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  • 1
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    SAT0077 CARDIOVASCULAR RISK ASSESSMENT WITH CAROTID ULTRASONOGRAPHY IN ADDITION TO THE TRADITIONAL CARDIOVASCULAR RISK FACTORS IN RHEUMATOID ARTHRITIS PATIENTS: A CASE CONTROL STUDY
    BMJ ; 2020
    In:  Annals of the Rheumatic Diseases Vol. 79, No. Suppl 1 ( 2020-06), p. 973-973
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 973-973
    Abstract: Cardiovascular disease (CV) is the most frequent cause of death in rheumatoid arthritis (RA) patients. It is well known that RA acts as an independent cardiovascular risk factor. Objectives: To assess the CV risk in RA patients using carotid ultrasonography (US) additionally to the traditional CV risk factors. Methods: A prospective transversal case control study was performed, including adult RA patients who fulfilled ACR/EULAR 2010 criteria and healthy controls matched according to CV risk factors. Population over 75 years old, patients with established CV disease and/or chronic kidney failure (from III stage) were excluded. The US evaluator was blinded to the case/control condition and evaluated the presence of plaques and the intima-media thickness. Statistical analysis was performed with R (3.6.1 version) and included a multivariate variance analysis (MANOVA) and a negative binomial regression adjusted by confounding factors (age, sex and CV risk factors). Results: A total of 200 cases and 111 healthy controls were included in the study. Demographical, clinical and US data are exposed in table 1. Not any difference was detected in terms of CV risk factors between the cases and controls. In both groups a relationship between age, BMI and high blood pressure was detected (p 〈 0.001). Table 1. Table 2. RA basal characteristics Disease duration (years) 16,98 (11,38) Erosions (X-Ray of hands/feet) 163 (81,5%) Seropositive (RF/anti-CCP) 146 (73%) Extra-articular symptoms 44 (22%) Intersticial difusse lung disease 10 (5%) Rheumatoid nodules 14 (7%) Prednisone use 103 (51,5%) Median dose of Prednisone last year (mg) 2,34 (2,84) sDMARDs Methotrexate 104 (52%) Leflunomide 29 (14,5%) Hydroxycloroquine 9 (4,5%) bDMARDs 89 (44,5%)  TNFi 41 (20,5%)  Abatacept 15 (7,5%)  IL6i 22 (11%)  RTX 11 (5,5%) JAKi 26 (13%)  Baricitinib 11 (5,5%)  Tofacitinib 15 (7,5%) DAS 28-ESR 3,1 (2,3, 3,9) SDAI 7,85 (4,04, 13,41) HAQ 0,88 (0,22, 1,5) RF (U/mL) 51 (15, 164,25) Anti-CCP (U/mL) 173 (22, 340) Patients showed higher intima-media (both right and left) thickness compared to controls (p 〈 0.006). Moreover it was also related to the disease duration and DAS28 score (p 〈 0.001). A higher plaque account was noted in cases(p 〈 0.004) and it was also related to the disease duration (p 〈 0.001). Conclusion: RA implies a higher CV risk. Traditional CV risk factors explains only partially the global risk. These findings support that RA acts as an independent cardiovascular risk factor. Disclosure of Interests: None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2020-eular.6420
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    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
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  • 2
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    AB1316 PREVALENCE, DIAGNOSTIC DELAY AND TREATMENT PROFILE OF PATIENTS WITH MONOGENIC AUTOINFLAMMATORY DISEASES IN AN ADULT RHEUMATOLOGY SERVICE OF A TERTIARY HOSPITAL.
