tbuckley/cabot-search huggingface dataset:
POS0492 GENDER-SPECIFIC PERFORMANCE OF DISEASE ACTIVITY ASSESSMENT TOOLS IN AXIAL SPONDYLOARTHRITIS: ANCILLARY ANALYSIS OF THE PREDICT-SPA STUDY
Authors: S. Hamroun, L. Gossec, S. Perrot, M. Dougados, A. Moltó
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> There are several tools for assessing disease activity in spondyloarthritis (SpA). The literature reveals gender differences, with unfavorable Patient Reported Outcomes in women compared with men [1]. <h3>Objectives:</h3> The aim of this study was to evaluate the influence of gender on the tools used to assess disease activity in axial SpA, and their ability to discriminate Patient Acceptable Symptom State (PASS), depending on gender. <h3>Methods:</h3> This is an ancillary analysis of the Predict-SpA cross-sectional study (NCT03039088). Patients had a diagnosis of axial SpA according to their rheumatologist and an indication to start a TNF inhibitor. Disease activity was assessed prior to initiation of treatment using BASDAI, ASDAS-CRP scores, patient and physician global assessment of disease activity. Patients were also asked to rate whether their health status in relation to axial SpA was considered acceptable or unacceptable (PASS, yes/no). To analyse the ability of disease activity assessment tools to discriminate PASS, we calculated a standardized mean difference (SMD) for each tool in the total population, in men and in women. <h3>Results:</h3> Of the 526 patients included in Predict-SpA, 522 had an available PASS and were analysed, including 279 (53.4%) men and 243 (46.6%) women. Overall, women with a PASS had comparatively lower activity scores than men with a PASS. In the overall population, the BASDAI, ASDAS-CRP and patient global assessment of disease activity performed well in discriminating PASS (SMD 1.17, 0.93 and 1.36, respectively). However, there were gender differences, with BASDAI score performing better in women than in men (SMD 1.47 and 0.94, respectively). The physician global assessment was the least discriminating tool, with no gender differences (SMD 0.75, 0.80 and 0.81 in the overall population, in men and in women, respectively). <h3>Conclusion:</h3> The disease activity assessment tools appear to be able to discriminate PASS, apart from the physician global assessment of disease activity, in the whole population. The ASDAS-CRP performs homogeneously according to gender, which argues in its favour at the population level. As the BASDAI has a better discriminating performance in women, it could be used in studies including only women. <b>Table 1.</b> Performance of disease activity assessment tools in discriminating PASS in men and women with axial SpA. GA: global assessment, PASS: Patient Acceptable Symptom State. <h3>REFERENCES:</h3> [1] Tournadre A. Arthritis Care Res. 2013 Sep;65(9):1482-9. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS1121 ASSESSMENT OF SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) DISEASE ACTIVITY USING THE SLE DISEASE ACTIVITY SCORE (SLE-DAS): RESULTS FROM A SWEDISH TERTIARY REFERRAL CENTER
Authors: R. Andraos, J. Lindblom, I. Parodis, C. Sjöwall
Journal: Annals of the Rheumatic Diseases (2024)
POS0809 SWITCH OR SWAP? SECOND TARGETED THERAPY CHOICE IN PATIENTS WITH SPONDYLOARTHRITIS: A COHORT STUDY WITHIN THE FRENCH NATIONAL HEALTH DATA SYSTEM (SNDS)
Authors: C. Miceli Richard, R. Curmin, B. Flachaire, S. Pinto, F. Tubach, T. Pham
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> <h3>Objectives:</h3> Our objective was to describe the cumulative incidence of intra-class (switch) or inter-class (swap) therapeutic changes following the initiation of a first targeted therapy in patients treated for spondyloarthritis (SpA). <h3>Methods:</h3> This retrospective cohort study within the French National Health Data System (SNDS), included adult subjects diagnosed with SpA, including axial SpA and psoriatic arthritis, who received a first targeted therapy between 01/01/2015 and 31/12/2018. The therapeutic classes considered for defining intra-class switches and swaps were anti-TNF, anti-IL17, anti-IL23, anti-IL12/23, Janus Kinase inhibitor (JAKi), and phosphodiesterase-4 