Rheumatology最新文献

{"title":"OA37 Validating QRISK3 for cardiovascular disease risk prediction in rheumatoid arthritis in the UK Biobank","authors":"Michael Stadler, Sizheng (Steven) Zhao, Anne Barton, John Bowes","doi":"10.1093/rheumatology/keaf142.037","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf142.037","url":null,"abstract":"Background/Aims Established cardiovascular disease (CVD) risk prediction tools, such as QRISK3, have been shown to be less accurate in patients with rheumatoid arthritis (RA). QRISK3 was developed for use in the general population, but study cohorts are not always representative of the wider public, which may explain some of these discrepancies. Our aim here, therefore, was to validate QRISK3 for RA CVD risk prediction in the UK Biobank (UKB), a large-scale health study of the general population. Methods Data from UKB participants was used to derive the necessary fields to calculate and validate QRISK3 separately per sex. Prevalent RA and incidence cases of CVD were defined relative to the initial UKB assessment date, using self-report questionnaires and hospital inpatient data. Prevalent CVD cases, as well as participants with a prescription for statins or who were missing data for the Townsend deprivation index, were excluded from the analysis. Missing data for other covariates were imputed via MICE, and the predicted QRISK3 probabilities were pooled using Rubin’s rules. QRISK3 has previously been shown to overestimate CVD risk in the UKB, and predictions were therefore re-calibrated by estimating new 10-year baseline hazards for the UKB cohort. Survival analysis was performed to validate QRISK3 in assessing 10-year CVD risk using Harrell’s C-statistic (discrimination) and calibration plots (calibration). Results Data for 412,899 participants was eligible for inclusion (∼57% women; N = 237,515), with 4570 prevalent cases of RA (0.01%) and 19,552 incidence cases of CVD (0.05%), over a median follow-up time of 10.8 years. With 358 incidence cases of CVD (∼8%), men and women with RA had significantly worse survival outcomes than the rest of the cohort (log-rank test p = 6.8x10-20 and p = 5.2x10-19, respectively). The RA subgroup additionally differed significantly across a variety of clinical CVD risk factors, including BMI (p = 5.7x10−22), systolic blood pressure (p = 8.2x10−17), and hypertension (p = 3.5x10−67). QRISK3 discrimination was modest and comparable across the two groups, with C-statistics of 0.68 for men, and 0.69 for women with RA, compared to 0.7 and 0.72 for the rest of the cohort. After re-calibration, QRISK3’s predictions are shown to be largely accurate across the cohort. However, issues persist in the RA subgroup, where predictions did not align with observed CVD risk, particularly at the tail end of predictions and in young women. Conclusion UKB participants are on average healthier than the general population, and re-calibration is therefore essential for accurately estimating a model’s predictive accuracy. Here we show that QRISK3 has poor calibration for RA patients; together with previous results this highlights the need for an updated QRISK version for use in RA. The re-calibrated QRISK3 model provides a baseline to further explore prediction modelling of CVD risk across different rheumatic and musculoskeletal diseases in","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"27 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P091 Mortality rates in children, young people, and young adults with JIA using UK GP data","authors":"Lianne Kearsley-Fleet, Natasha Shaw, Jasmine Leslie, Michelle Johnson, Lucy R Wedderburn, Kimme L Hyrich, Jenny H Humphreys","doi":"10.1093/rheumatology/keaf142.131","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf142.131","url":null,"abstract":"Background/Aims JIA affects approximately 1-2 in 2000 children and young people in the UK. Rheumatological conditions are known to impact mortality; however, there is conflicting evidence regarding mortality rate and impact in JIA. The aim of this study was to calculate the all-cause mortality rate of patients with JIA, compared with (a) matched-controls, and (b) general population estimates. Methods Using UK General Practice data, CPRD (Aurum+Gold), this analysis included both prevalent and incident JIA cases under the age of 16 years old. Non-JIA control patients were matched 4-to-1 based on year of birth, gender, and practice. Date of death was identified through CPRD, or NHS-linked data (including cause of death). Exposure started on first JIA code date (or matched-date for controls) or 1-Jan-2000, whichever