    BMJ ; 2022
    In:  Annals of the Rheumatic Diseases Vol. 81, No. Suppl 1 ( 2022-06), p. 1765.1-1765
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 81, No. Suppl 1 ( 2022-06), p. 1765.1-1765
    Abstract: Monogenic autoinflammatory diseases (MAISs) have a low prevalence and a delay in their diagnosis, with the risk of complications being AA amyloidosis the most serious. Biological therapy has been a fundamental pillar in improving the prognosis of these diseases, reducing said risk. Objectives We aim to study the prevalence, diagnostic delay and treatment profile of MAISs patients in an adult rheumatology service of a tertiary hospital. Methods Observational and retrospective study of patients with MAISs, excluding those without genetic test or negative genetic test, with a follow-up period of 17 years (2005-2021). Demographic, clinical and therapeutic variables were collected. Results 24 patients (50% men) were included with a mean age of 27,88 ± 11.57y. The prevalence of MAISs was 0.34%, from a total of 7,032 patients followed up in the Rheumatology service during 2020. Familial Mediterranean Fever (FMF) was the most frequent (70.83%). FMF, Tumor Necrosis Factor Receptor Associated Periodic Syndrome (TRAPS), and Hyperimmunoglobulin D Syndrome (HIDS) had a median age at symptom onset of 6, 8.5 and 2 years, a median diagnostic delay of 6, 8.75 and 11 years and a mean duration of the bouts of 4.47 (2.87), 12.25 (7.59) and 6 (2.65) days, respectively. The most frequent symptoms were: fever (79.17%), arthralgia/arthritis (79.17%) and abdominal pain (75%). During follow up 20.83% received glucocorticoids (GC) chronically (more than 3 months), 79.16% colchicine, 16.66% methotrexate and 41.66% biological therapies (Table 1). At the end of follow up 4.17% were receiving GC, 79.16% colchicine, 4.16% methotrexate and 33.33% biological therapies (Table 1). No AA amyloidosis or deaths were reported. Table 1. MAISs Gender (men % ) Biological therapies prescribed during follow up (n ) Patients under biological therapies at the end of follow up (n ) FMF (n=17 ) 41.17% Anakinra: 2 Anakinra: 3 Canakinumab: 2 Canakinumab: 2 Etanercept: 1 Tocilizumab: 1 TRAPS (n=4 ) 100% Anakinra: 1 Canakinumab: 1 Canakinumab: 1 Etanercept: Tocilizumab: HIDS (=3 ) 66.66% Anakinra: 3 Canakinumab: 2 Canakinumab: 3 Etanercept. 1 Conclusion MAISs prevalence was 0.34%. The diagnostic delay was of years, more than a decade for HIDS. Colchicine was widely used and well tolerated. Synthetic DMARDs had little role in treatment. Biological therapies were prescribed in a third of patients, anti IL-1 being the most used. Disclosure of Interests None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2022-eular.4143
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    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2022
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  • 3
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    AB1256 TRANSITIONAL CARE IN JUVENILE IDIOPATHIC ARTHRITIS: TIMING, PREVALENCE OF SUBTYPES AND TREATMENT PROFILE IN A SPANISH TERTIARY HOSPITAL.
    BMJ ; 2022
    In:  Annals of the Rheumatic Diseases Vol. 81, No. Suppl 1 ( 2022-06), p. 1738.1-1738
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 81, No. Suppl 1 ( 2022-06), p. 1738.1-1738
    Abstract: Juvenile Idiopathic Arthritis (JIA) is the leading cause of chronic inflammatory rheumatic disease in children. It’s classified into subtypes with different relative prevalences depending on geographical area (Oligarticular subtype predominates in Western Europe/North America. Enthesitis-related arthritis subtype predominates in Eastern Europe/Asia). To ensure continuity of care in adult rheumatology services, a systematic transition process is recommended. Various authors recommend that the process, of which pediatric and adult rheumatology teams should be part, begins around 14 years and ends around 18 years of age. Objectives We aim to study the age, relative prevalence and treatment profile in JIA subtypes at the beginning of the transitional care. Methods