2014 ACR/ARHP Abstract Supplement

1411 Pages·2015·20.12 MB·English

Volume66•Number10 (Supplement)•October 2014
ABSTRACT SUPPLEMENT
2014 ACR/ARHP ANNUAL MEETING
November 14–19, 2014
Boston, MA
AMERICAN COLLEGE OF RHEUMATOLOGY
ABSTRACT SUPPLEMENT
AMERICAN COLLEGE OF RHEUMATOLOGY
78th Annual Meeting
ASSOCIATION OF RHEUMATOLOGY HEALTH PROFESSIONALS
49th Annual Meeting
November 14–19, 2014
Boston, MA
Copyright© 2014 by the American College of Rheumatology, Atlanta, GA
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TABLE OF CONTENTS
SUNDAY,NOVEMBER16,2014 Osteoporosis and Metabolic Bone Disease -
Clinical Aspects and Pathogenesis: Clinical
8:30AM–4:00PM
ACRPosterSessionA Osteoporosis: Treatment and Safety
Posterpresenterswillbeavailablefrom9:00–11:00AM. (Abstracts #916-921).................................................... S406
(Abstracts #1-814)........................................................ S1 Pain: Basic and Clinical Aspects I
(Abstracts #922-927).................................................... S409
11:00AM–12:30PM Pediatric Rheumatology - Clinical and
ACRPlenarySessionI
Therapeutic Aspects: Juvenile Idiopathic Arthritis
Discovery 2014
(Abstracts #928-933).................................................... S412
(Abstracts #815-819).................................................... S357
Rheumatoid Arthritis - Animal Models I
2:30–4:00PM (Abstracts #934-939).................................................... S415
ACRConcurrentAbstractSessions Rheumatoid Arthritis - Clinical Aspects II: Remission
Epidemiology and Public Health I: Drug and and De-escalation of Therapy
Vaccine Safety (Abstracts #940-945).................................................... S418
(Abstracts #820-825).................................................... S360 Rheumatoid Arthritis - Small Molecules, Biologics and
Metabolic and Crystal Arthropathies I: Clinical Aspects Gene Therapy II: Novel Therapies in Rheumatoid
(Abstracts #826-831).................................................... S363 Arthritis - Early in Development
Miscellaneous Rheumatic and Inflammatory Diseases (Abstracts #946-951).................................................... S420
(Abstracts #832-837).................................................... S366 Spondyloarthropathies and Psoriatic Arthritis II - Novel
Rheumatoid Arthritis - Clinical Aspects: Treatments Psoriatic Arthritis
Cardiovascular Disease Risk (Abstracts #952-957).................................................... S423
(Abstracts #838-843).................................................... S369 Systemic Lupus Erythematosus - Clinical Aspects and
Rheumatoid Arthritis - Small Molecules, Biologics and Treatment: Lupus Nephritis
Gene Therapy I: Safety of Biologics and Small (Abstracts #958-963).................................................... S426
Molecules in Rheumatoid Arthritis - Malignancy and SystemicSclerosis,FibrosingSyndromesandRaynaud’s-
Infection Pathogenesis,AnimalModelsandGeneticsI
(Abstracts #844-849).................................................... S372 (Abstracts #964-969).................................................... S429
Spondyloarthropathies and Psoriatic Arthritis I - Novel 4:30–6:00PM
Treatments Axial Spondyloarthritis ACR/ARHPCombinedAbstractSession
(Abstracts #850-855).................................................... S375 Epidemiology and Public Health
Systemic Lupus Erythematosus - Animal Models (Abstracts #970-975).................................................... S432
(Abstracts #856-861).................................................... S378 ARHPConcurrentAbstractSession
Systemic Lupus Erythematosus - Clinical Aspects and Osteoarthritis
Treatment: Cardiovascular Disease and Pregnancy (Abstracts #976-981).................................................... S434
(Abstracts #862-867).................................................... S381
MONDAY,NOVEMBER17,2014
Systemic Lupus Erythematosus - Human Etiology and
Pathogenesis I: Pathways of Inflammation/Injury 8:30AM–4:00PM
ACR/ARHPPosterSessionB
(Abstracts #868-873).................................................... S383
SystemicSclerosis,FibrosingSyndromesandRaynaud’s- Posterpresenterswillbeavailablefrom9:00–11:00AM.
