scholarly journals POS0549 FUNCTIONAL IMPACT OF FOREFOOT INVOLVEMENT IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 509.1-509
Author(s):  
K. Maatallah ◽  
H. Boussaa ◽  
H. Riahi ◽  
H. Ferjani ◽  
W. Triki ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Significant Positive Correlation ◽  
Foot Deformities ◽  
X Rays ◽  
Functional Impact ◽  
Positive Correlation ◽  
Larsen Score ◽  
The Mean ◽  
Hands And Feet

Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease that mainly affects small joints of the hands and feet. Foot deformities may affect the patient’s gait, thus compromising their daily activities and autonomy.Objectives:The aim of this study was to analyze its functional impact.Methods:We conducted a cross-sectional study including patients diagnosed with RA according to the ACR/EULAR 2010 criteria. Demographic variables, Foot Function Index (FFI), and Health Assessment Questionnaire (HAQ) scores were analyzed. We collected data on the following clinical variables: The pain Visual Analog Scale (VAS), forefoot deformities, erythrocyte sedimentation rate (ESR), and Disease Activity Score 28 (DAS28). All patients had feet X-rays and the Larsen score was calculated. A blinded radiologist experienced in musculoskeletal imaging using a Philips HD11 device with a high-frequency linear transducer performed ultrasonography (US) of MTP joints. Synovitis was defined as an abnormal hypoechoic synovial tissue within the capsule that is not displaceable and poorly compressible and that may exhibit Doppler signals. The composite synovitis score (power doppler / grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:We included 31 patients (25 men and six women) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. The mean ESR and DAS28 ESR were 33±26 mm [5-102] and 3.8±1.5 [0.6-7], respectively. Twenty-nine percent of patients had a high disease activity.Metatarsalgia was reported by 54.8% of patients with a mean VAS of 4.5±3.7 [0-9]. Forefoot deformities were noted in 42% of patients: round forefoot in 13% of cases, triangular forefoot in 29% of cases, hallux valgus in 29% of cases, Quintus varus in 29% of cases, and claw toes in 13% of cases. Corns and calluses were noted in 42% and 29% of cases respectively.X-rays showed abnormalities in 75% of patients. The mean Larsen score was 9.8±6.2 [0-28].US showed synovitis in 46.3% of MTP1, in 53.7% of MTP2, in 48.3% of MTP3, in 42.6% of MTP4, and in 37% of MTP5 joints. Doppler signal was detected in 5.6% of MTP1 and MTP2, and in 3.7% of MTP3, MTP4, and MTP5 joints. The mean US score was 5.3±4.3 [0-15].The mean FFI was 66.5%. Mean rates of pain, difficulty, and disability were 89.5%, 40%, and 70% respectively. The mean HAQ score was 0.5±0.5 [0-2]. Severe disability was noted in 20% of patients.A significant positive correlation was noted between FFI and, Larsen score (r=0.214, p=0.014) and US score (r=0.420, p=0.021). A significant positive correlation was also noted between HAQ score and, foot pain VAS (r=0.555, p=0.009).Conclusion:Foot involvement is frequently seen in RA. This condition may affect patients’ autonomy. Early diagnosis and appropriate treatment are necessary in order to preserve the quality of life.Disclosure of Interests:None declared

Anti carbamylated protein antibodies as a diagnostic marker in patients with rheumatoid arthritis and its association with disease activity

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Magda Medhat Awad El debsy ◽  
Mervat Mohammed Abdul Hakim ◽  
Henaz Farouk Khaled ◽  
Hala Mohamed Abd El Sabour Sabbah
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Plasma Levels ◽  
Significant Positive Correlation ◽  
Diagnostic Marker ◽  
Complete Blood Count ◽  
Control Group ◽  
Positive Correlation ◽  
Larsen Score ◽  
Function Tests

