tbuckley/cabot-search huggingface dataset:
AB1328 IS THERE A NEED FOR ROUTINE IMAGING FOLLOW-UP IN PATIENTS WITH TAKAYASU ARTERITIS?
Authors: F. Yildirim, C. Bes, M. E. Kutu, S. Celik, F. Tastekin, G. Keser, T. Ocak, E. Dalkilic, Y. Pehlivan, H. Kocaayan, S. Akar, S. Isik, A. Omma, S. San, A. Yazici, A. Cefle, G. Kenar, F. Onen, A. Avcu, F. Alibaz- Oner, H. Direskeneli, B. C. Uludogan, N. S. Yasar Bilge, N. A. Kanitez
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Understanding disease progression in patients with Takayasu arteritis (TA) has not always been simple for rheumatologists due to possibility of mild vascular inflammation without clinical signs and ongoing vascular fibrosis independent of disease activity. There is no hesitation regarding the indication of radiological imaging in case of differences in clinical or laboratory findings however there is no consensus among rheumatologists on whether imaging should be performed at regular intervals to detect disease progression <h3>Objectives:</h3> It was aimed to determine the effectiveness of follow-up imaging in making treatment decisions. <h3>Methods:</h3> A total of 60 adult patients with TA whose followed up in eleven tertiary centers in Türkiye were included in this study. The clinical and laboratory findings as well as all imaging findings were recorded retrospectively from the outpatient clinic files. At each imaging visit, disease activity status and whether treatment changes were recorded. <h3>Results:</h3> The median age of the patients analyzed was 41 (20-68) years and 46 (77%) were women. Progression or activity was detected in 31 (20%) of a total of 153 images [15 (25%) for computerized tomography angiography, 2 (12%) positron emission tomography, 8 (24%) magnetic resonance angiography and 5 (13%) Doppler ultrasonography] were performed during a median follow-up period of 43 (14-142) months. In the progressive group, clinical activity rates and treatment change rates were found to be significantly higher compared with the non-progressive group (Table 1). On the other hand, physician global evaluation was active in 35 (28%) patients from non-progressive group and treatment changes were made in 30% of patients. <h3>Conclusion:</h3> In our study, no radiological progression or activity was detected in a significant portion of the patients who underwent radiological imaging. Treatment change rates are similar to physician global activity rates. It is understood that rheumatologists make treatment changes based on their clinical assessment rather than imaging findings. In this case, routine imaging follow-up in TA may not be appropriate, considering the cost and radiation exposure. Data collection continues and more definitive results will be obtained. <h3>REFERENCES:</h3> [1] Alibaz-Oner F, Direskeneli H. Update on Takayasu's arteritis. Presse Med. 2015 Jun;44(6 Pt 2):e259-65. DOI: 10.1016/j.lpm.2015.01.015. [2] Keser G, Aksu K, Direskeneli H. Takayasu arteritis: an update. Turk J Med Sci. 2018 Aug 16;48(4):681-697. DOI: 10.3906/sag-1804-136. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
POS1454-PARE PEER EDUCATOR PATIENTS: A NEW APPROACH TO HEALTH LITERACY FOR PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: F. Rodriguez-Florido, N. Pinto-Florez, G. S. Rodríguez-Vargas, P. Rodríguez-Linares, A. Rojas-Villarraga, P. Santos-Moreno
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Health literacy is an essential component to the well-being of patients with rheumatoid arthritis (RA). This chronic autoimmune disease, which affects the joints and can have a significant impact on quality of life, requires a deep understanding of both the condition itself, and the treatment options available. The relationship of patients with their peers allows them to share experiences, have emotional support, receive practical information, increase self-care awareness, and adherence to treatment. <h3>Objectives:</h3> To develop an educational program for patients with RA, led by expert patients with the same diagnosis, and previously trained for this purpose. <h3>Methods:</h3> A review of the literature on health education for patients by their patient peers was conducted, and subsequently a training program was designed by patients with RA who had previously participated in a multicomponent educational program, and were certified as expert patients. The purpose of this strategy was to achieve social appropriation of knowledge, in which RA patients will participate in interventions led by their peers, the expert patients. <h3>Results:</h3> A program has been developed focused on enhancing knowledge about rheumatoid arthritis, as well as improving communication skills, the ability to motivate and inspire, emotional management, connection with health resources and institutions. These expert patients, now trained as mentors for other patients have been certified as "Patient Educator Peers" (PEP) (see Figure 1). PEPs will have the ability to educate, guide, and provide support to other patients who share the same health condition, promoting healthy lifestyles, and facilitating communication between patients and their medical teams. <h3>Conclusion:</h3> Peer patient education allows patients receiving education to connect with a common experience, promote supportive environments, and exchange of information, which may not be achieved with patient education by health professionals. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Fernando Rodriguez-Florido: None declared, Noralma Pinto-Florez: None declared, Gabriel-Santiago Rodríguez-Vargas: None declared, Pedro Rodríguez-Linares: None declared, Adriana Rojas-Villarraga: None declared, Pedro Santos-Moreno Abbvie, Abbott, Biopas-UCB, Bristol, Janssen, Pfizer, Roche, Sanofi, Abbvie, Abbott, Biopas-UCB, Bristol, Janssen, Pfizer, Roche, Sanofi.
