AB1078-HPR Telephone Follow-Up, Standardized To The Initiation of Biologic Therapy of Patients with Rheumatoid Arthritis (RA) in A Specific Unit of Biologic Therapy. Pilot Study

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 1300.2-1300 ◽  
Author(s):  
L. Cano-Garcia ◽  
S. Manrique-Arija ◽  
I. Ureña ◽  
N. Mena-Vazquez ◽  
M.C. Ordoñez-Cañizares ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Pilot Study ◽  
Biologic Therapy ◽  
Specific Unit

scholarly journals POS1467-HPR SEVERE RESPIRATORY INFECTIONS IN RHEUMATOID ARTHRITIS PATIENTS WITH BIOLOGIC THERAPY. COMPARATIVE STUDY BETWEEN VACCINATED AND NON VACCINATED PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1018.2-1019
Author(s):  
L. Domínguez ◽  
P. Rodriguez Cundin ◽  
T. Dierssen-Sotos ◽  
V. Calvo-Río ◽  
N. Vegas-Revenga ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Biologic Therapy ◽  
Respiratory Infections ◽  
Vaccination Program ◽  
Incidence Density ◽  
Erosive Disease ◽  
Conventional Dmards ◽  
Group 2 ◽  
Group 1

Background:Rheumatoid arthritis (RA) patients are at increased risk of severe infections due to the disease itself, and the immunosuppressive treatment. Vaccination programs are designed to decrease the risk of infections.Objectives:In patients with RA treated with biologic therapy (BT) our aim was to assess a) the incidence of severe respiratory infections and b) to compare the risk between vaccinated and non vaccinated patients.Methods:Observational study of 431 patients diagnosed with RA that iniciated BT. One group of patients participated in a vaccination program from October 2011 to October 2016 (Group 1). The other group was not included in the vaccination program (Group 2). The follow-up was made until June 2017 with a minimum follow-up period of 8 months and a maximum of 5.5 years.Information on severe respiratory infections, defined as those that required hospitalization or at least one dose of intravenous antibiotic treatment at the emergency room, was retrieved from the hospital medical records.Results:We studied 431 patients (335 women/96 men); mean age 63.4±13.7 years. In the vaccination program (group 1) were included 299 (69.37%) patients and in the group 2 132 patients (30.63%). The main features of both groups are summarized in Table 1.During the follow-up, we registered 299 hospital admissions due to severe respiratory infections in both groups (incidence density 9.9 (95% CI: 6.9-13.6).In group 1, vaccinated patients, this incidence density was reduced to 7.1 (95% CI: 4.1-11.6). Figure 1.The vaccination program reduced the general incidence of severe respiratory infection in 44%.Conclusion:RA patients with BT included in the vaccination program present a lower incidence of severe respiratory infections compared with non vaccinated patients.Table 1.Main general features at BT onsetGroup 1Vaccination programN=299Group 2Non vaccination programN=132pAge (years) mean±SD61.32±13.0467.97±14.170.32Women, n (%)231 (77.3%)105 (79.5%)0.59Duration of RA (months) mean±SD73.24±10.4112.62±60.2Positive RF/ Positive ACPA, n (%)177(59.2)/172 (57.52%)93(70.5%)98 (74.24%)0.02/0,01Erosive disease, n (%)116 (38.8%)70 (53%)0.06Vasculitis, n (%)15 (5%)2 (1.5%)0.08Interstitial lung disease n (%)12 (4%)7 (5.3%)0.54Subcutaneous nodules n (%)16 (5.4%)6 (4.5%)0.72Corticosteroids299 (100%)132 (100%)1Number of conventional DMARDs, mean±SD1.66±0.892.03±1.050.3Figure 1.Disclosure of Interests:None declared

scholarly journals AB0317 BIOLOGIC THERAPY OPTIMIZATION IN RHEUMATOID ARTHRITIS PATIENTS IN COLOMBIA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1457.2-1458
Author(s):  
W. G. Rojas Zuleta ◽  
O. J. Felipe Díaz ◽  
A. E. Pantoja Marquez ◽  
R. Giraldo ◽  
J. G. López Velandia ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Drug Exposure ◽  
Biologic Therapy ◽  
Standard Dose ◽  
Rank Test ◽  
P Value ◽  
Sustained Remission ◽  
Disease Evolution ◽  
Kaplan Meier

