tbuckley/cabot-search huggingface dataset:
AB0167 SPINAL TUBERCULOSIS: A RETROSPECTIVE STUDY
Authors: S. Ben Jemaa, R. Ben Chehida, Z. Gassara, A. Feki, M. H. Kallel, H. Fourati, S. Baklouti
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Spinal tuberculosis (ST) is an extrapulmonary form of tuberculosis caused by Mycobacterium tuberculosis. It is a common form of osteoarticular tuberculosis, particularly in developing countries such as Tunisia. <h3>Objectives:</h3> Our objective was to clarify the etiological, bacteriological and radiological characteristics but also the progressive characteristics of ST. <h3>Methods:</h3> We conducted a retrospective study including all patients hospitalized in our Rheumatology department for ST during 22 years. <h3>Results:</h3> We collected 46 cases of ST divided into 28 women and 18 men (sex ratio: 0.64). The average age was 54.7 years. A history of tuberculosis was noted in eight patients (17.4%). Only seven patients (15.2%) received BCG vaccination. The most frequent reason for consultation was spinal pain, which was observed in all patients. The onset of the disease was progressive in 91.3% of cases (n=42/46). The lumbar spine was the most affected site in 34 cases (73.9%). On physical examination, a neurological deficit was noted in 3 cases and sphincter disorders in one case. The tuberculin skin test was positif in 47.8% of cases. In our series, all patients had a standard radiograph. A decrease in intervertebral disc space was the most common condition (61% of cases). Erosions of the vertebral endplates were observed in half of the cases. An MRI of the spine was done in 45 cases. It confirmed the diagnosis in forty-two cases. In the others three cases, it demonstrate vertebral without disc involvement. The diagnosis of ST was made in 20 patients (43.5%) following a positive histological study or PCR of a neuroimaging guided-needle biopsy from the affected site or a sample of an abscess, in 10 others patients the histological study showed presence of epithelioid cells on the biopsy material. In the remaining 16 cases, the diagnosis was made based on a combination of clinical, paraclinical and evolving arguments under anti-tuberculosis treatment. All patients received anti-tuberculosis treatment. The average duration of anti-tuberculosis antibiotic therapy was 16.1 months (9 months to 29 months). The evolution of the disease was favourable in 32 patients (69.6%). <h3>Conclusion:</h3> Our series shows that ST mainly affects unvaccinated middle-aged women. Diagnosis is often made late(presence of radiological signs). Biopsy of the disc and vertebra is an important diagnostic contribution. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0132 THE IMPACT OF FIBROMYALGIA AND FIBROMYALGIA-RELATED SYMPTOMS ON TREATMENT ADHERENCE IN A COHORT OF PATIENTS WITH RHEUMATIC DISEASES: RESULTS OF A PILOT CROSS-SECTIONAL STUDY
Authors: M. Rapisarda, D. Sangari, G. Miceli, C. Crisafulli, R. Talotta
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Treatment adherence in rheumatic patients is often a challenge and has a negative impact on the cost-effectiveness of therapies. Fibromyalgia (FM) is one of the rheumatic diseases most strongly associated with poor treatment adherence. Screening rheumatic patients for associated FM or FM spectrum symptoms can help identify those who are more likely to be medication non-adherent and could benefit from tighter control or personalized therapeutic strategies. <h3>Objectives:</h3> To investigate treatment adherence in a cohort of patients with a pool of rheumatic diseases in relation to the prevalence of FM or FM–related symptoms and to identify risk factors associated with poor medication compliance. <h3>Methods:</h3> In this cross-sectional cohort study outpatients with a diagnosed rheumatic disease from the Rheumatology Unit of the University Hospital "G. Martino" in Messina were consecutively enrolled by face-to-face or telephone interview. Specifically, patients were screened for primary or associated FM based on the ACR 2016 criteria, and assessed for FM disease activity, quality of life, physical and psychological symptoms using the FIQR, FAS, BDI and SF-36 questionnaires. Treatment adherence was measured using the MMAS-8 questionnaire. Demographic and clinical data were also collected. <h3>Results:</h3> We consecutively enrolled a total of 100 patients whose demographic and clinical characteristics are listed in Table 1. Of them, 54 had FM, which was primary in 28 cases. Other rheumatic diseases included osteoarthritis and inflammatory conditions such as arthritis and connective tissue diseases. Overall, adherence to pharmacologic treatment (immunosuppressants, steroids, analgesics, NSAIDs, muscle relaxants, antiepileptics, antidepressants and nutritional supplements) was good, with MMAS-8 scores = 8 in 69% of cases. When categorizing patients according to the 2016 ACR FM criteria, we found a significant difference in MMAS-8 scores as well as FIQR, FAS, SSS, WPI, SF-36, and BDI scores (unpaired two-sample t-test, Table 2). Fibromyalgia and worse WPI, SSS, FAS, FIQR and BDI scores were associated with risk of low medication adherence (unpaired two-sample t-test and Fisher's exact test, Table 3). <h3>Conclusion:</h3> The results of this study show a high prevalence of FM and FM-related symptoms in rheumatic patients, which may affect medication adherence. Questionnaires can help to identify individuals at higher risk of discontinuing therapy. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0163 PECULIARITIES OF INTERPRETATION OF THE PROCALCITONIN TEST IN RHEUMATOLOGICAL PATIENTS
Authors: G. Koilubaeva, G. Tarasova, A. Bolotbekova
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Assessment of serum procalcitonin (PCT) levels is of great interest in rheumatology in the diagnosis of infections, including infectious complications during active immunosuppressive therapy. <h3>Objectives:</h3> To evaluate the significance of PCT as a specific marker of infection in rheumatological patients. <h3>Methods:</h3> The study included 100 patients with inflammatory rheumatic diseases; PCT in the blood serum was determined for all of them. <h3>Results:</h3> Infectious diseases were diagnosed in 41 out of 100 patients: 11 had a generalized infection, 30 had a focal infection. In the generalized infection group, PCT was significantly higher than in the local infection group (p=0.004) and the group without infection (including those with highly active rheumatic disease), p&lt;0.0001. There were no significant differences in PCT values in the group with local infection and in the group without infection (including those with highly active rheumatic disease, p = 0.8. C-reactive protein levels and erythrocyte sedimentation rate correlated with PCT concentrations in different groups of patients (Table 1). According to ROC analysis, the optimal values of sensitivity (82%) and specificity (98%) of PCT in the diagnosis of systemic infection in patients with rheumatic diseases corresponded to a PCT concentration of ≥2.3 ng/ml, while the area under the curve (AUC) was 0,9, which indicates the high clinical informativeness of the test. According to the area under the characteristic curve (ROC analysis), when differentiating systemic infection/without infection, the effectiveness of the PCT test is "excellent", when differentiating local infection/without infection – "good", when differentiating systemic infection/local infection – "very good". <h3>Conclusion:</h3> Determination of PCT contributes to the diagnosis of generalized infections, and also helps in the differential diagnosis of systemic RZ and infectious pathology. The issues of determining diagnostically significant threshold values of PCT deserve further study in the course of prospective comparative studies. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0169 KAP SURVEY (KNOWLEDGE, ATTITUDES, AND PRACTICES) ON THE MANAGEMENT OF ACUTE SEPTIC ARTHRITIS BY RHEUMATOLOGISTS IN MOROCCO: RESULTS OF A NATIONAL SURVEY
Authors: N. Benzine, H. Rkain, F. Kronbi, S. Ez-Zaoui, I. Bensaghir, R. Honsali, S. Farih, H. Lheri, T. Latifa, R. Abouqal, N. Hajjaj-Hassouni, F. Allali
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Septic arthritis, a potentially severe joint condition, requires prompt and effective management to mitigate its impact on patients. <h3>Objectives:</h3> The objective of this study is to assess the knowledge, attitudes, and practices of Moroccan rheumatologists in the management of acute septic arthritis. <h3>Methods:</h3> A descriptive cross-sectional study was conducted within the Moroccan rheumatology community. A total of 440 rheumatologists received a structured Google Forms questionnaire, comprising four sections: Sociodemographic data, knowledge related to the management of acute septic arthritis, attitudes of rheumatologists, and their practices in the management of acute septic arthritis. A Likert scale ranging from 1 to 5 was utilized. <h3>Results:</h3> Among the 440 contacted rheumatologists, 131 responded to the survey (mean age of 42.9 ± 12.7, 84.8% female, average practice experience of 13.8 ± 11.3 years), yielding a response rate of 33.58%. The results of the KAP survey are presented in Table 1. <h3>Conclusion:</h3> This KAP survey on the management of septic arthritis highlights the need to focus on early, multidisciplinary management, and the standardization of care protocols adapted to our context. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
