tbuckley/cabot-search huggingface dataset:
AB1055 MACHINE LEARNING MODELING FOR PREDICTION OF POTENTIAL RISK FACTORS ASSOCIATED WITH KIDNEY INVOLVEMENT IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) PATIENTS
Authors: S. Xie, Y. Jiang, B. Xie, F. Yuan, A. Chen, Z. Lin
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies and inflammation that can affect multiple organs and systems within the body. Patients with SLE are at risk for kidney damage due to different self-characteristics, underlying risk factors, and disease history, etc. Relevant machine learning modeling predictions will provide adequate support and reference information for the exploration of these potential factors. <h3>Objectives:</h3> The primary objective of this study is to predict potential key determinants affecting kidney involvement in SLE patients through comprehensive machine learning modeling. <h3>Methods:</h3> This study employs a machine learning approach to predict kidney involvement in patients with systemic lupus erythematosus (SLE). The dataset underwent preprocessing to address missing values, including imputation and dummy coding for categorical variables. And data was split into an 80% training set and a 20% testing set, with stratification to balance the outcome variable. The study used the "lightgbm" package within the tidymodels framework (by R software) to tune a gradient boosting model, optimizing for area under the curve (AUC). Cross-validation with five folds was performed to evaluate model performance and determine optimal hyperparameters. The final model was selected based on the highest AUC. <h3>Results:</h3> The study included 1029 participants, consisting of 121 males and 908 females, with a mean age of 28.0 (23.0-39.5) years and a median disease duration of 1.0 year (ranging from 0.5 to 4.0 years). Overall, 333 of these patients developed kidney involvement. Notably, there were no significant differences observed in age, age at onset, and disease duration between male and female patients with systemic lupus erythematosus (SLE). The optimized gradient boosting model demonstrated high predictive performance with an AUC of 0.97, indicating excellent discrimination between SLE patients with and without kidney involvement. The ROC curve plotted emphasizes the model's sensitivity and specificity across different thresholds. Furthermore, the SHAP value analysis revealed the most influential features, with 24h urine protein quantification, urine protein/creatinine ratio, and higher Scr being the top contributors. <h3>Conclusion:</h3> In this analysis, the key determinants for kidney involvement in SLE are identified as urinary protein metrics, serum creatinine, complement levels, and SLEDAI scores. These findings highlight the intricate relationship between clinical and laboratory indicators in managing and forecasting renal outcomes in SLE patients. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1018 RILONACEPT USE IN LUPUS PERICARDITIS
Authors: A. Fava, M. Cammarata, L. Adamo
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:S</h3> Lupus pericarditis affects 22% of patients with systemic lupus erythematosus (SLE), is associated with worse outcomes, and often requires immunosuppression. Rilonacept is an IL-1 receptor antagonist approved for the treatment of recurrent idiopathic pericarditis, but its efficacy in lupus pericarditis is unknown. <h3>Objectives:</h3> To report the efficacy of rilonacept in a case series of patients with lupus pericarditis. <h3>Methods:</h3> We describe a case series of 4 patients with refractory lupus pericarditis treated with rilonacept in the Johns Hopkins Lupus Center. All patients met the 2012 SLICC criteria for SLE. Refractory lupus pericarditis was defined as recurring or persistent typical pericardial pain symptoms despite standard-of-care treatment including at least one immunosuppressant. <h3>Results:</h3> Four patients with refractory pericarditis were included (Table 1). All patients were women, age ranged 26-44 years, 2 patients reported White, 1 Black, and 1 Hispanic ethnicity. Extra-pericardial SLE manifestations were heterogeneous among patients. Only 1 of 3 patient had elevated CRP (not measured in one). Two patients were previously treated with anakinra with initial response, but pericarditis redeveloped in both. Rilonacept led to complete resolution of pericardial symptoms in 3 patients, and partial resolution (40%) in 1, within 2 weeks. <h3>Conclusion:</h3> Rilonacept successfully treated lupus pericarditis in this case series. Rilonacept should be considered for the treatment of lupus pericarditis. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Andrea Fava Sanofi, AstraZeneca, AnnexonBio, UCB, Michael Cammarata: None declared, Luigi Adamo Kiniksa.