(Abstracts #982-1793).................................................. S437
ClinicalAspectsandTherapeuticsI:SystemicSclerosis,
AdvancesinTherapy 11:00AM–12:30PM
(Abstracts #874-879).................................................... S386 ACRPlenarySessionII
Discovery 2014
Vasculitis I
(Abstracts #1794-1799)................................................ S788
(Abstracts #880-885).................................................... S388
ARHPConcurrentAbstractSession 2:30–4:00PM
ACRConcurrentAbstractSessions
Exemplary Abstracts
EpidemiologyandPublicHealthII:Osteoarthritis,
(Abstracts #886-891).................................................... S392
SedentaryBehaviorandMore
4:30–6:00PM (Abstracts #1800-1805)................................................ S791
ACRConcurrentAbstractSessions
Health Services Research: Improving Clinical
Fibromyalgia, Soft Tissue Disorders, Regional and
Practice
Specific Clinical Pain Syndromes I: Research
(Abstracts #1806-1811)................................................ S793
Perspectives
Innate Immunity and Rheumatic Disease
(Abstracts #892-897).................................................... S394
(Abstracts #1812-1817)................................................ S795
Health Services Research: Risk Assessment and
Osteoarthritis - Clinical Aspects I: Imaging in
Outcomes of Rheumatic Disease Osteoarthritis
(Abstracts #898-903).................................................... S397 (Abstracts #1818-1823)................................................ S798
Imaging of Rheumatic Diseases: Ultrasound Pediatric Rheumatology - Clinical and
(Abstracts #904-909).................................................... S400 Therapeutic Aspects: Pediatric Systemic Lupus
Muscle Biology, Myositis and Myopathies Erythematosus
(Abstracts #910-915).................................................... S403 (Abstracts #1824-1829)................................................ S800
Quality Measures and Quality of Care TUESDAY,NOVEMBER18,2014
(Abstracts #1830-1835)................................................ S803
8:30AM–4:00PM
Rheumatoid Arthritis - Clinical Aspects III: ACR/ARHPPosterSessionC
Malignancies, Vaccinations, Pregnancy and Posterpresenterswillbeavailablefrom9:00–11:00AM.
Surgery (Abstracts #1938-2780)................................................ S854
(Abstracts #1836-1841)................................................ S806
11:00AM–12:30PM
Rheumatoid Arthritis - Small Molecules, Biologics
ACRPlenarySessionIII
and Gene Therapy III: Innovative Therapeutic
Discovery 2014
Strategies in Rheumatoid Arthritis
(Abstracts #2781-2786)................................................ S1214
(Abstracts #1842-1847)................................................ S809
Spondyloarthropathies and Psoriatic Arthritis III - 2:30–4:00PM
ACRConcurrentAbstractSessions
Clinical Aspects Psoriatic Arthritis
2014 Rheumatology Research Foundation
(Abstracts #1848-1853)................................................ S813
Edmond L. Dubois, MD Memorial Lectureship
Systemic Lupus Erythematosus - Clinical Aspects
(Abstracts #2787-2791)................................................ S1217
and Treatment: Complications of Systemic Lupus
Biology and Pathology of Bone and Joint I: Bone
Erythematosus
Remodeling in Inflammation and Arthritis
(Abstracts #1854-1859)................................................ S815
(Abstracts #2792-2797)................................................ S1219
Vasculitis II
Cytokines, Mediators, Cell-cell Adhesion, Cell
(Abstracts #1860-1865)................................................ S818
Trafficking and Angiogenesis I
ACR/ARHPCombinedAbstractSession (Abstracts #2798-2803)................................................ S1222
Pediatric Rheumatology Miscellaneous Rheumatic and Inflammatory
(Abstracts #1866-1871)................................................ S821 Diseases/Innate Immunity and Rheumatic
4:30–6:00PM Disease: Assessing Outcomes of Infections in
ACRConcurrentAbstractSessions Rheumatic Disease
Epidemiology and Public Health III: Gout and (Abstracts #2804-2809)................................................ S1224
Systemic Lupus Erythematosus Rheumatoid Arthritis - Clinical Aspects V:
(Abstracts #1872-1877)................................................ S824 Mortality and Other Outcomes
