GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    POS1365 ANNALYSIS OF PRO-INFLAMMATORY BIOMARKERS IN A POLYMYALGIA RHEUMATICA COHORT DURING THE ACUTE ONSET OF THE DISEASE
    BMJ ; 2021
    In:  Annals of the Rheumatic Diseases Vol. 80, No. Suppl 1 ( 2021-06), p. 964.2-965
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 80, No. Suppl 1 ( 2021-06), p. 964.2-965
    Abstract: Polymyalgia Rheumatica (PMR) is a common inflammatory disease found in elderly patients and results in a high burden of long-term CS-based therapies. Most patients diagnosed with PMR have a good evolution following the introduction of medium-dose glucocorticoid treatment. However, the need to maintain corticosteroid treatment for an extended period (around 12-15 months) is often the norm in standard clinical practice. Activation of Th-17 lymphocytes with the consequent action of pro-inflammatory cytokines such as IL-1, IL-6, IL-17, or IL-23 is well known in the acute phase of this disease and treated by glucocorticoids or IL-6 blockers satisfactorily. However, activation of Th-1 lymphocytes appears to play a leading role in a chronic phase of the disease through the activation of INF-gamma and IL-12. Objectives: Our aim was to assess proinflammatory biomarkers in a cohort of patients with PMR during the acute onset of the disease and its possibly relationship with corticosteroid dose. Methods: Prospective study of a wide and unselected series of patients classified as PMR following 2012 ACR/EULAR classification criteria for PMR. Patient evaluations were performed at baseline and at 3 and 6 months after initiation of corticosteroid therapy. Serum levels of the proinflammatory biomarkers interleukin-6 (IL-6), interleukin-8 (IL-8), CXC motif ligand 10 chemokine (CXCL10), CXC motif ligand 9 chemokine (CXCL9), CXC motif ligand 2 chemokine (CXCL2) and CC motif ligand 2 chemokine (CCL2) were measured in PMR patients and in healthy controls. Results: A total of 25 patients with PMR were studied (32% men; 68% women). The mean age was 72.72 ±9.32 years (range 65-79). We also included 35 healthy controls. In reference to laboratory parameters and proinflammatory biomarkers at the onset of PMR, the mean values (± standard deviation) were as follows: C reactive protein (CRP): 28.4±26.6 mg/dL; erythrocyte sedimentation rate (ESR): 54.3±21.3 mm/h; haemoglobin: 12.6±1.6 g/dL; IL-6: 17.6±30.1 pg/mL; IL-8: 10.1±6.9 pg/mL; CXCL10: 259.4±290.7 pg/mL; CXCL9:5175±4396.8 pg/mL;, CXCL2: 25.9±12.5 pg/mL; CCL2: 471.3±152.9 pg/mL. IL-6, IL-8 and CXCL9 levels were significantly increased in PMR patients comparing with the healthy control group. The Health Assessment Questionnaire (HAQ) performed at the onset of the PMR yielded a mean value of 1.6±0.6. The mean dose of prednisone employed at the onset of PMR was 14.8±5.6 mg/day. After 6 months, the mean dose of prednisone employed was 6.7±3.9 mg/day, the median [range] value for CRP was 3.1 [1.75-7.2] mg/dl and the mean value for ESR was 22±14 mm/h. Regarding relationship between proinflammatory biomarkers studied and doses of prednisone employed, no differences were observed. Regarding pain perception and disability, we observed higher visual analogic scale values (VAS) in association with higher IL-6 levels (P=0.03) and higher HAQ values in association with higher IL-6 and CXCL2 values. After 6 months, our patients showed an excellent evolution, and no complications were observed. Conclusion: During the acute onset of PMR, IL-6, IL-8 and CXCL9 levels were significantly increased in our population of PMR patients. No differences were observed between proinflammatory biomarkers studied and doses of prednisone employed. Disclosure of Interests: None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2021-eular.3114
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 1481557-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    AB0165 THE ROLE OF CXCL4, CXCL8 AND GDF-15 IN SYSTEMIC SCLEROSIS
    BMJ ; 2020
    In:  Annals of the Rheumatic Diseases Vol. 79, No. Suppl 1 ( 2020-06), p. 1382.2-1383
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 1382.2-1383
