tbuckley/cabot-search huggingface dataset:
AB0688 THE RELATIONSHIP BETWEEN DIETARY INFLAMMATORY INDEX SCORES AND RHEUMATOID ARTHRITIS DISEASE ACTIVITY
Authors: H. Baygin, F. Siriken, G. Sargin, S. Cildag, T. Senturk
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Many patients diagnosed with rheumatoid arthritis (RA) report relief of symptoms after eating certain foods. Previous research shows positive effects of food and food components on clinical outcomes in RA, but there is insufficient evidence to provide specific dietary advice. Diet plays an important role in regulating the inflammation seen in rheumatoid arthritis. <h3>Objectives:</h3> Our aim is to investigate the relationship between Dietary Inflammation Index (DII) scores and RA activity. <h3>Methods:</h3> Forty-one RA patients were enrolled in the study. The general inflammatory index of the diet was analyzed by recording the 24-hour food consumption of the patients, and the nutrients were analyzed using the Nutrition Information Systems Package Program. Dietary inflammatory indices were calculated for each patient using the patients' macro and micronutrient intake levels. RA disease activity was assessed using the Disease Activity Score-28 (DAS-28). <h3>Results:</h3> The DAS-28 score was lower in the anti-inflammatory diet group compared to the pro-inflammatory diet group (p=0.163) (Table 1). A weak but significant relationship was found between diet inflammation index score and DAS-28 (r=0.3468, p=0.0263). The effect of the dietary inflammatory index on the DAS-28 was %12,02 (Figure 1). Dietary iron, vitamin C, niacin, and magnesium intakes were statistically significantly higher in the quartile group that received an anti-inflammatory diet than in the quartile group that received a pro-inflammatory diet. The intake of some micronutrients, such as iron, zinc, magnesium, and folic acid, was significantly lower than the recommended values in all RA quartile groups (Table 1). <h3>Conclusion:</h3> Our results suggest that reducing inflammation through the diet may have a weak but significant effect in controlling disease activity in RA patients. <h3>REFERENCES:</h3> [1] Forsyth C, Kouvari M, D'Cunha NM, Georgousopoulou EN, Panagiotakos DB, et al. The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies. Rheumatol Int. 2018; 38:737-747. [2] Gomez EF, Kaufer-Horwitz M, Mancera-Chavez GE. Medical nutrition therapy for rheumatic disease in: Mahan KL, Raymond JL, editors. Krause's Food &amp; The Nutrition Care Process-E Book. 14 th ed. Kanada: Elsevier Health Sciences;2017.p.(790-805). <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0037 FAMILIAL MEDITERRANEAN FEVER: GENOTYPE-PHENOTYPE RELATIONSHIP AND RESISTANCE TO COLCHICINE IN A COHORT IN SOUTHWESTERN SPAIN
Authors: A. Gonzalez-Estrada, C. Hernández-Quiles, M. Perez-Quintana, D. Loaiza Cabello, A. Rodriguez-Trigeros, I. Rey-Chacon, R. Pertusa-Mataix, M. Garrido Montes, A. Ruiz Román, S. García Morillo
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Familial Mediterranean Fever (FMF) is an autosomal recessive autoinflammatory disease, characterized by recurrent episodes of fever, abdominal pain, arthritis, and rash. Even though, colchicine is the ideal treatment, an important number of patients continue to be resistant. <h3>Objectives:</h3> To determine associations between phenotype and colchicine resistant with phenotype. <h3>Methods:</h3> Patients under active follow-up for the Autoinflammatory Diseases Unit of Virgen del Rocio University Hospital of Seville from 2010 to 2023 were included. Genotyping of the familial Mediterranean fever gene (<i>MEFV</i>) was performed. Colchicine resistant was defined by 2016 EULAR guideline. Data on their biological, clinical characteristics and treatment received were collected. SSPS statistical package version 26 was used for the analysis. <h3>Results:</h3> Sixty-four patients were included. The mean age at the time of diagnosis was 36.8 years, 59% were female. All patients had undergone a genetic study, with 42,4% presenting polymorphism, 40,6% pathogenic and 17.2% low penetrance mutations. Heterozygosity was 87.5%. Mutation locations were on exon-2 (77.5%), exon-9 (10.4%) exon-3 (6.2%), exon-10 (6.4%) and exon-4 (1,5%). Most prevalent mutations were p.R202Q (51%), p.E148Q (17%) and p.I591T (9%). Forty-two percent were asymptomatic carriers. No significant