AB0647 DMARD MONITORING IN RHEUMATOID ARTHRITIS: A SCOPING REVIEW OF INTERNATIONAL/NATIONAL GUIDELINES
Authors: C. Hill, M. Kwon, A. Chin, S. Lester, S. Whittle
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> <h3>Objectives:</h3> International and national clinical guidelines for managing rheumatoid arthritis (RA) with disease-modifying antirheumatic drugs (DMARDs) aim to optimise patient care by providing recommendations based on a summary of the evidence for both efficacy and safety. The aim of this study was to compare international and national guidelines for monitoring DMARD use in adult RA patients. <h3>Methods:</h3> We conducted a PRISMA-compliant scoping review to identify all international and national guidelines for the management of adult RA using DMARDs, regardless of language. We searched the Embase and MEDLINE databases and performed a hand search using the snowball method. Two authors independently screened titles and abstracts, conducted full-text reviews according to the protocol's eligibility and exclusion criteria, and extracted data from the selected papers. For non-English guidelines, we utilized Google Translate to translate the documents into English. Data extraction included guidance for baseline laboratory assessments before starting DMARDs and follow-up laboratory tests during DMARD treatment. We included guidelines published in 2014 or later in our analysis to focus on the most current recommendations. <h3>Results:</h3> We first identified 141 guidelines from 26 national and international organizations that addressed the management of adult RA patients between 1996 and 2023. Of these, 76 (53.9%) guidelines provided information on DMARD monitoring. Thirty-five guidelines were published in 2014 or later. DMARD categories included conventional synthetic DMARDs (csDMARDs) (17.1%), biologic DMARDs (bDMARDs) (8.6%), csDMARDs + bDMARDs (8.6%), csDMARDs + bDMARDs + targeted synthetic DMARDs (tsDMARDs) (57.1%), bDMARDs + tsDMARDs (5.7%), and tsDMARDs (2.9%). Among these guidelines, 6 (17.1%) exclusively focused on the management of a single medication. In terms of the geographic origin of the published recommendations, Europe contributed 18 (51.4%) recommendations, followed by America with 9 (25.7%), and the Asia-Pacific region with 8 (22.9%). DMARD monitoring encompassed baseline laboratory assessments (n=21, 60%) and regular follow-up tests (n=12, 34.3%). For both baseline and follow-up assessments, the recommended tests varied between guidelines. Guidance on baseline testing addressed 15 DMARDs and included 10 tests. Fewer tests were recommended for the 13 DMARDs included in guidance on routine monitoring. <h3>Conclusion:</h3> Numerous national and international guidelines exist for DMARD monitoring. However, there is inconsistency in the recommendations regarding DMARD monitoring for both prescreening and regular monitoring. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1075 COMPARATIVE SHORT-TERM EFFECTS OF ANIFROLUMAB AND BELIMUMAB ON PATIENT-REPORTED OUTCOMES IN SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Y. Arinuma, S. Kyoda, K. Ino, K. Oku, K. Yamaoka
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Understanding the impact of biologics, such as anifrolumab (ANF) or belimumab (BEL) on patient-reported outcomes (PROs) in addition to disease activity could lead to uncovering novel aspects of pathogenesis in systemic lupus erythematosus (SLE), particularly in relation to neuropsychiatric mechanisms. <h3>Objectives:</h3> The aim of this study is to demonstrate the short-term effects of biologics on PRO in SLE patients. <h3>Methods:</h3> We conducted a study on SLE patients at our hospital who commenced treatment with ANF or BEL. We evaluated disease activity using the SLE disease activity index 2000 (SLEDAI) and PROs with the lupus impact tracker (LIT) three months post-biologic introduction. <h3>Results:</h3> The study included 11 patients treated with ANF and 29 patients with BEL. At baseline, ANF group had a longer disease duration (p=0.099), more