Abstract Background Despite the diagnostic contribution of anti-citrullinated protein( anti-CCP) antibody and rheumatoid factor (RF), approximately one-third of patients with rheumatoid arthritis (RA) remain seronegative .Anti-carbamylated protein (Anti-Carp) antibodies have been attracting increasing attention as a new diagnostic marker of RA. Objective evaluate levels of anti-carp antibodies in RA patients in order to detect its role as a diagnostic marker and its possible association with disease activity and severity. Methods This study included thirty adult patients with clinical evidence of rheumatoid arthritis and thirty healthy matched age and sex as controls. All underwent history taking, clinical examination, assessment of disease activity with modified Disease Activity28 (DAS28), Laboratory investigations including Complete blood count (CBC), erythrocytes sedimentation rate (ESR), C-Reactive Protein (CRP), Liver function tests, Kidney function tests, Serum uric acid, RF, anti CCP Ab, anti-Carp Ab and radiographic Assessment with Larsen score. Results Plasma levels of anti-Carp Ab were significantly higher in patients than control group (p &gt; 0,001) with sensitivity of 73.33% and specificity of 100%.it showed significant positive correlation with CRP (r = 0.37 )(p &lt; 0.05) as a marker of activity of RA and also there was significant positive correlation with RF and ACPA (r = 0.45)(r = 0.48) (p &lt; 0.05) respectively as a diagnostic marker for RA. Plasma levels of anti-Carp Ab were higher in patients with more joints damage and erosions as assessed by Larsen radiological score as there was a highly significant correlation between Larsen score and serum Anti-Carp(r = 0.61)(p &lt; 0.001).. Conclusion serum Anti–Carp antibody level was higher in RA patients which serve as a diagnostic marker for RA, also its significant correlation with CRP and Larsen score may serve as a marker for disease progression and severity.

scholarly journals Glycated Albumin, a Marker for RA associated Coronary Artery Athelosclerosis

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M R Y Eskander ◽  
H ELsebaie ◽  
N Assaf ◽  
N Elgharbawy ◽  
L Allam
Keyword(s):  
Coronary Artery ◽  
Disease Activity ◽  
Negative Correlation ◽  
Significant Positive Correlation ◽  
Glycated Albumin ◽  
Enzyme Linked Immunosorbent Assay ◽  
Carotid Imt ◽  
Positive Correlation ◽  
Das 28 ◽  
The Mean

Abstract Objectives to detect the value of serum Glycated Albumin measurement as a marker for RA associated coronary artery atherosclerosis and also a marker for RA disease activity. Patients and Methods serum GA using enzyme-linked immunosorbent assay (ELISA), chemical and immunological markers of RA were measured in 30 RA patients and 15 age and sex matched controls known to have established coronary artery disease. Disease activity was assessed using the DAS-28 score. Carotid ultrasound was done to both groups to measure the carotid IMT. Results A significantly higher serum GA level on comparing RA patients and controls (T = 5.096, P &lt; 0.001). Serum GA had a significant positive correlation with ESR (r = 0.546, P &lt; 0.002) and CRP (r = 0.768, P &lt; 0.001), a significant positive correlation with DAS-28 (r = 0.532 , P &lt; 0.002), a significant positive correlation with mean carotid IMT (r = 0.471, P = 0.019). The mean carotid IMT showed a highly significant positive correlation with the disease duration (r = 0.645, P &lt; 0.001), a positive correlation with severe disease activity (r = 0.771, P = 0.015), but negative correlation with mild and moderate disease activity (r = 0.500, P = 0.667) and ( r = 0.452, P = 0.059) respectively. Another significant positive correlation was found between the mean carotid IMT and the LDL (r = 0.408, P = 0.025) but negative correlation with total cholesterol and HDL (r = 0.120, P = 0.527) and (r = -0.250, P = 0.183). On comparing the mean carotid IMT with the presence of soft atheromatous plaque it gave negative results with positive correlation (T = -3.273, P = 0.003) Conclusion Serum GA is a specific and sensitive biomarker for detection of subclinical atherosclerosis and disease activity in RA.

scholarly journals P084 C-Reactive Protein Correlates with Tumor Necrosis Factor-α in Ulcerative Colitis

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S184-S186
Author(s):  
P McDonagh ◽  
F O’Connell ◽  
J O’Connell ◽  
R Argue ◽  
R Corcoran ◽  
...  
Keyword(s):  
Disease Activity ◽  
Significant Positive Correlation ◽  
P Value ◽  
C Reactive Protein ◽  
Positive Correlation ◽  
Reactive Protein ◽  
Mayo Score ◽  
Tnf Α ◽  
The Mean ◽  
The Relationship

