P0453BIOSIMILAR RITUXIMAB AND BRAND RITUXIMAB: RELAPSES AND PROTEINURIA IN THE GLOMERULAR PRYMARY DISEASES

Abstract Background and Aims Biosimilar drugs need to prove similar effectiveness to the brand name drug, in order to have their authorization from regulatory agencies. Rituximab initially developed as a treatment for non-Hodgkin lymphoma, is used as a therapeutic alternative to several autoimmune diseases, including primary glomerular diseases. The objective of this study is to observe if there were differences in terms of effects measured in proteinuria and relapse episodes between rituximab brand versus biosimilar in primary glomerular diseases Method This is a retrospective descriptive study that included patients receiving rituximab brand or biosimilar for the first time between March 2018 to March 2019, collecting information from the reported medical records with primary glomerulopathy were included. The collected laboratory data included creatinine, proteinuria, leukocyte and lymphocyte count before (0-60 days before) and after (0-60 days after) administration of rituximab. Results A total of 19 patients with primary glomerulopathy were included. Six patients (59-years-old (26-74); 50% female) with baseline 6.52±2.00x10^9/L leucocyte count, 2.28±1.10x10^9/L lymphocyte count, 1.63±1.04 mg/dL creatinine and 6.84±3.36g/24h proteinuria, were treated with biosimilar-rituximab. Thirteen patients (58-years-old (25-81); 30% female) with baseline 9.80±4.62x10^9/L leucocyte count, 1.92±1.13 x10^9/L lymphocyte count, 1.61±0.85 mg/dL creatinine and 5.81±4.55 g/24h proteinuria, were treated with brand-rituximab. After the rituximab administration, these values were 6.13±1.94x10^9/L leucocyte count, 1.30±0.59x10^9/L lymphocyte count, 1.16±1.19 mg/dL creatinine, 3.29±0.58g/24h and proteinuria for the biosimilar group; and 8.77±3.78x10^9/L leucocyte count, 1.67±1.13x10^9/L lymphocyte count, 1.56±1.19 mg/dL creatinine and 3.36±2.20g/24h proteinuria for the brand group. After rituximab administration CD19+ lymphocytes become negative in both groups (5/5 for the biosimilar group; 6/6 for the brand group). There were 2 total remissions, 1 partial remission and 3 without response with the biosimilar and 1 total remission, 5 partial remissions and 7 without response with the rituximab brand. Biosimilar was well tolerated in 6/6 patients and Rituximab brand infection did not develop was well tolerated in 11/13 patients and 4/13 patients showed an episode of infection. No statistically significant results were observed for the response to treatment between both groups. Conclusion The biosimilar shows a similar profile in terms of proteinuria and remissions against rituximab mark in the reported follow-up period, however our study is limited since it has a small sample, so a larger study is necessary to demonstrate these results with statistical significance

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Abstract 190: Predictors and Outcome of Anthracycline-induced Cardiomyopathy among Lymphoma Patients

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.7.suppl_1.190 ◽

2014 ◽

Vol 7 (suppl_1) ◽

Author(s):

Jennifer R Brown ◽

Christopher R Flowers ◽

Tian Dai ◽

Susmita Parashar

Keyword(s):

