scholarly journals FRI0088 CHANGE IN SERUM BILIRUBIN SUGGESTS TREATMENT RESPONSE IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH MOLECULAR-TARGETED AGENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 621.2-622
Author(s):  
S. J. Choi ◽  
S. H. Nam ◽  
J. S. Lee ◽  
W. J. Seo ◽  
J. S. Oh ◽  
...  

Background:Bilirubin is an antioxidant with anti-inflammatory properties. In previous reports, serum bilirubin levels were correlated with disease activity of autoimmune diseases including rheumatoid arthritis (RA). Various molecular-targeted agents have been developed for RA, and targets, such as IL-6 and TNFα, are associated with liver function. However, the association between serum bilirubin and treatment response in RA patients treated with molecular-targeted agents is still unknown.Objectives:We aimed to evaluate the role of serum bilirubin in the prediction of the early treatment response in RA patients who initiated molecular-targeted agents.Methods:We retrospectively recruited biologic naïve RA patients (n=292) with moderate-to-high disease activity from a tertiary hospital between Jan 2013 and Dec 2019. Patients with viral hepatitis, drug-induced hepatitis, or alcoholic liver disease were excluded. Molecular-targeted agents included tocilizumab (TCZ, n=40), adalimumab (ADA, n=59), etanercept (ETN, n=66), golimumab (GOL, n=60), abatacept (ABA, n=31), and tofacitinib (TOF, n=36). Clinical and laboratory data were collected from electronic medical records. Patients were categorised into an increased bilirubin group (higher serum bilirubin at 3 months than at baseline) and decreased bilirubin group (equal or lower serum bilirubin at 3 months than at baseline). At 6 months of treatment, good response (defined as a DAS28 score ≤3.2) was evaluated. Multivariate logistic regression analysis and multiple linear regression analysis were used to evaluate the association between serum bilirubin and treatment response. The variables included in the multiple logistic and linear regression analyses were age, female sex, rheumatoid factor, prednisolone, DMARDs, baseline liver enzymes, baseline DAS28 score, and components.Results:The mean serum bilirubin level at baseline was 4.7±1.8 mg/L. After 6 months of treatment, 180 (61.6%) patients achieved good responses. The mean serum bilirubin levels at 3 and 6 months were 5.3±2.3 and 5.5±2.2 mg/L, respectively. At 6 months, a good response was more frequent in the increased bilirubin group than in the decreased bilirubin group (71.2% [99/139] vs. 52.9% [81/153], p=0.001). In multivariate logistic regression analysis, the ORs among good responders at 6 months were 1.221 (95% CI 1.014–1.471, p=0.036) for baseline serum bilirubin and 1.377 (95% CI 1.146–1.654, p=0.001) for the change in serum bilirubin at 3 months. According to target agents, the mean changes in serum bilirubin from baseline to 6 months were 1.9±2.5 for TCZ, 1.0±1.5 for ADA, 0.7±1.9 for ETN, 0.6±2.2 for GOL, 0.3±1.2 for ABA, and 0.4±2.2 for TOF (Figure 1). Among the target agents, TCZ showed a significant increase in the mean serum bilirubin level at 3 and 6 months from baseline. In multiple linear regression analysis performed on TCZ, the change in bilirubin at 3 months was associated with the DAS28 score at 6 months (β=−0.349, p=0.020).Figure 1.Change in serum bilirubin during treatment with molecular-targeted agents in rheumatoid arthritis patientsConclusion:High baseline serum bilirubin and an increase in serum bilirubin during treatment are helpful to predict a good response to molecular-targeted agents, especially TCZ.Disclosure of Interests:None declared