was latest. Follow-up continued until cut-off date (31-Dec-2018), or death, whichever was first. Cox-proportional hazards model was used to compare mortality in JIA versus matched-controls. JIA rates were additionally stratified by systemic versus non-systemic JIA. Standardised mortality rates (SMRs) were generated for JIA compared with the ONS general population estimates, based on calendar year, year of age, and gender. All patients were from England, due to the requirement for linkage with NHS hospital data. Results 4983 children and young people with JIA, and 14604 matched-control patients, were identified (Table); patient characteristics were similar between the cohorts. Mortality rate for JIA patients was 6.3/10000 person years (95%CI:4.4-8.9), and 2.0/10000 person years (95%CI:1.4-2.8) for control patients; JIA patients had 3.2 times higher mortality (95%CI:1.9-5.2). Patients with systemic JIA had 2.9 times higher mortality (95%CI:1.3-6.2) versus patients with non-systemic JIA (crude rate 13.9/10000 versus 5.2/10000). The SMR for JIA was 2.9 (95%CI:2.1-4.1); JIA patients had 2.9 times higher mortality versus the general population. Fifteen (47%) JIA deaths occurred before 2010. Conclusion This analysis calculated mortality rates in young people with JIA in the UK and found that death in young people with JIA is exceedingly rare. Slightly higher rates were observed in patients with systemic JIA, with approximately one additional death for every 2500 years versus controls. Almost half the deaths occurred before 2010 when biologic treatment, particularly for systemic JIA, was limited. Disclosure L. Kearsley-Fleet: None. N. Shaw: None. J. Leslie: None. M. Johnson: None. L.R. Wedderburn: None. K.L. Hyrich: None. J.H. Humphreys: None.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"33 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P120 Characteristics and safety outcomes of rheumatoid arthritis patients treated with Amgevita® in the UK using data from a national register","authors":"Argentina E Servin, Mark Lillie, Laura C Coates, Michele Brunori, Latha Krishnamoorthy, Frances Humby","doi":"10.1093/rheumatology/keaf142.160","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf142.160","url":null,"abstract":"Background/Aims Rheumatoid arthritis (RA) is a chronic inflammatory disease that can cause joint damage and impair quality of life. Research advances have led to seven adalimumab (ADL) biosimilars approved in the EU, making it crucial to understand their long-term benefit-risk profiles. This study aims to 1) estimate the clinical characteristics, serious adverse events (SAEs), and outcomes in patients with RA exposed to Amgevita® and 2) to estimate the incidence rates for the same outcomes from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRB-RRA) antitumor necrosis factor (TNF) comparison cohort. Methods Results from a crude pharmacovigilance report sent to Amgen on a subset of all Amgevita patients in the BSRBR-RA are presented. The BSRBRRA is a nationwide prospective study for patients with RA receiving biologic treatments, including anti-TNF inhibitors (i.e., adalimumab) and non-TNF biologics, that seeks to evaluate the long-term toxicity of these agents in clinical practice. Eligible participants were men and women ≥16 years of age with RA who registered in the study within 6 months of initiating Amgevita to comprise study cohort (these patients represent one-third of all Amgevita patients recruited into the BSRBR-RA). Descriptive characteristics were calculated for all variables of interest. Summary statistics for continuous variables include the number of patients, mean, median, SD or standard error, minimum, and maximum. Results From 01/01/2019 to 31/03/2022, 307 RA patients treated with Amgevita were enrolled in the registry. The follow-up period for this cohort ended 30/11/2023. The mean (SD) age of the population was 59.7 (12.0) years, 86 (28.0%) of patients identified as male, and mean (SD) disease duration at initiation was 9.9 (9.8) years. Two-thirds of Amgevita patients were biologically naïve and 9.8% were using steroids at Amgevita initiation. Non-adjusted incident rates of SAEs per 1,000 patient years by patient cohort are presented in Table 1. Conclusion These results show crude safety incidence rates for Amgevita patients in the BSRBR-RA, with point estimates similar to the anti-TNF cohort, though the confidence intervals are large due to small patient numbers. Ongoing monitoring of biosimilars is essential to optimize RA treatment and patient care. Disclosure A.E. Servin: Corporate