(Abstracts #2810-2815)................................................ S1226
Fibromyalgia, Soft Tissue Disorders, Regional and
Rheumatoid Arthritis - Human Etiology and
Specific Clinical Pain Syndromes II: Clinical
Pathogenesis I: Mechanisms of Joint Damage
Perspectives
(Abstracts #2816-2820)................................................ S1229
(Abstracts #1878-1883)................................................ S826
Rheumatoid Arthritis - Small Molecules, Biologics
Genetics, Genomics and Proteomics I: Epigenetic
and Gene Therapy V: Novel Therapies in
Mechanisms in Autoimmunity
Rheumatoid Arthritis - Late in Development
(Abstracts #1884-1889)................................................ S828
(Abstracts #2821-2826)................................................ S1231
ImagingofRheumaticDiseases:X-ray,MRIandCT
Spondyloarthropathies and Psoriatic Arthritis IV -
(Abstracts #1890-1895)................................................ S831
Clinical Aspects Axial Spondyloarthritis
Pediatric Rheumatology - Pathogenesis and
(Abstracts #2827-2832)................................................ S1235
Genetics
Systemic Lupus Erythematosus - Clinical Aspects
(Abstracts #1896-1901)................................................ S834
and Treatment: Novel Therapies for Systemic
Rheumatoid Arthritis - Clinical Aspects IV:
Lupus Erythematosus
Promising Biomarkers
(Abstracts #2833-2838)................................................ S1238
(Abstracts #1902-1907)................................................ S837
Systemic Lupus Erythematosus - Human Etiology
Rheumatoid Arthritis - Small Molecules, Biologics
and Pathogenesis II: Pathogenic Targets, Genetic
and Gene Therapy IV: Safety of Biologics and
Variants and Apoptosis
Small Molecules in Rheumatoid Arthritis -
(Abstracts #2839-2844)................................................ S1241
Cardiovascular and Other Systems
T cell Biology and Targets in Autoimmune
(Abstracts #1908-1913)................................................ S840
Disease
Spondyloarthropathies and Psoriatic Arthritis - (Abstracts #2845-2850)................................................ S1243
Pathogenesis, Etiology: From Genes to Cytokines Vasculitis III
(Abstracts #1914-1919)................................................ S843 (Abstracts #2851-2856)................................................ S1245
Systemic Lupus Erythematosus - Clinical Aspects
ACR/ARHPCombinedAbstractSession
and Treatment: Biomarkers in Systemic Lupus
Rehabilitation
Erythematosus
(Abstracts #2857-2862)................................................ S1249
(Abstracts #1920-1925)................................................ S845
Systemic Sclerosis, Fibrosing Syndromes and 4:30–6:00PM
ACRConcurrentAbstractSession
Raynaud’s - Clinical Aspects and Therapeutics II:
Antiphospholipid Syndrome
Approaches to Cardiac and Vascular
(Abstracts #2863-2868)................................................ S1251
Manifestations in Systemic Sclerosis
BcellBiologyandTargetsinAutoimmuneDisease
(Abstracts #1926-1931)................................................ S847
(Abstracts #2869-2874)................................................ S1254
ARHPConcurrentAbstractSession Cytokines, Mediators, Cell-cell Adhesion, Cell
Health Disparities/Social Determinants of Health Trafficking and Angiogenesis II
(Abstracts #1932-1937)................................................ S851 (Abstracts #2875-2880)................................................ S1256
Education (Abstracts #2947-2952)................................................ S1288
(Abstracts #2881-2886)................................................ S1258 Genetics, Genomics and Proteomics II: Genetics
Epidemiology and Public Health IV: Rheumatoid of Autoimmunity
Arthritis Pathogenesis (Abstracts #2953-2958)................................................ S1290
(Abstracts #2887-2892)................................................ S1261 Metabolic and Crystal Arthropathies II:
Osteoarthritis - Clinical Aspects II: Osteoarthritis Mechanisms of Disease
Risk Factors and Therapies (Abstracts #2959-2964)................................................ S1293
(Abstracts #2893-2898)................................................ S1264