Statistical Significance ◽

Therapeutic Benefit ◽

Logistic Regression Models ◽

Non Hodgkin Lymphoma ◽

Increased Risk ◽

Before And After ◽

Tobacco Abuse ◽

History Of ◽

Imaging Surveillance ◽

Artery Disease

Background: Anthracyclines (AC) are one of the most potent anti-neoplastic agents in the treatment of lymphoid malignancies. However their therapeutic benefit is limited by cardiotoxicity. Among patients receiving AC, it is unclear whether traditional cardiovascular markers predict cardiomyopathy (CMP) and whether patients with AC-CMP have higher mortality compared with non-CMP patients. Methods: We performed a retrospective analysis of a cohort of Non-Hodgkin lymphoma (NHL) patients evaluated by the Emory Lymphoma program who received AC between 1992 and 2013. We assessed cardiac function by echocardiogram or equilibrium radionuclide imaging. We examined the prevalence of AC-CMP (defined as an absolute decrease in LVEF > 10% with a decline <50%, or an LVEF reduction of at least 15% with absolute LVEF > 50%). Analyses only included patients who received assessment of LVEF both pre and post-AC. Statistical analysis was performed by univariable and multivariable logistic regression models of clinical characteristics potentially associated with a decrease in LVEF. Results: Of 218 patients who received AC (median dose 300 mg/m2), 41% (89 of 218) had imaging surveillance before and after AC. Twenty seven percent of patients had AC-CMP. In the multivariate analyses after adjusting for demographics and traditional cardiac comorbidites, among patients receiving AC, patients with tobacco abuse [OR, 2.4; 95% CI, 0.8 to 7.0; P = 0.12], coronary artery disease [OR, 2.6; 95% CI, 0.8 to 7.9; P = 0.10] and diabetes [OR, 2.9; 95% CI, 0.9 to 9.9; P = 0.08] were more likely to have CMP although the association did not reach statistical significance. Mortality among CMP patients was numerically higher compared with non-CMP patients (50% vs. 35%; P = 0.28). Conclusions: Among patients receiving AC for lymphoma, there is a trend towards increased risk of CMP in patients with history of tobacco abuse, CAD and diabetes. Additionally, AC-CMP patients had numerically higher mortality compared with non-CMP patients. Future studies are needed to confirm these important findings in larger samples to ascertain predictors and outcome of AC induced CMP in cancer patients.

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Thrombin-Generating Capacity of Microvesicles (MVs) in Patients with Immune Thrombocytopenia (ITP) before and during Treatment with Thrombopoietin-Receptor Agonists (TPO-RA)

Blood ◽

10.1182/blood-2018-99-116911 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 2511-2511

Author(s):

Lamya Garabet ◽

Waleed Ghanima ◽

Marit Hellum ◽

Per Morten Sandset ◽

James B. Bussel ◽

...

Keyword(s):

