POS0877 A COMPARISON OF PSA AND RA PATIENT PROFILES REQUIRING ADVANCED THERAPIES: PSA PATIENTS ACCESS TO THE ADVANCED THERAPIES EARLIER THAN RA
Notice bibliographique
Résumé
Background International guidelines recommend switching to advanced therapy (AT) in patients with Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PsA), when conventional synthetic disease modifying antirheumatic drugs (csDMARD) fail. There are several factors playing a role in that decision, including patients’ comorbidities and choices as well as the availability of the treatments. Objectives Here we present the results of a comparison of PsA and RA patient profiles requiring advanced therapies, from our pilot biologics clinic. Better patient outcomes in one disease may help us to recognize what can be improved in the other. Methods Biologics clinic is a new initiative at Ottawa Hospital aiming to improve the long-term outcomes. Patients who are about to start or switch advance therapy are evaluated at the biologics clinic. Extensive data regarding disease history, medication exposure and disease activity are collected in a standardized fashion; the comorbidity burden is documented. A protocoled ultrasound (US) is conducted at baseline and three-month intervals, until reaching remission. The data presented here represent a pilot exploratory comparative analysis. Results PsA (n=18) and RA(n=42) patients had similar demographic features, other than RA patients being older (table 1). The majority of the comorbidities were similar in both groups, although PsA patients had more frequent liver disease numerically (5 (27.8 %) vs 5 (11.9%), p= 0.149) and less alcohol use (19 (38.9%) vs 7 (45.2%), p= 0.649). PsA patients had more frequent moderate/severe depression using the PHQ (61.1% of PsA vs 26.2% of RA; p=0.01). For disease activity, PsA patients tend to have higher disease activity based on the TJC, HAQ and physician global; in addition to significantly longer morning stiffness then RA (Table 1). Conversely, the disease activity within the joints based on the US scores of RA patients were higher. Disease duration at the time of initiation of the first advanced therapy was significantly shorter in PsA (median (IQR) 1.0 (7.75) years) compared to RA (6 (12.5), p=0.005) and PsA patients were treated with less numbers of csDMARD. Conclusion According to our preliminary data, PsA patients access to advanced therapy earlier than the RA. This may be due to the heterogeneity of PsA, such as manifestations other than the joint inflammation (enthesitis and axial disease) determining treatment decisions. PsA patients also had more frequent liver disease, which also may have prevented initiation of csDMARD and led to expediated initiation of the advance therapy- as early as at diagnosis. Whether earlier access leads to better patient outcomes in PsA, will be investigated with long-term follow up. PsA patients having more tender joints despite less severe US scores may be due to the proximity of the enthesis to the joints and difficulties to differentiate entheseal pain from joint involvement by the physical exam. The use of US may improve the assessment of the domains in PsA leading to choosing the right treatments. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests None Declared.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,011 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».