appointments; Amgen. Shareholder/stock ownership; Amgen. M. Lillie: Corporate appointments; Amgen. Shareholder/stock ownership; Amgen. L.C. Coates: Consultancies; AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Gilead, Galapagos, Janssen, Moonlake, Novartis, Pfizer, Takeda, UCB. Grants/research support; AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, UCB. M. Brunori: Corporate appointments; Amgen. Shareholder/stock ownership; Amgen. L. Krishnamoorthy: Corporate appointments; Amgen. Shareholder/stock ownership; Amgen. F. Humby: Consultancies; Roche, AbbVie, Genentech, UCB, Novartis. Honora","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"79 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E065 The importance and challenges of continuing to use data beyond the age of 16 years old in research","authors":"Lianne Kearsley-Fleet, Jasmine Leslie, Natasha Shaw, Michelle Johnson, Kimme L Hyrich, Jenny H Humphreys","doi":"10.1093/rheumatology/keaf142.300","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf142.300","url":null,"abstract":"Background/Aims Many childhood-chronic conditions, such as juvenile idiopathic arthritis (JIA), can continue into adulthood. Investigating long-term outcomes for patients is vital to generate a bigger picture of the clinical, physical, social, and psychological impact of chronic conditions over time. When children and young people contribute to research, a parent/guardian will sign the consent form at enrolment. Studies can then be linked with NHS national datasets (hospitalisations/cancers/death) for a more complete picture of a patient’s journeys within healthcare. However, without additional patient consent, linkage must stop at 16 years old, and there are no straightforward mechanisms within the research ethics framework to continue linkage. Methods There is growing concern and confusion around why data collected post-16 years old may not be used in research without explicit consent. Re-consent might not be possible at this point for several reasons. Firstly, the person may have been discharged from clinic as they are in remission. Secondly, they may have moved to an adult rheumatology centre that does not want/is not sufficiently resourced to participate in research. Finally, there may be personal circumstances (financial/educational/personal) which mean they are not able to continue within research but would like their data to still be used. This may be particularly relevant to people from more deprived areas, or ethnic minority groups, as data suggests people from more deprived groups are less likely to continue into adult services. By stopping data linkage at age 16 years, research into adults with JIA would be at increased risk of excluding data from individuals that are in remission, from under-resourced NHS trusts, from more deprived areas, or from minority/other under-represented backgrounds. Results If linkage could be continued for all patients, regardless of additional consent, this bias could be avoided, meaning research outputs are more applicable to all people living with JIA. Feedback from patients and families highlight that they “would not expect to be asked to reconsent”, and instead “assume this consent/linkage would continue into adulthood”, regardless of when they (or their guardian) gave initial consent. Some are even “surprised and disappointed to hear that their data are not being used in a way they believe it should be”. There are real concerns around losing important data, with some families highlighting that “not linking information that is already available would mean there is a black hole once someone becomes an adult”. Conclusion We are advocating for all data linkage to continue beyond 16 years of age without the need for additional consent. We want all experiences to be accounted for, regardless of hospital or background. Through this initiative, we want to ensure that paediatric and young people’s research remains a priority and receives the same amount of attention as equivalent research in adult-only conditi","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"27 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P122 Comparative study between DAS28-CRP and SDAI in assessing rheumatoid arthritis activity","authors":"Mohammed Khalil Jnyah, Imane El Mezouar, Nessrine Akasbi, Taoufik Harzy","doi":"10.1093/rheumatology/keaf142.162","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf142.162","url":null,"abstract":"Background/Aims The choice between different indices for assessing disease activity in rheumatoid arthritis (RA) is often challenging due to the