=0.723). <h3>Conclusion:</h3> Through this study, we observed that cervical involvement is common in RA. ACPA has prognostic value for RA but is not associated with cervical spine involvement. However, there is a significant association between cervical involvement and a high DAS CRP, as well as a late diagnostic delay. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1293 FREQUENCY AND THE EFFECTS OF SPONDYLOARTHRITIS-SPECTRUM DISORDERS ON THE CLINICAL COURSE AND MANAGEMENT OF TAKAYASU ARTERITIS
Authors: K. Abacar, S. Kaymaz Tahra, O. Bayindir, B. Ince, M. E. Kutu, A. Yazici, E. Durak Ediboglu, T. Demirci Yildirim, Z. Ademoğlu, A. Omma, N. S. Yasar Bilge, G. Kimyon, T. Kaşifoğlu, H. Emmungil, F. Onen, S. Akar, A. Cefle, N. A. Kanitez, S. Celik, M. Inanc, K. Aksu, G. Keser, H. Direskeneli, F. Alibaz-Oner
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Extravascular findings of Takayasu arteritis (TAK), a chronic large-vessel vasculitis, usually belong to the spondyloarthritis (SpA)-spectrum of diseases. However, the characteristics of these findings and their effect on the vascular manifestations of TAK are not fully known. <h3>Objectives:</h3> Therefore, we aimed to investigate the frequency of axial-SpA, inflammatory bowel disease (IBD), and psoriasis in TAK patients and the effect of these associations on the clinical features and management of TAK. <h3>Methods:</h3> Patients with TAK followed in 12 tertiary rheumatology clinics across Turkey were included in the study and were evaluated for the presence of axial-SpA, IBD or psoriasis. Demographic characteristics, clinical features, angiographic involvement patterns, disease activity, damage scores and treatments of TAK patients with or without SpA-spectrum disorders were analyzed and compared. <h3>Results:</h3> Patients (n=350) classified according to ACR 1990 criteria were included in the study. Mean age (SD) was 45.5 (13.6) years and mean (SD) follow-up 76.1 (65.9) months. Thirty-one (8.8%) patients also had diseases in the SpA-spectrum. Among them, 8 (2.2%) patients had IBD, 8 (2.2%) had psoriasis and 20 (5.7%) had axial SpA. (Figure 1) The symptoms of TAK presented at a significantly earlier age in the TAK with SpA group than without SpA (TAK with SpA: mean (years) (SD): 26.03 (7.49) vs TAK without SpA: 31.59 (12.6), p=0.041). Furthermore, a significantly higher rate of biological therapy use was detected in the TAK with SpA group (TAK with SpA: 22 (70.9%) vs TAK without SpA: 85 (27.9%), p&lt;0.001). Vascular involvement was similar in both groups. <h3>Conclusion:</h3> Our study confirmed that diseases in the SpA-spectrum are not rare in TAK patients. TAK symptoms also appeared earlier in the group accompanied by SpA. However, most patients in the TAK with SpA group had an earlier onset of SpA-related symptoms than symptoms attributable to TAK. More aggressive therapy with biological agents was required in the TAK with SpA group and mostly for the severity and activation of TAK. Our results suggest that presence of SpA-spectrum disorders may cause more severe disease course and earlier disease onset in TAK patients. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1294 EFFICACY AND SAFETY OF DISEASE-MODIFYING ANTI-RHEUMATIC DRUGS IN THE TREATMENT OF TAKAYASU ARTERITIS
Authors: Q. Huang, Y. Wu, B. Zhou, Q. Cui, F. Xie
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Disease-modifying anti-rheumatic drugs are used in the treatment of Takayasu arteritis, and understanding the effectiveness and safety of drugs in the treatment is crucial for guiding clinical medication. <h3>Objectives:</h3> To elucidate the efficacy and safety of disease-modifying anti-rheumatic drugs (DMARDS) used in Takayasu arteritis (TAK). <h3>Methods:</h3> Data was retrieved from database included Web of Science, Pubmed Central, Scopus, CNKI, SinoMed and WanFang Data for studies published before 20 December 2023. Studies with a sample size <5 patients with TAK were excluded. Two authors independently screened studies for eligibility, extracted, assessed data for accuracy. Random effects meta-analyses of various effect measures were performed. <h3>Results:</h3> Ninety-one studies totaling 3767 patients from 9 randomized