OP0235-HPR COMPARING A NURSE-LED TREAT-TO-TARGET URATE-LOWERING STRATEGY WITH USUAL CARE FOR GOUT PATIENTS: A PROSPECTIVE COHORT STUDY
Authors: C. Rasmussen, J. W. Larsen, H. M. Christensen, M. B. Larsen, A. M. Thomsen, T. Leismann Andersen, J. Kragh
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Gout is a common inflammatory arthritis linked to reduced quality of life and increased mortality. Currently, gout management, particularly urate-lowering therapy (ULT), is often suboptimal, with less than 40% of patients receiving adequate treatment. As gout prevalence is rising, and rheumatologists and general practitioners face shortages, a new approach is imperative. Nurses successfully manage various diseases in primary care, and studies have shown promising results for patients with gout managed by nurses. <h3>Objectives:</h3> This real-life prospective cohort study aimed to evaluate the effectiveness of nurse-led care employing a treat-to-target strategy for gout management compared to "treatment as usual" over a two-year period. <h3>Methods:</h3> Patients in the nurse-led cohort received nurse-led care for one year before dedicated transitioning to care in general practice. The nurse-led clinic, manned by specialized nurses trained in gout care, implemented a structured treatment plan encompassing consultation, patient leaflets, telephone contacts, and laboratory monitoring. Patients in the usual care cohort were treated with usual care from point of diagnosis until follow-up at two years. Usual care encompassed care within general practice and other departments, such as orthopedic surgery, emergency wards, and internal medicine. The primary outcome was achieving target p-urate levels (&lt;0.36 mmol/L) at 2 years after diagnosis. Secondary outcomes included treatment continuation and achievement of target p-urate levels in specific subgroups. All consecutively gout patients confirmed by microscopy were included. <h3>Results:</h3> Enrolling 286 patients (114 nurse-led care, 172 usual care), both groups were comparable at baseline (Table 1). In the nurse-led group, 83% achieved target p-urate levels, compared to 44% in usual care (p&lt;0.0001) two years after diagnosis. This trend persisted across various patient subgroups (Figure 1). ULT was continued in 98% of the nurse-led group and 73% of the control group, albeit with lower allopurinol doses in usual care (235 vs. 306 mg/day). Nurse-led care involved an average of 2 visits and 3 telephone contacts over 336 days. The 2-year mortality rate was 4% in the nurse-led care group and 23% in the usual care group. <h3>Conclusion:</h3> Nurse-led gout care, employing a targeted approach, outperformed standard care. This study underscores the significance of patient education, engagement, and collaboration with general practitioners in long-term care. It points to a promising avenue for improving gout management, which is vital given the increasing prevalence of this condition and its associated burdens. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB0155 SLEEP AND ANXIETY-DEPRESSIVE DISORDERS IN CHRONIC LOW BACK PAIN PATIENTS
Authors: L. Rouached, M. Ben Messaoud, T. Bjeoui, S. Bouden, A. Ben Tekaya, R. Tekaya, I. Mahmoud, O. Saidane, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Chronic low back pain is both a public health issue with significant economic and social impact and a patient-specific health problem that can exacerbate other comorbidities. <h3>Objectives:</h3> The objective of our study was to assess the impact of chronic low back pain on the occurrence of sleep and anxiety-depressive disorders. <h3>Methods:</h3> This is a cross-sectional study conducted in the rheumatology department of Charles Nicolle Hospital from November 2022 to December 2023. The study included male patients with chronic low back pain. Anxiety-depressive disorders and sleep disorders were respectively assessed using the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). A PSQI score of 5 or higher indicates poor sleep quality. <h3>Results:</h3> Eighty-five patients were included in the study, with a mean age of 53 ± 13 years. The average duration of the disease was 1 year. The majority of patients (60%) had low back pain with radiculopathy. The predominant nerve root involvement was S1 (31%) and L5 (27%). Forty-two percent of patients were sedentary. Fifty-seven percent of subjects were smokers, with an average of 23 pack-years. Pain assessment using the visual analog scale was on average 60 out of 100 [10-100]. The evaluation