highly heterogeneous clinical presentation. The objective of our study was to assess the level of similarity between the SDAI (Simplified Disease Activity Index) and DAS28-CRP (Disease Activity Score using C-reactive protein) in evaluating RA activity. Methods In this cross-sectional study, a total of 183 patients diagnosed with RA according to the ACR/EULAR 2009 criteria were included. The correlation between the two indices was assessed using Pearson’s correlation coefficient (r), and the similarity between these two scores was evaluated with Kendall’s tau coefficient (K). Results The female-to-male ratio was 9:1, and the average age was 58.54 ± 12.23 years. Seropositivity and joint deformity were present in 87% and 69% of the patients, respectively. The mean DAS28-CRP score was 4.69 ± 1.43 [1.6-7.7], and the mean SDAI score was 29.62 ± 14.04 [2.5-66]. A strong and statistically significant positive correlation was observed between the DAS28-CRP and SDAI indices (p = 0.000). The DAS28-CRP categorized patients into the same disease activity category as the SDAI in 88% of cases. Specifically, 68% of patients had active RA according to both DAS28-CRP and SDAI, and 20% were in remission based on both scores. A discrepancy between the two scores was observed in only 12% of patients. Conclusion Our study demonstrated a high level of concordance between the SDAI and DAS28-CRP scores. In daily practice, DAS28 remains the most widely used index. However, our results suggest that SDAI should be used more frequently due to its reproducibility and inclusion of a physician’s global assessment of RA activity. Disclosure M. Jnyah: None. I. El Mezouar: None. N. Akasbi: None. T. Harzy: None.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"7 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P171 Bimekizumab maintained efficacy responses in patients with active psoriatic arthritis: up to 2-year results from two Phase 3 studies","authors":"Jessica A Walsh, Joseph F Merola, Christopher T Ritchlin, Yoshiya Tanaka, Ennio G Favalli, Dennis McGonagle, Diamant Thaçi, Barbara Ink, Rajan Bajracharya, Jason Coarse, William Tillett","doi":"10.1093/rheumatology/keaf142.208","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf142.208","url":null,"abstract":"Background/Aims Bimekizumab (BKZ) has demonstrated clinically meaningful improvements in efficacy outcomes to Week (Wk)16, that were sustained to Wk52, in psoriatic arthritis (PsA) patients. We report proportions of Wk16 responders maintaining response in joint/skin/composite efficacy outcomes to 2 years in BKZ-treated PsA patients. Methods Two Phase 3 studies assessed BKZ 160mg every 4 wks in PsA patients: BE OPTIMAL (biologic DMARD [bDMARD]-naïve; NCT03895203) and BE COMPLETE (TNF inhibitor inadequate response/intolerance [TNFi-IR]; NCT03896581); both placebo-controlled to Wk16. BE OPTIMAL Wk52 and BE COMPLETE Wk16 completers could enter BE VITAL (open-label extension; NCT04009499). Efficacy data reported for BKZ-randomised patients; safety data reported for all BKZ-treated patients. Maintenance of response reported as the proportion of Wk16 responders who were responders at Wk104/100 (BE OPTIMAL/BE COMPLETE). Efficacy outcomes include ACR20/50/70, Psoriasis Area and Severity Index (PASI)75/90/100, Minimal/Very Low Disease Activity (MDA/VLDA) and Disease Activity Index for PsA (DAPSA) remission or low disease activity responses (REM ≤4; REM+LDA ≤14); reported here to Wk104 (BE OPTIMAL) and Wk100 (BE COMPLETE). Data are reported as observed case or using non-responder or worst category imputation. Exposure-adjusted incidence rates per 100 patient-years (EAIR/100 PY) are reported to Wk104 for both bDMARD-naïve and TNFi-IR patients. Results Of BKZ-randomised patients, 359/431 (83.3%) bDMARD-naïve and 215/267 (80.5%) TNFi-IR completed Wk104/100. High proportions of patients achieving ACR50, PASI100 and MDA at Wk16 maintained responses at Wk104/100 (Table). At Wk16, 189 (43.9%) bDMARD-naïve and 115 (43.1%) TNFi-IR patients achieved ACR50; 150 (79.4%) bDMARD-naïve and 87 (75.7%) TNFi-IR patients maintained response at Wk104/100. At Wk16, 103/217 (47.5%) bDMARD-naïve and 103/176 (58.5%) TNFi-IR achieved PASI100; 73 (70.9%) bDMARD-naïve, 83 (80.6%) TNFi-IR patients maintained response at Wk104/100. At Wk16, 194 (45.0%) bDMARD-naïve and 117 (43.8%) TNFi-IR patients achieved MDA; 147 (75.8%) bDMARD-naïve, 87 (74.4%) TNFi-IR maintained response at Wk104/100. Results were similar for other joint/skin/composite efficacy outcomes at Wk104/100 (Table). To Wk104, the EAIR/100 PY for BKZ-treated patients with ≥1 treatment-emergent