AB0123 ELEVATED NEUTROPHIL-TO-LYMPHOCYTE AND MONOCYTE-TO-LYMPHOCYTE RATIOS ARE ASSOCIATED WITH INCREASED FLARES AND ELEVATED CARDIOVASCULAR DISEASE RISK IN GOUT
Authors: D. Liping, R. Stultz, E. Van Geel, M. Gerritsen, M. T. Nurmohamed, C. Lood
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Although gout is the most common inflammatory arthritis, there are a few tools to monitor disease activity and predict complications in gout patients. The neutrophil-to-lymphocyte ratio (NLR) and the monocyte-to-lymphocyte ratio (MLR) have been shown to associate with disease activity in gout. <h3>Objectives:</h3> To evaluate the use of neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) as novel biomarkers to measure disease activity and predict cardiovascular disease risk in gout. <h3>Methods:</h3> Data were collected from 38 consecutive gout patients. Disease activity and 10-year risk of cardiovascular morbidity were assessed at the patient visit. Calprotectin levels were measured from patient plasma using ELISA. Cell counts and serum uric acid levels were measured from blood. <h3>Results:</h3> Levels of calprotectin, a marker of neutrophil activation, correlated with NLR (r=0.56, p=0.0004). The MLR correlated with total number of gout attacks as well (r=0.39, p=0.02). Absolute neutrophil counts and NLR levels were significantly increased in gout patients with diabetes and hypertension (p &lt; 0.05). Further, NLR and MLR but not absolute monocyte or neutrophil counts were significantly increased in gout patients with high cardiovascular disease risk (p &lt; 0.05). Using logistic regression analysis, gout patients having high NLR or MLR were at increased risk of high CVD risk (OR = 7.5 (1.7 – 33.0), p=0.008). <h3>Conclusion:</h3> NLR and MLR are potential biomarkers for gout flares and risk of cardiovascular morbidity in patients with gout. <h3>REFERENCES:</h3> [1] Lottmann K, Chen X, Schädlich PK. Association Between Gout and All-Cause as well as Cardiovascular Mortality: A Systematic Review. Curr Rheumatol Rep. 2012. [2] Vedder D, Gerritsen M, Nurmohamed MT, van Vollenhoven RF, Lood C. A neutrophil signature is strongly associated with increased cardiovascular risk in gout. Rheumatology. 2021. [3] Vedder D, Gerritsen M, Duvvuri B, van Vollenhoven RF, Nurmohamed MT, Lood C. Neutrophil activation identifies patients with active polyarticular gout. Arthritis Research &amp; Therapy. 2020. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1024 EFFECT OF BELIMUMAB ON CLINICAL PROFILES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) -ALTERATIONS OF IMMUNOLOGICAL ACTIVITY, DISEASE ACTIVITY AND DAILY LIVING SCORE (AS), AND ASSOCIATION BETWEEN IMPROVEMENT OF AS AND ABOVE FACTORS -
Authors: T. Ishizuka, K. Fujioka, H. Tani, M. Tangiku, A. Maeda, H. Oida, H. Okada, Y. Uno, I. Mori, M. Asano, H. Morita
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Belimumab (BE) has been shown to decrease disease activity, glucocorticoid (PSL) intake, and flare rates, thereby suppression of damage progression, and also has been included in the 2023 EULAR recommendations on SLE management as an approved biological drug to be used in patients with a refractory response to a standard of care regimen. <h3>Objectives:</h3> We have previously examined the effect of belimumab on immunological activities, disease activities (DA), activities of daily living score (AS)<sup>1</sup> in patients with SLE. We summarized the data from three centers for rheumatology concerning about patients with SLE using BE to clarify the effects on each immunological activities such as anti-ds DNA, RNP, Sm, SS-A and SS-B antibodies, and the association between improvement of AS and factors such as immunological activities, dose of PSL, DA. and AS. <h3>Methods:</h3> We selected 69 cases (F/M 55/14) from 2018 to 2023 in patients with SLE treated with belimumab (BE) to clarify the effect of BE on immunological data, disease activities (SLEDAI), daily living score (AS) and doses of PSL after treatment for 6 months (M), 12 M and 24M. Statiscal analyses such as correlation coefficient and anlyses of variance were performed by JMP12.2.0. <h3>Results:</h3> Mean BMI age and duration of disease were 20.9±3.7 kg/m2, 45.5±17.1 and 15.7±13.8 years. After treatment with BE for 6M, 12M and 24M anti-dsDNA antibodies (AU/ml) were significantly decreased for 6M, 12 M and 24 M, respectively (p&lt;0.05, before 60±146, 6M 21±38, 12M 17±20, 24M 18±18), and C3, C4 and CH50 (U/ml) were significantly increased. Levels of SLEDAI score were significantly decreased (p&lt;0.001, before 11±7, 6M 6±3, 12 M 5±3, 24M 5±4 and Doses of PSL (mg) were significantly