Descriptive and cross-sectional study of patients with JIA (according to ILAR criteria), diagnosed and treated in the pediatric rheumatology service and seen in the transitional care unit of the adult rheumatology service within the same tertiary hospital between January 2013 and December 2018. Demographic, clinical, analytical and treatment data were collected at the first visit to the transitional care unit. Results 72 patients were included (46 women) mean age at diagnosis of 9.5 ± 4.6y and mean of 11.3 ± 4.36y from diagnosis to the first visit at the transitional care unit. 27.7% were diagnosed with oligoarticular JIA, 20.8% with arthritis-enthesitis JIA, 19.4% with Rheumatoid Factor negative (RF-) polyarticular JIA, 11.1% with systemic JIA, x9.7% with undifferentiated JIA, 5.5% with Rheumatoid Factor positive (RF+) polyarticular JIA and 5.5% of psoriatic arthritis. The mean age at the first visit to the transitional care unit was 20.81 ± 2.96y (no differences between subtypes). Oral ulcers (20.8%), anterior uveitis (13.8%) and enthesitis (13.8%) were the most frequent extra-articular manifestations. 56.9% had antinuclear antibodies (ANA) titers 〉 1/160 at some point in course of disease (Table 1). 43% were treated with methotrexate, 38% with biological therapies, 11.% with glucocorticoids (GC) and 22.% had no treatment. Table 1. JIA subtypes Gender Age at diagnosis Age at first visit transicion care unit ANA positivity TNF alfa inhibitors Tocilizumab Abatacept Methotrexate Leflunomide GC NSADs No treatment n (%) (% woman ) Mean (SD ) Mean (SD ) Oligoarticular (n=20) 77% 7,35 (4,88) 20,55 (2,91) 85% Etanercept: 3 (15%) 1 (5%) 0 11 (55%) 1 (5%) 3 (15%) 5 (25%) 5 (25%) Adalimumab: 2 (10%) Arthritis/ Enthesitis 27% 10,07 (4,3) 19,67 (2,38) 33,33% Etanercept: 4 (26,66%) 0 0 6 (40%) 1 (6,67%) 0 5 (33.33%) 2 (13,33%) Adalimumab: 1 (6,66%) (n=15) RF- Polyarticular (n=14) 77% 10,64 (4,99) 22,14 (2,48) 57,14% Etanercept: 2 (14,28%) 1 (7,14%) 0 7 (50%) 0 1 (7,14%) 7 (50%) 2 (14,28%) Adalimumab: 2 (14,28%) Infliximab: 1 (7,14%) Systemic (n=8) 56% 9,12 (4,88) 20,75 (3,58) 12,5% Etanercept: 1 (12,5%) 1 (12,5%) 0 2 (25%) 0 2 (25%) 0 3 (37,5%) Adalimumab: 1 (12,5%) Infliximab: 1 (12,5%) Undifferenciated (n=7) 61% 11 (2,24) 19,57 (3,46) 57,14% Etanercept: 1 (14,29%) 0 0 1 (14,29%) 0 1 (14,29%) 2 (28,57%) 3 (20%) RF+ Polyarticular (n=4) 100% 14,5 (1,29) 22,5 (4,04) 75% 0 1 (25%) 1 (25%) 3 (75%) 0 0 2 (50%) 1 (25%) Psoriatic Arthritis (n=4) 50% 7,5 (σ: 3,7) 22,25 (σ: 2,2) 75% Etanercept: 1 (25%) 2 (50%) 0 1 (25%) 0 0 0 0 Golimumab: 1 (25%) Conclusion The oligoarticular form was the most prevalent subtype of JIA, similar to previously published series from Western Europe. The first visit at the transition care unit occurred significantly later than recommended by various authors. The most frequent treatment was methotrexate. The use of biological therapies was high, with TNF alpha inhibitors being the most widely used, especially etanercept. The use of glucocorticoids was low. A non-negligible number of patients were treatment free. Disclosure of Interests None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2022-eular.4126
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    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2022
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  • 4
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    FRI0437 CT GUIDED NEEDLE BIOPSY IN VERTEBRAL OSTEOMYELITIS: RELIABILITY ANALYSIS AND STUDY OF WHICH FACTORS COULD INFLUENCE ON THE RESULT
    BMJ ; 2020
    In:  Annals of the Rheumatic Diseases Vol. 79, No. Suppl 1 ( 2020-06), p. 816.2-816
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 816.2-816