adverse event was 179.9 in bDMARD-naïve and 100.3 in TNFi-IR patients. Conclusion BKZ demonstrated robust maintenance of response at 2 years in bDMARD-naïve/TNFi-IR Wk16 responders among patients with PsA. Safety profile was consistent with previous reports. Disclosure J.A. Walsh: Consultancies; Consultant for/grant support from AbbVie, Amgen, Eli Lilly, Johnson & Johnson Innovative Medicine, Merck, Novartis, Pfizer and UCB. J.F. Merola: Consultancies; Consultant and/or investigator for AbbVie, Amgen, AstraZeneca, Biogen, BMS, Boehringer Ingelheim, Dermavant, Eli Lilly, Incyte, Johnson & Johnson Innovative Medicine, LEO Pharma","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"66 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P054 Five stars Talking Rheumatology: can you learn Rheumatology through podcasts?","authors":"Stephanie Gall, Pippa A Watson, Rosalind Benson, Daisy Southam, Louise Coulson, Caroline Groves","doi":"10.1093/rheumatology/keaf142.096","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf142.096","url":null,"abstract":"Background/Aims Podcasts have been around for over 20 years with recent expansion into the medical education. They form a popular way to access education in a portable format and enable learning. Methods The British Society for Rheumatology (BSR) launched its own Talking Rheumatology (TR) podcast channel in 2022. This includes clinical (TR spotlight), research (TR research) and general (guidelines, careers) podcasts. Podcasts are available via the BSR eLearning site and via all podcast platforms. We collected feedback on our pods via an online survey and download and ratings data from podcast providers. Results Our podcasts continue to grow and have become our most popular digital output. Since launching in 2022 we have had >56,000 downloads. Listeners can be found across the globe and represent the whole multi-disciplinary team. Our most popular episodes to date are: TR spotlight Sjögren’s syndrome (>2000 downloads) and TR research long term use of tocilizumab in GCA (>360 downloads). Topical podcasts like ‘CAR T cell therapy in SLE’ (334 downloads in the first 8 days) showed high download numbers on release indicating topics are current and in line with listeners interests. Feedback from our online survey (79 responses) has been extremely positive with 86% of survey respondents rating it good or very good. Listeners liked the fact that podcasts are easy to access and relevant. Free text comments include as follows: ‘succinct and informative’, ‘easy to digest’, ‘easy to access, different format’, ‘relevant to clinical practice’, ‘I like listening to people discussing topics in an informal way’, ‘professional and engaging’, ‘relevant to my role’, ‘good way to get CPD’, ‘really interesting topics’ and ‘expert guests help me improve my knowledge’. As well as being popular our podcasts are having an impact. For example listeners reported following listening to a relevant episode making a diagnosis of VEXAS syndrome and introducing a new telephone clinic to manage gout. One listener reported improved detection of treatment response and efficiency in clinic after listening. Conclusion Podcast downloads indicate topic choices are in line with key topics of interest to the rheumatology community. Feedback demonstrates learning through podcasts have led to changes in clinical practice. Current work is focusing on raising awareness, international reach (both listeners and guests) and evaluation of this relatively new modality. We’d love to hear any suggestions or feedback from the BSR community. Disclosure S. Gall: None. P.A. Watson: None. R. Benson: None. D. Southam: None. L. Coulson: None. C. Groves: None.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"55 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P116 Is physical activity associated with central sensitisation indices or pain in rheumatoid arthritis?","authors":"Aya A Ibrahim, Stephanie Smith, Vasileios Georgopoulos, Daniel McWilliams, David A Walsh","doi":"10.1093/rheumatology/keaf142.156","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf142.156","url":null,"abstract":"Background/Aims Rheumatoid arthritis (RA) is a chronic condition where pain often persists despite controlled inflammation. Central sensitisation (CS), characterised by an amplified response of the central nervous system to nociceptive inputs, drives this persistent pain. While physical activity is important for health, its effectiveness in reducing pain and CS in RA is unclear. This study investigates whether self-reported physical activity levels influence