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Chlabicz ◽  
M Paniczko ◽  
J Jamolkowski ◽  
P Sowa ◽  
M Lapinska ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Bialystok, Poland Introduction A low thigh circumference is associated with an increased risk of high blood pressure, diabetes, cardiovascular diseases, and total mortality. Objectives The aim of the study was to investigate the relationship between the thigh circumference and cardiovascular (CV) risk classes, and to assess what type of tissue, adipose tissue or muscle tissue affects the thigh circumference. Methods The longitudinal, population-based, Polish study was conducted in 2017-2020. A total of 931 individuals aged 20-79 were analyzed. Pol-SCORE system was used to assess the 10-year risk of fatal CV based on the following risk factors: age, gender, smoking, systolic blood pressure, and total cholesterol for individuals aged 40-70.  Then, CV risk classes were assessed using the 2019 ESC/EAS guidelines. The measurement of thigh circumference were performed directly below the gluteal fold of the thigh. Both thighs were measured and the mean value was calculated as the final thigh circumference. Body composition was assessed using Dual Energy X-ray Absorptiometry (DEXA). Results The mean age was 49.1 ± 15.5 years and 43.2% male. The mean thigh circumference was 58.2 ± 5.9 cm, the mean legs fat mass was 7.7 ± 2.8kg, and the mean legs lean mass was 16.9 ± 4.0kg. Lower thigh circumference was associated with higher CV risk classes in univariate linear regression analysis (β -0.516, p = 0.002), as well adjusted by age and sex (β -0.839, p = 0.008), adjusted by age, sex, BMI (β -0.886, p <0.001), and age, sex, WHR (β -0.988, p <0.001). In linear regression analysis legs adipose tissue and muscle tissue were related to the thigh circumference independently of CV risk classes (Model 1) and Pol-SCORE value (Model 2). However, fatty tissue (Model 1: β 0.746, p < 0.001; Model 2: β 0.749, p < 0.001) affects the thigh circumference more than the muscle tissue (Model 1: β 0.479, p < 0.001; Model 2: β 0.442, p < 0.001) (Fig. 1). Conclusion Smaller thigh circumference was associated with higher CV risk classes. Thigh circumference was more influenced by adipose tissue than by muscle tissue, regardless of the Pol-SCORE  or CV risk classes. Table 1. Variable Model 1 Model 2 Beta p R2 Beta p R2 Legs fat mass 0.746 <0.001 0.785 0.749 <0.001 0.760 Legs lean mass 0.479 <0.001 0.785 0.442 <0.001 0.760 Model 1: adjusted for Cardiovascular risk classesModel 2: adjusted for Pol-SCOREResults of the linear regression analysis thigh circumference in the general population Abstract Figure 1.


1989 ◽  
Vol 56 (4) ◽  
pp. 665-668 ◽  
Author(s):  
María A. Esteban ◽  
Andrés Marcos

SummaryBy linear regression analysis, a highly significant negative correlation (r = −0·96) was found between the mean ash concentration values (g/100 g moisture) and water activity (aw) of six types of processed cheeses (low-fat, semi-fat, fat, extra-fat, double fat and special). The regression equation aw = 0·9951 − 0·0032* (ash), applied to 40 cheese samples, yielded aw values which differed by < 0·005 aw units from those measured experimentally in 75% of the samples. The maximum differences between the calculated and experimental aw values (found in only two samples) were ±0·01 aw units.


2020 ◽  
Vol 102-B (8) ◽  
pp. 967-980
Author(s):  
Te-Feng A. Chou ◽  
Hsuan-Hsiao Ma ◽  
Jou-Hua Wang ◽  
Shang-Wen Tsai ◽  
Cheng-Fong Chen ◽  
...  

Aims The aims of this study were to validate the outcome of total elbow arthroplasty (TEA) in patients with rheumatoid arthritis (RA), and to identify factors that affect the outcome. Methods We searched PubMed, MEDLINE, Cochrane Reviews, and Embase from between January 2003 and March 2019. The primary aim was to determine the implant failure rate, the mode of failure, and risk factors predisposing to failure. A secondary aim was to identify the overall complication rate, associated risk factors, and clinical performance. A meta-regression analysis was completed to identify the association between each parameter with the outcome. Results A total of 38 studies including 2,118 TEAs were included in the study. The mean follow-up was 80.9 months (8.2 to 156). The implant failure and complication rates were 16.1% (95% confidence interval (CI) 0.128 to 0.200) and 24.5% (95% CI 0.203 to 0.293), respectively. Aseptic loosening was the most common mode of failure (9.5%; 95% CI 0.071 to 0.124). The mean postoperative ranges of motion (ROMs) were: flexion 131.5° (124.2° to 138.8°), extension 29.3° (26.8° to 31.9°), pronation 74.0° (67.8° to 80.2°), and supination 72.5° (69.5° to 75.5°), and the mean postoperative Mayo Elbow Performance Score (MEPS) was 89.3 (95% CI 86.9 to 91.6). The meta-regression analysis identified that younger patients and implants with an unlinked design correlated with higher failure rates. Younger patients were associated with increased complications, while female patients and an unlinked prosthesis were associated with aseptic loosening. Conclusion TEA continues to provide satisfactory results for patients with RA. However, it is associated with a substantially higher implant failure and complication rates compared with hip and knee arthroplasties. The patient’s age, sex, and whether cemented fixation and unlinked prosthesis were used can influence the outcome. Level of Evidence: Therapeutic Level IV. Cite this article: Bone Joint J 2020;102-B(8):967–980.