decreased (p&lt;0.001, before 15.6±14.2, 6 M 7.2±5.0, 12 M 5.9±3.9, 24M5.7±3.8). AS scores were also significantly improved (p&lt;0.001-0.05, before 25.7±14.4, 6M 17.6±12.3, 12M12.5±12.9, 24 M 12.8±11.9). Anti-SS-A, SS-B and Sm antibodies were tend to be decreased, but not anti-RNP antibody. No significant relationship between changes of AS and each improved factor by BE treatment were observed. <h3>Conclusion:</h3> Effects of BE on clinical results, and induction of clinical remission and maintenance treatment were useful without major adverse effects in patients with SLE. BE-induced Improvement of AS might be independent factor. <h3>REFERENCES:</h3> [1] Inoue M,et al. Lupus 26:849,2017 <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0127 EVALUATION OF TREATMENT COMPLIANCE IN GOUT PATIENTS: A PATIENT-CENTERED STUDY
Authors: B. Görgülü, R. C. Kardaş, D. Koç Şeramet, R. Mercan, M. E. Tezcan, H. Küçük, B. Göker, M. A. Öztürk
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Most studies on the unsuccessful treatment of gout suggest that knowledge gaps and inadequate physician interventions are the major contributors. However, no research has investigated to what extent patients educated by physicians with sufficient knowledge and experience about gout adhere to these recommendations. <h3>Objectives:</h3> This study aims to assess the treatment compliance of gout patients who received adequate information about diet, target serum uric acid levels, and gout from rheumatologists in university rheumatology clinics. The evaluation includes examining the impact of regular follow-up visits and medication adherence on achieving the target uric acid level and controlling the clinical manifestations of the disease. <h3>Methods:</h3> In this study, 302 gout patients initiating treatment in tertiary rheumatology centers and adequately informed about their condition were screened. A total of 198 patients meeting the study criteria were included. Compliance with treatment was assessed through self-reports, and the achievement of the target uric acid level was determined using medical records. <h3>Results:</h3> Regular follow-up visits and adherence to prescribed medications significantly influenced the attainment of the target uric acid level. The median serum uric acid level decreased from 8.85 mg/dL (IQR: 1-15 mg/dL) before treatment to 6.5 mg/dL (IQR: 2.1-13.2 mg/dL) after treatment. Of the patients informed by rheumatologists and consistently taking medication, 68.5% were compliant even after a median of 7 years. Those attending regular follow-ups had a higher treatment goal achievement rate (90.6%) compared to those who did not (29.4%). <h3>Conclusion:</h3> Achieving an acceptable level of treatment adherence and success in gout patients is contingent on adequate disease knowledge and appropriate education. Regular follow-up visits and consistent medication use, as recommended by physicians, significantly contribute to reaching the treatment goals and controlling clinical manifestations of gout over the long term. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1001 HIGH NEUTROPHIL-TO-LYMPHOCYTE RATIO IS A RISK FACTOR FOR CHRONIC KIDNEY DISEASE IN PATIENTS WITH LUPUS NEPHRITIS
Authors: S. S. Lee, J. H. Kang, S. E. Choi, D. J. Park
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Objectives:</h3> The neutrophil-to-lymphocyte ratio (NLR) is associated with a poor outcome in patients with chronic kidney disease (CKD). Several studies have reported that NLR is closely related to active systemic lupus erythematosus (SLE). However, little is known about the prognostic role of NLR in patients with lupus nephritis (LN). <h3>Background:</h3> Thus, the aim of this study was to determine whether NLR can predict progression to CKD in LN patients. <h3>Methods:</h3> We enrolled 175 LN patients with available clinical data at the time of renal biopsy from the longitudinal SLE cohort. We divided LN patients into three groups based on NLR levels (T1, &lt; 2.43; T2, 2.43–4.75; T3, &gt; 4.75), compared their demographic, clinical, histological and laboratory findings, and assessed long-term prognosis among the groups. Univariate and multivariable Cox proportional hazard regression models were used to identify independent risk factors for CKD in LN patients. <h3>Results:</h3> Patients in the highest NLR tertile were older and had a higher SLEDAI score, lower eGFR, and higher white blood cell and platelet counts than those in the lowest tertile. During a mean follow-up of 100.8 ± 65.6 months, development of CKD and end-stage renal disease (ESRD) was more frequent in patients in the highest tertile (p &lt; 0.001, p = 0.026). Finally, the highest NLR tertile was associated with an increased risk of development of CKD [adjusted hazard ratio (HR) = 2.972, 95% CI (1.429–6.182), p = 0.004 for all LN patients; adjusted HR = 3.180, 95% CI (1.298–7.792), p = 0.011 for those with class III, IV, and V LN]. <h3>Conclusion:</h3> Our results demonstrated that a higher NLR in LN patients corresponded to more advanced disease leading to rapid decline of kidney function from the onset of LN. Therefore, NLR can be used as a prognostic marker for predicting CKD and ESRD in LN patients. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0636 RISK OF TUBERCULOSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS: A NATIONWIDE POPULATION-BASED COHORT STUDY
Authors: Y. Eun, S. Kang, K. Lee, K. D. Han, J. K. Ahn, H. Kim
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patients with rheumatoid arthritis (RA) are known to have an increased risk of tuberculosis, particularly in association with the use of biologic disease-modifying anti-rheumatic drugs (bDMARD) including tumor necrosis factor-α (TNF-α) inhibitors. Korea is a country with an intermediate risk of tuberculosis, and large-scale studies on the risk of tuberculosis in patients with RA in Korea are still lacking. <h3>Objectives:</h3> Our study aimed to identify the risk of tuberculosis in patients with RA compared to the general population in a large population-based cohort, and to identify factors associated with the risk of tuberculosis in patients with RA. <h3>Methods:</h3> Among patients diagnosed with RA between 2010 and 2017, patients who had undergone a national health examination within two years prior to RA diagnosis were included in the study (n = 59,577). Control group included age- and sex-matched non-RA controls who received a health check-up at the same time as RA patients (n = 297,885). The primary outcome of the study was incident tuberculosis, which was defined by an ICD-10 code and enrollment in the rare intractable disease program. Kaplan-Meier curves and Cox proportional hazards regression analysis were used for the analysis. <h3>Results:</h3> During a mean follow-up period of 4.5 ± 2.2 years, 979 subjects in the control group and 619 patients in the RA group developed tuberculosis. Patients with RA had a 3-fold higher risk of tuberculosis than age- and sex-matched non-RA controls (adjusted hazard ratio [aHR] 3.02, 95% confidence interval [CI] 2.73–3.35). The association between RA and tuberculosis was more prominent in young adults aged 20-39 years. Using the control group as the reference, the aHR of tuberculosis in bDMARD-naïve patients with RA was 2.87 (95% CI 2.58–3.19), and the aHR of tuberculosis in bDMARD-exposed patients with RA was 4.97 (95% CI 3.92–6.29). In patients with RA, male sex, advanced age, underweight, diabetes, hypertension, airway disease, and bDMARD exposure were associated with an increased risk of tuberculosis. <h3>Conclusion:</h3> In a nationwide population-based cohort in Korea with a intermediate risk of tuberculosis, patients with RA had a three-fold higher risk of tuberculosis than age- and sex-matched controls, and even bDMARD-naïve patients had a higher risk of tuberculosis than the general population. Even in patients who do not use bDMARDs, if suspicious symptoms occur, the possibility of tuberculosis should be considered. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0998 PLASMA LEVELS OF GDF-15 ARE ASSOCIATED WITH ARTERIAL THROMBOSIS AND NEPHRITIS IN SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: M. Barguil Macedo, I. Gunnarsson, A. Zickert, E. Svenungsson, C. Lood
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Growth differentiation factor 15 (GDF-15) is an inducible peptide with cardioprotective functions, whose expression is increased during hypoxia or oxidative stress conditions, such as ischemic myocardial injury (MI). It has been demonstrated to deter polymorphonuclear infiltration to the myocardium, and ultimately to counterbalance pathologic myocardial remodelling and fibrosis. A meta-analysis with over 53,000 patients highlighted its role as a useful prognostic biomarker for both hospitalization due to heart failure, and death due to cardiovascular disease. In lupus animal models, GDF-15 has been shown to negatively modulate immune cell activation, including plasma cell expansion and the induction of a type I interferon signature. However, the role of GDF-15 in human systemic lupus erythematosus (SLE) has not been addressed. <h3>Objectives:</h3> To evaluate the plasma levels of GDF-15 in a cross-sectional cohort of SLE patients in comparison