differences were found between the affected exon and the character of the mutation and the presence of classic clinical manifestations of FMF, except for a higher prevalence of headache in non-exon-2 mutations (18.4% Vs 46.7%, p = 0.021). Regarding the therapy used, 58 % received treatment, 36% were on colchicine treatment and 22% were colchicine resistant. No relationship was found between the type of mutation and the presence of colchicine resistance. Patients with colchicine resistance (n=14) were mainly women (71%, p 0.029) with higher frequency of arthritis (64% vs 20%, p 0.001) and myalgias (85% vs 44%, p= 0.005) than the colchicine-responsive group. <h3>Conclusion:</h3> Based on our study, FMF patients with non-exon-2 mutations presents with headaches more. Patients with FMF refractory to colchicine were women with a clinical presentation dominated by the presence of arthritis and myalgias. The identification of this subgroup of patients will allow early treatment with interleukin-1 blockade to avoid long-term complications. <h3>REFERENCES:</h3> [1] Ozen S, Demirkaya E, Erer B<i>, et al</i>. EULAR recommendations for the management of familial Mediterranean fever. <i>Annals of the Rheumatic Diseases</i> 2016;<b>75:</b>644-651. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0081 SIGNIFICANCE OF NON-ADHERENCE IN A TERTIARY HOSPITAL IN MEXICO: PRE AND POST-PANDEMIC IMPACT
Authors: D. A. Salcedo-Soto, A. C. Bardan-Inchaustegui, D. M. Lara-Mendez, D. E. Flores-Alvarado, J. A. Cardenas-de la Garza, D. A. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Non- attendance to medical appointments and poor adherence to treatment negatively impact the control of rheumatic diseases (RD), increasing the risk of complications and healthcare costs[1]. <h3>Objectives:</h3> This study aims to assess reasons for non-adherence to disease-modifying drugs (DMARDs) and non-attendance in appointments and to identify underlying causes before and after the pandemic. <h3>Methods:</h3> An observational cross-sectional study was conducted. We included patients ≥18 years old with a diagnosis of RD who attended both follow-up and initial assessments at the "Dr. José Eleuterio González" University Hospital during the period May to September 2023 and agreed to participate in the study. Those who missed their appointments were contacted to evaluate the reason for non-attendance. A questionnaire evaluated DMARDs taken, adherence to them, and reasons for non-adherence. Adherence was categorized based on intake frequency: Good &gt;75% of the time (&gt;21 days), regular 50-74% (15-21 days), poor 25-49% (8-14 days), null &lt;25% (7 days or less). To compare adherence during the COVID-19 pandemic, we used a database covering rheumatology patients from 2021 to 2022. <h3>Results:</h3> A total of 4,289 patients were scheduled for assessment and 2,078 (48.44%) did not attend. Of this group, 354 patients had a first appointment scheduled, and 1,724 had a follow-up. During this same period, 78 patients were hospitalized, 73% attended follow-up, 23% did not attend and 4% died. Economic factors were the main cause of non-attendance (70%), followed by transportation (14%), forgetting (9%), and personal reasons (2%). Of the 161 patients evaluated for adherence to DMARDs, 135 (83.8%) considered adherence to be good. Hydroxychloroquine was the most common DMARD used by 34% of the patients, followed by methotrexate 29%, prednisone 16%, leflunomide 8%, mycophenolate mofetil 8%, azathioprine 3% with, and sulfasalazine 2%. The non-adherence reasons during 2021 and 2023 are shown in Table 1. <h3>Conclusion:</h3> Non-attendance and adherence to DMARDs depend on economic and social circumstances. Probably because the study was conducted in a developing country, it is worthwhile to rethink the cost/benefit ratio of the drugs prescribed at the assessment. New strategies are needed to recover patients who stopped attending our service. <h3>REFERENCES:</h3> [1] Jimmy B, Jose J. Patient medication adherence: measures in daily practice. Oman Med J. 2011;26(3):155-159. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0926 REAL-WORLD EFFECTIVENESS AND SAFETY OF TOCILIZUMAB IN PATIENTS WITH POLYMYALGIA RHEUMATICA
Authors: Y. Imai, S. Takanashi, Y. Kaneko
