POS0877 A COMPARISON OF PSA AND RA PATIENT PROFILES REQUIRING ADVANCED THERAPIES: PSA PATIENTS ACCESS TO THE ADVANCED THERAPIES EARLIER THAN RA
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.011 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".