Background:The optimization of biological agents (bDMARD), is a strategy that has proven to be cost effective and its use can reduce the risk related to drug exposure (1–3). It is included in the EULAR management guidelines and in the consensus of the Colombian Rheumatology Association.Objectives:To analyze optimization success of bDMARD therapies in patients with RA.Methods:Cohort study of RA patients in a specialized multicenter institution in Colombia, followed from January 2015 to December 2019. Patients in remission or low activity for at least 6 months with bDMARD, and with at least two consecutive medical visits, were included. Optimization types were dose decrease, application interval increments, or both. Patients who had disease reactivation (DAS28- CPR >3.2) and returned to standard dose, were considered a failure. By Kaplan-Meier analysis, the optimization failure was estimated according to bDMARD typeResults:92 patients were included, 78.26% were women, with a median age of 57 years (IQR 50-64), a disease evolution time of 15 years (IQR 10-21), a treatment of 5.6 years (IQR 2.7-8.0), and optimization of 7.75 months (IQR 3.25-15.75). The most commonly used bDMARD therapies were etanercept 36.96%, tocilizumab 30.43% and adalimumab 16.30%. 69.39% (34) were naive for biological treatment. The 53.26% (49) of patients had a follow-up time greater than 6 months.95.92% remained under optimization scheme without disease activity changes, and 4.08% of patients underwent definitive discontinuation of bDMARD, for sustained therapeutic objective. 8.16% (4) had relapses in the first 6 months after onset, of which 2 patients returned to standard doses. In survival analysis it was observed that patients who were optimized for antiTNF failed faster than the non-antiTNF, although this difference was not statistically significant (Log Rank test 0.003 p value = 0.959). Of the total patients, 28 have been optimized for 12 months or more, of these, 96.43% (27) continue in sustained remission, and 55.56% (15) received combined therapy with s synthetic DMARD (sDMARD).Figure 1.Kaplan MeierConclusion:During follow-up, most patients remain in optimization strategy. In those who continued in sustained remission, more than half received sDMARD, this suggests that their use may be a determining factor in preventing disease relapses. More studies are required to evaluate this hypothesis.References:[1]Niccoli L, Nannini C, Blandizzi C. Personalization of biologic therapy in patients with rheumatoid arthritis: Less frequently accounted choice-driving variables. Ther Clin Risk Manag. 2018;14:2097–111.[2]ASOREUMA. Asociación Colombiana de Reumatología. Consenso sobre recomendaciones para disminución y descontinuación de la terapia biológica en pacientes con artritis reumatoide, espondilitis anquilosante y artritis psoriásica. Rev Colomb Reumatol. 2019 Jan;26(1):11–23.[3]Cantini F, Niccoli L, Nannini C. Second-line biologic therapy optimization in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. Semin Arthritis Rheum. 2017;47(2):183–92.Disclosure of Interests:None declared

scholarly journals AB0485 DOES THE REASON OF DISCONTINUATION OF THE FIRST TNF INHIBITOR INFLUENCE THE RESPONSE TO THE SECOND TNF INHIBITOR IN SPONDYLOARTHRITIS? PILOT STUDY FROM THE MOROCCAN RBSMR REGISTRY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1270.2-1270
Author(s):  
T. Fatima Zahrae ◽  
T. Latifa ◽  
H. Rkain ◽  
I. Hmamouchi ◽  
L. Achemlal ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Pilot Study ◽  
Side Effects ◽  
Disease Activity ◽  
Tumour Necrosis ◽  
Tnf Inhibitor ◽  
Tumour Necrosis Factor Α ◽  
Factor Α ◽  
Necrosis Factor