inhibitor (PD4i). <h3>Results:</h3> A total of 36,039 SpA patients initiating a first targeted therapy were identified, with a median age at initiation of 45 years (IQR [35.3-54.9]) and 56% women. Among the included subjects, 33,840 (93.9%) had a diagnosis of axial SpA, and 8,839 (24.53%) had psoriatic arthritis. The cumulative incidence of a second targeted therapy was 25.6% (CI95%: 25.1-26.1) at 1 year and 51.1% at 5 years (50.5-51.8). The initial therapy was a monoclonal anti-TNF antibody, a TNF receptor, and an anti-IL17 in 62.9%, 24.3%, and 4.3% of cases, respectively. Switch rates were 18.4%, 25.6%, 29.5%, and swap rates were 7.2%, 11.3%, and 13.8% at 1, 2, and 3 years, respectively. Compared to subjects offered a switch, subjects offered a swap appeared slightly older (median age of 47.4 years (IQR [37.8-55.9]) vs. 42.6 years (IQR [33.99-51.84]) and with a higher proportion of women (67.2% vs. 62.6%). The most frequent types of swaps were from a monoclonal anti-TNF antibody to an anti-IL17 (n=1697, 35.0%) and from a TNF receptor to an anti-IL17 (n=518, 10.69%). A total of 319 subjects (6.6%) received an anti-TNF after an anti-IL17 as the first-line therapy. Among patients with a first-line anti-TNF and a subsequent switch, 75.0% received another anti-TNF, 17.9% received an anti-IL17, and 7.1% received another treatment. <h3>Conclusion:</h3> This analysis of SNDS data provides insight into the use of biologics in France during the pre-COVID-19 period. Although anti-TNF agents remained the most commonly used therapeutic class as a first-line treatment, anti-IL17 prescriptions were observed in 4.3% of cases. Moreover, this study suggests the feasibility of a prospective study comparing the options of anti-TNF to anti-IL17 versus anti-IL17 to anti-TNF in terms of response rates in second line and the therapeutic maintenance of either options. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1556-HPR PSYCHOSOCIAL CHARACTERISTICS BY STAGE OF THUMB BASAL JOINT OSTEOARTHRITIS AND THEIR ASSOCIATION WITH HAND FUNCTION
Authors: T. Firat, F. Karademir
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Osteoarthritis (OA) is a common joint disease with a significant impact on hand function and quality of life. However, the psychosocial aspects at different stages of the disease remain understudied. Understanding the interplay between psychosocial factors and the stages of thumb basal joint OA is crucial for holistic, patient-centred care. <h3>Objectives:</h3> To investigate the psychosocial characteristics associated with different stages of thumb basal joint OA and their association with hand function. <h3>Methods:</h3> Ninety-five patients diagnosed with osteoarthritis were enrolled. Demographic information, Eaton-Littler stage, and patient-reported outcome measures, including the Michigan Hand Outcomes Questionnaire (patient satisfaction subscore), Short Form-36 (mental health, general health perception, and vitality subscores), and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, were collected. Differences in psychosocial characteristics between Eaton-Littler stages were assessed using the Kruskal-Wallis test. The correlation between DASH score and psychosocial factors was examined using the Spearman correlation test. <h3>Results:</h3> There were 21 patients in stage 1, 40 patients in stage 2 and 34 patients in stage 3. The only significant difference between the stages was in general health perception (respectively: stage 2 &lt; stage 1 &lt; stage 3). The relationship between psychosocial factors and DASH is shown in Table 1. Vitality, patient satisfaction and mental health were found to be moderately to strongly correlated with hand function in all three stages. <h3>Conclusion:</h3> Psychosocial factors were found to be more associated with hand function in the early stages. These findings highlight the patient-centered treatment approaches from the early stages, emphasizing the importance of addressing not just physical symptoms but also the psychological. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1587-HPR HOW DOES HO’OPONOPONO MEDITATION AFFECT QUALITY OF SLEEP IN CHRONIC MUSCULOSKELETAL PAIN PATIENTS?