Tissue Factor ◽

Research Funding ◽

Thrombin Generation ◽

Statistical Significance ◽

Small Sample ◽

Activity Assay ◽

Thrombotic Risk ◽

Increased Risk ◽

Significant Difference ◽

Before And After

Abstract Introduction: ITP is an acquired autoimmune disorder characterized by isolated thrombocytopenia and an increased risk of bleeding. Paradoxically, ITP is also associated with an increased risk of thrombosis, which may be exacerbated with TPO-RA-treatment. The underlying mechanism(s) involved in the development of thrombosis in ITP and especially in TPO-RA-treated ITP-patients remain poorly understood. MVs released from activated/apoptotic cells are procoagulant due to the presence of tissue factor (TF) and phospholipids such as phosphatidylserine (PS) on their membrane. MVs have been shown to be increased in ITP-patients but the prothrombotic role of these MVs before and after treatment with TPO-RA is unclear. We measured MV-associated thrombin generation, PS-dependent thrombin generation in plasma, TF-activity and PS-activity in plasma of ITP-patients vs controls and investigated the effect of TPO-RA on these measurements. Methods: In 15 controls and 11 ITP patients, before TPO-RA and 2 and 6 weeks after the initiation of TPO-RA, citrated plasma was prepared (2000gx20 min) and immediately frozen. After thawing of plasma, MVs were isolated by centrifugation (17,000gx30 min), the supernatant removed and the remaining MV-pellet washed twice. Isolated plasma-derived MVs were added to pooled normal plasma (PNP), and to obtain measureable thrombin generation, antibodies against tissue factor pathway inhibitor were also added to the PNP. The ability of MVs to generate thrombin was measured by the calibrated automated thrombogram method and the thrombin generation parameters lag time (LT), peak, endogenous thrombin potential (ETP), time to peak (ttPeak) and velocity index (VI) were calculated by the Thrombinoscope software. To estimate the contribution of procoagulant PS, PS-activity in plasma (PS equivalents) was measured with the Zymuphen MP-activity assay. In addition, thrombin generation was measured directly in plasma where only TF (1pM), but not PS, had been added (PS-dependent thrombin generation). TF-activity in plasma was measured with the Zymuphen MP-TF-activity assay. Friedman test with Dunn's multiple comparisons was used to compare measurements in ITP-patients before and after TPO-RA-treatment. Kruskal-Wallis test was used to compare measurements in ITP-patients and controls. Results: Median age of ITP-patients and controls: 53 and 50 years. Eight (73%) were on romiplostim and three (27%) were on eltrombopag. Median values (IQR) for all measurements before, 2 weeks and 6 weeks on TPO-RA-treatment and in controls are shown in the table. ITP-patients before treatment with TPO-RAs vs controls: No significant difference was found in MV-associated thrombin generation, PS-activity or TF-activity in plasma. There was a trend towards a higher peak, VI and ETP and lower ttPeak in PS-dependent thrombin generation in plasma of ITP-patients vs controls; lack of statistical significance may be due to the small sample size. TPO-RA-treated ITP-patients (2 and 6 weeks) vs controls: MV-associated thrombin generation: significant changes after 2 weeks (shorter LT/ttPeak (p=0.03/p=0.03), higher peak/VI (p=0.04/p=0.04)). PS-dependent thrombin generation in plasma: significant changes after 2 weeks (shorter ttPeak (p=0.007), higher peak/VI (p=0.003/p=0.001)), and after 6 weeks (shorter ttPeak (p=0.002), higher peak/ETP/VI (p=0.004/p=0.02/p=0.002)). PS-activity in plasma: significant changes after 2 and 6 weeks (p=0.006/p=0.02). TF-activity in plasma: no significant changes. ITP-patients before vs after TPO-RA-treatment (2 and 6 weeks): Only MV-associated thrombin generation was significantly increased after 2 weeks (higher peak/VI (p=0.03/p=0.04)). Conclusions: Compared with controls, treatment with TPO-RAs increases PS-dependent thrombin generation and PS-activity in plasma that is partly accompanied by an increase in MV-associated thrombin generation, but not with an increase in TF-activity in plasma. Similarly, we find a trend of increase in PS-dependent thrombin generation in ITP vs controls. This suggests that PS-positive MVs, most likely released from activated/apoptotic platelets, may contribute to the pre-existing increased thrombotic risk present in at least some of the patients with ITP, and may be used as a potential marker to estimate the risk of future thromboembolic events in TPO-RA-treated ITP-patients. Disclosures Ghanima: Roche, Amgen, Novartis, Bayer, BMS: Other: Personal Fees, Research Funding; GlaxoSmithKline and Pfizer: Other: Personal Fees. Bussel:Prophylix: Consultancy, Research Funding; Protalex: Consultancy; Uptodate: Honoraria; Novartis: Consultancy, Research Funding; Amgen Inc.: Consultancy, Research Funding; Momenta: Consultancy; Rigel: Consultancy, Research Funding.

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Participant Reactions to Suicide-Focused Research

Crisis ◽

10.1027/0227-5910/a000650 ◽

2020 ◽

Vol 41 (5) ◽

pp. 367-374

Author(s):

Sarah P. Carter ◽

Brooke A. Ammerman ◽

Heather M. Gebhardt ◽

Jonathan Buchholz ◽

Mark A. Reger

Keyword(s):

Medical Records ◽

Research Study ◽

Small Sample Size ◽

Psychiatric Inpatient ◽

Small Sample ◽

Inpatient Unit ◽

Online Laboratory ◽

Psychiatric Inpatient Unit ◽

Before And After ◽

Participant Reactions

Abstract. Background: Concerns exist regarding the perceived risks of conducting suicide-focused research among an acutely distressed population. Aims: The current study assessed changes in participant distress before and after participation in a suicide-focused research study conducted on a psychiatric inpatient unit. Method: Participants included 37 veterans who were receiving treatment on a psychiatric inpatient unit and completed a survey-based research study focused on suicide-related behaviors and experiences. Results: Participants reported no significant changes in self-reported distress. The majority of participants reported unchanged or decreased distress. Reviews of electronic medical records revealed no behavioral dysregulation and minimal use of as-needed medications or changes in mood following participation. Limitations: The study's small sample size and veteran population may limit generalizability. Conclusion: Findings add to research conducted across a variety of settings (i.e., outpatient, online, laboratory), indicating that participating in suicide-focused research is not significantly associated with increased distress or suicide risk.

