ABS0324 IMPROVEMENT IN COGNITIVE PERFORMANCE IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH TNF INHIBITORS
Notice bibliographique
Résumé
Background: Patients with rheumatoid arthritis (RA) have a higher risk of cognitive impairment, one of the possible causes is the impact of TNF-alpha on the central nervous system (CNS). It has been seen that in patients with Alzheimer's disease there are elevated levels of TNF-alpha and the administration of anti-TNF improved cognitive functions [1]. Objectives: To analyze the evolution of cognitive performance in RA patients treated with anti-TNF biologic therapy after 6 months of treatment. Methods: Design and protocol: prospective observational study of a cohort of RA patients selected for anti-TNF treatment as a first biologic treatment due to moderate to high inflammatory activity. The same neuropsychological battery was performed at the start of treatment and 6 months later. Variables: the main variable was cognitive impairment defined by a score of <26 points on the Montreal Cognitive Assessment Questionnaire (MoCA test). As secondary variables we included the score on each item of the MoCA test separately; the direct and inverse digit span; the STROOP test for the assessment of processing speed (STROOP-P), selective attention (STROOP-C) and inhibition (STROOP-PC); the Hospital Anxiety and Depression Scale (HADS); and the Quality of Life-Rheumatoid Arthritis Scale-II (QOL-RA). Other variables included average inflammatory activity according to DAS28 and C-reactive protein (CRP) since diagnosis, the Health Assessment Questionnaire (HAQ), epidemiological characteristics, comorbidities and treatments. Statistical analysis: descriptive analysis, bivariate analysis between baseline and 6 months, and linear regression multivariate analysis to analyze associated factors. Results: Seventy patients with RA were included, with a loss to follow-up of 2 patients at 6 months. The majority (81.4%) were women with a mean (DS) age of 56.2 (12.3) years at baseline. Baseline and 6-month patient characteristics are shown in Table 1. Significant improvements were observed in the MoCA test score, which increased from 23.1 ± 3.6 to 24.1 ± 3.3 (p=0.001). The most improved item in the median score (IQR) was attention (4.0 [3.0-5.0] vs. 4.5 [4.0-6.0]; p=0.009). There were more frecuency of patients (%) that achieved the item memory (56 [80] vs. 64 [94.1]; p=0.002). The media score (DS) was also higher in the digit span direct (5.9 [2.0] vs. 6.6 [2.0]; p=0.003) and inverse (4.0 [1.7] vs. 4.6 [1.9]; p=0.021); the STROOP-P test (93.5 [28.3] vs. 99.7 [28.8]; p=0.040); the STROOP-C test (74.7 [22.5] vs. 80.3 [22.9]; p=0.014) and the STROOP-PC test (47.1 [19.0] vs. 51.7 [20.5]; p=0.035). There was also an improvement in the quality of life scales, as the HADS anxiety (p=0.008), depression (p=0.007) and the QOL-RA-II (p<0.001). Table 2 presents various models of multivariate multiple linear regression analysis exploring cognitive performance according to the tests conducted. Conclusion: RA patients presented an improvement in cognitive performance 6 months after starting anti-TNF treatment. The domains with the greatest improvements were attention and memory in the MoCA test, in addition to the direct and inverse digit test, the STROOP test in its three categories, and inflammatory activity. The factors associated with cognitive performance were academic level, average CRP, functional status and obesity. REFERENCES: [1] Tobinick EL, Gross H. Rapid improvement in verbal fluency and aphasia following perispinal etanercept in Alzheimer's disease. BMC Neurol. 2008 Jul;8:27. Acknowledgements: NIL . Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.
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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) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
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 ».