tbuckley/cabot-search huggingface dataset:
AB1714 COMPARISON OF SUPERB MICROVASCULAR IMAGING WITH POWER DOPPLER ULTRASOUND IN SCORING KNEE SYNOVITIS IN JUVENILE IDIOPATHIC ARTHRITIS: PRELIMINARY DATA
Authors: D. Windschall, F. Gohar
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Superb Microvascular Imaging (SMI) is a novel ultrasound (US) doppler technology that expands the visible range of low microvascular blood flow improving the sensitivity of US for joint inflammation in contrast to conventional power Doppler (CPD). To date, limited studies have been published comparing SMI with CPD in Juvenile idiopathic arthritis (JIA). <h3>Objectives:</h3> To investigate the sensitivity of SMI vs CPD in the US-evaluation of synovial inflammation in patients with JIA using the OMERACT score. <h3>Methods:</h3> JIA patients with clinically determined knee synovitis who consented to the study were investigated using B-Mode (BM) and Doppler US with SMI and CPD. US and probe settings were standardised and six standard views saved for each knee joint (suprapatellar longitudinal and transverse, parapatellar medial and lateral and longitudinal medial and lateral). A semi-quantitative grading scale from 0 (no blood flow signal within the synovial membrane) to 3 (blood flow signal in more than one-half of the synovial membrane) defined by OMERACT was used to score the intra-synovial blood flow indicated by SMI and CPD. The BM findings were also graded 0-3, depending on the extent of synovial effusion or synovial hypertrophy. As 6 individual views per knee joint were evaluated, the highest individual CPD and SMI grade per knee were also compared (Table 1), as well as the individual images. Within this study, we additionally tested a novel US-score using the different Doppler techniques, calculated using the highest single BM grade (max.3, as per OMERACT score) plus the highest single CPD or SMI grade (max.3) for each patient, with a maximum possible score of 6. <h3>Results:</h3> 144 images (72 US views with each technique, 12 knees with synovitis) were analysed. The mean BM grade was 1.8. SMI grading was significant higher than CPD (mean SMI score 1.1 vs mean CPD score 0.3 (p &lt; 0.01) when analysing all scans. The mean ultrasound score using SMI+BM was also significant higher than when calculated using CPD+BM (p &lt; 0,01). <h3>Conclusion:</h3> SMI Doppler seems to be a highly sensitive Doppler Mode for the detection of synovial hypervascularity in knee joints of JIA patients. Qualitative analysis of images indicated better definition of synovial vascular microarchitecture with SMI compared to CPD. SMI could therefore represent a more precise imaging tool for diagnosing and monitoring intrasynovial hypervascularization. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
Estimating the health care costs associated with receipt of lisocabtagene maraleucel: Insights from adults with mantle cell lymphoma (TRANSCEND NHL 001).
Authors: Tycel Jovelle Phillips, Ashley Martin, Abraham D. Lee, Sana Mirza, Thomas Carattini, November H. McGarvey, Pallavi Patwardhan
Journal: Journal of Clinical Oncology (2024)

7028 Background: Anti-CD19 CAR T cell therapy is a major advancement for treating R/R B-cell malignancies such as mantle cell lymphoma (MCL). While effective disease management with CAR T cell therapy is expected to reduce patients’ health care resource utilization (HCRU) over the long-term, few studies have examined the short-term impacts of this treatment on HCRU and associated health care costs. Here, we used data from the TRANSCEND NHL 001 (NCT02631044) clinical trial to estimate the HCRU-related costs incurred by patients with R/R MCL over the first 12 months after receipt of lisocabtagene maraleucel (liso-cel). Methods: A retrospective analysis of clinical trial data was conducted to calculate the frequency of HCRU (medications [excluding liso-cel], diagnostics, procedures, ICU and non-ICU hospitalizations) observed over the 12 months immediately after administration of liso-cel. Costs for each HCRU event were derived from public databases and literature, adjusted to 2023 United States (US) dollars, and used to estimate patient-level health care costs. Results: Of the patients treated (N = 88), 76.1% were male, 87.5% were White, and mean ± standard deviation (SD) age was 67.5 ± 9 years. All patients were treated in the US and completed a median (range) of 3 (1–11) prior lines of therapy before receiving liso-cel. Most patients (93.2%) received the recommended dose of 100 × 10 6 CAR + T cells. The total mean ± SD per-patient cost (excluding liso-cel) was estimated at $138,413 ± $58,555 over 12 months. Facility use accounted for 77.7% of all costs, primarily owing to non-ICU hospitalizations (98.9%), which had a mean ± SD length of stay of 19.5 ± 16.7 days per eligible patient. Half of all health care costs were incurred within the first month of infusion (53.2%), with each subsequent month contributing a fraction (1.5%–6.3%) of total costs. A total of 13 out of 88 patients received their initial infusion in an outpatient setting and incurred 23% fewer costs compared with those who received their infusion in an inpatient setting ($110,050 vs $143,418), primarily as a function of reduced first-month facility use. Total costs for patients receiving liso-cel in outpatient settings were further reduced to $72,771 upon exclusion of 3 outliers. Conclusions: Non-ICU hospitalizations were the largest driver of liso-cel–related costs in this R/R MCL cohort of clinical trial participants. Most of the cost burden was incurred within 1 month of treatment, with dramatic reductions in HCRU and health care costs observed thereafter. Results suggest that treatment in the outpatient setting, even in part (eg, at initial infusion only), may confer substantial cost savings to the health care system.
