P024 The mighty mimic: intravascular large b-cell lymphoma masquerading as myositis: a case series
Conclusion IVBCL is a rare disease that can present in various ways and often a delay in reaching a diagnosis leads to patient deterioration and death. A multidisciplinary approach involving the microbiologists, rheumatologists and haematologists led to a timely identification of the disease and subsequent management in these two cases. As the disease is characteristically contained within the blood vessels, the diagnosis is normally not confirmed from peripheral blood tests or even bone marrow biopsy. Biopsy of the affected area is what revealed the diagnosis in our two cases. Random skin biopsies ma y be very useful in...
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
P023 Secondary membranous nephropathy in a patient with a background of rheumatoid arthritis treated with biosimilar etanercept
Conclusion This is the case of an 80-year-old gentleman who developed membranous nephropathy eight months after commencing etanercept biosimilar - Benepali® - for rheumatoid arthritis. Although attribution to a single agent is challenging, we believe that it is likely Benepali® was the main attributing fa ctor for the development of membranous nephropathy. The temporal relationship between the initiation of Benepali® and the subsequent development of biopsy proven membranous nephropathy along with the resolution following withdrawal of Benepali® supports drug-related renal injury. Although TNF inhi bitor-induced rena...
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
P022 Audit of musculoskeletal ultrasound to optimise DMARD therapy among patients in a district general hospital
Conclusion MSUS avoided unnecessary DMARD escalation in a significant proportion of patients with inflammatory arthritis and features of concomitant chronic pain and/or fibromyalgia (n = 26, 37%), potentially resulting in reduced patient exposure to harmful DMARD side effects, and cost savings for the servi ce.Disclosure M. Chen-Xu: None.D. Hyseni: None.K. Achilleos: None. (Source: Rheumatology)
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
P021 Rheumatology shielded patients, hospitalised COVID-19 and outcomes in Essex: an audit across Mid and South Essex and Barking, Havering and Redbridge Hospitals NHS Trusts
Conclusion This audit supports the idea that shielding is an effective tool in protecting these vulnerable patients. Most of our patients admitted were elderly, had multiple co-morbidities and generally conformed with the known risk factors for severe COVID-19 illness. This supports Government guidelines an d BSR risk scoring and is particularly important as it is becoming increasingly apparent that COVID-19 will be prevalent for a long time to come. In line with the recent EULAR COVID-19 registry report, only one of the hospitalised patients from these Trusts was on anti-TNF therapy, suggesting that t hese therapies wer...
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
P006 The potential of colour Doppler ultrasound in reducing temporal artery biopsies in suspected giant cell arteritis
Conclusion After the routine introduction of CDUS, the percentage of patients requiring TAB has declined. Approximately one fourth patients would still require TAB as per BSR guidelines. To improve the clinical relevance of biopsies further we recommended; the routine use of GCA probability score, improve C DUS skills and arrange availability of urgent slots in clinic for CDUS. We also noticed that the number of patients referred has almost doubled. This might be due to better education and awareness at the primary and secondary care level which was done as part of the project.Disclosure A.A. Sidhu: None.A. Nandagudi: ...
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
P005 Rheumatology virtual clinics during COVID-19: are our patients satisfied?
Conclusion Patient satisfaction among those surveyed was high, despite having to introduce the service abruptly during the COVID-19 pandemic. There are many improvements we can adopt to improve our service and even maintain after the pandemic as a way of communicating with our stable patients. As we are cov ering a large geographical catchment, we can continue to implement the virtual clinic for some appointments. We should prioritize our efforts on identifying the right patient and the type of service we can offer, further training of staff, and increasing awareness of the patients as to how to get th e most out of a vi...
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
O33 Baricitinib in the BSRBR-RA registry: characteristics and status of patients at first follow-up
Conclusion In an RA study population with severe longstanding disease, in which almost two thirds had received biologics, baricitinib showed good effectiveness and tolerability (continuation) in patients completing first follow-up. Although sample sizes were small, subgroup results suggested good baricitini b effectiveness in all subgroups studied. Further analyses are needed to assess longitudinal outcomes in larger sample sizes at follow-ups beyond 6 months.Disclosure C.J. Edwards: Honoraria; Abbvie, BMS, Biogen, Celgene, Fresenius, Gilead, GSK, Janssen, Lilly, Pfizer, MSD, Novartis, Roche, Samsung, Sanofi, UCB. Memb...
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
O32 Serious infection with tocilizumab compared to TNF-inhibitors and other bDMARDS in rheumatoid arthritis patients: does line of therapy matter?