Abstract Background Monitoring disease activity in Ulcerative colitis (UC) is essential. Inflammatory markers like C-Reactive Protein (CRP) and faecal calprotectin have been shown to correlate with clinical and endoscopic disease activity. To date the relationship between CRP and the inflammatory analytes within the colonic microenvironment have not been analysed. Methods Our primary aim was to evaluate the relationship between CRP and key inflammatory cytokine, TNF-α, in UC patients. We also sought to investigate whether CRP correlates with clinical parameters. Ethical approval was granted by our Research Ethics Committee. Patients over the age of 17 with a confirmed diagnosis of UC presenting for colonoscopy were offered the opportunity to participate. Basic patient demographics and Mayo score were recorded. At endoscopy colonic biopsies were taken and cultured in dimethyl sulfoxide (DMSO). Multiplex inflammatory and angiogenic enzyme-linked immunosorbent assay (ELISAs) were performed to evaluate the colonic microenvironment and assess real time secretion of TNF-α. Correlations were carried out on SPSS 24 and plotted using R Studio corrplot. Results 26 patients with UC participated in the study. The mean Mayo score was 4 (range 0–10). At endoscopy 15% had severe colitis (Mayo endoscopy sub-score 3), 31% had moderate disease, 54% had mild disease. 35% of patients were receiving biologic therapy. The mean CRP was 6.19mg/L (range 1–48.35mg/L), albumin 43.5g/L (range 31-49g/L). CRP had a negative correlation with albumin (r=-0.585, p-value 0.002). CRP had a statistically significant positive correlation with clinical, endoscopic and total Mayo scores (r= 0.469, 0.543, 0.526. p-values 0.016, 0.004, 0.006, respectively). Bleeding at colonoscopy also correlated very strongly with an elevated CRP (r=0.859, p-value=0.00). CRP had a moderate positive correlation with TNF-α (r=0.603, p-value=0.001) and VEGF receptor (r=0.492, p-value=0.011) levels. Conclusion CRP displayed a statistically significant positive correlation with the Mayo score. There was a significant correlation between the CRP and TNF-α expression within the colonic micro-environment. TNF-α is a key cytokine and therapeutic target in UC, its relationship with CRP has not been previously assessed. CRP is produced primarily by hepatocytes and is activated by TNF-α, interleukin 6 and interleukin 1β. It therefore stands to reason that there would be correlation between the two. The importance of TNF-α in UC is well known, this study supports and provides new evidence for the use of CRP as a non-invasive marker of disease activity.

scholarly journals THU0536 ASSOCIATION BETWEEN OVERWEIGHT/OBESITY AND DISEASE ACTIVITY ON BONE SCINTIGRAPHY IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 507.2-507
Author(s):  
S. M. Lee ◽  
J. W. Lee
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Bone Scintigraphy ◽  
Significant Positive Correlation ◽  
Blood Pool ◽  
Study Data ◽  
Uptake Ratio ◽  
Positive Correlation ◽  
Multi Center Study ◽  
Baseline Bmi