Real-world outcomes following adverse events and dose reduction of first-line ibrutinib in Medicare beneficiaries with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).
Authors: Mazyar Shadman, Bhavini P. Srivastava, Monika Salkar, Chadi Saifan, Barnabie C. Agatep, Barton Jones, Olga Ryan, Shaffee Bacchus, Deborah M. Stephens
Journal: Journal of Clinical Oncology (2024)

e19017 Background: Dose reduction (DR) has been used to manage treatment-related adverse events (AEs) effectively and avoid early treatment discontinuation in patients (pts) with CLL/SLL receiving ibrutinib (ibr) in the first-line (1L) setting. This study evaluated DR and time to next treatment (TTNT) following AE in Medicare pts with CLL/SLL who were initiating ibr. Methods: Medicare Fee-for-Service (FFS) closed claims and enrollment data were used to identify pts with CLL/SLL who initiated 1L single-agent ibr (420 mg/day) from January 2014 to September 2020 with an incident AE following treatment initiation. Ibr DR was defined as reduction of starting dose following the first reported incident AE. Demographics, clinical characteristics, time to first incident AE, TTNT, and Healthcare Resource Utilization (HCRU) were analyzed among pts with and without DR (time to event measured in months). TTNT was defined as time from first incident AE to initiation of a new agent (≤90 days of ibr discontinuation) or death and was compared in pts with and without DR using Kaplan-Meier analysis and a time-varying Cox proportional hazards model. Results: Of 3575 pts included in the analysis (median age: 76 years; male: 63.4%), 459 (12.8%) had a DR. Duration of 1L ibr, time to first incident AE, time to DR, and TTNT varied among study cohorts. Median TTNT (standard deviation [SD]) for pts with and without DR was 49.8 months (1.4) and 22.0 months (0.6), respectively. After 6 and 12 months of follow-up, significantly fewer pts with DR discontinued treatment than pts without DR (6 months: 8.3% vs 27.3%, P = 0.0062; 12 months: 13.8% vs 38.2%, P = 0.0003). A total of 51 pts discontinued treatment immediately after the first incident AE; 414 deaths were reported within 90 days of the first incident AE. After controlling for baseline demographics and clinical characteristics as well as time-varying HCRU and costs, pts with DR were not significantly likely to discontinue treatment compared with pts without DR (hazard ratio [95% CI], DR vs no DR: 0.89 [0.71–1.12]). Increased age, comorbidity index score, healthcare costs, and number of hospitalizations were significant predictors of treatment discontinuation. Conclusions: Among Medicare FFS pts with CLL/SLL and an AE following initiation of 1L ibr, pts with DR remained on therapy significantly longer than pts without DR. Ibr DR may be an effective strategy to manage tolerability while maintaining clinical efficacy.
Real-world risk of bleeding events in patients with chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL) treated with BTKi.