Conclusion Whilst initially there appears to be a difference in rates of serious infections between biologic therapies, line of therapy may be a confounding factor when comparing the risk of serious infections between bDMARDs.Disclosure K. Lauper: Honoraria; Gilead-Galapagos. Grants/research support; AbbVie. Other; AbbVie, Pfizer.L. Kearsley-Fleet: None.R. Davies: None.K. Watson: None.M. Lunt: None.K.L. Hyrich: Honoraria; AbbVie. Grants/research support; Pfizer, BMS. (Source: Rheumatology)
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
O25 The impact of COVID-19 lockdown on mental health and quality of life in patients with inflammatory arthritis
Conclusion There has been a clear impact of the pandemic on the mental health of people with IA, and this should be taken into consideration by clinicians, especially as it appears to be related to worse overall reported physical health. The mixed results for loneliness in comparison to other mental health measures may illustrate the inter-relatedness of these aspects of mental and physical health, particularly in the context of lockdown.Disclosure M. Sweeney: None.L. Carpenter: None.S. de Souza: None.H. Chaplin: None.H. Tung: None.E. Caton: None.J. Galloway: None.A. Cope: None.M. Yates: None.S. Norton: None. (Source: Rheumatology)
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
O24 Risk of death during the 2020 UK COVID-19 epidemic and annual influenza seasons among people with vasculitis compared to the general population: a whole-population study using data from the NDRS and the RECORDER project
Conclusion People with vasculitis are at increased risk of death during circulating COVID-19 and influenza epidemics. The ASMR among people with vasculitis was high both during the 2014/15 influenza season and during the first wave of the COVID-19 epidemic. COVID-19 vaccination and annual influenza vaccinat ion for people with vasculitis are both important, regardless of patient age.Disclosure M. Rutter: None.P.C. Lanyon: Grants/research support; PCL has received funding for research from Vifor Pharma..M.J. Grainge: None.R.B. Hubbard: None.E.J. Peach: Grants/research support; EJP has received funding for research from ...
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
O17 Effectiveness of rituximab in the treatment of neuro-psychiatric SLE: results from the British Isles Lupus Assessment Group Biologics Register
Conclusion RTX use is associated with improvement in NP-SLE with reduction in oral steroid dose. Concomitant CYC may enhance the level of improvement seen with RTX. Large scale studies are therefore warranted to establish the effectiveness of RTX alone or in combination with CYC in the treatment of NP-SLE.Disclosure T. David: None.R. Hum: None.E. Sutton: None.B. Parker: None.E. McCarthy: None.I. Bruce: None. (Source: Rheumatology)
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
O09 Safety profile of baricitinib for the treatment of RA up to 8.4 years: an updated integrated safety analysis
Conclusion In this update, with 3021 additional PY of exposure, BARI maintained a safety profile similar to that previously reported, with no increase of IRs across safety topics through exposures up to 8.4 years.Disclosure K.L. Winthrop: Consultancies; AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly and Company, Pfizer, and UCB Pharma. Grants/research support; Bristol Myers Squibb and Pfizer.T. Takeuchi: Consultancies; AbbVie, Asahi Kasei Medical, Astellas, AstraZeneca, Bristol Myers Squibb, Chugai, Daiichi Sankyo, Eisai, Eli Lilly and Company, GlaxoSmithKline, Janssen, Mitsubishi Tanabe Pharma, Nippon Kayaku, Novartis...
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
O02 Low birthweight is associated with decreased grip strength and reduced leg muscle mass in middle age: findings from the UK Biobank imaging enhancement
Conclusion Birthweight was positively associated with MRI measures of thigh muscle volume and grip strength in a population of middle-aged UK adults. These findings provide novel evidence in support of the developmental programming hypothesis and suggest that interventions to optimise birthweight may help t o prevent sarcopenia and reduce the risk of falls in future generations. (Project 3593)Disclosure E.M. Curtis: None.S. D'Angelo: None.S. Ashai: None.K. Ward: None.Z. Raisi-Estbragh: None.S. Petersen: None.C. Cooper: None.N.C. Harvey: None. (Source: Rheumatology)
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
P200 Acceptability of a brief fatigue intervention for patients with inflammatory arthritis: a qualitative process evaluation
Conclusion There is potential for this brief fatigue intervention to benefit patients. Future research will focus on flexibility to fit with local services and creating educational learning resources for practitioners to use in a range of contexts.Disclosure A. Berry: None.S. Bridgewater: None.B. Abbott: None.J. Adams: None.E. Dures: None. (Source: Rheumatology)
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
P199 The reliability of using ultrasound for the detection of hypoechogenicity of enthesitis in patients with spondyloarthropathies
Conclusion This study is novel as in that it has specifically evaluated the scoring of hypoechogenicity within the entheses of patients with SpA. It has demonstrated variation in scoring between observers and highlighted the challenges of image interpretation. A lack of correlation of expert scoring with th e manual pixel MGV was limited by the image artefacts and different machine settings which may have implications as we work towards future AI systems.Disclosure A.S. Aldahes: None.R. Wakefield: None.K. Smith: None. (Source: Rheumatology)
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