    Abstract: Vertebral Osteomyelitis is an infectious disease of the vertebral body, also termed spondylodiscitis if the intervertebral disc is involved (which its avascular). Since the bacteriological characterization is in many times difficult and blood cultures are often negative, a bone biopsy is in most of the cases encouraged. Objectives: The aim of this study is to analyze which factors could influence on the result of a CT guided biopsy (CTGB) in vertebral spondylodiscitis patients. Methods: A retrospective observational study was performed including patients diagnosed of spondylodiscitis in a single center who underwent a CTGB. Demographic features and comorbidities, acute phase markers, microbiological results, radiological data, antibiotic exposure, medical complications and the clinical outcomes were also collected for analysis. Standard procedure in our center is performed by Musculoskeletal Specialized Radiologist under local anesthesia and CT control. Abscess sample is collected with a 18G needle with coaxial technique, trying to obtain at least 3 samples. For discal space, a thicker needle (13.5G-15G) is used. A logistic regression including cofounding factors was performed using R software. Results: A total of 86 were included with a mean age of 62.75 (14.98) years old and predominationg male sex (68.60%). 15 patients (17.44%) presented any kind of immunosuppression. Clinical data are summarized in Table 1. Blood cultures were positive in 39.71% and sample culture showed a reliability of 49%. Organism which grew were gram + (66.67%), gram – (12.70%), mycobacteria (12.7%) and fungi (7.94%). In only 16 cases (18.6%) there was isolated the same organism in blood and on biopsy culture. From admission to procedure, a mean of 6 days was observed. Antibiotic treatment had a median value of 2 days (0, 6) and its exposure did not modified the culture positivity (IC 95% [0.274-5.211] p=0.816). Detailed analysis was performed looking for the influence of the days of exposure, which also failed (IC 95% [0.939-1.101] p=0.747). The longer duration of the pain was related to a higher probability of obtaining a negative result on the biopsy (IC 95% [1.004-1.035] p=0.026) (graphic 1). Neither fever (p=0.303) or higher CRP (IC 95% [0.992-1.006] p=0.761) value modified the culture result. Table 1. Demographic and clinical characteristics. N=86 % Clinical history High blood pressure 42 48.84 Diabetes Mellitus 19 22.09 Liver cirrhosis 16 18.60 Chronic kidney failure 13 15.12 Active Systemic Malignancy* 2 2.33 Rheumatoid arthritis* 3 3.49 Spondyloarthritis* 1 1.16 HIV infection* 4 4.65 Solid organ transplant receptor* 3 3.49% Systemic Amyloidosis* 1 1.16 Splenectomy* 2 2.33 Previous spine pathology 50 58.14 Underlying/associated endocarditis 2 2.33% *Considered as immunosuppressed patients Conclusion: Even in cases under antibiotic treatment, CTGB displays an acceptable reliability. The longer the length of painful period before diagnosis was related to a higher chance of obtaining a negative result on culture. This result could be explained by a greater aggressiveness of pyogenic organisms that perhaps congregate in the lesser time span instead of non-pyogenic agents, that could deliver in more silent infection. References: [1]IDSA Clinical Practice Guidelin es for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults Disclosure of Interests: None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2020-eular.6383
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    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
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  • 5
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    AB1048 RHUPUS SYNDROME IN A TERTIARY HOSPITAL
    BMJ ; 2020
    In:  Annals of the Rheumatic Diseases Vol. 79, No. Suppl 1 ( 2020-06), p. 1815.1-1815
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 1815.1-1815