Pain: Basic and Clinical Aspects II/Orthopedics,
Pediatric Rheumatology - Clinical and
Low Back Pain and Rehabilitation
Therapeutic Aspects: Miscellaneous Pediatric
(Abstracts #2965-2970)................................................ S1296
Rheumatic Diseases
Rheumatoid Arthritis - Clinical Aspects VII: New
(Abstracts #2899-2904)................................................ S1267
Aspects of Monitoring Disease
Rheumatoid Arthritis - Animal Models II
(Abstracts #2971-2976)................................................ S1298
(Abstracts #2905-2910)................................................ S1270
Sjögren’s Syndrome II: Insights into
Rheumatoid Arthritis - Clinical Aspects VI:
Pathophysiology
Impact of Treatment and Other Interventions
(Abstracts #2977-2982)................................................ S1301
(Abstracts #2911-2916)................................................ S1272
Rheumatoid Arthritis - Human Etiology and Spondyloarthropathies and Psoriatic Arthritis VI -
Pathogenesis II: Citrullination, Autoantibodies Imaging and Biomarkers
and Genes (Abstracts #2983-2988)................................................ S1304
(Abstracts #2917-2922)................................................ S1275 Systemic Lupus Erythematosus - Clinical Aspects
Rheumatoid Arthritis - Small Molecules, Biologics and Treatment: Central Nervous System and
and Gene Therapy VI: Biomarkers and Predictors Other Clinical Aspects
of Rheumatoid Arthritis Disease Response and (Abstracts #2989-2994)................................................ S1306
Outcomes Systemic Sclerosis, Fibrosing Syndromes and
(Abstracts #2923-2928)................................................ S1277 Raynaud’s - Clinical Aspects and Therapeutics III:
Sjögren’s Syndrome I: Clinical Perspectives Updates in Predictors and Outcomes in Systemic
(Abstracts #2929-2934)................................................ S1280 Sclerosis
Spondyloarthropathies and Psoriatic Arthritis V - (Abstracts #2995-3000)................................................ S1309
Clinical Aspects and Treatment Systemic Sclerosis, Fibrosing Syndromes and
(Abstracts #2935-2940)................................................ S1282
Raynaud’s - Pathogenesis, Animal Models and
ARHPConcurrentAbstractSession Genetics II
Epidemiology/Public Health
(Abstracts #3001-3006)................................................ S1312
(Abstracts #2941-2946)................................................ S1285
ARHPConcurrentAbstractSession
WEDNESDAY,NOVEMBER19,2014
Clinical Practice/Patient Care
9:00–10:30AM
ACRConcurrentAbstractSessions (Abstracts #3007-3012)................................................ S1314
Biology and Pathology of Bone and Joint II: Innovations in Rheumatologic Care
Cartilage Biology and Synovial Activation (Abstracts #3013-3018)................................................ S1317
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Deadline for submissions is Friday, November 21, 2014
patientswiththrombocytopeniahasnotbeenfullyelucidated.Thepurposeof
ACR Poster Session A
thisstudyistoanalyzetheclinicalprofileofpatientswithprimaryAPSand
AntiphospholipidSyndrome
thrombocytopeniaandtoexaminetherelationbetweentheriskofthrombosis S
Sunday,November16,2014,8:30AM–4:00PM andthrombocytopenia. un
d
Methods:Thisstudycomprisedof57consecutivepatientswithprimary a
y
APS and 72 autoimmune disease control patients (non-systemic lupus ,
1 N
erythematosus) who visited Hokkaido University Hospital Rheumatology o
LymphocyteProliferationtoaCross-ReactiveGutCommensalCandi- ClinicbetweenJanuary2000andMay2014.Thrombocytopeniawasdefined ve
date in Antiphospholipid Syndrome. William Ruff1, Silvio M. Vieira1, as a platelet count less than 100,000 per microliter, persistent on two mb
CassyanneAguiar2,JohnSterpka1,AndrewGoodman3,DorukErkan2 and occasionsmorethan12weeksapartandwithoutnounderlyingcausesbesides e
r
MartinKriegel1. 1YaleSchoolofMedicine,NewHaven,CT,2NewYork aPL.PrimaryAPSpatientswereretrospectivelyfollowed-upfortheincidence 1
Presbyterian/WeillCornellMedicalCenter,NewYork,NY,3YaleSchoolof ofthrombosis.Kaplan-Meiersurvivalprobabilityestimatewasperformedto 6
Medicine,MicrobialDiversityInstitute,NewHaven,CT. analyzetheoccurrenceofthromboticeventsinprimaryAPSpatientswithand
withoutthrombocytopenia.