Background:In rheumatoid arthritis, studies have shown that the response to a second TNF inhibitor is better if the first TNF inhibitor was stopped for a secondary failure or adverse event compared to a primary failure [1,2]. However, few studies have provided evidence regarding the response to a second TNF inhibitor based on the reason for discontinuation of the first TNF inhibitor in patients with a diagnostic of spondyloarthritis (SpA).Objectives:To evaluate the efficacy of the 2nd TNF inhibitor in real life from a cohort of patients with SpA from the Moroccan registry of biological therapies in rheumatic diseases (RBSMR Registry), according to the reason for discontinuation of the 1st TNF inhibitor.Methods:We have included from the RBSMR Registry any patient with a diagnosis of SpA starting a 2nd TNF inhibitor on inclusion in the registry or during the 1st year of follow-up. A descriptive study was conducted by measuring the therapeutic maintenance of the 2nd TNF inhibitor as well as the disease activity in different groups of patients according to the reason for stopping the first TNF inhibitor: stopping for ineffectiveness, side effect or non-availability of the drug.Results:Of the total 194 patients with SpA included in the RBSMR registry, 40 patients were on their 2nd TNF inhibitor at one year follow-up. The mean age of the patients was 43.6 ± 15.1 with a male predominance (57.5%) and a mean of disease duration of 13.75±6.95 years. At 1 year, treatment was maintained in 72.5% of all patients: 100% after ineffectiveness, 82% after discontinuation for side effects and 52.9% for unavailability of the first TNF inhibitor. Moderate disease activity as defined by an Ankylosing Spondylitis Disease Activity Score using ASDAS-CRP <2.1 was achieved at 1 year in 75%, 64.7% and 52.9% respectively in patients who stopped their first TNF inhibitor for side effects, ineffectiveness or unavailability of treatment.Conclusion:This pilot study gives us a small insight into the fate and efficacy of the 2nd TNF inhibitor based on the reason for discontinuation of the first. The follow-up data at 2 and 3 years will allow us to include more patients and thus be able to do a real statistical study with a comparison between the different groups.References:[1]Remy A, Avouac J, Gossec L, Combe B. Clinical relevance of switching to a second tumour necrosis factor-α inhibitor after discontinuation of a first tumour necrosis factor-α inhibitor in rheumatoid arthritis: a systematic literature review and meta-analysis. Clin Exp Rheumatol. 2011;29:96–103.[2]Chatzidionysiou K, Askling J, Eriksson J, Kristensen LE, van Vollenhoven R, ARTIS group. Effectiveness of TNF inhibitor switch in RA: results from the national Swedish register. Ann Rheum Dis. 2015;74:890–6.Disclosure of Interests:None declared.

A Pilot Study of Mobile Telephone Message Interventions with Suicide Attempters in China

Crisis ◽  
2010 ◽  
Vol 31 (2) ◽  
pp. 109-112 ◽  
Author(s):  
Hui Chen ◽  
Brian L. Mishara ◽  
Xiao Xian Liu
Keyword(s):  
Pilot Study ◽  
Effective Means ◽  
Text Message ◽  
Text Messages ◽  
Mobile Telephone ◽  
Future Research ◽  
Quick Method ◽  
Suicide Attempters ◽  
To Receive

Background: In China, where follow-up with hospitalized attempters is generally lacking, there is a great need for inexpensive and effective means of maintaining contact and decreasing recidivism. Aims: Our objective was to test whether mobile telephone message contacts after discharge would be feasible and acceptable to suicide attempters in China. Methods: Fifteen participants were recruited from suicide attempters seen in the Emergency Department in Wuhan, China, to participate in a pilot study to receive mobile telephone messages after discharge. All participants have access to a mobile telephone, and there is no charge for the user to receive text messages. Results: Most participants (12) considered the text message contacts an acceptable and useful form of help and would like to continue to receive them for a longer period of time. Conclusions: This suggests that, as a low-cost and quick method of intervention in areas where more intensive follow-up is not practical or available, telephone messages contacts are accessible, feasible, and acceptable to suicide attempters. We hope that this will inspire future research on regular and long-term message interventions to prevent recidivism in suicide attempters.

Prognostic significance of C1–C2 facet malalignment after surgical decompression in adult Chiari malformation type I: a pilot study based on the Chicago Chiari Outcome Scale

2020 ◽  
pp. 1-7
Author(s):  
Michael Lumintang Loe ◽  
Tito Vivas-Buitrago ◽  
Ricardo A. Domingo ◽  
Johan Heemskerk ◽  
Shashwat Tripathi ◽  
...  
Keyword(s):  
Pilot Study ◽  
Chiari Malformation ◽  
Prognostic Significance ◽  
Foramen Magnum ◽  
Bivariate Analysis ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Swallowing Function ◽  
Chiari Malformation Type I