pain and CS indices. Methods Ninety-two participants with RA from the Central Aspects of Pain in RA (CAP-RA) cohort completed the International Physical Activity Questionnaire (IPAQ) at baseline, categorising physical activity levels as Low, Moderate, or High. Quantitative Sensory Testing (QST) modalities, including pressure pain thresholds (PPT), temporal summation (TS), and conditioned pain modulation (CPM) were used as CS indices. Pain severity was the sum of 3 numerical rating scales (NRS) from the painDETECT questionnaire. Disease activity was assessed using the Disease Activity Score 28 (DAS28). Sixty-four participants provided 3-month follow-up data. Spearman’s correlations and multivariable linear regressions explored associations between physical activity, CS indices, and pain at baseline and over time. Results The median age of participants was 65 (range: 30,85) years. The majority were female (87%). Participants reported moderate pain, with a median pain severity score of 20 (IQR 16, 23) out of 30, and moderate disease activity (median DAS28: 4.5 [IQR 3.8,5.2]). DAS28 decreased by a median of -0.14 (IQR -1.1,+0.7), and median CRP decreased from 5.0 mg/L (IQR 2.0,8.0) to 4.5 mg/L (IQR 2.0,7.0) from baseline to follow-up. About half (54%) reported low physical activity levels, with no significant group change in physical activity from baseline to follow-up. However, 46% of participants transitioned between activity categories, indicating some movement in physical activity levels. Bivariate correlations revealed no significant associations between baseline physical activity and CS indices or pain, nor between change in physical activity and change in CS indices or pain. Multivariable linear regression showed that increases in CS indices and pain severity were most strongly predicted by their baseline values (β = range -1.05 to -0.25, all p < 0.05), but not by physical activity levels. Additionally, male sex significantly predicted increased TS (pain sensitivity) (β = 1.28 ,p =0.01), and high baseline swollen joint count was a significant predictor for increased pain severity after 3 months (β = 0.31, p = 0.02). Conclusion These findings indicate that people with RA who are more physically active do not tend to have lower pain sensitivity or pain, either at baseline or over time. Other factors, such as sex and inflammation, might have a greater impact on CS and pain than physical activity. This highlights the need for tailored interventions that effectively target central pain m","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"25 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E013 A service evaluation of a diagnostic ultrasound service for the assessment of giant cell arteritis","authors":"Shivang P Shastri, Andrew Longmead, Catherine Oldham, Alison Hall, Ajit Menon, Samantha L Hider","doi":"10.1093/rheumatology/keaf142.250","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf142.250","url":null,"abstract":"Background/Aims Early recognition and treatment are key in the management of Giant Cell Arteritis (GCA) to prevent visual loss. Temporal artery ultrasound (TAU) is increasingly used as the first line investigation for GCA. Classic GCA findings include the halo sign, slope sign and compression sign. We established a TAU service in 2023: the aim of this service evaluation (e2024-108) is to assess the effectiveness of the service, including wait time and outcomes. Methods: Methods Case-record review of all patients who had a TAU between 05/04/2023 and 14/08/2024. Information was collected on demographics, clinical features, management and scan findings. Results were collated and correlation calculated between likelihood of positive/negative result, duration of glucocorticoid course and inflammatory marker status. Results 133 people had first TAU scans (2 patients had repeat scans). 35 (26%) were positive, and 98 (74%) negative. The median (range) age was 70 (42-89) years. Patients with positive scans were older: median 76 (57-88) years compared with 67 (42-89) years. Of those with positive TAU 51% had raised inflammatory markers, with higher mean inflammatory markers: mean (range) CRP 46.9 (0-284), ESR 20.5 (2-112) versus mean CRP 12.9 (0-119.2), ESR 13.3 (2-92) with negative TAU. 45% of those with negative scans had raised inflammatory markers. Delay between referral and scan was similar with median (range) of 2 (0-15) days for negative scans vs 2 (0-27) for positive scans. 