skin lesions (p=0.001), higher total LIT score (p=0.006) and higher SLEDAI (p=0.050). After three months, SLEDAI significantly improved in the ANF group (p=0.002) but remained stable in the BEL group (p=0.177). Both groups experienced significant reduction in daily prednisolone doses (ANF: p=0.031, BEL: p&lt;0.001). The total LIT score significantly decreased in ANF group (p=0.043) but not in BEL group (p=0.142). Notably, the median LIT score for pain significantly decreased only in the ANF group (p=0.016), while fatigue scores significantly improved only in the BEL group (p=0.016). In multivariate analysis, BEL showed a higher odds ratio (OR) for fatigue score improvement (1.65), compared to SLEDAI (1.15), disease duration (0.9) and total LIT score (1.04). In contrast, ANF had an OR of 2.75 for pain improvement with other confounders nearly at 1.0 (Figure 1). <h3>Conclusion:</h3> BEL could contribute more significantly to rapid fatigue improvement than to disease activity reduction, while ANF may alleviate pain in conjunction with improving disease activity. These differential effects provide valuable insights into the pathogenesis of SLE, potentially related to neuropsychiatric SLE. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1037 CURRENT USE OF GLUCOCORTICOIDS FOR THE TREATMENT OF SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: C. Imaizumi, Y. Minegishi, Y. Takakura, T. Ogura, H. Kameda
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The current "treat-to-target (T2T)" strategic concept has been applied to systemic lupus erythematosus (SLE), stating "lupus maintenance treatment should aim for the lowest glucocorticoid (GC) dosage, and if possible, GCs should be withdrawn completely". We have already reported the successful trade-off between GCs and immunosuppressive agents (ISA) in the prevention of SLE flare. <h3>Objectives:</h3> We aimed at the retrospective evaluation of current SLE treatment status by focusing on the maintenance dose of GCs and the use of ISA as well as the rate of GC-free patients. <h3>Methods:</h3> We enrolled 121 patients with SLE patients who was visiting our medical center.All the patients met the American College of Rheumatology (ACR) 1997 or 2012 revised criteria for SLE classification and were followed-up for ≥ 6 months after diagnosis. We evaluated patient backgrounds, SLE disease activity index (SLEDAI) score, the dose of GC, and the use of ISA or biologics from the medical records. <h3>Results:</h3> Currently, 94% of patients achieved GC dosage of 5 mg/day (prednisolone equivalent) or less and the median GC dosage was 2 mg/day. In addition, 48 (40%) patients were successfully managed with hydroxychloroquine (HCQ) and/or ISA only (including never- and ex-users of GCs). The users of HCQ, ISA, and biologics were 63%, 68% and 7%. respectively. Among ISA, mycophenolate mofetil (38%) and tacrolimus (35%) were commonly used, including their combined use (16%). GC-free patients achieved the median SLEDAI of 1 despite the median SLEDAI of 10 at the first presentation and the median disease duration of 10.5 years, which were comparable with the remaining patients. <h3>Conclusion:</h3> The T2T strategy for GC dose is applicable for almost all the patients with SLE, and GC-free management is becoming a realistic treatment goal with the aggressive use of HCQ, ISA, and biologics. <h3>REFERENCES:</h3> [1] Nat Rev Rheumatol. 2022 Mar;18(3):146-157. [2] Intern Med. 2022;61(21):3189-3196. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1271 EVALUATION OF SINONASAL INVOLVEMENT IN ANCA-ASSOCIATED VASCULITIS USING THE SNOT-22 QUESTIONNAIRE
Authors: D. Baş, R. C. Kardaş, D. Yildirim, B. Kaya, İ. Vasi, R. Duran, A. Erden, H. Küçük, B. Göker, M. A. Öztürk