Background:In previous studies, obesity is highly prevalent in patients diagnosed with rheumatoid arthritis and it is positively associated with disease activity1. Although Tc-99m-labeled bone scintigraphy has been widely performed to evaluate the disease activity of the joints involved in this disease2; the effect of body mass index (BMI) on the results of bone scintigraphy is yet to be accessed.Objectives:In the present study, we evaluated the relationship between BMI and uptake intensity of the joints that was measured using bone scintigraphy in patients with rheumatoid arthritis.Methods:A total of 80 patients (21 men and 59 women; mean age 56±14 years) with rheumatoid arthritis who underwent Tc-99m methylene diphosphonate bone scintigraphy before treatment were enrolled in this study. Data were collected for baseline BMI and disease activity score for the 28 joints using erythrocyte sedimentation rate (DAS28-ESR) of these patients. Uptake intensity of these 28 joints was automatically measured for each patient using an in-house software, expressed as joint uptake-to-background normal bone uptake ratio (joint uptake ratio). The correlation of BMI with DAS28-ESR and joint uptake ratio on bone scintigraphy was assessed.Results:Mean BMI of the enrolled patients was 24.4±3.7 kg/m2and 50 patients (62.5%) were classified as overweight/obesity. BMI was significantly positively correlated with the sum of 28 joint uptake ratios on bone scintigraphy (p=0.021, correlation coefficient=0.358) as well as DAS28-ESR (p=0.030). Patients with overweight/obesity (39.2±9.5) had significantly higher values of the sum of 28 joint uptake ratios than the other patients (33.9±9.5; p=0.025). In correlation analysis with each joint uptake ratio of 28 joints, BMI more significantly positively correlated with uptake ratios of shoulder, elbow, and knee joints than those in wrist and hand joints. In subgroup analysis of patients having low (DAS28-ESR ≤3.2) and high (DAS28-ESR >3.2) disease activity, BMI still showed significant positive correlation with the sum of 28 joint uptake ratio on bone scintigraphy in both subgroups (p<0.05 for all).Conclusion:The Baseline BMI in patients with rheumatoid arthritis had significant positive correlation with joint uptake intensity measured on bone scintigraphy, especially for large joints. The results of our study might provide an evidence that supports an association between BMI and disease activity of rheumatoid arthritis.References:[1]de Resende Guimaraes MFB, Rodrigues CEM, Gomes KWP, et al. High prevalence of obesity in rheumatoid arthritis: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study. Adv Rheumatol 2019;59:44.[2]Kim JY, Choi YY, Kim CW, et al. Bone scintigraphy in the diagnosis of rheumatoid arthritis: is there additional value of bone scintigraphy with blood pool phase over conventional bone scintigraphy? J Korean Med Sci 2016;31:502-9.Acknowledgments:Research relating to this abstract was funded by the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science and ICT) (grant number: NRF-2018R1C1B5040061).Disclosure of Interests:None declared

Evaluation of Toll-like Receptor 2 Gene Expression in Rheumatoid Arthritis and Correlation with the Disease Activity

2019 ◽  
Vol 13 (2) ◽  
pp. 140-148
Author(s):  
Mai Nasser ◽  
Noha M. Hazem ◽  
Amany Atwa ◽  
Amina Baiomy
Keyword(s):  
Rheumatoid Arthritis ◽  
Gene Expression ◽  
Autoimmune Diseases ◽  
Disease Activity ◽  
Mrna Expression ◽  
Disease Activity Score ◽  
Activity Score ◽  
Tlr2 Expression ◽  
Positive Correlation ◽  
Tlr2 Mrna

Background: Rheumatoid Arthritis (RA) is an autoimmune, chronic, and systematic disease. It affects joints and bones. The exact etiology of RA is still unclear. Varied genetic and environmental factors have been associated with the increased risk for RA. Overactivation of Toll-Like Receptors (TLRs) could initiate the development of autoimmune diseases including RA. Objective: The aim of the study was to evaluate TLR2 gene expression in rheumatoid arthritis patients and investigate its correlation with the disease activity. Materials and Methods: This study included 60 patients and 20 healthy individuals. The patients were diagnosed with RA according to the 2010 American College of Rheumatology/ European League Against Rheumatism criteria (ACR/EULAR). All included subjects did not have any joint disorders and /or autoimmune diseases. RA disease activity was determined by the disease activity score of 28 joints. Whole blood was collected from all participants. Total RNA extraction was done. TLR2 mRNA expression was assessed by reverse transcription-PCR (RT-PCR). Results: TLR2 mRNA expression was found to be significantly higher in RA patients compared to healthy controls. Also, a strong positive correlation was found between TLR2 expression level and the disease activity score. A non significant positive correlation was found between TLR2 expression and serum Rheumatoid Factor (RF) level. Conclusion: TLR2 pathway may have an important role in RA pathogenesis and could be a new biomarker for diagnosis and monitoring disease activity.