Authors: Javid J. Moslehi, Svea K Wahlstrom, Anna Teschemaker, Rachel H Mackey, Diana DeVincenzo, Leslie A Carabuena, Samantha L Thompson, Brittaney Gordon, Ning A Rosenthal
Journal: Journal of Clinical Oncology (2024)

7052 Background: Bruton tyrosine kinase inhibitors (BTKis) are effective treatments for various B-cell malignancies including CLL/SLL but are known to be associated with increased bleeding risk. Current evidence indicating this association has largely been demonstrated in clinical trial research. However, bleeding risk in real-world CLL/SLL patients, who are often sicker with more comorbidities requiring anticoagulant (AC) or antiplatelet (AP) use is not well described. This study aimed to assess the prevalence of AC/AP use and explore risk factors for bleeding among real-world CLL/SLL patients receiving BTKi therapies. Methods: We conducted a retrospective cohort study using the claims-linked Premier PINC AI Healthcare Database of patients aged ≥18 years with a diagnosis of CLL/SLL from July 1, 2016 to March 31, 2022. Patients were followed from first BTKi prescription fill (index date) to earliest of BTKi discontinuation, death, or end of the study period. Patient comorbidities, treatments, and bleeding events were assessed using diagnosis and procedure codes and prescription claims. Multivariable-adjusted risk for bleeding events was assessed with Cox proportional-hazards regression. Results: Among 2091 patients with CLL/SLL receiving BTKi therapies, mean age was 65.7 years, 61.8% were men, and 77.7% were White. BTKi treatments included ibrutinib (86.3%), acalabrutinib (13.1%), and zanubrutinib (&lt;1%). Overall, 4.3% of patients switched BTKis during follow-up; 615 (29.4%) had AC/AP use at any time during the study period, of whom 411 (66.8%) started after BTKi initiation. Bleeding events occurred in 526 (25.2%) patients during a mean BTKi exposure of 14.2 months, with an incidence of 26.6 per 100 person-years (PYs) overall, and 37.2 and 22.0 per 100 PYs in patients with and without any prescription AC/AP use, respectively. The proportion of patients with fatal bleeding was &lt;0.3%. In adjusted models, risk of first bleeding event was higher for AC use (HR [95% CI] 2.33 [1.83–2.98]), age ≥65 years (1.32 [1.14–1.53]), women (1.28 [1.10–1.48]), and history (during 90 days prior to BTKi start) of bleeding (2.27 [1.87–2.76]), ulcers (2.21 [1.06–4.63]) or myocardial infarction (MI) (1.74 [1.31–2.33]) (all P≤0.05). Prescription AP use, race/ethnicity, and history of chronic kidney disease or thrombocytopenia were not statistically significant. Conclusions: In this large real-world study of bleeding risk in patients receiving BTKis, bleeding events occurred in 26.6 per 100 patients per year, with higher risk in AC users, women, and patients with history of bleeding, ulcers, or MI. However, the risk of fatal bleeding was low.
POS0576 OUTCOMES OF COVID-19 INFECTION IN PATIENTS WITH AUTOIMMUNE RHEUMATIC DISEASES COMPARED TO THE GENERAL POPULATION: A NATIONWIDE POPULATION-BASED RETROSPECTIVE STUDY USING THE KOREAN HEALTH INSURANCE REVIEW AND ASSESSMENT SERVICE (HIRA) DATABASE
Authors: E. J. Park, H. Jeong, E. J. Joo
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> There is concern that patients with autoimmune rheumatic diseases (AIRD) are at an increased risk of infection and complications, related to the nature of their disease and the use of immunosuppressive therapies. <h3>Objectives:</h3> We aimed to evaluate clinical characteristics and outcomes of COVID-19 in patients with AIRD compared to the general population. <h3>Methods:</h3> In this nationwide population-based retrospective study, we investigated the data of AIRD patients and propensity score-matched the general population with laboratory-confirmed COVID-19, aged ≥ 18 years using database of the Korean Health Insurance Review and Assessment Service (HIRA) claim records. Comorbidities and medications used were identified using HIRA codes, and outcomes including requiring oxygen therapy, mechanical ventilator, cardiopulmonary resuscitation (CPR), or extracorporeal membrane oxygenation (ECMO), ICU admission and mortality due to COVID-19 infection were analyzed using logistic regression