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Criteria positive and criteria negative anaphylaxis, with a focus on undifferentiated somatoform idiopathic anaphylaxis: A review and case series

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.41.200076 ◽

2020 ◽

Vol 41 (6) ◽

pp. 436-441 ◽

Cited By ~ 1

Author(s):

Daniel A. Rosloff ◽

Kunal Patel ◽

Paul J. Feustel ◽

Jocelyn Celestin

Keyword(s):

Diagnostic Criteria ◽

Statistical Significance ◽

Case Series ◽

Poor Response ◽

Response To Treatment ◽

Fisher Exact Test ◽

Subjective Symptoms ◽

Significant Difference ◽

Physical Findings ◽

Idiopathic Anaphylaxis

Background: Undifferentiated somatoform (US) idiopathic anaphylaxis (IA) is considered a psychogenic disorder characterized by a lack of observable physical findings and poor response to treatment. Although failure to diagnose true anaphylaxis can have disastrous consequences, identification of US-IA is crucial to limit unnecessary expenses and use of health care resources. Objective: To better define the presentation and understand the potential relationship between US-IA and underlying psychiatric comorbidities. Methods: We retrospectively reviewed 110 visits by 107 patients to our institution for evaluation and management of anaphylaxis over a 1-year period. The patients were classified as having either criteria positive (CP) or criteria negative (CN) anaphylaxis based on whether they met Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium criteria for the clinical diagnosis of anaphylaxis. Patient characteristics, including objective and subjective signs and symptoms, and the presence of psychiatric diagnoses were collected and analyzed. Statistical significance was assessed by using the Fisher exact test. A literature review of US-IA and other psychogenic forms of anaphylaxis was performed. Results: Patients with CP anaphylaxis were more likely to present with hypotension, wheezing, urticaria, and vomiting than were patients with CN anaphylaxis. The patients with CN anaphylaxis were more likely to present with subjective symptoms of sensory throat tightness or swelling compared with patients with CP anaphylaxis. No significant difference was detected in the prevalence of psychiatric conditions between the two groups. Conclusion: Patients who met previously established diagnostic criteria for anaphylaxis were more likely to present with objective physical findings than those who did not meet criteria for true anaphylaxis. CN patients who presented for treatment of anaphylaxis were more likely to present with subjective symptoms. Formal diagnostic criteria should be used by clinicians when evaluating patients with suspected anaphylaxis.

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STUDY CLINICAL FEATURE AND RESULT OF TREATMENT PHACOMORPHIC GLAUCOMA

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2015.1.9 ◽

2015 ◽

pp. 71-75

Author(s):

Van Nam Phan ◽

Ba Ken Tran

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Statistical Significance ◽

Corneal Edema ◽

Clinical Feature ◽

Anterior Chamber Angle ◽

Male Population ◽

Significant Difference ◽

Operative Complications ◽

Before And After

Purpose: Study clinical feature of phacomorphic glaucoma. To evaluate the result of treatment phacomorphic glaucoma. Method: The retrospective, interventional study on 36 cases with phacomorphic glaucoma who underwent treated at Hue Central Hospital from 6/2010 to 6/2011. Standard of research: visual, IOP, before and after surgery, accompanying lesions and post-operative complications. The surgery is considered successful when postoperative IOP less than 21 mmHg. Results: Age 50-59 presented 30.5 percent, ≥ 60 presented 91.7 percent. There was a slight female preponderance (66.7%) compared to the male population (33.3%) which implies a statistically marginally significant difference. However there was no statistical significance difference when compared by the two subgroups. Patient in country presented 61,1% and city presented 38,9%. The duration between the onset of pain and surgery from 0 to < 5 days (77.8%), from 6 to 10 (16.7%) and >10 days presented 5.5%. The preoperative intraocular pressure 35 to 45mmHg (47.2%), 46-55 (30.6%), 56-65 (13.9%) and more than 65 presented 8.3%. The visual acuity preoperation less than 1metre count finger (94.5%), less than 3 metre count finger presented 5.5%. Close anterior chamber angle presented 80.6% and shallow was presented 19.4%. Corneal edema presented 100%, iritis presented 94.4%, dilated pupil larger 5mm presented 83.3%, Synchynea iris and cataract presented 72.2%. ECCE, implantation IOL combined trabeculectomy presented 11.1%, Phaco, implantation IOL combined trabeculectomy presented 69,5%, ECCE implantation IOL presented 5.6%, Phaco, implantation IOL presented 13.8%. Postoperative visual acuity from 1/10 to 5/10 presented 72.2%, no case have VA larger than 5/10. Postoperative 3 months VA 1/10 to 5/10 presented 72.2%, larger VA 5/10 presented 8.3%. Postoperative 3 months intraocular pressure ≤ 21mmHg presented 91.7%, 22 to 24mmHg presented 8.3%, no case have IOP ≥25mmHg. Postoperative edema presented 58.3%, iritis presented 58.3%. Key words: phacomorphic Glaucoma