Background/Purpose: Antiphospholipid syndrome (APS) is an auto- Results:Themedianageofpatientswas41years(IQR32–50)inprimary
immuneclottingdisorderofunknownetiologytargetingamajorautoantigen, APSpatientsand50years(IQR31–59)inthecontrolgroup.Thrombocyto-
(cid:2)-glycoprotein I ((cid:2)GPI). Infectious triggers have been implicated in penia was more frequently diagnosed in patients with primary APS 17/
tra2nsient autoantibody2production, but the persistent stimuli for anti-(cid:2)GPI 57(30%)thaninthecontrolgroup4/72(6%),p(cid:3)0.001.
2
antibodies remain unknown. Given the vast antigenic potential of the gut InprimaryAPSgroup,arterialthrombosiswasdevelopedin9patients
microbiota,wehypothesizethathumangutcommensalbacteriainduceand (16%) throughout the follow-up period (106 months [IQR 36–142]); 8
sustainautoreactivityviacross-reactivity.Tothisend,wecharacterizedAPS patientshadcerebralinfarctionsand1myocardialinfarction.Arterialthrom-
PBMCreactivitytoinsilicocandidatesanddeterminedfecalautoantibody bosiswasmorefrequentlydevelopedinpatientswiththrombocytopeniathan
production. in those without (6/17(35%) vs. 3/40(8%), p(cid:2)0.014), while no correlation
Methods: Protein BLAST and Clustal Omega were used to identify wasfoundbetweenvenousthrombosisandthrombocytopenia.Therewasno
commensal protein sequences with high homology to (cid:2)GPI-dominant statisticallysignificantdifferenceintherateofhemorrhagiceventbetween
2
epitopes.Usinganaerobiccultures,wegrewisolatedcandidateandcontrol APSpatientswithandwithoutthrombocytopenia(1/17(6%)vs.0/40(0%),
strains. Blood and stool samples were obtained from anti-(cid:2)GPI-positive p(cid:2)0.298). Kaplan-Meier curve revealed that the inferior survival was
2
patients,non-autoimmunethrombophiliapatients,andhealthycontrols.Stool associatedwiththrombocytopenia(6/9(67%)vs11/48(23%),p(cid:2)0.047log-
DNAwasisolatedusingtheMoBioextractionkit.Anovelspecies-specific ranktest:Figure1).
real-timePCRstrategywasdevelopedandvalidatedusingisolatedstrainsand Conclusion:ThrombocytopeniainAPSpatientsrepresentsariskfactor
definedfecalmicrobiomes.InvitroproliferationofPBMCtobacterialprotein forarterialthrombosisandnotforbleeding.Theriskofthrombosisassociated
extractswasassessedby[3H]-thymidineincorporation.Anin-houseELISA withthrombocytopeniainprimaryAPSmustbecarefullyevaluatedand,if
was established with high-binding plates to analyze anti-(cid:2)GPI levels in necessary,appropriateantithrombotictherapyadministered.
2
plasmaandfecalsupernatants.