models. <h3>Results:</h3> Among patients confirmed COVID-19 between January 2020 and February 2022, 6627 of AIRD patients and 6627 propensity score-matched the general population were identified from HIRA database. Mean age of AIRD patients and the general population with COVID-19 infection was 52.45 and 52.43 years, respectively. Female were 68.2 % in each group. AIRD patients were not significantly higher risk of supplementary oxygen therapy (adjusted OR 0.94, 95% CI: 0.83-1.07 (adjusted <i>P value = 0.34</i>)), mechanical ventilator (adjusted OR 1.03, 95% CI: 0.75-1.40 (adjusted <i>P value = 0.88</i>)), CPR (adjusted OR 1.05, 95% CI: 0.58-1.91 (adjusted <i>P value = 0.88</i>)), or ECMO (adjusted OR 1.20, 95% CI: 0.52-2.78 (adjusted <i>P value = 0.67</i>)), ICU admission (adjusted OR 1.04, 95% CI: 0.85-1.36 (adjusted <i>P value = 0.73</i>)) and mortality (adjusted OR 0.94, 95% CI: 0.70-1.28 (adjusted <i>P value = 0.70</i>)) due to COVID-19 infection compared to the general population after adjusting age, sex, comorbidities and medication. <h3>Conclusion:</h3> Patients with AIRD dose not showed significantly increased risk of poor outcome of COVID-19 compared to the general population. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS1020 AMBISPECTIVE, MULTICENTER REGISTRY OF TREATMENT WITH ANIFROLUMAB IN REAL LIFE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS FROM SPANISH RHEUMATOLOGY DEPARTMENTS (ANIFRO-REU): BASELINE CHARACTERISTICS
Authors: T. C. Salman-Monte, I. Carrión-Barberà, J. Font, A. Riveros-Frutos, M. J. Garcia-Villanueva, E. Diez Alvarez, C. Moriano, J. Narváez, M. Galindo, C. De Frías Polo, Á. García-Aparicio, J. Cortés-Hernández, S. Sandoval-Moreno, C. Ramos Giráldez, J. A. Gómez-Puerta, B. Frade-Sosa, C. Marras Fernandez Cid, M. M. Piqueras Garcia, S. Garcia-Cirera, J. M. Pego-Reigosa, I. Altabás González, J. Martínez-Barrio, S. Heredia, J. Rosas Gómez de Salazar, A. Hernández, J. Calvo Alén, M. C. Fito Manteca, N. Del Val del Amo, Í. Rúa-Figueroa
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Anifrolumab is a biological treatment with recent approval for systemic lupus erythematosus (SLE), supported by its efficacy in clinical trials. However, data from real clinical practice are lacking. <h3>Objectives:</h3> To describe the patient's baseline clinical characteristics at the time of anifrolumab initiation and reasons for its prescription in patients with SLE under follow-up in Spanish Rheumatology Departments. <h3>Methods:</h3> Observational, uncontrolled, ambispective and multicenter study with medication of a cohort of patients with SLE (according to the 2019 EULAR/ACR criteria), treated in 19 Rheumatology departments. All patients who received at least one dose of anifrolumab and signed the informed consent were included. Sociodemographic, clinical, blood test variables and treatments, were collected. In addition, indexes or scales of activity (SLEDAI-2k, SFI, SLE-DAS, CLASI), damage (SLICC/ACR/DI), fatigue (FACIT), neuro-cognitive dysfunction (MoCA) and disease impact (LIT) of the baseline visit were calculated. A descriptive analysis of the sample was performed. Ethics Committee code: 2023/10814. <h3>Results:</h3> A total of 56 SLE patients were included. Table 1 shows the demographic, clinical characteristics and treatments of the patients. Graph 1 shows the main clinical manifestations that motivated the initiation of treatment with anifrolumab. <h3>Conclusion:</h3> To date, in this registry, anifrolumab was initiated in a real-life setting in patients with a long disease evolution and refractory to several synthetic and biological treatments. Even though patients presented with a whole array of clinical manifestations, there was a clear predominance of the mucocutaneous ones. It remains to be elucidated, through systematic follow-up and the analysis of prospective data, if anifrolumab is just as effective when used in real-life clinical practice as compared to clinical trials. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1732 PROFILE OF MULTISYSTEM INFLAMMATORY SYNDROME (MIS-C) IN INFANTS DURING THE SECOND WAVE OF SARS-CoV-2 PANDEMIC: AN OBSERVATIONAL CROSS-SECTIONAL STUDY
Authors: R. Gupta, A. Maheshwari, D. Mahto, S. Basu, S. Sehgal, A. Kumar