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) constitutes a diverse group of diseases characterized by inflammatory damage to small to medium-sized vessels, leading to organ and tissue impairment. Along with pulmonary and renal, upper airway involvement is a common feature, especially for granulomatosis with polyangiitis. The Sinonasal Outcome Test 22 (SNOT-22) is a 22-item questionnaire that combines both nasal and general health symptoms, providing a quantitative measurement of the severity of various symptoms related to chronic rhinosinusitis, with each question scored on a scale of 0 to 5 and a total possible score of 110. It has been widely used and validated for assessing disease-specific outcomes and quality of life in patients with sinonasal conditions. <h3>Objectives:</h3> Primary objective of this study was to utilize the SNOT-22 questionnaire to evaluate sinonasal symptoms in AAV patients. <h3>Methods:</h3> AAV patients followed in Gazi University outpatient rheumatology clinic between January and December 2023 were included in the study. During their routine follow-up, SNOT-22 was administered to all consenting patients. Information regarding demographic, clinical and laboratory was extracted from patient files. <h3>Results:</h3> A total of 90 AAV patients were included in the study, with a mean age of diagnosis at 47.8 ± 14.4 years. The majority of patients were female (53%) GPA was the predominant diagnosis (75.6). 61 patients (68%) had upper respiratory tract symptoms. ANCA patterns revealed c-ANCA in 55.2% and p-ANCA in 20.7%. Mean BVAS score at the time of diagnosis was 18,3 and median FFS score was 1,0 (Table 1). At the time of SNOT-22 administration, patients had a mean age of 53.7 ± 13.5 years. 35 patients (38.9%) had upper respiratory tract findings, with most common being sensorineural hearing loss in 21.1%. Median CRP was 5,1 mg/L (IQR: 6,9). Most patients were at remission (median BVAS: 0). SNOT-22 median score (IQR) was 0 (4), with 37.8% of patients having a score greater than 0; categorically, 62.2% scored 0, 10% scored 1–3, 14.4% scored 4–9, and 13.3% scored ≥10 (Table 2). There was no difference between SNOT-22 score and demographic, clinical and laboratory findings. <h3>Conclusion:</h3> SNOT-22 has the potential to be used as a patient reported outcome tool in AAV patients. Further research is needed to confirm this prospectively. <b>REFERENCES: NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0914 PREVALENCE OF POSTERIOR SEGMENT LUMBAR ENHANCEMENT ON MRI IN PATIENTS WITH AXIAL SPONDYLOARTHROPATHY, LOW BACK PAIN AND HEALTHY VOLUNTEERS: A CROSS-SECTIONAL STUDY
Authors: C. Mourad, T. Borges Baptista, A. Dumusc, P. Omoumi
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Spinal and sacroiliac involvement is frequent in axial spondyloarthropathy (axSpA). MRI criteria defining structural and inflammatory lesions for axSpA have been clearly described. However, enhancement of posterior spinal ligaments and zygapophyseal joints may be observed in patients with back pain who undergo contrast-enhanced MRI of the lumbar spine but have no other signs of axSpA. The clinical significance of this enhancement remains to be defined. <h3>Objectives:</h3> To compare the prevalence of enhancement of the posterior lumbar spine elements on contrast-enhanced MRI in patients with axSpA, low back pain (LBP) and asymptomatic volunteers. <h3>Methods:</h3> This is a retrospective cross-sectional study including patients with axSpA (fulfilling ASAS 2010 criteria) followed in the rheumatology clinic, patients with LBP without features of axSpA and a prospective cohort of volunteers who underwent a clinically indicated contrast-enhanced MRI of the abdomen or pelvis, did not have back pain based on a questionnaire, and consented to an additional MRI sequence covering the lumbar spine. Two musculoskeletal radiologists (R1 and R2) reviewed MRI images blinded to patient clinical data. Anonymized contrast-enhanced sagittal fat-suppressed T1-weighted MRI images were independently analyzed. 