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Treatment of HIV-associated facial lipoatrophy: impact on infection progression assessed by viral load and CD4 count

Anais Brasileiros de Dermatologia ◽

10.1590/abd1806-4841.2013895 ◽

2013 ◽

Vol 88 (4) ◽

pp. 570-577 ◽

Cited By ~ 5

Author(s):

Flávia Machado Gonçalves Soares ◽

Izelda Maria Carvalho Costa

Keyword(s):

Viral Load ◽

Disease Progression ◽

Statistical Significance ◽

Undetectable Viral Load ◽

Fat Distribution ◽

Cd4 Count ◽

Before And After ◽

Facial Lipoatrophy ◽

A Prospective Study ◽

The Impact

BACKGROUND: HIV/AIDS-Associated Lipodystrophy Syndrome includes changes in body fat distribution, with or without metabolic changes. The loss of fat from the face, called facial lipoatrophy, is one of the most stigmatizing signs of the syndrome.OBJECTIVES:To evaluate the effect of FL treatment using polymethylmethacrylate (PMMA) implants on disease progression, assessed by viral load and CD4 cell count.METHODS: This was a prospective study of 44 patients treated from July 2009 to December 2010. Male and female patients, aged over 18 years, with clinically detectable FL and who had never been treated were included in the study. PMMA implantation was done to fill atrophic areas. Laboratory tests were conducted to measure viral load and CD4 count before and after treatment.RESULTS: Of the 44 patients, 72.72% were male and 27.27% female, mean age of 44.38 years. Before treatment, 82% of patients had undetectable viral load, which increased to 88.6% after treatment, but without statistical significance (p = 0.67). CD4 count before treatment ranged from 209 to 1293, averaging 493.97. After treatment, the average increased to 548.61. The increase in CD4 count after treatment was statistically significant with p = 0.02.CONCLUSION: The treatment of FL with PMMA implants showed a statistically significant increase in CD4 count after treatment, revealing the impact of FL treatment on disease progression. Viral load before and after treatment did not vary significantly.

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Myositis autoantibodies in a racially diverse population of children with idiopathic inflammatory myopathies

Pediatric Rheumatology ◽

10.1186/s12969-021-00574-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Megan Mariko Perron ◽

Natalia Vasquez-Canizares ◽

Gabriel Tarshish ◽

Dawn M. Wahezi

Keyword(s):