Anti-carbamylated Protein Antibodies and Serum Level of 14-3-3 Protein for Early Detection of Rheumatoid Arthritis Patient in Correlation with Rheumatoid Factor, Anti-CCP Antibodies, Disease Activity and Joint Damage using High Frequency Musculoskeletal Ultrasound

2020 ◽  
Vol 7 (2) ◽  
pp. 141-153
Author(s):  
Sahar A. Ahmed ◽  
Enas M. Darwish ◽  
Walaa A. Attya ◽  
Mai Samir ◽  
Mennatallah Elsayed ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Rheumatoid Factor ◽  
Disease Activity Score ◽  
Joint Damage ◽  
Musculoskeletal Ultrasound ◽  
Activity Score ◽  
Das 28 ◽  
Significant Difference ◽  
Hands And Feet

Background: Rheumatoid arthritis (RA) is a common progressive chronic inflammatory autoimmune disease which affects mostly small joints, causing pain, swelling, deformity, and disability. Although progress has been made in exploring RA nature, still there is a lot to know about the disease pathogenesis, diagnosis, and treatment. Aim of the Work: To investigate the role of serum anti-carbamylated protein antibodies and 14-3-3η in the diagnosis of RA compared to rheumatoid factor (RF), anti-CCP antibodies, and highfrequency musculoskeletal ultrasound used to assess the disease activity and joint damage. Methods: Serum anti-carbamylated protein antibodies and 14-3-3η were measured using ELISA in 61 RA patients and 26 normal controls. RA Disease Activity Score (DAS 28), X-ray and musculoskeletal ultrasound (hands and feet), carotid ultrasound (Intima-Media Thickness IMT) were used in assessing the RA disease. Results: Anti-carbamylated protein antibodies were significantly elevated in RA patients 4.5 (4.1- 8.9 U⁄ml) compared to the control 3.2(1.9- 4.3 U⁄ml) (p< 0.001) but 14-3-3η showed no significant difference. There was a significant positive correlation between anti-carbamylated protein antibodies, 14-3-3η levels and disease activity score assessed by DAS 28, increased IMT measured by carotid duplex, total synovitis and total erosion score were assessed by musculoskeletal ultrasound. There was no correlation between RF and anti-CCP antibodies. Anti-carbamylated protein antibodies were found to have 66.7% sensitivity and 85.2% specificity in RA diagnosis, while 14- 3-3η had 51.9% sensitivity and 72.1% specificity. Conclusion: Anti-carbamylated protein antibodies and 14-3-3η have a high sensitivity and specificity in RA diagnosis and had a correlation with the disease activity and joint damage.

scholarly journals AB0179 INFLUENCE OF AINFLUENCE OF ANTI-CITRULLINATED PROTEIN/PEPTIDE ANTIBODIES (ACPAS)ON ARTICULAR MANIFESTATIONS, DISEASE ACTIVITY AND STRUCTURAL SEVERITY IN ALGERIAN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1115.1-1115
Author(s):  
F. Rahal ◽  
N. Brahumi ◽  
A. Ladjouze-Rezig ◽  
S. Lefkir
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Early Rheumatoid Arthritis ◽  
Disease Activity Score ◽  
Activity Score ◽  
Symptom Duration ◽  
Early Ra ◽  
The Mean ◽  
Citrullinated Protein ◽  
Peptide Antibodies