    Abstract: Systemic Sclerosis (SSc) is an autoinmune disease that can affect several organs and its mortality is fundamentally related to its pulmonary involvement. It is mandatory to seek for biomarkers that help us with early diagnosis and that are also useful for predicting organic involvement, so that we can adjust the diagnostic and therapeutic approach. Objectives: Our aim was to check if the presence of CXCL4, CXCL8 and GDF-15 is greater in the disease than in healthy population, and also their involvement in organic damage. Methods: Observational and cross-sectional study, with a prospectively performed protocol, of patients diagnosed of SSc according to ACR/EULAR 2013 criteria. Demographic, clinical, analytical, activity (EUSTAR index), severity (Medsger scale and modified Rodnan index), health perception (SF36) and disability (HAQ and Cochin test) variables were collected. Moreover, Videocapillaroscopy (VCL) and Respiratory Function Test were made, as well High Resolution Lung Tomography and Echocardiography in order to describe pulmonary features. Serum levels of CXCL4, CXCL8 and GDF-15 were measured in SSc patients and in healthy controls. Results: A total of 42 patients (95.4% women) were included, with an average age of 59.2 years. The median of years since diagnosis was 4, by 6 since the first non-Raynaud symptom. 20 patients were diagnosed with limited SSc, 20 patients diffusely and 2 patients with SSc without scleroderma. 42 healthy controls were also included. We found significantly higher levels of GDF-15 in patients with SSc (P 〈 0.001), without significant differences in CXCL4 and CXCL8 levels between patients with SSc and healthy controls. The presence of GDF-15 was associated with diffuse SSc (P=0.009), pulmonary arterial hypertension (P=0.038), interstitial lung disease (P=0.004), decreased forced vital capacity (FVC), (P=0.002), high serum titles of antiScl70 (P=0.006), increased disease activity measured by EUSTAR index (P=0.001), as with capillary dilations in Capillaroscopy (P=0.015). Moreover, we found an association between CXCL4 levels and the consumption of complement C3 fraction (P=0.008) and skin involvement (higher Rodnan modified score), (P = 0.001); not finding association with lung involvement or other features (spirometric or analytical changes, capillaroscopy or functional tests). Attending to CXCL8, it was associated to consumption of the C4 fraction of complement (P=0.013) and the presence of tortuosities in capillaroscopy (P=0.02) with no other significant findings. Conclusion: The presence of GDF-15 is associated with diffuse SSc, lung impairment, disease activity and changes in capillaroscopy. In addition, CXCL4 was only associated with skin involvement, while CXCL8 was not related to any organic damage in our patients. Disclosure of Interests: None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2020-eular.5019
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 1481557-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    AB1066 EFFICACY AND SAFETY OF APREMILAST IN BEHÇET DISEASE PATIENTS
    BMJ ; 2020
    In:  Annals of the Rheumatic Diseases Vol. 79, No. Suppl 1 ( 2020-06), p. 1822.2-1822
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 1822.2-1822
    Abstract: Apremilast (APR), a small molecule inhibitor of phosphodiestersa-4, has been shown to be effective in the treatment of oral and genital ulcers in Behçet’s disease (BD). BD is a systemic vasculitis with great heterogeneity of symptoms and manifestations. It can affect the blood vessels, mucosa, skin, joints, eyes, nervous system and digestive system. APR is indicated for treatment of oral ulcers in BD in some countries such as the USA and Japan. Objectives: To evaluate the efficacy and safety of APR treatment in BD patients. Methods: Single-center descriptive study of BD patients on APR treatment from February 2017 to December 2019. Demographic, clinical and analytical data were collected. Results: 10 patients (9 women) were included, with a mean age at the beginning of APR treatment of 37±12 years and a mean disease evolution of 100±105 months. 8 of them showed HLAB51 positivity. Before treatment with APR, 4 patients were refractory to DMARDs (2 MTX, 2 AZA) and one patient to 2 anti-TNF (ADA, IFX). All patients were under treatment with colchicine and 5 with steroids before APR therapy. The concomitant treatment with APR were: corticosteroids (5), NSAIDs (2), colchicine (8), MTX (2), AZA (2). The main symptoms at the beginning of the APR treatment were: oral ulcers (100%), genital ulcers (60%) and arthritis/arthralgia (90%). We observed a clinical improvement after 3 months of treatment of 90% of oral ulcers, 100% of genitals and 55% of joint symptoms. The patients had a mean follow-up of 37±12 months and they maintain the therapy response during the APR treatment. Patients presented adverse events, some of them transitory: headache (5), diarrhea (5), nausea (3), dysthymia (1), tremors (2), herpes zoster (1) and autolytic ideation (1). The treatment was withdrawn in 4 patients with a mean duration of 11 ± 13 months. 