OBJECTIVEThe authors assessed the prognostic significance of various clinical and radiographic characteristics, including C1–C2 facet malalignment, in terms of surgical outcomes after foramen magnum decompression of adult Chiari malformation type I.METHODSThe electronic medical records of 273 symptomatic patients with Chiari malformation type I who were treated with foramen magnum decompression, C1 laminectomy, and duraplasty at Mayo Clinic were retrospectively reviewed. Preoperative and postoperative Neurological Scoring System scores were compared using the Friedman test. Bivariate analysis was conducted to identify the preoperative variables that correlated with the patient Chicago Chiari Outcome Scale (CCOS) scores. Multiple linear regression analysis was subsequently performed using the variables with p < 0.05 on the bivariate analysis to check for independent associations with the outcome measures. Statistical software SPSS version 25.0 was used for the data analysis. Significance was defined as p < 0.05 for all analyses.RESULTSFifty-two adult patients with preoperative clinical and radiological data and a minimum follow-up of 12 months were included. Motor deficits, syrinx, and C1–C2 facet malalignment were found to have significant negative associations with the CCOS score at the 1- to 3-month follow-up (p < 0.05), while at the 9- to 12-month follow-up only swallowing function and C1–C2 facet malalignment were significantly associated with the CCOS score (p < 0.05). Multivariate analysis showed that syrinx presence and C1–C2 facet malalignment were independently associated with the CCOS score at the 1- to 3-month follow-up. Swallowing function and C1–C2 facet malalignment were found to be independently associated with the CCOS score at the 9- to 12-month follow-up.CONCLUSIONSThe observed results in this pilot study suggest a significant negative correlation between C1–C2 facet malalignment and clinical outcomes evaluated by the CCOS score at 1–3 months and 9–12 months postoperatively. Prospective studies are needed to further validate the prognostic value of C1–C2 facet malalignment and the potential role of atlantoaxial fixation as part of the treatment.

Short-Term Ultramicronized Palmitoylethanolamide Therapy in Patients with Myasthenia Gravis: a Pilot Study to Possible Future Implications of Treatment

2019 ◽  
Vol 18 (3) ◽  
pp. 232-238 ◽  
Author(s):  
Emanuela Onesti ◽  
Vittorio Frasca ◽  
Marco Ceccanti ◽  
Giorgio Tartaglia ◽  
Maria Cristina Gori ◽  
...  
Keyword(s):  
Pilot Study ◽  
Myasthenia Gravis ◽  
Repetitive Nerve Stimulation ◽  
Beneficial Effects ◽  
Antibody Titers ◽  
The Stability ◽  
Ultramicronized Palmitoylethanolamide ◽  
Open Pilot

Background: The cannabinoid system may be involved in the humoral mechanisms at the neuromuscular junction. Ultramicronized-palmitoylethanolamide (μm-PEA) has recently been shown to reduce the desensitization of Acetylcholine (ACh)-evoked currents in denervated patients modifying the stability of ACh receptor (AChR) function. <p> Objective: To analyze the possible beneficial effects of μm-PEA in patients with myasthenia gravis (MG) on muscular fatigue and neurophysiological changes. <p> Method: The duration of this open pilot study, which included an intra-individual control, was three weeks. Each patient was assigned to a 1-week treatment period with μm-PEA 600 mg twice a day. A neurophysiological examination based on repetitive nerve stimulation (RNS) of the masseteric and the axillary nerves was performed, and the quantitative MG (QMG) score was calculated in 22 MG patients every week in a three-week follow-up period. AChR antibody titer was investigated to analyze a possible immunomodulatory effect of PEA in MG patients. <p> Results: PEA had a significant effect on the QMG score (p=0.03418) and on RNS of the masseteric nerve (p=0.01763), thus indicating that PEA reduces the level of disability and decremental muscle response. Antibody titers did not change significantly after treatment. <p> Conclusion: According to our observations, μm-PEA as an add-on therapy could improve muscular response to fatigue in MG. The possible modulation of AChR currents as a means of eliciting a direct effect from PEA on the conformation of ACh receptors should be investigated. The co-role of cytokines also warrants an analysis. Given the rapidity and reversibility of the response, we suppose that PEA acts directly on AChR, though further studies are needed to confirm this hypothesis.

PO-0814 Developmental Follow Up Of Former Premature Infants: A Pilot Study In Lebanon: Abstract PO-0814 Table 1

2014 ◽  
Vol 99 (Suppl 2) ◽  
pp. A520.2-A520
Author(s):  
L Charafeddine ◽  
R El Hage ◽  
H Tamim ◽  
L Akouri-Dirani ◽  
D Sinno
Keyword(s):  
Pilot Study ◽  
Premature Infants
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