Background:Anti-citrullinated protein/peptide antibodies (ACPA) are highly specific and sensitive markers for rheumatoid arthritis (RA). There are also suggested to have a more severe rheumatoid arthritis.Objectives:The aim of this study was to assess the influence of ACPA on disease activity, radiological severity, and functional disability in Algerian patient with early rheumatoid arthritis (RA).Methods:Consecutive early RA patients (symptom duration ≤24 months) recruited were included in the descriptive, longitudinal, prospective study. Demographic, biological, immunological and radiographic data were collected at the time of inclusion in the study. Disease activity as determined by the Disease Activity Score 28-CPR (DAS28- CPR: 4 variables), functional handicap as calculated by Heath Assessment Score (HAQ), and bone and joint damage as evaluated by Sharp-Van der Heijde (SVDH) erosion and narrowing score.Results:One hundred and sixty-one patients with RA were recruited. Patients mean age 43.71±14 years and mean symptom duration at inclusion was 10.48±7 months. Small and larges were affected in 64,3%. The mean ESR was 23,53±15,2 mm/1st hour, and the mean CRP level was 19,42±39.8 mg/l. Rheumatoid Factors (RFs) and Anti-Citrullinated Protein Antibodies (ACPAs) were present in 74% and 88% of patients, respectively. The presence of ACPAs was significantly associated with DAS28 (p=0,004) and HAQ (p=0,002). There was no significant difference in inflammatory markers and radiographic SVDH score between patients with and without ACPAs. Stepwise regression analysis showed that the presence of ACPAs was independently associated with localization when RA affected smalls and larges joint in the same time (OR=5,24; IC 95% 1,224-22,483; p=0,026).Conclusion:These data show that in patients with early RA, ACPAs positivity was significantly associated with articular manifestations, activity disease and functional handicap, but not with structural damage.References:[1]Nikiphorou E, Norton S, Young A, et al. Association between rheumatoid arthritis disease activity, progression of functional limitation and long-term risk of orthopaedic surgery: combined analysis of two prospective cohorts supports EULAR treat to target DAS thresholds. Ann Rheum Dis. 2016;75(12):2080-2086. doi:10.1136/annrheumdis-2015-208669.[2]Karimifar M, Salesi M, Farajzadegan Z. The association of anti-CCP1 antibodies with disease activity score 28 (DAS-28) in rheumatoid arthritis. Adv Biomed Res. 2012;1:30. doi:10.4103/2277-9175.98156.[3]Boman A, Brink M, Lundquist A, et al. Antibodies against citrullinated peptides are associated with clinical and radiological outcomes in patients with early rheumatoid arthritis: a prospective longitudinal inception cohort study. RMD Open. 2019;5(2):e000946. Published 2019 Sep 3. doi:10.1136/rmdopen-2019-000946.Disclosure of Interests:None declared

scholarly journals AB0101 THE IMPACT OF TIME SPAN TO ACHIEVE BOOLEAN REMISSION FOR MAINTAINING DISEASE ACTIVITY AFTER ACQUISITION IN RHEUMATOID ARTHRITIS PATIENT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1079.1-1079
Author(s):  
I. Yoshii
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Remission Rate ◽  
Mean Value ◽  
Time Span ◽  
Mean Values ◽  
The Mean ◽  
The Relationship