Clinical Phenotype ◽

Laboratory Data ◽

Small Sample ◽

Organ Involvement ◽

Idiopathic Inflammatory Myopathies ◽

Diverse Population ◽

Inflammatory Myopathies ◽

Racially Diverse ◽

Parametric Testing ◽

Overlap Myositis

Abstract Background Juvenile idiopathic inflammatory myopathies (JIIMs) is a group of autoimmune disorders, including juvenile dermatomyositis (JDM), juvenile polymyositis (JPM) and overlap myositis, that are characterized by proximal muscle weakness, elevated levels of serum muscle enzymes, and pathognomonic skin findings. While the exact etiology of JIIMs is unclear, the presence of myositis specific autoantibodies (MSAs) have been associated with certain clinical phenotypes, organ involvement and disease prognosis. To date, there have been few studies of the associations between MSA presence and patient ethnicity. It is important to understand the extent to which ethnicity impacts disease manifestations, organ involvement and clinical outcomes. The goal of our study is to determine MSA and myositis associated autoantibody (MAA) presence, clinical phenotype, and disease course in a racially diverse population of pediatric patients with JIIMs. Methods Patients age 2–21 years with a prior diagnosis of JDM, JPM or overlap myositis, who had been tested for MSA/MAA, were eligible for study inclusion. Clinical and laboratory data were collected retrospectively via manual chart review in this single-center study. Descriptive statistics were performed to summarize each variable. Given the small sample size, non-parametric testing was performed using Fischer’s exact test, Wilcoxon rank sum test and Kruskal-Wallis test. Results Thirty one patients were included in the analysis. Race and ethnicity were self-reported as Hispanic (48.4%), white (25.8%), and Black (25.8%). The most prevalent MSAs were anti-MDA5 (25.8%), anti-p155/140 (22.6%) and anti-MJ (19.4%). Presence of autoantibodies (p = 0.04) and pulmonary disease (p = 0.03) were significantly higher in patients of Black or Hispanic descent compared with white descent. Anti-MDA5 antibodies, cutaneous ulceration, cardiopulmonary involvement, hospitalizations and one death were only reported in patients with Black or Hispanic descent. Patients with anti-MDA5 antibodies were more likely to be male (p = 0.04) and to have cutaneous ulceration (p = 0.02). Conclusions This study describes the prevalence of MSA/MAA in a racially diverse group of patients with JIIM and further delineates clinical phenotype and disease complications in these groups. We found a relatively high proportion of children with anti-MDA5 antibodies and described potentially worse clinical courses in children of Black or Hispanic descent. Further investigation is warranted to examine these findings.

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AB0655 RHEUMATOID ARTHRITIS ACTIVITY BEFORE AND AFTER COVID-19 LOCKDOWN PERIOD

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.576 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1360.1-1360

Author(s):

M. Jordhani ◽

D. Ruci ◽

F. Skana ◽

E. Memlika

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Musculoskeletal Diseases ◽

Statistical Tests ◽

Laboratory Data ◽

World Population ◽

Chronic Patients ◽

Das 28 ◽

Significant Difference ◽

Before And After

Background:The COVID-19 global pandemic has had a great impact on world population due to morbidity, mortality and restriction measures in order to stop the progression of COVID-19.Patients with rheumatic and musculoskeletic diseases, and especially rheumatoid arthritis (RA) patients, being one of the vulnerable classes of chronic patients, were recommended to follow the government’s rules1.Objectives:The aim of this study was to evaluate DAS-28-ESR in patients with rheumatoid arthritis before and after lockdown period.Methods:This is a multi-center observational study including 85 patients which were evaluated before and after lockdown for their disease activity score according to DAS-28-ESR score. They had been diagnosed with rheumatoid arthritis more than 5 years ago. A thorough physical examination was performed before and after the lockdown period. It included examination of tender and swollen joints and patient’s global health. They were completed with all required laboratory data, including erythrosedimentation rate. For a more accurate calculation, DAS-28-ESR was used in an electronic version. Patients with other inflammatory or infective diseases were excluded from the study. All data were statistically evaluated using statistical tests such as t-student test.Results:The first group (the one before lockdown) had an average DAS-28-ESR of 4.7 while after the lockdown period, the average DAS-28-ESR was 5.16.After statistically evaluating all data, it was found that there exists a significant difference between DAS-28-ESR score before and after COVID-19 lockdown (p=0.0011).Conclusion:Our study showed that lockdown period due to COVID-19 pandemic, has aggravated disease activity in patients with Rheumatoid Arthritis. This may be consequence of various causes such as physical inactivity and difficulty to follow-up or to take the medication properly.References:[1]Landewé RB, Machado PM, Kroon F, et al, EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2, Annals of the Rheumatic Diseases 2020;79:851-858.Disclosure of Interests:None declared.

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FRI0612-HPR EFFECT OF THERMOFORMABLE ORTHOSES ON FOOT FUNCTION IN RHEUMATOID ARTHRITIS PATIENTS: PRELIMINARY RESULTS FROM AN OPEN CLINICAL TRIAL.