of neuropathic pain using the DN4 score was on average 2.1 [0-8]. The abnormalities responsible for low back pain and/or lumbosciatica were staged degenerative discopathy in 32% of cases, disc herniation in 28% of cases, narrow lumbar canal in 15% of cases, scoliosis in 9% of cases, Scheuermann's disease in 3% of cases, and vertebral fracture in 2% of cases. According to the HADS score, anxiety was noted in 40% of patients. The evaluation showed a major depressive syndrome in 27% of cases. Sleep disorders were present in all patients with an average evaluation on the PSQI scale estimated at 9 [1-21], indicating poor sleep quality. The presence of anxiety-depressive disorders in patients with low back pain was associated with sedentary lifestyle (p=0.03) and smoking (p=0.01). Sleep disorders were significantly correlated with the intensity of pain (p&lt;0.01). HADS and PSQI scores were statistically significantly correlated (p&lt;0.01). Neuropathic pain was correlated with sleep disorders (p=0.05). <h3>Conclusion:</h3> In our study, chronic low back pain may be associated with anxiety-depressive disorders and sleep disorders. The management of these patients involves systematic screening for these comorbidities to reduce their psychosocial impact. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
AB1455 EXPLORING THE RISK, CAUSALITY RELATIONSHIP AND MOLECULAR MECHANISM BETWEEN SYSTEMIC LUPUS ERYTHEMATOSUS AND THYROID CANCER: A META, MENDELIAN RANDOMIZATION AND TRANSCRIPTOME ANALYSES
Authors: S. Liu, H. Chen, Q. Sun, Y. Liu, X. Yuan, D. Wang, L. Sun
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The relationship between Systemic Lupus Erythematosus (SLE) and Thyroid Cancer (TC) has been extensively explored through numerous studies, however, the results of the different observational cohorts are still controversial. Existing research predominantly relies on clinical findings, with limited insight into the genetic aspect. Further investigation at the genetic level is crucial for a comprehensive understanding of the SLE-TC relationship. <h3>Objectives:</h3> To determine the causal relationship between SLE and TC risk, and to investigate the co-pathogenesis between them. <h3>Methods:</h3> Meta-analysis was first performed to investigate the association between SLE and the risk of TC. MR analysis was then conducted to determine the potential causality between SLE and TC. Sensitivity analyses were applied to validate the reliability of MR results. Transcriptomic data analyses based on the databases were finally performed to identify and construct a SLE-related gene signature (SLEscore). <h3>Results:</h3> The pooled estimate showed a significantly increased overall SIR for TC in SLE of 1.66 (95% CI: 1.35-2.04). The MR analysis demonstrated that genetic predisposition to SLE was casually associated with the increased risk of TC in the European cohort (OR= 1.388, 95% CI: 1.072-1.798, P=0.013). However, no casual associations were observed in the East Asian population. Furthermore, sensitivity analyses proved the robustness of the present MR results. A prognostic SLEscore consisting of four SLE-related genes (IFITM1, RAP1GAP, MT1A, and ALAS2) could distribute patients with TC into the high- and low-risk groups according to survival rates with good predictive ability both in training group and validation group (P&lt;0.05). <h3>Conclusion:</h3> Our MR study provided evidence that genetic changes in SLE were significantly associated with the increased risk of thyroid cancer in the European population, while no causality was found in the East Asian cohorts. Transcriptome data analyses indicated that the SLEscore could serve as a novel biomarker for predicting prognosis when TC and SLE coexisted in patients. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>
OP0112 DEVELOPMENT OF A DEEP LEARNING MODEL FOR AUTOMATED DETECTION OF CALCIUM PYROPHOSPHATE DEPOSITION ON HAND RADIOGRAPHS
Authors: T. Hügle, E. Rosoux, T. Manigold, G. Fahrni, D. Markham, F. Becce