Background:Boolean remission criteria is one most popular and stringent criteria in treating patient with rheumatoid arthritis (RA), because it may guarantees a stable clinical course after attaining remission.Objectives:Impact of time span from initiation to achieving Boolean remission on maintaining disease activity, daily activities, and quality of life after attaining Boolean remission was investigated from daily clinical practice data.Methods:685 patients with RA since August 2010 under the T2T strategy were treated. They were monitored for their TJC, SJC, PGA, EGA, CRP, and disease activity indices such as CDAI, SDAI, DAS28, and Boolean criteria at every visit. HAQ-DI score, pain score using visual analog scale (PS-VAS), and EQ-5D were also monitored, and the quality of life score (QOLS) calculated from EQ-5D was determined at every visit from the time of diagnosis (baseline).Of 685 patients, 465 patients had achieved Boolean remission >1 times, and were consecutively followed up for >3 years. These patients were enrolled in the study. Time span from the first visit to first Boolean remission was calculated. The relationship between the time span and each of background parameters, and the relationship between the time span and each of the mean values of the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at the first Boolean remission and thereafter was evaluated statistically.Patients were subsequently divided into the G ≤ 6 and G > 6 groups based on the achievement of first Boolean remission within two groups: time span G ≤ 6 months and G > 6 months. The two groups were compared with regard to the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at first visit and at the time of first Boolean remission, and the mean values of these parameters after remission were evaluated statistically. Moreover, changes of these parameters and the mean Boolean remission rate after the first remission, and SDAI remission rate at the first Boolean remission to thereafter were compared between the two groups statistically.Results:Out of 465 patients, females comprised 343 (73.7%), and the mean age was 67.8 years (range, from 21–95 years). The mean disease duration at first visit was 6.1 years (range, from 1 months–45 years). The mean follow up length was 88.1 months (range: 36–122 months; median: 85 months) and mean time span from the first visit to the first Boolean remission was 8.1 months. The mean SDAI score, HAQ score, PS-VAS, and the QOLS at first visit were 13.3, 0.467, 33.2, and 0.834, respectively. Among the study parameters, PS-VAS and QOLS were significantly correlated with the time span. For parameters at the first Boolean remission, HAQ-DI score, PS-VAS, and QOLS demonstrated significant correlation with the time span, whereas SDAI, HAQ-DI score, PS-VAS, SHS, and QOLS after the Boolean remission demonstrated significant correlation with the time span.The comparison between the G ≤ 6 and the G > 6 groups revealed that the disease duration, HAQ score, and PS-VAS at baseline in the G > 6 were significantly higher than that in the G ≤ 6 group, and QOLS in the G ≤ 6 group was significantly higher than that in the G > 6 group at baseline. Similarly, the HAQ score and PS-VAS at the first Boolean remission in the G > 6 group were significantly higher than that in the G ≤ 6 group, whereas QOLS in the G ≤ 6 group demonstrated no significant difference compared with that in the G > 6 group.The mean value of the SDAI score after the first Boolean remission in the G > 6 group was significantly higher than that in the G ≤ 6 group. Similarly, the SDAI score, HAQ score, and PS-VAS after the first Boolean remission in the G > 6 group were also significantly higher than those in the G ≤ 6 group, and the mean value of the QOLS in the G ≤ 6 group were significantly higher than that in the G > 6 group. The Boolean remission rate and SDAI remission rate after the first Boolean remission were significantly higher in the G ≤ 6 group than those in the G > 6 group.Conclusion:Attaining Boolean remission ≤ 6 months for RA has significant benefit for more stable disease control, that leads good maintenance of ADL.Disclosure of Interests:None declared

scholarly journals Interleukin-37 as an anti-inflammatory cytokine: does its relation to disease activity suggest its potential role in rheumatoid arthritis therapy?

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Eman A. Baraka ◽  
Mona G. Balata ◽  
Shereen H. Ahmed ◽  
Afaf F. Khamis ◽  
Enas A. Elattar
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Tender Joint ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Significant Difference ◽  
The Mean ◽  
Anti Inflammatory

Abstract Background This study aimed to measure the serum and synovial interleukin (IL)-37 levels in rheumatoid arthritis (RA) patients compared to patients with primary knee osteoarthritis (PKOA) and healthy controls and to detect its relation to RA disease activity. Results This cross-sectional study included 50 RA patients with a mean age of 40.24 ± 8.62 years, 50 patients with PKOA with a mean age of 56.69 ± 4.21, and 40 healthy controls with a mean age of 41.75 ± 7.38 years. The mean serum IL-37 level in the RA patients (382.6 ± 73.97 pg/ml) was statistically significantly (P < 0.001) the highest among the studied groups; however, it showed a non-significant difference between the PKOA patients (70.38 ± 27.49 pg/ml) and the healthy controls (69.97 ± 25.12 pg/ml) (P > 0.94). Both serum and synovial IL-37 levels were significantly positively correlated with disease activity scores (r = 0.92, P< 0.001 and r = 0.85, P < 0.001), tender joint counts (r = 0.83, P < 0.001 and r = 0.82, P < 0.001 ), swollen joint counts (r = 0.72, P < 0.001 and r = 0.60, P < 0.001), visual analog scale (r = 0.82, P < 0.001 and r = 0.82, P < 0.001), erythrocyte sedimentation rate (r = 0.75, P < 0.001 and r = 0.65, P < 0.001), and C-reactive protein (r = 0.93, P < 0.001 and r = 0.79, P < 0.001), respectively. Conclusion Serum and synovial IL-37 were significantly elevated in the RA patients, and they were closely correlated. Being less invasive, the serum IL-37 could be a marker of disease activity and could reflect the effective disease control by drugs. Having an anti-inflammatory effect could not suggest IL-37 as the key player to control inflammation alone, but its combination with other anti-proinflammatory cytokines could be investigated.