controlled trials and 82 observational studies were identified, consisting of 15 different drugs. The main outcomes assessed included the proportion of the clinical responses, angiographic stabilization rates, the adverse event rates and the relapse rates, the changes of glucocorticoid (GC) doses and acute phase inflammation markers (CRP/ESR) after treatment analyzed by random effects model. Observational studies showed a high risk of bias. The pooled at least partial clinical remission rates of all DMARDs were 77% (95% CI:72%~81%), and the remission rates of tocilizumab and leflunomide (83%,95%CI:76%-89%;89%,95%CI:82%-94%)were highest in the biological agents and the conventional DMARDs(cDMARDs),respectively. The proportion of TAK patients achieving angiographic stabilization was 83%(95% CI:78%-88%). Among the drugs, angiographic stabilization rates of tofacitinib were high (94%,95% CI:81%-100%; two study), next was followed by methotrexate (90%, 95%CI:82%-95%). The pooled relapses rates after the treatment were 24% (95% CI:17%-31%). The relapse rate was 37% for anti-TNF agents (95% CI:19%-56%; 7 studies) and 18% for secukinumab (95% CI: 5%-40%; one study). The GC doses and CRP/ESR were significantly decreased after the treatmengt of tocilizumab and anti-TNF agents. The adverse events occurred in 21% (95% CI:15%-27%), and the rates of the cyclophosphamide is significantly high (37%,95%CI:24%-51%). <h3>Conclusion:</h3> Among the biological agents, tocilizumab and anti-TNF agents had a significant impact on outcomes in TAK,especially on decreasing GC doses and acute phase inflammation markers. Secukinumab was shown to have a low relapse rate, while the relapse rates of anti-TNF agents need to be noted. Among the cDMARDS, leflunomide had a significant effect on clinical remission.Methotrexate provides functional benefits in angiographic stabilization. Future more refined studies should attempt to include larger cohorts. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0782 IN VITRO EFFECT OF UPADACITINIB AND TOFACITINIB ON PERIPHERAL BLOOD LEUKOCYTES FROM PATIENTS WITH EARLY AND ESTABLISHED RHEUMATOID ARTHRITIS
Authors: R. L. Teixeira, C. A. Bento, C. Tomé, V. C Romão, J. E. Fonseca, I. Alcobia, R. A. Moura
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) is a chronic, systemic, immune-mediated inflammatory disease that mainly targets the joints. The pathogenesis of RA involves dysregulations in immune pathways such as the JAK-STAT signaling pathway. JAK inhibitors (JAKi) are a class of disease modifying anti-rheumatic drugs that are approved for RA treatment. <h3>Objectives:</h3> To compare the in-vitro cellular effect of two JAKi, tofacitinib and upadacitinib, in peripheral blood leukocytes from patients with untreated early rheumatoid arthritis (ERA), established refractory RA and healthy individuals. <h3>Methods:</h3> Blood samples were collected and peripheral blood mononuclear cells (PBMCs) were isolated and cultured during 24 hours with either tofacitinib or upadacitinib. The frequency, phenotype, STAT phosphorylation levels (pSTAT) and apoptosis of B cells, T cells, monocytes and dendritic cells (DCs) were analysed by flow cytometry before and after cell culture with JAKi in all groups. <h3>Results:</h3> We included 6 patients (50 % female, 55.0±22.1 years old, with a mean disease duration of 6.2 months). Changes in the frequency of B cells and DCs' subpopulations, but not in T cells or monocytes, were observed after 24 hours of in vitro cell culture with both JAKi (Figure 1). Furthermore, phenotypic analysis has revealed a reduction in the expression of activation markers on B cells, T cells and monocytes after culture with upadacitinib and tofacitinib. In addition, changes in pSTAT levels measured by median fluorescence intensity (MFI) were also detected in all leukocyte populations after culture with both JAKi when compared to baseline and/or drug vehicle (Figure 2). Notably, JAKi did not significantly affect cell viability. <h3>Conclusion:</h3> Overall, our data supports a similar immunomodulatory effect of tofacitinib and upadacitinib in peripheral blood leukocytes of early untreated RA. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>