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Multisystem inflammatory syndrome in children (MIS-C) secondary to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has affected not only the older children, adolescents and adults but also infants, more so during the second wave of the global pandemic. <h3>Objectives:</h3> To alert the clinicians to the early diagnosis of MIS-C by lowering the threshold for its diagnosis in compatible clinical settings and timely institution of IVIg in these vulnerable infants to prevent the morbidity and long term complications. <h3>Methods:</h3> All sequentially admitted infants hospitalized during a period of 6 months, who fulfilled the WHO criteria for MIS-C or AHA 2017 criteria for Kawasaki Disease (and positive COVID serology) were included in the present study. <h3>Results:</h3> A total of 19 infants were studied. 13 (68.3%) had evidence of recent COVID-19 infection. The median age of presentation was 2 months (IQR 25<sup>th</sup>, 75<sup>th</sup> 0.5, 3). The most common presenting symptoms were fever (68.4%), gastrointestinal complaints (63.1%) and edema (36.8%). Other predominant signs were shock (78.9%), myocarditis (52.6%) and neurological complaints (26.3%). Incomplete Kawasaki disease was present in 21% patients. Elevated CRP, ferritin, D-Dimer, NT pro BNP and reduced fibrinogen were markers of severe illness. All subjects received IVIG (100%), 31.5% received a second dose of IVIG and 63.1% received pulse intravenous methylprednisolone. A total of 5(26.3%) died as a result of the disease process. <h3>Conclusion:</h3> The spectrum of MIS-C in infants can be varied and is different from older children. A high index of suspicion is therefore needed in infants who present with critical illness and don't respond appropriately to conventional antibiotics and supportive care. Addition of IVIG and corticosteroids to the treatment regimen leads to favourable outcome. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS0383 LOW SERUM ADIPONECTIN LEVELS WERE ASSOCIATED WITH RADIOGRAPHIC PROGRESSION OF HAND OSTEOARTHRITIS IN A 6-YEAR FOLLOW-UP OF THE DONG-GU STUDY
Authors: S. S. Lee, S. E. Choi, J. H. Kang, D. J. Park, M. H. Shin
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Objectives:</h3> The association between serum adiponectin levels and hand osteoarthritis (OA) has been studied cross-sectionally, but longitudinal studies on the radiographic progression of hand OA are lacking. Thus, we investigated the relationship between serum adiponectin levels and radiographic features of hand OA in a prospective longitudinal cohort. <h3>Methods:</h3> A total of 1,356 subjects were enrolled from the Dong-gu study. Baseline serum adiponectin levels were measured by enzyme linked immunosorbent assay, and hand joint radiographs were assessed using a semi-quantitative grading system at the first visit and 6 years later. Multiple linear regression analysis was used to investigate the association between serum adiponectin levels and radiologic changes in hand OA. <h3>Results:</h3> Total hand joint scores increased from 16.5 ± 5.74 at baseline to 19.4 ± 8.11 at year 6 (<i>p</i> &lt; 0.001). The baseline adiponectin levels were negatively associated with the changes in total hand joint score (<i>p</i> = 0.019), subchondral cyst score (<i>p</i> = 0.006), and malalignment score (<i>p</i> = 0.026) after adjusting for age, gender, body mass index, smoking, alcohol consumption, education, physical activity, hypertension, diabetes mellitus, dyslipidemia, chronic pulmonary disease, chronic liver disease, cardiovascular disease, cerebrovascular disease, and malignancy. When serum adiponectin levels above and below the median were compared with the total score for hand OA based on the median radiographic scores, subjects with serum adiponectin levels below the median exhibited radiographic progression in hand joints after adjustment (odds ratio = 0.618, 95% confidence interval: 0.477–0.801, <i>p</i> &lt; 0.001). <h3>Conclusion:</h3> In this longitudinal population-based study, decreased serum adiponectin levels were associated with progression of radiographic hand OA. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>