2021 ◽  
Vol 9 ◽  
Author(s):  
Nibras H. Chasib ◽  
Muhanad L. Alshami ◽  
Sarhang S. Gul ◽  
Hayder R. Abdulbaqi ◽  
Ali A. Abdulkareem ◽  
...  

Objectives: During the COVID-19 pandemic, dentists have had to work under stressful conditions due to the nature of their work. Personal protection equipment (PPE) has become mandatory for work in the dentistry field. This study aimed to examine dentists' practices and attitudes regarding the use of PPE and the associated drawbacks and cost implications during the pandemic.Methods: A questionnaire-based survey was used and was divided into five sections dedicated to collect demographic variables and to examine the dentists' practices, attitudes toward PPE, drawbacks, and cost of using PPE. Mann-Whitney U and Kruskal-Wallis tests were used to compare different sections of the questionnaire and linear regression was used to determine the predictors of the dentists' practices and attitudes toward PPE.Results: The mean of practices regarding use of PPE was 5.41 ± 1.71 (median 6), attitude toward using PPE scored 2.26 ± 0.90 (median 2), while the means of drawbacks and cost recorded equal scores of 5.22 ± 1.24 (median 5) and 1.68 ± 0.74 (median 2), respectively. The recently graduated dentists, those with postgraduate degrees and those working in the private sector demonstrated higher levels of practices on PPE than their counterparts. Regression analysis revealed that practices of PPE can be predicted on the basis of qualifications and work place, whereas attitude toward PPE is significantly influenced by qualification only.Conclusions: The study participants demonstrated satisfactory levels of practices and positive attitudes toward PPE. While complaints from using PPE and their cost were moderately affected.


1982 ◽  
Vol 28 (10) ◽  
pp. 2098-2100 ◽  
Author(s):  
R J Elin ◽  
E Johnson ◽  
R Chesler

Abstract Uric acid as measured in serum by three different uricase (EC 1.7.3.3) methods (aca, Ektachem, and SMAC) and by the SMAC method with phosphotungstic acid was compared with a candidate Reference Method for uric acid. Serum specimens from 83 patients (uric acid concentrations, 19 to 141 mg/L) were analyzed by all five methods. Results were compared by using linear regression analysis, and the mean difference between results by the candidate Reference Method and the four other methods was calculated. Compared with the candidate Reference Method, the aca method gave the smallest deviation from zero for the intercept and the smallest mean difference, and the SMAC phosphotungstic acid method showed a slope closest to unity. The SMAC uricase method had the largest intercept and greatest deviation of the slope from unity.


2018 ◽  
Vol 11 (1) ◽  
pp. 41
Author(s):  
Runa Laila ◽  
Begum Nasrin ◽  
Shayela Shamim ◽  
Md. Mozammel Hoque

<p class="Abstract">This study was conducted to evaluate the association of serum cancer antigen (CA-125) level with the severity of pelvic endometriosis. Seventy diagnosed cases of pelvic endometriosis were included in this study. The CA-125 level was estimated in all these patients, cutoff value of the serum CA-125 level was considered 35.0 U/mL. The correlations between serum CA-125 and different stages of endometriosis were evaluated by linear regression analysis. In Stage I of endometriosis, the mean serum CA-125 level was 21.8 ± 15.1 U/mL, in Stage II 26.0 ± 17.3 U/mL, in Stage III 83.2 ± 48.9 U/mL and in Stage IV 117.0 ± 41.6 U/mL. A significant positive correlation (r=0.729; p=0.001) was found between the serum CA-125 and different stages of endometriosis.</p>


