ABS0324 IMPROVEMENT IN COGNITIVE PERFORMANCE IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH TNF INHIBITORS
Bibliographic record
Abstract
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.
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) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".