    Abstract: Rhupus syndrome (RhS) is a rare combination of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Different studies describe RhS cases that begin with erosive arthritis and the presence of rheumatoid factor (RF) and/or anti CCP and then the SLE symptoms. Objectives: Despite the fact that RhS shows a low prevalence, it would be useful to know clinical characteristics of RhS patients since their therapy and outcome differ from those having RA or SLE alone. Methods: Retrospective study with systematic revision of electronic clinical records of RhS patients was performed. Demographic, clinical and immunological data were collected. Results: Eight RhS patients were included (all fulfilled SLICC 2012 criteria for SLE and ACR 2010 for RA). Mean age was 67.3 (45-84) years (7 were female). In 3 cases RA was the first diagnosis with a mean evolution of 4.5 years until SLE diagnosis. In contrast, in 5 cases SLE was the first diagnosis with a mean evolution of 7.2 years until RA diagnosis. Photosensitivity and arthritis were the predominant clinical manifestations. One patient presents pericarditis and other case showed rheumatoid nodules in elbows. Renal, pulmonary or neurological affection was no reported. 4 patients were under biological/JAK inhibitors therapies (2 abatacept, 1 rituximab and 1 baricitinib) with favorable response of treatment. Conclusion: In contrast to other series, only the 37.5% of our RhS cases begins with polyarticular seropositive arthritis. The 62.5% started with SLE symptoms as haematological alterations, cutaneous and serological manifestation, and showed longer progression to have polyarticular affection. Thus, RhS diagnosis is earlier in patients that begin with RA symptoms. 4 RhS patients were refractory to DMARd treatments, where biological/JAK inhibitors therapies are needed. Disclosure of Interests: None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2020-eular.3468
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    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
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  • 6
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    FRI0124 EFFICACY AND SAFETY OF BARICITINIB AND TOFACITINIB IN RHEUMATOID ARTHRITIS: DATA FROM REAL-WORLD
    BMJ ; 2020
    In:  Annals of the Rheumatic Diseases Vol. 79, No. Suppl 1 ( 2020-06), p. 643-644
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    In: Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 643-644
    Abstract: Oral targeted synthetic disease modifying anti-rheumatic drugs (DMARDs) including baricitinib and tofacitinib (JAKi), are the latest addition to the therapeutic options for rheumatoid arthritis (RA). Objectives: To assess and compare the efficacy and safety of Baricitinib and Tofacitinib in RA patients in real life. Methods: An observational longitudinal retrospective study was performed including RA patients who fulfilled the ACR/EULAR 2010 criteria and initiated treatment with Baricitinib or Tofacitinib from September 2017 to January 2020. Demographic, clinical and laboratory parameters and adverse events were collected. Infection was considered severe if it implied hospitalization. Statistical analysis was performed with R software (3.6.1) which consist in Bayesian lineal regression models including monotonic effect and Kaplan-Meier survival curves. Results: 98 patients were included. Basal characteristics are exposed in table 1. Table 1. Basal characteristics Baricitinib n=32 Tofacitinib n= 66 Female sex 96,88% 84,85% Age 53,2 (13,1) 55,4 (13,4) Disease evolution (years) 12,6 (9,1) 14,4 (8,6) Monotherapy 14 (21,21%) 20 (30,3%) DMARD  Metotrexate 13 (40,63%) 24 (36,36%)  Leflunomide 4 (12,5%) 10 (15,15%)  Hydroxychloroquine 1 (3,7%) 2 (3,03%) Glucocorticoids 22 (68,75%) 48 (72,73%) First indication 6 (18,75%) 22 (33,33%) After bDMARD failure 24 (75%) 44 (66,67%) In both groups, a significative reduction of disease activity scores was noted (graphics 1 and 2). Any difference between both treatments was detected in terms of efficacy even in first line, after bDMARD failure, in monotherapy nor combined therapy. Safety data are exposed in table 2 and neither was detected any statistical difference. In 2 of the cases of herpes zoster infection developed postherpetc neuralgia. Definitive discontinuation was registered in 23 cases (23,45%) accounting 6 (6,12%) for intolerance symptoms such as dizziness, nausea or headache (4 with Tofacitinib and 2 in Baricitinib group). Table 2. Safety data Baricitinib n=32 Tofacitinib n=66 Temporary interruption 24 (75%) 50 (75,75%) Adverse reaction 8 (25 %) 17 (25.75%) Infections 22 (68,75%) 46 (69,69%) Serious infections 3 (9,37%) 5 (7,57%) Herpes Zoster 2 (6,25%) 2 (3,03%) Permanent discontinuation 9 (28,13%) 14 (28,2%) Intolerance 2 (6,25) 8 (12,12%) Primary failure 1 (3,13%) 2 (3,03%) Secondary failure 5 (15,63%) 3 (4,54%) Infections 1 (3,13) 1 (1,51%) Drug survival 23 (71,87%) 52 (78,78%) Survival analysis did not showed any difference between groups. Conclusion: Baricitinib and Tofacitinib are both comparable in terms of efficacy and safety in real world conditions. Graphic 1. Evolution of DAS28 Graphic 2. Evolution of HAQ Disclosure of Interests: None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2020-eular.6321
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
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  • 7
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    AB0327 CARDIOVASCULAR RISK ASSESSMENT IN RHEUMATOID ARTHRITIS WITH CAROTID ULTRASONOGRAPHY AND CARDIOVASCULAR RISK SCORES: A CASE CONTROL STUDY
    BMJ ; 2022
    In:  Annals of the Rheumatic Diseases Vol. 81, No. Suppl 1 ( 2022-06), p. 1287.2-1288
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    In: Annals of the Rheumatic Diseases, BMJ, Vol. 81, No. Suppl 1 ( 2022-06), p. 1287.2-1288
    Abstract: The risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is higher than individuals from the general population. This excess risk might be explained by the chronic inflammation. Objectives To assess the Cardiovascular Risk (CV) in Rheumatoid Arthritis (RA) patients using the Framingham Score, SCORE (systematic coronary risk evaluation) and carotid ultrasound additionally to the traditional cardiovascular risk factors. Methods A single center case control study was performed. Inclusion criteria were adult RA patients (cases) and matched healthy adults in terms of age, sex, and CV risk factors (controls). Population over 75 years old, patients with established CV disease and/or stage III chronic kidney disease were excluded. Controls with other inflammatory diseases, pregnant women or any malignancy were also excluded. This study was performed from July-2019 to January-2020. The US study included presence of plaques, plaque number and measurement the intima-media thickness in both right and left carotid. Scores were multiplicated x1.5 according to EULAR recommendations. Results Overall, a total of 200 cases and 111 healthy controls were included in the study. Demographical and clinical variables were comparable between cases and controls and are shown in Table 1. In both groups a relationship between age, BMI and high blood pressure was detected (p 〈 0.001). RA patients had a Disease duration of 18.93 years (11.36); 163 (81.5%) Erosions (X-Ray of hands/feet), Extra-articular symptoms 44 (22%), Prednisone use 103 (51.5%) with Median dose of Prednisone last year 2.34 (2.84). In treatment with Methotrexate 104 (52%), bDMARDs 89 (44.5%) and JAK inhibitor 26 (13%). US study revealed a higher IMT in both right and left carotid arteries with greater presence of plaques in patients than in controls (CI 95% [1.542; 3.436], p 〈 0.001). Plaques were found in both carotid arteries in the 32% of cases and 9.91% of controls. The longer duration of RA was related to a higher presence of carotid plaques (95% [1.015; 1.056], p 〈 0.001). US and blood test results are shown in Table 3. SCORE and Framingham correlated with the CV estimation with US (p 〈 0.001), however, seemed to underestimate the global findings in cases (p 〈 0.001). Table 1. Demographic, clinical characteristics, Ultrasound Results, SCORE and Framingham of patients and controls. Characteristic RA cases n=200 Healthy controls n=111 Age - years 62.05 (10.75) 58.3 (12.14) Female sex – number (%) 163 (81.5) 73 (65.77) BMI – value (ds) 26.38 (5.03) 26.2 (5.19) Smoking habit Never Smoked 107 (53.5%) 71 (63.96%) Ex-smoker 51 (25.5%) 20 (18.02%) Active smoker 42 (21%) 20 (18.2%) Race – number (%)Caucasian 186 (93) 62 (93.94) Comorbidities – number (%) High blood pressure 83 (41.5%) 34 (30.63%) Dyslipemia 93 (46.5%) 39 (35.14%) Blood pressure -- mmHg 127.2(18.36)/78.67(10.21) 