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6308 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 911.2-912

Author(s):

I. Aachari ◽

H. Rkain ◽

F. Safaa ◽

L. Benzakour ◽

T. Latifa ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Trial ◽

Small Sample ◽

Activity Limitation ◽

Foot Orthoses ◽

Functional Impact ◽

Pain Disability ◽

Before And After ◽

Foot Function ◽

The Impact

Background:Orthoses and footwear can play an important role in managing foot pathology in patients whose systemic disease is controlled. Foot orthoses are frequently prescribed in clinical practice as an intervention for people with rheumatoid arthritis (RA).Objectives:The aim of our study is to evaluate the impact of thermoformable orthoses on the functional index of the foot (FFI) in patients with rheumatoid arthritis.Methods:We conducted an open clinical trial, having consecutively included 14 patients (85.7% female, average age 54.8 ± 10 years) suffering from rheumatoid arthritis (median progression time of 9 years [5 - 12]). The average DAS28 was 2.7 ± 1.2 and the functional impact objectified by the Health Assessment Questionnaire (HAQ) was on average 0.9 ± 0.7.The median deadline from the start of RA and the onset of the foot problem was 3 years [0 – 7,75]. The foot problem was bilateral in 100% of the cases and inaugural in 85.7% of the cases.We evaluated the functional impact of foot injury for all our patients at baseline and 8 weeks after the use of thermoformable orthoses, based on the FFI (Foot function Index) measuring the impact of foot pathology on function in terms of pain, disability and activity limitation.The comparison of the FFI domains before and after the use of orthoses was carried out using parametric or nonparametric paired tests using The SPSS statistical software.Results:With the use of foot orthoses, FFI values decreased in all subscales (p=0,024) (pain, disability and activity limitation). This reduction was significant for disability (0,011) but not for pain and activity limitation.There were no significant correlations between the global FFI and the progression of RA, the duration of foot damage and the functional impact measured by the HAQ.Table 1. The comparison of the FFI domains before and after the use of orthoses.psignificatif if< 0,05; Test used: Non-parametric test for two linked samples.Conclusion:Foot orthoses were effective as an adjuvant in the management of rheumatoid foot. They significantly reduced disability as measured by the FFI. The absence of factors associated with pain and limitation of activity could possibly be related to the small sample size.Disclosure of Interests:None declared

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Temporal dynamics of encrusting communities during the Late Devonian: a case study from the Central Devonian Field, Russia

Paleobiology ◽

10.1017/pab.2017.8 ◽

2017 ◽

Vol 43 (4) ◽

pp. 550-568 ◽

Cited By ~ 8

Author(s):

Michał Zatoń ◽

Tomasz Borszcz ◽

Michał Rakociński

Keyword(s):

Temporal Dynamics ◽

Small Sample ◽

Time Interval ◽

Faunal Turnover ◽

Central Devonian Field ◽

Before And After ◽

Substrate Size ◽

Mass Extinction Event ◽

Diversity Dynamics

AbstractIn this study we focused on the dynamics of encrusting assemblages preserved on brachiopod hosts collected from upper Frasnian and lower Famennian deposits of the Central Devonian Field, Russia. Because the encrusted brachiopods come from deposits bracketing the Frasnian/Famennian (F/F) boundary, the results also shed some light on ecological differences in encrusting communities before and after the Frasnian–Famennian (F-F) event. To explore the diversity dynamics of encrusting assemblages, we analyzed more than 1300 brachiopod valves (substrates) from two localities. Taxon accumulation plots and shareholder quorum subsampling (SQS) routines indicated that a reasonably small sample of brachiopod host valves (n=50) is sufficient to capture the majority of the encrusting genera recorded at a given site. The richness of encrusters per substrate declined simultaneously with the number of encrusting taxa in the lower Famennian, accompanied by a decrease in epibiont abundance, with a comparable decrease in mean encrustation intensity (percentage of bioclasts encrusted by one or more epibionts). Epibiont abundance and occupancy roughly mirror each other. Strikingly, few ecological characteristics are correlated with substrate size, possibly reflecting random settlement of larvae. Evenness, which is negatively correlated with substrate size, shows greater within-stage variability among samples than between Frasnian and Famennian intervals and may indicate the instability of early Famennian biocenoses following the faunal turnover. The occurrence distribution of encrusters points to nonrandom associations and exclusions among several encrusting taxa. However, abundance and occupancy of microconchids remained relatively stable throughout the sampled time interval. The notable decline in abundance (~60%) and relatively minor decline in diversity (~30%) suggest jointly that encrusting communities experienced ecological collapse rather than a major mass extinction event. The differences between the upper Frasnian and lower Famennian encrusting assemblages may thus record a turnover associated with the F-F event.

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