Authors: Y. EL Mabrouk, A. Ben Ammou, S. Akremi, A. Ben Abid, M. Ben Salah
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Chronic musculoskeletal pain (CMSP) disorders are a leading cause of disability globally, affecting up to one in three people. Mindfulness-based interventions (MBI) have become a popular treatment for CMSP. Mindfulness has been defined as "the awareness that arises from paying attention, on purpose, in the present moment and non-judgmentally". <h3>Objectives:</h3> The aim of our study was to explore the effectiveness of Ho'oponopono meditation as a MBI for adults with CMSP and so to identify the associated factors. <h3>Methods:</h3> Participants were adults with chronic low back pain, randomized into 2 groups: cases=30, controls=30. The case group followed a therapeutic education session about improving <b>spiritual healing</b> while undergoing physical and pharmacological therapy. The meditation method used was <b>the Ho'oponopono (restored harmony) practice</b>: Ancient Hawaiian secret for letting go of limiting beliefs, a <b>gratitude</b> and <b>forgiveness</b> meditation. Patients completed questionnaires assessing pain, sleep quality: Pittsburgh Sleep Quality Index (PSQI), hospital anxiety and depression scale (HAD), pain catastrophizing scale (PCS) and opioid use. <b>The PSQI</b> is a 19 item scale which assesses sleep quality and disturbances over a 1-month time interval. Seven component scores are derived, each scored 0 (no difficulty) to 3 (severe difficulty). The component scores are summed to produce a global score (range 0 to 21). Higher scores indicate worse sleep quality. All data were recorded at T0 (pre-meditation) and T1 (one month post-meditation). <h3>Results:</h3> A total of 60 patients with chronic low back pain were included, with a sex ratio (M/ F) of 1.4. Their average age was 56 years [20-70]. All of them were under physical and pharmacological therapy. Thirty percent of these patients received surgical treatment. There were no differences in pre-MBI pain VAS and sleep quality between cases and controls. Patients who were performing the meditation technique had no significant decrease in back pain VAS: (average pre-VAS: 6, post-VAS: 5, p=0.2) but a significant decrease in opioid use (p=0.03). PSQI score decreased from 14 to 8 (p=0.002). Compared to controls, patients undergoing MBI had significant lower post-PSQI scores (p= 0.003), less anxious thoughts (p=0.01) and lower levels of catastrophizing (p=0.02). In our series, there were positive associations between the spiritual treatment and age (p=0.003). <h3>Conclusion:</h3> By integrating Ho'oponopono meditation and other therapeutic interventions in a multi-disciplinary pain management plan, clinicians can improve treatment outcomes and potentially decrease pain-related medication utilization. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1583-HPR GENERATIVE AI-BASED KNOWLEDGE GRAPH AND TEXT NETWORK ANALYSIS FOR THE ILLUSTRATION AND DEVELOPMENT OF MHEALTH SELF-MANAGEMENT CONTENT
Authors: M. Blanchard, V. Venerito, T. Hügle
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Digital therapeutics (DTx) in the form of mobile Health (mHealth) self-management programs have shown efficacy in reducing disease activity in different rheumatic diseases, including fibromyalgia and arthritis. They are mostly based on cognitive behavior therapy, lifestyle modification, adherence and physical exercise. The specific content of individual online programs are heterogeneous and hardly comparable. <h3>Objectives:</h3> To use generative artificial intelligence (AI)-based knowledge graphs and network analysis to illustrate and structure mHealth content in order to improve its quality. <h3>Methods:</h3> The content of a previously developed mHealth online program (POCOS) for post-viral fibromyalgia-like syndromes was used for this analysis (24 modules, 22.150 words in total). Animated or video files were excluded. We used ChatGPT4 (OpenAI) and Infranodus (Nodus Labs) with built-in GPT-4 as generative AI web-applications to create knowledge graphs and perform text network analysis. <h3>Results:</h3> ChatGPT-generated knowledge graph provided a visual overview with 5 main edges: 'Mental health challenges', 'stress and its impact', 'immune system function', 'long covid and fibromyalgia', 'pain management and therapeutic approaches'. In the 3-dimensional visualization, the term 'pain' had the highest betweenness with 'sleep', 'body' and 'stress'. Topical cluster analysis revealed the following categories: chronic pain management, sleep hygiene, immune system function cognitive therapy, healthy eating, emotional development, fibromyalgia causes and deep relaxation. A gap analysis revealed several lacking connections such as between the terms 'negative behavior' and 'systemic inflammation'. Selected Concepts Relation Analysis was performed for several nodes. For example, the node 'pain' and 'covid' had an influence of 0.48 (19% of total). It was connected to 23 of 150 nodes (15%) in the knowledge graph with a relation to the terms sleep, muscle and breathing. <h3>Conclusion:</h3> Generative AI-tools for text network analysis structure and illustrate DTx content. They can be used to highlight concepts and work on knowledge-synapses and to elucidate gaps in order to improve content. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Marc Blanchard Atreon, Vincenzo Venerito: None declared, Thomas Hügle Pfizer, GSK, Roche, Abbvie, Galapagos, Novartis, Janssen, Atreon, Vtuls, Sidekick.