to population controls (PC), and to determine which clinical characteristics, within SLE patients, were associated with increased GDF-15 levels. <h3>Methods:</h3> GDF-15 levels were measured by a commercially available ELISA kit (R&amp;D # DY957) on plasma samples from the Karolinska SLE cohort (SLE n= 303, PC n= 303). The 95<sup>th</sup> percentile of the PC measurement was established as a cut-off for dichotomous evaluation of high <i>versus</i> low levels. Statistical analysis was performed on SPSS v.29. Mann-Whitney, Spearman's correlation, and Fisher exact tests were applied. <h3>Results:</h3> Plasma levels of GDF-15 were elevated in SLE patients as compared to PC, with a mean GDF-15 level of 201 pg/mL in SLE, and a mean GDF-15 level of 161 pg/mL in PC (p=0.0016). Among SLE patients, GDF-15 levels were particularly increased in patients with a history of arterial events (p&lt;0.0001), MI (p=0.03), and lupus nephritis (LN, p=0.004). Plasma levels above the 95<sup>th</sup> percentile (239 pg/mL) were twice more frequent in LN (25.2% <i>versus</i> 12.7% of SLE patients without LN, p=0.006), and a moderate correlation between creatinine and GDF-15 plasma levels was observed (r<sub>s</sub> = 0.418, p&lt;0.001). <h3>Conclusion:</h3> GDF-15 plasma levels are positively associated with a past of arterial events in general, and MI in particular, in SLE patients. Further, GDF-15 levels correlate with plasma creatinine levels, being primarily increased in patients with a history of LN. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0999 CORRELATION BETWEEN NEUROPSYCHIATRIC SYSTEMIC LUPUS ERYTHEMATOSUS AND IMMUNOLOGICAL MARKERS
Authors: Z. Lin, Y. Jiang, Y. Liu, Y. Zhang, F. Yuan, X. Xu, C. Zhao
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Nervous system involvement in SLE, also named neuropsychiatric SLE (NPSLE), can present as a series of neurological and psychiatric (NP) manifestations. NPSLE has been closely linked to specific autoantibodies, but the findings have been inconsistent across studies [1-3]. <h3>Objectives:</h3> This study aimed to investigate disparities in clinical profiles and autoantibody patterns between patients with and without NPSLE in a cohort and to identify risk factors associated with NPSLE in the Chinese population. <h3>Methods:</h3> SLE patients were retrospectively reviewed from two tertiary hospitals. The relationships between NPSLE and immunological biomarkers were explored. <h3>Results:</h3> Among the 945 SLE patients, 75 (7.94%) were diagnosed with NPSLE. The most prevalent NP manifestations involved cognitive disorder (30.67%), headache (26.67%), seizure disorder (26.67%), and psychosis (26.67%).We observed significant associations between psychosis and anti-β2GPI antibodies (F= 6.092, <i>p</i>= 0.015), polyneuropathy and anti-Scl70 antibodies (F= 20.161, <i>p</i>&lt; 0.001), demyelinating syndrome and anti-cardiolipin antibodies (F= 6.637, <i>p</i>= 0.011), myasthenia gravis and anti-RNP (F= 5.864, <i>p</i>= 0.017) and anti-Smith antibodies (F= 5.096, <i>p</i>= 0.026). Multivariate logistics analysis showed that anti-prothrombin (aPT) IgM antibodies (OR= 10.985, CI 1.279–94.343, <i>p</i>= 0.029), age (OR= 1.169, CI 1.032-1.325, <i>p</i>= 0.014), and serum creatinine (SCr) (OR= 1.014, CI 1.003-1.025, <i>p</i>= 0.009) were independent risk factors of NPSLE, while anti-Sjogren syndrome antigen B (SSB) antibodies (OR 0.023, CI 0.002-0.622, <i>p</i>= 0.023) and complement C3 (OR= 0.001, CI 0-0.045, <i>p</i>&lt; 0.001) indicated reduced risk of NPSLE. <h3>Conclusion:</h3> Various neuropsychiatric manifestations in SLE were found to be correlated with specific autoantibodies. Independent risk factors for NPSLE included aPT IgM antibodies, age, and elevated serum creatinine, while the absence of anti-SSB antibodies and low complement C3 levels were associated with reduced risk. <h3>REFERENCES:</h3> [1] F. B. Karassa, J. P. Ioannidis, K. A. Boki, G. Touloumi, M. I. Argyropoulou, K. A. Strigaris and H. M. Moutsopoulos (2000) Predictors of clinical outcome and radiologic progression in patients with neuropsychiatric manifestations of systemic lupus erythematosus. Am J Med 109: 628-34. [2] J. Mikdashi and B. Handwerger (2004) Predictors of neuropsychiatric damage in systemic lupus erythematosus: data from the Maryland lupus cohort. Rheumatology (Oxford) 43: 1555-60. [3] C. S. Yee, H. Hussein, J. Skan, S. Bowman, D. Situnayake and C. Gordon (2003) Association of damage with autoantibody profile, age, race, sex and disease duration in systemic lupus erythematosus. Rheumatology (Oxford) 42: 276-9. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>