40 anatomical structures, from L1 to S1 levels, were scored on every MRI, using a Likert scale (0-3): interspinous and supraspinous ligaments, articular recess, joint space, and periarticular soft tissues of bilateral zygapophyseal joints. A positive enhancement was defined as a score ≥2 for every structure. A global enhancement score was calculated by summing up all anatomical structures' scores, which were compared between groups. <h3>Results:</h3> MRI images of 248 patients (mean (SD) age: 51.9 (19.0)) were reviewed, including 77 patients with axSpA (39.6 (12.7)), 88 with LBP (61.5 (19.5)) and 83 volunteers (53.3 (17.0)). The prevalence of positive enhancement of the posterior elements (median global score [IQR]) for R1 was 62% (13 [8.0-20.2]) in the axSpA group, 72% (20 [12.0-28.5]) in the LBP group and 73% (26 [18-32]) in the volunteers group. For R1 and R2, the difference between groups was statistically significant (p&lt;0.05). Interobserver agreement between R1 and R2 was fair (kappa=0.43, [0.37 to 0.49, 95%CI]). <h3>Conclusion:</h3> Enhancement of the posterior elements of the lumbar spine is a frequent finding on MRI of the lumbar spine, is not specific for axSpA, and is encountered in patients with non-inflammatory LBP as well as in asymptomatic volunteers. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Charbel Mourad: None declared, Tiago Borges Baptista: None declared, Alexandre Dumusc Novartis, Lilly, Abbvie, Pfizer, Abbvie, Patrick Omoumi: None declared.
AB0877 A HIGH PROPORTION OF WOMEN WITH AXIAL SPONDYLOARTHRITIS BREASTFED IN NORWEGIAN COHORT
Authors: I. Mørdre, E. H. Grøntvedt, M. Wallenius, C. Götestam Skorpen
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> There is sparse research done on the topic of breastfeeding in women with axial spondyloarthritis (axSpA). Previous research has focused on the use of medication during lactation. <h3>Objectives:</h3> Our aim was to obtain more knowledge about variables affecting breastfeeding for women with axSpA. <h3>Methods:</h3> The current prospective study used data from the nationwide quality register RevNatus, including 350 patients with axSpA in a total of 417 pregnancies. The breastfeeding and non-breastfeeding women were compared at follow up visits six weeks, six months and twelve months postpartum. The groups were compared in regard to demographic and obstetric data, disease characteristics, medical treatment and health related quality of life. Information on breastfeeding was registered at least once during the follow-up postpartum. <h3>Results:</h3> The proportion of women with axSpA breastfeeding at the postpartum follow ups was 86% at six weeks, 70% at six months, and 38% at twelve months. At inclusion the mean age was 31 years, mean disease duration was 4,5 years, and 53% had previous live births. Mean age was higher for the breastfeeding group at six weeks and twelve months postpartum. The use of tobacco was more common for the non-breastfeeding group at all follow ups. Mean BMI was higher for the non-breastfeeding women at the six month follow up. There was also a larger proportion of obesity among these women. A larger proportion of the non-breastfeeding group had delivered with cesarean section (CS). ASDAS-CRP was higher for the non-breastfeeding group at six weeks and six months, and BASDAI was higher for the same group at six months. VAS pain scores were higher for the non-breastfeeding group at six weeks and six months. The same was the case for VAS fatigue at six months. The use of methotrexate and secukinumab was more common among those not breastfeeding av six months. The use of TNF-inhibitors varied from 30% at six weeks to 51% at six months and 56% at twelve months. <h3>Conclusion:</h3> Our study showed that a large proportion of women with axSpA were breastfeeding at six weeks and six months after giving birth. The non-breastfeeding group was younger. A significantly larger proportion of the non-breastfeeding women had given birth with CS. The women not breastfeeding had higher disease activity according to ASDAS-CRP and BASDAI at all postpartum follow ups. They also reported higher levels of pain, fatigue and total disease burden. Being able to control the disease in a better way might increase the chance that these patients breastfeed. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>