AB0402 HIGHER LEVELS OF HIGH-SENSITIVITY CRP IS ASSOCIATED WITH FUTURE DEVELOPMENT OF PSORIATIC ARTHRITIS IN PSORIASIS: A PROSPECTIVE COHORT STUDY
Bibliographic record
Abstract
Background: Simple and accessible biomarkers that predict the development of psoriatic arthritis (PsA) among psoriasis patients are critically needed to improve early detection of high-risk individuals. High-sensitivity C-Reactive Protein (hs-CRP) is a biomarker of systemic inflammation. Objectives: We aimed to assess whether higher levels of hs-CRP are associated with risk of future development of PsA among patients with psoriasis. Methods: We analyzed data from a prospective cohort of patients with psoriasis without PsA at enrollment. Participants were assessed annually by a rheumatologist for signs and symptoms of PsA. Information on patient demographics, psoriasis features, medications and musculoskeletal symptoms was collected using standard protocols. hs-CRP levels were measured in serum samples collected at baseline using standard commercial assays in a hospital laboratory. The differences in average hs-CRP levels were assessed across pre-defined patient groups using t-test. The association between hs-CRP levels and risk of development of PsA was assessed using multivariable Cox proportional hazards model adjusted for age, sex, psoriasis duration, PASI, nail lesions, BMI, FACIT-fatigue, use of biologics, use of systemic non-biologics/phototherapy. Results: A total of 589 patients with psoriasis followed from 2006 to 2019 were analyzed. Mean duration of follow up was 7.5 years. 57 patients developed PsA during the follow up period (incidence of 1.2 events per year). The mean age of study participants was 47.3±13.5 (43.1% females), duration of psoriasis 16.2±14.4. Mean level of hsCRP was 3.1±5.5 mg/L (hsCRP levels in incident PsA cases: 5.4±13.1). Significantly higher levels of hs-CRP at baseline were found in patients with arthralgia (4.2±8.53 vs. 2.71±3.67 mg/L), obesity (4.75±4.95 vs. 2.45±5.61 mg/L) and in females (3.92±7.13 vs. 2.51±3.68 mg/L); see Table 1 . Higher hs-CRP levels were associated with future development of PsA in univariate analysis (hazard ratio (HR) 1.03, 95% Confidence Interval (CI) 1.01, 1.05, p=0.002). This association remained significant in the multivariable regression analysis (HR 1.04, 95% CI 1.01, 1.06, p=0.008). Similar effect size was seen in males and females ( Figure 1 ). No significant interaction was found between hs-CRP and sex or BMI. Conclusion: Higher levels of systemic inflammation, as measured by hs-CRP, identifies patients with psoriasis at high risk of future development of PsA. Acknowledgements: NIL. Disclosure of Interests: Lihi Eder Abbvie, BMS, Janssen, Eli Lilly, Novartis, UCB, Amgen, Novartis, Fresenius Kabi, Janssen, Pfizer, Eli Lilly, UCB, Sandoz, Vinod Chandran Abbvie, Amgen, BMS, Eli Lilly, Janssen, Novartis, UCB, Abbvie, Amgen, Eli Lilly, Cheryl F. Rosen Abbvie, Amgen, BMS, Eli Lilly, Novartis, UCB, Richard Cook: None declared, Dafna D. Gladman Abbvie, Amgen, BMS, Celgene, Eli Lilly, Galapagos, Gilead Sciences, Janssen, Novartis, Pfizer, UCB, Abbvie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, UCB. Download: Download high-res image (150KB) Download: Download full-size image Download: Download high-res image (207KB) Download: Download full-size image
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | high |
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 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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, unvalidatedLabeled directly by 2 models reading the full record.
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".