127.77(19.42)/78.28 (10.59) Ultrasound findings Right carotid cIMT 0.78 (0.15) 0.62 (0.11) Left carotid cIMT 0.77 (0.14) 0.64 (0.12) Plaques 101 (50.5%) 32 (28.83%) Bilateral 64 (32%) 11 (9.91%) Right carotid 17 (8.5%) 7 (6.31%) Left carotid 20 (10%) 14 (12.61%) SCORE Very Hihg 13 (6.5%) 5 (4.5%) High 31 (15.5%) 15 (13.51%) Low 156 (78%) 91 (81.98%) Framingham High 76 (38%) 33 (29.7%) Low 124 (62%) 78 (70.3%) Conclusion Cardiovascular risk calculators such as Framingham and SCORE are useful in RA risk estimation. However, those tools may underestimate the real risk, so carotid US might be valuable. Disclosure of Interests None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2022-eular.5225
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    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2022
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    AB0597 PULMONARY FUNCTION IN PATIENTS DIAGNOSED OF EARLY SYSTEMIC SCLEROSIS: A NEW TOOL FOR SYSTEMIC SCLEROSIS CLASIFFICATION?
    BMJ ; 2020
    In:  Annals of the Rheumatic Diseases Vol. 79, No. Suppl 1 ( 2020-06), p. 1595.1-1595
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 1595.1-1595
    Abstract: Interstitial lung disease (ILD) is a frequent complication of systemic sclerosis (SSc) and is often progressive and has a poor prognosis. A restrictive ventilatory defect could suggest ILD either alone or in combination with pulmonary arterial hypertension. Nowadays, Early-SSc is well defined as preliminary stage of SSc. Patients who meet criteria for Early-SSc could benefit from an early diagnosis of pulmonary involvement. Objectives: Our aim was to assess the pulmonary function in patients diagnosed of Early SSc. Methods: Retrospective observational study of a wide and unselected series of patients diagnosed as Early-SSc from a single university hospital from 2012 to 2019. Patients were classified as Early-SSc following Le Roy criteria. Despite this, patients already did not meet 2013 ACR/EULAR classification criteria for SSc. We reviewed pulmonary function through conventional spirometry and diffusing capacity of lung for carbon monoxide (DLCO). Results: We included 56 patients with a mean age of 52.3±12.1 years (96.4% women; 3.6% men). At the diagnosis of Early-SSc, no one of our patients evidenced a restrictive ventilatory pattern. DLCO was below normal limits in 18 patients (32.1%). Small airway obstruction expressed according decreased maximal (mid-) expiratory flow (MMEF) 25-75 was present in 24 patients (42.8%). After a mean follow-up period of 38.3±2.4 months, 29 (51.8%) patients fulfilled 2013 ACR/EULAR criteria. The average time between diagnosis of Early-SSc and achieve SSc classification was 24.4±1.8 months. The remaining 27 patients continued classified as Early-SSc. An analysis of the subgroup of patients which progressed to SSc showed that DLCO was decreased in 15 of those 29 patients (51.7%) and 18 of 29 patients (62.1%) presented decreased MMEF 25-75. Comparing with the subgroup of patients which not progressed to SSc were significant differences (Decreased DLCO: 51.7% vs 11.1%; p=0.02 and decreased MMEF 25-75: 42.8% vs 22.2%; p=0.05). The analysis of pulmonary function of the subgroup of patients continued classified as Early-SSc after follow-up period did not show significative changes after follow-up. Conclusion: In our study, a third of the patients classified as Early-SSc presented at diagnosis abnormal values of DLCO and/or signs of small airway obstruction without the presence of a restrictive ventilatory pattern. Moreover, this pulmonary disfunction was significantly more frequent in patients who progressed to definitive SSc. Patients which remains classified as Early-SSc did not experience significative changes. Our results support the concept that pulmonary function was impaired in Early-SSc and that I should probably be considered for future Early-SSc classification criteria. Disclosure of Interests: None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2020-eular.4423
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 1481557-6