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Polymyalgia rheumatica (PMR) responds well to treatment with glucocorticoids, but high relapse rates during glucocorticoid tapering and adverse events associated with long-term glucocorticoid use are problematic. Tocilizumab, an anti-interleukin-6 receptor inhibitor, is approved for rheumatoid arthritis and giant cell arteritis, and recent clinical trials have reported its efficacy in PMR [1, 2], but the real-world data on tocilizumab in PMR are still unclear. <h3>Objectives:</h3> This study aims to evaluate the effectiveness and safety of tocilizumab in patients with PMR in clinical practice. <h3>Methods:</h3> We reviewed consecutive patients with PMR treated with tocilizumab at Keio University Hospital from May 2012 to October 2022. Patients complicated with active giant cell arteritis were excluded. We collected clinical data, including PMR-activity score (AS), prednisolone dosage, recurrence, and adverse events. Recurrence was defined as worsening of symptoms that required intensification of treatment, including initiation or increase in glucocorticoids, immunosuppressants, or tocilizumab, as well as shortening the interval of tocilizumab. <h3>Results:</h3> We identified 55 patients with PMR who were treated with tocilizumab. Tocilizumab was initially administered 8 mg/kg intravenously every 4 weeks (n = 33) or 162 mg/body subcutaneously every 2 weeks (n = 22). The median age at tocilizumab initiation was 76.2 (interquartile range [IQR]: 67.8-80.2) years and 40 (72.7%) were female. All patients were treated with prednisolone at the median dose of 8.0 (IQR: 6.0-11.0) mg/day at tocilizumab initiation, with 44 (80.0%) patients having had at least one recurrence before tocilizumab initiation with a median prednisolone dose of 7.3 (IQR: 5.0-10.0) mg/day. The median observation period from tocilizumab initiation to the last visit was 2.8 (IQR: 1.0-5.4) years. PMR-AS significantly improved after tocilizumab initiation from 0.51 (IQR: 0.11-3.22) to 0.05 (IQR: 0.02-0.23)(P &lt; 0.001), and the median prednisolone dose was significantly decreased from 8.0 mg/day to 0.0 (IQR: 0.0-2.0) mg/day (P &lt; 0.001) at the last visit (Figure 1), with 37 patients (67.3%) achieving glucocorticoid-free. While tocilizumab administration interval was prolonged in 16 patients (29.0%) with 11 patients (20.0%) achieving withdrawal, 19 patients (34.5%) experienced recurrences with a median prednisolone dose of 0.0 (IQR: 0.0-3.8) mg/day during tocilizumab treatment. A total of 10 adverse events including six fracture, three infection, and one diverticular bleeding were recorded. <h3>Conclusion:</h3> Tocilizumab is a useful treatment option with glucocorticoid sparing effects in patients with PMR in real world. <h3>REFERENCES:</h3> [1] Ann Rheum Dis. 2022;81:838–844. [2] JAMA. 2022;328:1053-1062. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0026 FEATURES OF FAMILIAL MEDITERRANEAN FEVER AFTER AGE 65: RETROSPECTIVE STUDY OF 59 FRENCH PATIENTS FROM THE JIR COHORT
Authors: G. Grateau, F. Rodrigues, L. Savey, M. Delplanque, R. Bourguiba, Z. Aknouche, L. Cuisset, S. Georgin-Lavialle
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease associated with <i>MEFV</i> mutations and characterized by recurrent attacks of fever. FMF almost always begins in childhood, but the natural history of FMF in elderly patients is not well known. <h3>Objectives:</h3> To describe the clinical features of FMF after 65 years of age and to look for associations with other comorbidities. <h3>Methods:</h3> A monocentric retrospective study was performed at the French adult reference center for FMF at the Tenon University Hospital in Paris, focusing on patients older than 65 years. <h3>Results:</h3> Of the 638 FMF patients followed at the French Adult Centre for FMF, 59 elderly patients consisting of 32 women and 27 men, were included. Their median age was 73 years. The majority were homozygous for M694V in <i>MEFV</i> (71%). The median age at diagnosis and colchicine initiation was 28 and 35.5 years, respectively. The median delay between symptom onset and colchicine initiation was 28 years. The median year of colchicine initiation was 1980, and the mean colchicine dose was 1.23 mg/day. Only 55% of patients had a complete clinical response to colchicine, and subclinical inflammation persisted despite colchicine in 73% of patients. Nineteen percent of patients were prescribed an increase in colchicine dose and 37% received an interleukin-1 