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Chondrocalcinosis is a frequently encountered pathology in rheumatology that can mimic or interfere with other diseases such as rheumatoid arthritis. As indicated in the recently established ACR/EULAR classification criteria, radiographic calcium pyrophosphate deposition (CPPD) affects the triangular fibrocartilage complex (TFCC) but also 2nd and 3rd metacarpophalangeal joints (MCP-2, MCP-3) and the carpometacarpal joint. <h3>Objectives:</h3> We aimed to develop a deep learning approach for automatically and reliably detecting CPPD on hand radiographs, focusing on the TFCC and MCP-2, MCP-3 in a combined (according ACR/EULAR classification criteria) or separate models. <h3>Methods:</h3> Two radiologists independently labeled a dataset of 926 hand radiographs, yielding 319 CPPD positive and 607 CPPD negative cases across the three sites of interest. CPPD presence was then predicted using a convolutional neural network. The model performance was assessed using the area under the receiver operating characteristic (AUROC) and area under the precision-recall (AUPR) curves, with heatmaps Grad-CAM) aiding in case discrimination. <h3>Results:</h3> The algorithm for combined TFCC, MCP-2, and MCP-3 classification showed the most robust performance with a mean AUROC of 0.85 and AUPR of 0.74, a sensitivity of 0.86, a specificity of 0.72, and a precision of 0.62. The TFCC-alone model had a mean AUROC of 0.83 with a lower mean AUPR of 0.69. In contrast, the MCP-2-alone and MCP-3-alone models exhibited mean AUROCs of 0.78-0.82, but lower mean AUPRs of 0.29-0.35. Heatmap analysis revealed activation in the regions of interest for positive cases (true and false positives), but unexpected highlights were encountered possibly due to correlated features in different hand regions. <h3>Conclusion:</h3> This study highlights the potential of an automated model for CPPD detection on hand radiographs with a high performance in the combined and TFCC-alone models. The algorithm could, for example, be used to screen larger databases or Electronic Medical Records for CPPD cases. Future work includes dataset expansion, threshold optimization, preprocessing refinement, and validation with an external dataset. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Thomas Hügle Roche, Novartis, BMS, GSK, Janssen, Galapagos, Atreon, Vtuls, Elisabeth Rosoux: None declared, Tobias Manigold: None declared, Guillaume Fahrni: None declared, Deborah Markham: None declared, Fabio Becce: None declared.
AB0134 PREVALENCE OF CENTRAL SENSITIZATION IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: INFLUENCE ON QUALITY OF LIFE AND POTENTIAL RISK OF FIBROMYALGIA
Authors: M. Stanislavchuk, I. Shapoval, V. Bombela, L. Shvets, L. Perebetiuk, O. Kulchytska
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Axial spondyloarthritis (axSpA) is a chronic rheumatic disease characterized by intensive chronic pain syndrome, that can include different components - nociceptive, neuropathic and nociplastic. From the literature data, it is known that in 15% to 40% of patients with rheumatic diseases, the phenomenon of central sensitization (CS) may occur, which may be one of the mechanisms of nociplastic pain. Chronic pain impacts quality of life (QoL); however, the role of CS in quality of life (QoL) needs clarification. Also, CS underlies the development of fibromyalgia (FM). <h3>Objectives:</h3> Our study aimed to determine the prevalence of CS in patients with axSpA and its influence on QoL and calculate the potential risk of FM. <h3>Methods:</h3> We examined 72 patients with axSpA according to the ASAS Criteria (38.9% female). The mean age of examined patients was 41.51±10.9 years (M±SD). All patients were asked to complete self-reported disease-related questionnaire QoL -ASQoL. To assess the intensity of pain, we used the VAS-Pain scale. To determine CS, the Central Sensitization Inventory (CSI) was used. Also, all patients completed the self-administered questionnaire Fibromyalgia Rapid Screening Tool (FiRST) for FM screening. The study was conducted in compliance with bioethical standards. All data were analyzed using IBM Statistics SPSS 23 software. <h3>Results:</h3> Among 72 patients with axSpA, there were 21 persons (29.2%) with CS (CSI≥40) with mean scores of CSI (M±SD) - 50.09±11.4. Presence of CS in axSpA patients was associated with higher intensity of pain according VAS-Pain scale (8.00±1.73 compared group without CS - 5.88±1.87, p&lt;0.01). Also, presence of CS may significantly influence on the quality of life patients with axSpA (12.7±4.04 compared group without CS - 7.21±3.32, p&lt;0.01). It was confirmed by the significant correlation found between CS and ASQoL (r= 0.578, p&lt; 0.01). FM screening in axSpA patients detected the presence of FM according to FiRST in 61.9% (13/21) in the CS(+) group and in 9.8% (5/51) in the CS(-) group, p&lt;0.05. Also, we calculated the potential risk of FM in axSpA patients: the presence of CS increases the chances of development of FM by more than 14 times (OR = 14.95; 95% CI 4.1744 - 53.5418, p &lt;0.01). <h3>Conclusion:</h3> Our results showed a high prevalence of CS in patients with axSpA and a significant influence on QoL. The presence of CS significantly increases the potential risk of FM. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>