2 of the 4 adverse events were by autolytic ideation and nausea, 1 for genesic desire and 1 for persistence of joint injury. The APR doses were reduced to 30 mg per day in 4 patients, resolving the adverse events and persisting with a good response. In addition, dose reduction of colchicine and prednisone was achieved in 4 patients. We observed other previous manifestations of BD such as uveitis (4), neurobehçet (3), cutaneous (folliculitis/pseudofoliculits) (4) and venous thrombosis (1). Cutaneous manifestations were resolved and the rest of previous manifestations remain without clinical changes during the follow-up. Conclusion: We observed an improvement in the most common manifestations of BD and a safety profile similar to those described in other studies. We observed a resolution of mucocutaneous manifestations, a variable response in joint manifestations and stability in neurological manifestations. Adverse effects referred included gastrointestinal and headache, most of which were transient and were resolved with adjustment of treatment. Disclosure of Interests: None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2020-eular.5330
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 1481557-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    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
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 1481557-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    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
    Details
    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
    detail.hit.zdb_id: 1481557-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    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
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    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
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    POS0167 SECONDARY PREVENTION OF VERTEBRAL FRACTURES IN REAL PRACTICE
    BMJ ; 2021
    In:  Annals of the Rheumatic Diseases Vol. 80, No. Suppl 1 ( 2021-06), p. 296.1-296
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 80, No. Suppl 1 ( 2021-06), p. 296.1-296
    Abstract: Vertebral fractures increases the risk of new fractures and deaths. There are different antiresorptive medications to prevent a secondary fracture, as bisphosphonates, teriparatide or denosumab, but little is known about the effects of secondary fracture appearance in real life. Objectives: To evaluate the appearance of new vertebral fractures depending on the treatment used for secondary prevention. Methods: We conducted a prospective descriptive study of patients with a first diagnosis of vertebral fracture from 2010 to 2017 and assessed the subsequent finding of new fractures. We selected patients with at least 3 years of secondary prevention with antiresorptive drugs or with sequential treatment (anabolic followed by, at least, 1 year with antiresorptive drugs), and excluded those who experienced new fractures within the first 6 months of treatment. Results: A total of 400 patients were selected from an initial base of 1018 patients. The average age of onset of the first fracture was 69.7 years, 84% of female patients and 16% of female patients. 38.5% suffered dorsal fractures, 33.75% lumbar fractures and 27.75% dorsolumbar fractures. We classified the secondary prevention strategies according to the different therapeutic options, as we can see in Table 1. We analysed the association between the appearance of new vertebral fracture corrected by sex with the age of the initial fracture its location. No association was found. We also performed a multivariate Bayesian model of logistic regression, in order to analyze the association between the appearance of new vertebral fracture and factors as the age of the initial fracture, its sex and the pharmacologic option used as secondary prevention. No statistically significant differences were observed between the different antiresorptive treatments and their efficacy as a secondary prevention of vertebral fractures. However, there was a tendency for a smaller occurrence of new fractures in patients undergoing sequential treatment. On the other hand, similar results were observed between denosumab and oral bisphosphonates, observing somewhat worse data with zoledronate (figure 1), probably due to patients under zoledronate treatment showed high osteoporotic risk and worse prognosis. Pharmacologic option Patients (%) New fractures (%) Denosumab 192 (48%) 10 (5.21%) Teriparatide (up to 2 years) + Denosumab (at least 1 year) 86 (21.5%) 0 (0%) Oral bisphosphonate (alendronate, risedronate or ibandronate) 58 (14.5%) 3 (5.17%) Zoledronate 33 (8.25%) 4 (12.12%) Teriparatide (up to 2 years) + oral bisphosphonate (at least 1 year) 28 (7%) 2 (7.14%) Teriparatide (up to 2 years) + Zoledronate (at least 1 year) 3 (0,75%) 0 (0%). Conclusion: No differences between the different secondary prevention options in terms of the appearance of new fractures were observed. Disclosure of Interests: None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2021-eular.3108