inhibitor after the age of 65 years old. The prevalence of AA amyloidosis was 10%. Common comorbidities were cardiovascular (n = 35, 59% of patients), hepatic (n = 22, 37%, mainly liver cirrhosis, n=16, 27%) and renal (n = 14, 24%; kidney disease caused by AA amyloidosis n=5, 8%). Fifteen percent of patients (n=9) died at a median age of 76.5 years. Two deaths were related to complications of FMF (AA amyloidosis, peritoneal mesothelioma), five to infections (Covid-19 n =2, undocumented bacterial pneumonia n=1, candidemia complicating chronic glucocorticoid use n=1), two to liver cirrhosis (NASH n=1, cryptogenic cirrhosis n=1). <h3>Conclusion:</h3> FMF remains a significant cause of morbidity in a group of patients over 65 years of age who, for historical reasons, were started on colchicine late in life. Follow-up of this population is therefore warranted. Interleukin-1 inhibitors are well tolerated after the age of 65 and should be prescribed for FMF complications or subclinical inflammation. The high prevalence of unexplained cirrhosis and persistent chronic inflammation in our study raises the question of a possible association with FMF, especially in elderly patients. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> JIR cohort. <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0844 ULTRASOUND IMAGING AS A DIAGNOSTIC TOOL FOR CONTIGUOUS OSTEOMYELITIS IN SYSTEMIC SCLEROSIS PATIENTS WITH INFECTED DIGITAL ULCERS – A PILOT STUDY
Authors: Y. Braun-Moscovici, N. Puchkov, Z. Keidar, D. Militianu, D. Markovits, K. Dolnikov, K. Toledano, S. Gyries, A. Arraf, S. Malak, A. Balbir-Gurman
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Digital ulcers (DUs) are common in systemic sclerosis (SSc) patients and cause significant morbidity. They are often complicated by local infection which can lead to contiguous osteomyelitis (OM). The clinical and imaging diagnosis of OM is challenging. The interpretation of MRI images, the gold standard for OM diagnosis, is problematic due to digital flexion contractures and acro-osteolysis. In our center (tertiary referral center for SSc), we use 99m-Technetium-Tc-labeled white blood cells (WBC) scintigraphy, for diagnosing OM in complicated DU. Despite the high sensitivity and specificity, it may be inconclusive in certain cases and it is a costly modality. Musculoskeletal ultrasound (US) imaging was found to be an accurate tool for OM diagnosis. <h3>Objectives:</h3> We aimed to assess the accuracy of US imaging in diagnosing contiguous OM in SSc patients with DU, compared to WBC scintigraphy. <h3>Methods:</h3> SSc patients with complicated DU, clinically suspected for OM, who were referred to WBC scan, were concurrently referred to US of the suspected DU. The US was performed by a highly skilled musculoskeletal imaging specialist, blinded to WBC scan results. Examinations were performed using the GE ML6-15-D Matrix Linear Probe LOGIQE9:R4.3.0 Ultrasound Machine. The sonographic findings indicating OM were periosteal thickening, cortical erosions, increased flow within or around periosteum on power Doppler sonography and deep soft tissue swelling. All patients had baseline hands x-ray to rule out calcinosis or acro-osteolysis. Clinical reassessment of DU healing was performed within 1-3 months. <h3>Results:</h3> Seven patients (6 females, 8 US examinations) were included in the pilot study. The mean(SD) age was 64.6(12.8), disease duration 14.6(7.4) years, 5 patients had diffuse SSc. One patient had 2 US examinations for separate events of suspected OM, in different sites. The results of both imaging tests concurred ruling in 2 cases and ruling out OM in 3 others. In the remaining 3 cases, the WBC scan was inconclusive, but the US ruled out OM. Patients that tested negative for OM on WBC scans and/or US were treated accordingly, with significantly shorter courses of antibiotics. Healing of the complicated DUs was achieved in all of them. <h3>Conclusion:</h3> In our pilot study, US imaging was found to be reliable in confirming and ruling out OM in SSc patients with complicated infected DUs, even in patients with inconclusive WBC scans. Musculoskeletal US may serve as a feasible and less expensive imaging technique for diagnosing contiguous OM in SSc-related DUs. Larger studies are required to confirm these preliminary results. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0064 BIOINFORMATICS AND SYSTEMS-BIOLOGY APPROACH TO IDENTIFY COMMON PATHOGENIC MECHANISMS FOR COVID-19 AND SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Y. Wu, Y. LI, X. Bai, Y. Liu