AB1535 A PROFILE OF SYSTEMIC AUTOIMMUNE RHEUMATIC DISEASE-ASSOCIATED PULMONARY ARTERIAL HYPERTENSION (SARD-PAH) FROM WESTERN INDIA: A SINGLE CENTRE RETROSPECTIVE STUDY
Authors: S. Jagennath, A. Kumar P H, R. Choudhary, M. K. Garg, M. Gopalakrishnan
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic autoimmune rheumatic disease-associated pulmonary arterial hypertension (SARD-PAH) is a major contributor to mortality. Few studies have explored the clinical profile and outcomes of this condition in India. <h3>Objectives:</h3> To describe the profile of SARD-PAH of the patients attending the rheumatology clinic at our centre, and to assess the response to therapy at 6 months from the diagnosis of PAH. <h3>Methods:</h3> We analysed the 4-year records of SARD-PAH patients who had at least 6 months of follow-up echocardiographic data since the diagnosis of PAH. Patients were diagnosed with SARD-PAH if they had definite evidence of a systemic autoimmune rheumatic disease, and echocardiographic PAH as defined by a right ventricular systolic pressure (RVSP) ≥30 mmHg and no pulmonary valve pathology. We used echocardiographic data as right heart catheterisation is not available at our centre, and is available only in a few centres across the country. Demographic data, diagnoses, clinical manifestations, details of autoantibodies, echocardiographic data at baseline and at 6 months, as well as details of therapy, were retrieved. Patients were considered to be responders if they had a decline in RVSP by ≥15mmHg or normalisation of pressures as measured by echocardiogram at 6 months. <h3>Results:</h3> Twenty-one patients were included, 86% were females with a median age of 42 years. The most common diagnosis was an overlap syndrome (43%), followed by mixed connective tissue disorder and systemic sclerosis (each 19%). Interstitial lung disease was present in 48% of patients. The median baseline RVSP was 47mm Hg, and at 6 months it was 36mm Hg (for n= 15 patients), while 6 patients had a qualitative report of normal RVSP. No patient had LV dysfunction either at baseline or at follow-up. No patient had chronic thromboembolic pulmonary hypertension. Fifteen (71%) patients responded to therapy. Almost all patients (95%) had received anti-PAH therapy, and almost all of them (95%) received immunosuppression for any indication. <h3>Conclusion:</h3> We describe one of the first SARD-PAH cohorts from India with follow-up data. Our study shows that most patients (71%) respond to appropriate anti-PAH measures and immunosuppression. Long-term, prospective follow-up studies are required to better understand this condition in our population and to design appropriate therapy. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
OP0054 ACTIVATED B-CELLS STEER FIBROBLASTS TOWARDS A PROINFLAMMATORY PHENOTYPE IN GIANT CELL ARTERITIS
Authors: S. Xu, W. F. Jiemy, Y. Ko, W. Abdulahad, E. Verschoor, Y. Van Sleen, J. C. Graver, K. Van der Geest, G. M. Verstappen, E. Brouwer, P. Heeringa, A. Boots, M. Sandovici
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Giant cell arteritis (GCA) is a large vessel vasculitis characterized by arterial wall inflammation and remodeling. Highly organized B-cell clusters are present in GCA-affected arteries, particularly in the adventitia of aorta [1]. Fibroblasts, the predominant cell type in the adventitia, may interact with B-cells owing to their location and phenotypic plasticity. We previously showed that in GCA arterial lesions, both B-cells and fibroblasts produce cytokines. <h3>Objectives:</h3> This study aims to explore the subtypes of fibroblast in B-cell clusters of GCA-affected aorta tissues, and to investigate the impact of B-cells on fibroblast activation and cytokine production through in vitro analyses. <h3>Methods:</h3> Immunohistochemistry, detecting several fibroblast markers (CD90, fibroblast activation protein alpha (FAP), podoplanin (PDPN), CD248, alpha-smooth muscle actin (α-SMA)) and B-cells (CD20), was performed on GCA-affected (n=9) and atherosclerotic (AS, n=11) aorta tissues. B-cells isolated from peripheral blood mononuclear cells (PBMCs) of GCA patients (n=10) and healthy donors (n=10), were incubated with/without CpG oligodeoxynucleotides (ODN) 2006, phorbol 12-myristate 13-acetate (PMA) and calcium ionophore (CaI) for 72 hours. Human aortic adventitial