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 1481557-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    AB0502 HEALTH-RELATED QUALITY OF LIFE MEASURES IN SPONDYLOARTHROPATY PATIENTS UNDER BIOLOGICAL THERAPIES IN REAL LIFE
    BMJ ; 2021
    In:  Annals of the Rheumatic Diseases Vol. 80, No. Suppl 1 ( 2021-06), p. 1278.2-1279
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 80, No. Suppl 1 ( 2021-06), p. 1278.2-1279
    Abstract: Spondyloarthropathy patients have reduced health-related quality of life (HRQL) compared to general population. Biological treatment strategies in real life aim to reduce patients’ symptoms and different HRQL parameters would share the same behavior as patients’ symptoms and disease activity. Objectives: We aim to assess the differences in HRQL reported by spondyloarthropathy patients during the first six months of biological therapy according to the treatment effectiveness. Methods: We performed a prospective observational study of six months of follow-up in spondyloarthropathy patients who are newly on biological therapy. A basal visit and 1, 3 and 6 months follow-up visits were conducted. We analyzed changes during follow-up in the HRQL parameters reported by patients through AsqoL and ASAS-health-index questionnaires. Moreover we measured functional disability through HAQ and BASFI index, disease activity by BASDAI, ASDAS-CRP and ASDAS-ESR index. Statistical analyses were achieved using R software, through multivariate linear regression models for continuous data and Bayesian mixed ordinal regression models with monotonic effect for ordinal data. The corresponding odd ratios (OR) were calculated with their confidence intervals (CI 95%). Results: We included 53 patients (71.77% male), the 73.58% diagnosed with ankylosing spondylitis (AS) and the 26.42% with axial spondyloarthritis. Mean age at the beginning of treatment was 48.74 (11.21) years, mean age at diagnosis was 41.57 (11.97) and mean disease evolution was 7.19 (9.24) years. 60.42% of them exhibited HLAb27 positivity. 34 patients started biological therapy with TNF-α inhibitors and 19 with IL-17 inhibitors. The 81.13% of patients were under monotherapy, and the other 18.87% was treated with DMARDs. The 77.36% of the total number of patients was on the biological therapy at 6 months of follow-up, while the 22.64% discontinued at 6 months of follow-up (9 due to inefficacy and 3 due to adverse effects). 42 patients completed the follow-up at 6 months, and 3 patients achieved until visit 3 due to treatment failure. In 1 case visit 1 and in 7 cases visit 3 could not be performed due to COVID19 pandemic situation. We observed a significant correlation among AsqoL and ASAS-hi values with disease activity indexes (BASDAI, ASDAS-CRP, ASDAS-ESR) and functional disability (HAQ, BASFI). The statistical analyses showed a significant association where AsqoL and ASAS-hi values are significantly decreased in treatment failures compared to the successful treatment (, and in patients with previous biological therapy compared to naïve patients. No effect of years of disease evolution and the type of biological treatment in the AsqoL and ASAS-hi values was observed. (See Table 1) These results were consistent with the significant association found among the disease activity and functional disability with the biological therapy efficacy and the previous biological treatment. Table 1. Comparison with effectiveness of biological therapy Odds Ratio (OR) 95% CI Comparison with previous biological therapy Odds Ratio (OR) 95% CI AsqoL 1.502 1.123–2.033 AsqoL 10.704 1.232–108.504 ASAS-HI 1.56 1.184–2.078 ASAS-HI 11.553 1.299–108.974 BASDAI 1.5 1.199–2.04 BASDAI 11.96 1.823–86.901 BASFI 1.348 1.036–1.76 BASFI 18.37 2.15–176.988 ASDAS-CRP 1.538 1.176–2.036 ASDAS-CRP 8.869 2.001–42.272 ASDAS-ESR 1.944 1.166–3.384 ASDAS-ESR 44.621 2.886–1077.816 HAQ 1.524 1.154–2.027 HAQ 24.111 1.779–371.742 Conclusion: The AsqoL and ASAS-hi questionnaire results are correlated with disease activity and functional disability and showed the same behaviour as these parameters, being also associated to the biological therapy efficacy as well as to previous biological therapies. The HRQL variables would be additional clinical results that make it possible to achieve a better management of biological therapies in spondyloarthropathy patients. Disclosure of Interests: None declared.
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2021-eular.2282
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 1481557-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    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
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 1481557-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...