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Yuki Hashimoto ◽  
Wataru Saito ◽  
Yuka Hasegawa ◽  
Kousuke Noda ◽  
Susumu Ishida

Purpose. To investigate relationships between total thickness and the thickness of inner and outer layers in the choroid during regression in patients with multiple evanescent white dot syndrome (MEWDS). Methods. This retrospective observational case series included 15 unilaterally affected eyes and 13 unaffected fellow eyes from 15 MEWDS patients (4 men and 11 women; mean age, 37.6 ± 17.6 years). Using enhanced depth imaging optical coherence tomography, whole, inner, and outer choroidal layer thicknesses at the fovea and perifovea were manually measured at the initial visit and at 1 and 3 months after the initial visit. The mean thickness values of the layers were compared at each stage. Results. With regression of MEWDS, the mean subfoveal whole and inner choroidal layer thicknesses significantly decreased at 1 and 3 months compared to baseline values in MEWDS eyes (P=0.01 and P<0.0001, respectively), but not in fellow eyes. The outer layer in MEWDS eyes tended to thin. Changes in the inner and outer layers at the perifovea in MEWDS eyes also showed the same trends. Simple linear regression analysis revealed significant positive correlations in choroidal thickness changes between the whole and inner layers (R = 0.53, P=0.04) and between the whole and outer layers (R = 0.91, P<0.0001) from baseline to 3 months. Multiple linear regression analysis revealed that choroidal thickness changes in the whole layer were significantly correlated with those in the inner (β = 0.51, P<0.0001) and outer (β = 0.73, P<0.0001) layers. Conclusion. The inner choroidal layer significantly thinned with regression of MEWDS, correlating with the thinning of total choroidal thickness. These results suggest that MEWDS lesions in the choroid are likely to lie mainly in the inner layer.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1953.2-1954
Author(s):  
Y. Wang ◽  
R. Zhao ◽  
C. Dong ◽  
Z. Gu

Background:The health-related quality of life (HRQL) of patients with rheumatoid arthritis associated interstitial lung disease (RA-ILD) is less concerned(1). This study hypothesized that HRQL of such patients decreased.Objectives:The aim of this study was to assess the difference in HRQL between RA with and without ILD, and to predict risk factors of HRQL in Chinese RA-ILD.Methods:A cross-sectional survey of RA-ILD patients included socio-demographic characteristics, clinical variables, psychological factors and HRQL. Data were analyzed by Student’s t or chi-square test. Linear regression analysis was used to investigate the predictors of HRQL in RA-ILD.Results:The data showed that 35.17% (51/145) of RA patients had ILD. There are significant differences in age, sex, smoking history, disease duration and activity between RA with and without ILD. HRQL of RA-ILD was impaired. Physical component score (PCS) of patients with RA-ILD was also worse than that of RA without ILD (48.91±2.48 vs. 50.80±2.55). Linear regression analysis showed that DAS28 and fatigue were risk factors for PCS in patients with RA-ILD, while depression and rural residence were risk factors for mental components summary in Table 1.Table 1.Stepwise multiple linear regression analysis of PCS and MCS in RA-ILDPredictorsBSEtP95%CIPCSDAS28-0.7770.227-3.4250.001-1.236,-0.319Fatigue-0.6550.206-3.1770.003-1.071, -0.238MCSDepression2.1880.6693.2720.0020.836, 3.539Rural residents-1.6090.756-2.1280.040-3.137,-0.081Footnotes: CI=Confidence interval. PCS=Physical component score; MCS=Mental component score; DAS28=28-joint disease activity score.Conclusion:Compared with RA without ILD, HRQL of patients with RA-ILD was significantly impaired. Disease activity, fatigue, depression and rural residence were independent predictors of HRQL in Chinese RA-ILD.References:[1]Zamora-Legoff JA, Krause ML, Crowson CS, Ryu JH, Matteson EL. Patterns ofinterstitial lung disease and mortality in rheumatoid arthritis. Rheumatology (Oxford, England). 2017;56(3):344-50.Disclosure of Interests:None declared


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