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  • 9
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    POS1157 CONCORDANCE BETWEEN THE QUANTIFERON-TB GOLD IN-TUBE AND TUBERCULIN TEST FOR THE DIAGNOSIS OF LATENT TUBERCULOSIS INFECTION IN PATIENTS WITH RHEUMATIC DISEASES
    BMJ ; 2021
    In:  Annals of the Rheumatic Diseases Vol. 80, No. Suppl 1 ( 2021-06), p. 857.1-857
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 80, No. Suppl 1 ( 2021-06), p. 857.1-857
    Abstract: Patients with rheumatic diseases (RD) are at higher risk of latent tuberculosis infection (LTBI) reactivation. To detect and treat it before starting treatment, especially with biological therapies, decrease the reactivation risk. Diagnosis is carried out by the tuberculin skin test (TST) or interferon-gamma release assays (IGRAs), IGRAs might be more specific and sensitive. Objectives: We aim to analyze the concordance between QuantiFERON-TB Gold In-Tube (QTF) and TST for the diagnosis of LTBI in patients with rheumatic diseases. Methods: A retrospective observational study was conducted including patients diagnosed with RD screened for LTBI with both TST and QTF (2014-2018). Demographical and clinical variables at screening and at follow-up were collected. The concordance between both tests has been estimated as categorical variables using Cohen´s Kappa test, considering “poor” if it is ≤ 0,20; “low” if 0,20 〈 k ≤ 0,40, “moderate” if 0,40 〈 k ≤ 0,60, “substantial” if 0,60 〈 k ≤ 0,80 and “optimal” if k 〉 0,80. Results: 167 patients were included (57% women) with a mean age of 52±16 years. 42% of them had systemic autoimmune diseases, 22% spondyloarthropathies and 36% other RD. 2 had history of past active tuberculosis (TB). At the time of screening, 46.11% were treated with GC. LTBI was diagnosed in 35 patients: 15 had both QTF and TST positive, 16 only QTF positive and 4 only TST positive. 12 from 31 QTF positive patients were treated with GC at the time of screening. 3 from 19 TST positive patients were treated with GC at the time of screening. After LTBI screening 62 patients received biological treatment, 4 of them had both test positive, 6 only QTF positive and 2 only TST positive. 11 received LTBI treatment according to the hospital protocol (isoniazid for 6 to 9 months). 10 completed treatment, 1 did not because of intolerance and did not receive other treatment. 1 patient with only TST positive was considered a false positive and did not receive treatment. During follow-up no TB reactivation was reported. 23 patients with LBTI received treatment other than biological therapy during follow-up, of them 8 received LBTI treatment. There was no TB reactivation during follow up. The Kappa concordance between QTF and TST was estimated: moderated in the whole sample, poor in the patients treated with GC at screening, and substantial when the patients treated with GC at screening were excluded. Results are shown in Table 1. Table 1. Kappa concordance between QTF and TST. Conclusion: QTF seems to be the most appropriate LTBI screening test in patients with RD treated with GC. Screening and treatment of LTBI in patients with RD treated with or without biological agents was effective in reducing TB reactivation. Disclosure of Interests: None declared.
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2021-eular.3157
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 1481557-6
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  • 10
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    AB0134 Oxidative Stress Levels Are Increased in Systemic Lupus Erythematosus Patients with A Higher Accumulative Damage Score
    BMJ ; 2016
    In:  Annals of the Rheumatic Diseases Vol. 75, No. Suppl 2 ( 2016-06), p. 942.2-943
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 75, No. Suppl 2 ( 2016-06), p. 942.2-943
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2016-eular.3183
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2016
    detail.hit.zdb_id: 1481557-6
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