Results:SystematicinsilicosearchesrevealedRoseburiaintestinalisasa
major candidate for cross-reactivity. R. intestinalis is a common colonic
gram-positive, flagellated, mucus adhering commensal containing high ho-
mology to the main B and T cell epitopes of (cid:2)GPI. R. intestinalis
2
colonizationloadwassemi-quantifiedinpatientsandcontrolsusingreal-time
PCR.APSPBMCproliferatedsignificantlymoretoproteinextractsfromR.
intestinalisversuscontrolsubjects(n(cid:2)5–6;p(cid:2)0.0002),andalsocomparedto
the closely phylogenetically related, but mimic-deficient gut commensal
Eubacterium rectale (n(cid:2)6, p(cid:2)0.020). Importantly, we were also able to
detectanti-(cid:2)GPIIgAantibodiesinAPSfecalsupernatants,whichdiffered
significantly2comparedtocontrols(n(cid:2)14–15;p(cid:2)0.0019).
Conclusion: We have identified a major cross-reactive commensal
candidate in silico with high homology to dominant (cid:2)GPI epitopes and
2
developed a highly specific real-time PCR-based screening strategy. APS
PBMCs proliferated significantly more to candidate protein extracts com-
paredtocontrols.Furthermore,wereport,toourknowledge,forthefirsttime
fecalautoantibodyproductioninanon-gutautoimmunedisease.Production
of fecal anti-(cid:2)GPI IgA in patients with peripheral blood anti-(cid:2)GPI IgG
2 2
supportsourhypothesisofagutmucosal,cross-reactivetriggerinAPS,which
weareactivelypursuing.
Disclosure:W.Ruff,None;S.M.Vieira,None;C.Aguiar,None;J.Sterpka,None; Disclosure:I.Nakagawa,None;K.Oku,None;O.Amengual,None;R.Hisada,
A.Goodman,None;D.Erkan,None;M.Kriegel,None. None; E. Sugawara, None;K. Ohmura, None;T. Fukui, None;S. Shimamura,
None;H.Shida,None;T.Watanabe,None;Y.Shimizu,None;M.Kono,None;T.
2 Kurita,None;T.Bohgaki,None;T.Horita,None;S.Yasuda,None;T.Atsumi,
None.
ThrombocytopeniainPrimaryAntiphospholipidSyndromeIsRelated
to Arterial Thrombosis. Ikuma Nakagawa, Kenji Oku, Olga Amengual, 3
Ryo Hisada, Eri Sugawara, Kazumasa Ohmura, Tomoko Fukui, Sanae
Shimamura, Haruki Shida, Toshiyuki Watanabe, Yuka Shimizu, Michihito Is There an Association Between Persistently High Positive Antiphos-
Kono,TakashiKurita,ToshiyukiBohgaki,TetsuyaHorita,ShinsukeYasuda pholipid Antibody Profile and Organ Damage Accrual in Lupus Pa-
and Tatsuya Atsumi. Hokkaido University Graduate School of Medicine, tients? DorukErkan1,LisaG.Criscione-Schreiber2,MariaDall’era3,Olga
Sapporo,Japan. Dvorkina4,RussellGriffin5,GalinaMarder6,MaureenA.McMahon7,Jorge
Sanchez-Guerrero8, Amit Saxena9 and Robert Roubey10. 1Hospital for
Background/Purpose: Antiphospholipid-associated syndrome refers to Special Surgery, New York, NY, 2Duke University School of Medicine,
organdysfunctionsdevelopedintheexistenceofantiphospholipidantibodies Durham,NC,3UniversityofCalifornia,SanFrancisco,SanFrancisco,CA,
(aPL), apart from the typical manifestations of antiphospholipid syndrome 4SUNYHealthScienceCenteratBrooklyn,Brooklyn,NY,5Universityof
(APS)suchasthromboembolismandpregnancymorbidities.Thrombocyto- AlabamaatBirmingham,Birmingham,AL,6NorthShoreLongIslandHealth
peniaisoneoftheaPL-associatedmanifestationsandisreportedin20–40% System, Great Neck, NY, 7UCLA David Geffen School of Medicine, Los
ofAPSpatients.PatientswiththrombocytopeniaandaPLareatriskofboth Angeles,CA,8UHNTorontoWesternHospital,Toronto,ON,9NewYork
bleedingandthrombosis.Theevaluationofthecoagulationstatusinpatients University School of Medicine, New York, NY, 10University of North
withthrombocytopeniaisparticularlydifficultandtheclinicalprofileofAPS CarolinaatChapelHill,ChapelHill,NC.
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