77% of positive scans were performed within 3 days of referral, 97% within 7 days compared with 59% of negative scans within 3 days of referral, and 94% within 7 days. 81% of negative scans were performed within 7 days of steroid commencement and 51% within 3 days. 63% of positive scans were performed within 7 days of steroid commencement and 40% within 3 days. 61% of patients were taking concurrent steroids with mean duration 5.46 days. Glucocorticoid duration median (range) prior to TAU was 3 (0-27 days [positive TAU]) vs 2 (0-92 days [negative TAU]). Correlation coefficient between duration of glucocorticoid treatment and scan result was -0.03, showing negligible correlation. For those testing negative, 20% were treated clinically despite scan result, and 52% stopped or tapered steroids immediately. 46% were prescribed daily 60mg prednisolone with a positive scan and 40% in negative. 40% were prescribed 60mg prednisolone with a negative scan and 48% prescribed 40mg. Conclusion This service evaluation demonstrates provision of rapid TAU service with 95% of all scans performed within 7 days of referral. No correlation was seen between duration of glucocorticoids and scan findings. More data is needed to explore the relationship between steroid dose, duration, USS findings and to assess how long positive findings remain on TAU. Disclosure S.P. Shastri: None. A. Longmead: None. C. Oldham: None. A. Hall: None. A. Menon: None. S.L. Hider: None.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"17 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P059 Insights across conditions: experiences of diagnosis, treatment and living well with arthritis from a large UK-wide survey","authors":"Victoria Arno, Michael Li, Karen Hodgson","doi":"10.1093/rheumatology/keaf142.101","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf142.101","url":null,"abstract":"Background/Aims Versus Arthritis is the UK’s largest charity dedicated to supporting people with arthritis. In this work, we aimed to gather quantitative data through a UK-wide survey to give a broad view of the perspectives of people with any type of arthritis condition(s). This included people who may not have engaged with healthcare systems in relation to their arthritis, or those yet to receive a formal diagnosis. Our work aims to explore both the differences and similarities in experiences across this population. A more detailed understanding of the experience of those with arthritis is crucial to identifying inequalities between groups. Methods Between June-August 2024, we commissioned YouGov to run a 15-minute online survey of adults living with arthritis in the United Kingdom, gathering insights into the experiences of getting a diagnosis, treatment and living with arthritis. The sample was recruited via YouGov’s population panel, with additional participants recruited via Versus Arthritis’ networks and advertising. This was a charity-led study using a self-referred anonymous questionnaire, and the NHS REC online tool confirms NHS ethical approval was not required. Participant consent was obtained and data are presented following best practice to ensure participants are non-identifiable. Results All analysis was undertaken by Versus Arthritis. After applying weighting, there were 7,928 respondents to the survey. 5,888 were recruited via YouGov’s panel and 2,040 from Versus Arthritis’ networks. The weighted sample was 59% (4,655) female, with an age breakdown of: 3% (238) aged 18-44, 48% (3,816) aged 45-64, and 49% (3,875) over 65. 84% lived in England (6,653), 8.5% in Scotland (673), 4.8% (380) in Wales and 2.8% (222) in Northern Ireland. In terms of arthritis conditions among respondents, 86% (6,783) reported osteoarthritis, 8% (664) rheumatoid arthritis, 4% (313) psoriatic arthritis, and 7% (594) gout or calcium crystal diseases. 3% (272) reported another arthritis condition and 9% (695) reported having an arthritis condition but did not know which condition it was. 1,525 people (16%) reported having more than one arthritis condition; of which 238 people have three or more arthritis conditions. Conclusion The data have been weighted by age, gender and type of arthritis condition to ensure a representative spread of people with arthritis in the UK. Further analysis is being undertaken of these data and we will describe and compare experiences by condition and demographics. We will consider both experiences of interacting with healthcare services alongside a wider view of the impact of arthritis on people’s lives. Funding: This survey was funded by Versus Arthritis. Disclosure V. Arno: None. M. Li: None. K. Hodgson: None.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"38 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}