fibroblasts were then cultured with B-cells-conditioned medium or with B-cells for 24 hours in either a co-culture or transwell system. Interleukin(IL)-6 levels in culture medium were measured by ELISA. RNA expression of IL-6, FAP, PDPN, granulocyte macrophage colony-stimulating factor (GM-CSF) and α-SMA in fibroblasts was examined by qPCR. <h3>Results:</h3> Abundant expression of CD90, PDPN, and CD248 was observed in the B cell clusters in adventitia, with no significant differences in fibroblast phenotypes between GCA-affected aorta and AS aorta. Fibroblasts showed enhanced RNA expression of IL-6 (Figure 1A), FAP, PDPN and GM-CSF, but not α-SMA, when cocultured with activated B-cells or activated B-cells-conditioned medium. Coculture with activated B-cells also promoted IL-6 protein secretion by fibroblasts (Figure 1B). Mechanistically, the effect of activated B-cells on fibroblasts was mainly mediated by soluble factors, and further boosted by cell-cell contact. <h3>Conclusion:</h3> Activated B-cells steer fibroblasts towards a proinflammatory phenotype in vitro, possibly contributing to disease chronicity and progression in GCA. If proven, B-cell-targeted therapy may alleviate both B-cell and fibroblasts-related inflammation in GCA. <h3>REFERENCES:</h3> [1] Graver JC, et al. Front Immunol. 2019; 10: 83. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0353 TREATMENT PATTERNS ANALYSIS IN PATIENTS WITH RARE AUTOINFLAMMATORY DISEASES IN THE UNITED STATES
Authors: N. Yasar, S. O’brien, K. Peres Da Costa, W. Toro, A. Patel, K. Akhras
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Objectives:</h3> We sought to analyze treatment patterns for patients with adult-onset Still's disease (AOSD), systemic juvenile idiopathic arthritis (sJIA), familial Mediterranean fever (FMF), and other periodic fever syndromes (PFS) in the United States, and their potential implications on patients with refractory Still's disease (SD). <h3>Methods:</h3> A retrospective longitudinal analysis of the US Komodo HealthMap claims database was conducted including patients with at least two confirmatory diagnoses of an autoinflammatory disease, 3 years of follow-up, and 1 year prior medical history from 2016–2023. <h3>Results:</h3> A total of 14,177 unique patients were identified as receiving first-line therapy for the diseases of interest during the study period. A majority (37%) received glucocorticoids (GC) as the first-line (1L) therapy, followed by nonsteroidal anti-inflammatory drugs (28%), biologics (12%), non-biologic disease-modifying antirheumatic drugs (nbDMARDS) (11%), colchicine (9%), and immunosuppressants (2%). Approximately 82% of patients advanced to receive second-line (2L) therapy and a further 56% received third-line (3L) therapy. GC use was reduced in 2L (13%) and 3L (8%), whereas biologics and nbDMARDS increased to 15% and 21%, and 23% and 31%, for 2L and 3L, respectively. This suggests that a substantial number of patients may have uncontrolled disease. Within the biologics, the use of canakinumab was substantially lower, with 7%, 11%, and 14% in 1L, 2L, and 3L, respectively, owing to its reserved use in patients after failure on other therapies. <h3>Conclusion:</h3> Patients with SD, FMF, and other PFS cycle through several lines of therapy that are likely to have an impact on their well-being, treatment satisfaction, and costs. Greater efforts are required to identify patients with severe and/or refractory disease who may benefit from receiving newer therapies, such as biologics, earlier in their treatment plan. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Narin Yasar Stock/other equities from Novartis Gene Therapies, Inc., Employee of Novartis Gene Therapies, Inc., Siobhan O'Brien Stock/other equities from Novartis Ireland, Ltd., Employee of Novartis Ireland, Ltd., Keith Peres Da Costa Contracted by Novartis Gene Therapies, Inc., for this research and analysis., Contracted by Novartis Gene Therapies, Inc., for this research and analysis., Walter Toro Stock/other equities from Novartis Gene Therapies, Inc., Employee of Novartis Gene Therapies, Inc., Anish Patel Stock/other equities from Novartis Gene Therapies, Inc., Employee of Novartis Gene Therapies, Inc., Kasem Akhras Stock/other equities from Novartis Gene Therapies, Inc., Employee of Novartis Gene Therapies, Inc.