scholarly journals AB0104 CONCORDANCE BETWEEN THE PHYSICIAN’S AND THE PATIENT’S ASSESSMENT OF DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS: RESULTS OF THE AUTODAS-MEAC STUDY AT ONE YEAR

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1080-1080
Author(s):  
N. Ziade ◽  
S. Al Emadi ◽  
M. Abu Jbara ◽  
S. Saad ◽  
L. Kibbi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Middle Eastern ◽  
Weighted Kappa ◽  
Arab Countries ◽  
Das 28 ◽  
The Mean ◽  
One Year ◽  
Middle Eastern Arab ◽  
Assessment Of Disease Activity

Background:Involving the patients with rheumatoid arthritis (RA) in the assessment of their disease may increase their adherence to treatment, improve the disease outcomes and facilitate the application of telehealth. We previously reported an excellent concordance between the Disease Activity Score (DAS-28) performed by physicians and patients at the baseline visit of this prospective study (1).Objectives:To evaluate the persistence of the concordance between the physician’ and the patient’s assessment of disease activity in RA using DAS-28 after one year.Methods:At the baseline visit, patients with RA from 7 Middle Eastern Arab Countries (MEAC) were briefed about DAS-28 by their rheumatologist during a routine consultation and given smartphone access to a video in Arabic language explaining the performance of DAS-28. At 3, 6 and 12 months (± 3 months), the patients were asked to self-report DAS-28, blinded to the physician’s assessment. Concordance between the continuous DAS-28 at each visit was calculated using paired t-test numerically and the Bland-Altman method graphically. Agreement between physician- and patient-DAS categories (remission, low-, moderate- and high disease activity) was calculated at each visit using weighted kappa for category comparison. Weighted kappa of the different agreements were compared over time using their respective confidence intervals (CIs). Predictive factors of positive concordance between physician and patient-DAS were identified using binary logistic regression.Results:The study included 428 patients over a period of three years (2018 to 2020). The mean age of participants was 49.8 years, 82.5% were females, 44.3% had a university degree and the mean disease duration was 11.4 years.At baseline, the average patient-DAS was higher (4.06 (±1.52)) than the physician-DAS (3.97 (±1.52)). The mean difference was -0.09 [95%CI -0.14; -0.04] and most of the pairs were within the limit of agreement in the Bland-Altman graph, indicating a good concordance, particularly in cases of remission.During the study follow-up, 299 patients consulted for visit 2 (69.9% of the total population), 232 for visit 3 (54.2%) and 199 for visit 4 (46.5%). The weighted kappa was 0.80 [95%CI 0.76;0.85] at visit 1 and 0.79 [95%CI 0.72;0.88] at visit 4 (Figure 1 showing kappa for DAS-28, CDAI and SDAI as well). A minor numerical decrease in kappa was observed over time; however, the CIs were overlapping over the four visits and the agreement was considered stable, remaining in the excellent range. At visit 4, a positive concordance between the physician- and the patient-DAS was associated with the profession (lower in blue collar, p=0.001), the educational level (higher in high school and university, p=0.034) and the baseline physician’s DAS (higher in high disease activity, p=0.46).Conclusion:The agreement between the DAS-28 performed by the physician and by the patient was excellent at baseline and remained stable over one year. A positive concordance was associated with the profession, the educational level and the level of disease activity. The present study can help the rheumatologist make informed decisions about the patients who may be suitable for a remote evaluation of their disease activity, that can be of particular interest in the context of the COVID-19 pandemic.References:[1]Ziade N, Saad S, al Mashaleh M, et al. Perceptions of Patients with Rheumatoid Arthritis about Self-Assessment of Disease Activity after Watching an Educational Video: Qualitative Pilot Results from the Auto-DAS in Middle Eastern Arab Countries Study [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10).Acknowledgements:The authors would like to acknowledge the patients for participating in the study and the assistants/ students/ nurses who assisted in the data collection: Dr. Fatima Abdul Majeed Al Hawaj, M. Atef Ahmed, M. Mohammad Alhusamiah, Ms Raquel De Guzman, Ms Lina Razzouk.Disclosure of Interests:None declared

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