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The epidemic of coronavirus disease 2019 (COVID-19) has brought a heavy burden to the world. It is worth to note that it shares many clinical symptoms with systemic lupus erythematosus (SLE), but whether there is a similar pathological process between them is not clear. <h3>Objectives:</h3> In this study, we analyzed the potentially similar pathogenesis between SLE and COVID-19, and explored their possible pharmacotherapy options using bioinformatics and systems biology approaches. <h3>Methods:</h3> The common differentially expressed genes (DEGs) were extracted from the COVID-19 datasets and the SLE datasets for functional enrichment, pathway analysis and candidate drug analysis. <h3>Results:</h3> Based on the two transcriptome datasets between COVID-19 and SLE, 325 common DEGs were selected. Hub genes were identified by protein-protein interaction (PPI) analysis. few found a variety of similar functional changes between COVID-19 and SLE, which may be related to the pathogenesis of COVID-19. Besides, we explored the related regulatory networks. Then, through drug target matching, we found many candidate drugs for patients with COVID-19 only or COVID-19 combined with SLE. <h3>Conclusion:</h3> COVID-19 and SLE patients share many common hub genes, related pathways and regulatory networks. Based on these common targets, we found many potential drugs that could be used in treating patient with COVID-19 or COVID-19 combined with SLE. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1014 PERFORMANCE OF THE SYSTEMIC LUPUS ERYTHEMATOSUS DISEASE ACTIVITY SCORE (SLE-DAS) IN CHINESE POPULATION WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A CROSS SECTIONAL VALIDATION STUDY
Authors: T. Ding, Z. Zhang
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> There is an unmet need to accurately assess disease activity and establish treatment goals for patients with systemic lupus erythematosus (SLE). Recently, the SLE Disease Activity Score (SLE-DAS) has been introduced and validated in Italian, Mexican and Indian populations<sup>[1]</sup>. Although SLE-DAS showed higher sensitivity than SLEDAI 2000 (SLEDAI-2K), little is known about the performance this novel instrument in Chinese patients with SLE, especially those with high disease activity. <h3>Objectives:</h3> We aimed to evaluate the validity of the SLE-DAS in Chinese population with SLE and determine the most appropriate tool for evaluating clinical changes. <h3>Methods:</h3> We retrospectively studied 346 patients with SLE (fulfilling the classification criteria of ACR 1997 and/or SLICC 2012 and/or EULAR/ACR 2019) from Peking University First Hospital. Disease activity was quantified using Physician Global Assessment (PGA), SLEDAI-2K, and SLE-DAS. Demographic, clinical and laboratory parameters were also collected. To assess the performance of various instruments, we compared the correlations and agreements between SLE-DAS, PGA and SLEDAI-2K. We also we evaluated whether SLE-DAS was associated with serum complement levels. <h3>Results:</h3> There were 78.3% patients with moderate to severe activity in our study. SLE-DAS score had a moderate positive correlation with PGA (r=0.7182, p&lt;0.0001), and with SLEDAI-2K (r=0.7524, p&lt;0.0001). SLE-DAS also showed a weak but evident association with C3 complement levels (r=-0.3479, p&lt;0.0001), and with C4 complement levels (r=-0.2254, p&lt;0.0001). The total agreement between SLE-DAS and SLEDAI-2K was 73.1% (κ = 0.52). When the analyses were carried out separately in patients with and without renal involvement, the agreement of SLE-DAS and SLEDAI-2K was similar. <h3>Conclusion:</h3> SLE-DAS was a novel and useful tool to measure activity in SLE. However, the performance of SLE-DAS in our population was not robust, partly due to the high disease activity of enrolled patients. We need to evaluate the validity of the SLE-DAS separately in patients with different disease activity. <h3>REFERENCES:</h3> [1] Jesus D, Matos A, Henriques C,et al. Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity[J]. Ann Rheum Dis. 2019 Mar;78(3):365-371. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>