AB0912 Swollen and tender joints improvement in the randomized controlled trials of psoriatic arthritis

BackgroundThe ACR response is used to evaluate peripheral joints in psoriatic arthritis. However the main component in ACR treatment response is swollen (SJ) and tender joints (TJ), therewithal patient and physician global assessment, acute phase response, pain and function are included in this treatment response. Therefore, it can be thought that peripheral arthritis can best evaluated over SJ and TJ. Although ACR treatment responses are generally found to be similar between anti-TNF and anti-IL17/anti-IL23 in PsA, there is a general opinion that anti-TNF treatments may be more effective on the peripheral joint. (1).ObjectivesIn this study, it was aimed to evaluate the efficacy on SJ and TJ in RCTs performed in PsA.MethodsWe was searched with the keywords ‘psoriatric arthritis’ and ‘randomized controlled trial’ in Pubmed. All studies between 1975 and 31.10.2021 were screened for TJ count (SD) and SJ count (SD) values at treatment initiation and primary endpoint. The 2 studies with anti-TNFs and the SPIRIT-1 study comparing ixekizumab with placebo and adalimumab showed the number of SJ and TJ at baseline and primary endpoint. Effect size calculated separately according to Morris and Klauer formula. (2,3) We can interpret the effect size according to Cohen as follows: 0-0,1 no effect; 0,2-0,4 small effect; 0,5-0,7 intermediate effect; 0,8-≥1 large effect. (4)ResultsCertolizumab study, ES was found at a good level in the number of TJ and SJ at 200 and 400 mg doses. (ES 0.84 for SJ). The study comparing ixekizumab with adalimumab and placebo, it was observed that administration of ixekizumab every 4 weeks was minimally more effective in the number of TJ (ES 0.16) and SJ (ES 0.13) than adalimumab. The effect of ixekizumab over placebo is also slightly better than that of Adalimumab over placebo. (0.51 vs 0.36 in TJ, 0.38 vs 0.29 in SJ)Table 1.Effect size analysis of studiesTender Joint CountReferenceWeek (w)InterventionControlBaseline (Intervention vs Control)ES (Morris)ES (Klauer)Spirit-112Ixekizumab 4 w (n=107)Adalimumab (n=101)20,5 (13,7) vs 19,3 (13,0)0.160.9112Ixekizumab 2 w (n=103)Adalimumab (n=101)21,5 (14,1) vs 19,3 (13,0)0.120.2912Ixekizumab 4 w (n=107)Plasebo (n=106)20,5 (13,7) vs 19,2 (13,0)0.515.112Ixekizumab 2 w (n=103)Plasebo (n=106)21,5 (14,1) vs 19,2 (13,0)0.473.912Adalimumab (n=101)Plasebo (n=106)19,3 (13,0) vs 19,2 (13,0)0.364.1GENOVESE, Mark C., et al. M02-570 Study Group12Adalimumab (n=51)Plasebo (n=49)25,3 (18,3) vs 29,3 (18,1)0.190.30RAPID-PsA24Certolizumab 200 mg (n=138)Plasebo (n=136)21,5 (15,3) vs 19,9 (14,7)0.670.7524Certolizumab 400 mg (n=135)Plasebo (n=136)19,6 (14,8) vs 19,9 (14,7)0.490.61Swollen Joint CountSpirit-112Ixekizumab 4 w (n=107)Adalimumab (n=101)11.4 (8.2) vs 9.9 (6.5)0.130.6312Ixekizumab 2 w (n=103)Adalimumab (n=101)12,1 (7,2) vs 9,9 (4,7)0.191.1812Ixekizumab 4 w (n=107)Plasebo (n=106)11,4 (8,2) vs 10,6 (7,3)0.383.812Ixekizumab 2 w (n=103)Plasebo (n=106)12,1 (7,2) vs 10,6 (7,3)0.453.212Adalimumab (n=101)Plasebo (n=106)9.9 (6.5) vs 10.6 (7.3)0.294.4GENOVESE, Mark C., et al. M02-570 Study Group12Adalimumab (n=51)Plasebo (n=49)18.2 (10.9) vs 18.4 (12.1)0.330.29RAPID-PsA24Certolizumab 200 mg (n=138)Plasebo (n=136)11.0 (8.8) vs 11.0 (8.8)0.840.8324Certolizumab 400 mg (n=135)Plasebo (n=136)10.5 (7.5) vs 11.0 (8.8)0.840.87ConclusionChanges in the number of SJ and TJ that directly assess the peripheral joint have not been reported enough in RCTs in PsA patients. According to a limited number of reports, Anti-TNFs (eg, certolizumab) cause significant improvement in the number of SJ and TJ in the primary endpoint. On the other hand, Ixekizumab has as much effect on SJ and TJ as Adalimumab. The effect of anti-IL 17 treatments on the peripheral joint is not less than that of anti-TNFs, as thought.References[1]Noviani M et at. Ther Adv Musculoskelet Dis. 2020[2]Klauer, K. J. Handbuch kognitives Training[3]Morris, S. B. Estimating Effect Sizes From Pretest-Posttest-Control Group Designs.[4]Cohen, J. Statistical power analysis for the behavioral sciences (2. Auflage)Disclosure of InterestsNone declared</jats:sec

A Novel Dual-Band Ultrathin FSS With Closely Settled Frequency Response

This study presents a novel ultrathin dual-band frequency selective surface (FSS) for X-band applications. The proposed single-layer FSS operates as a band reject filter at 8.47 and 10.45 GHz. The ratio of these two operating bands has small value such as 1.23, and it points out that the proposed FSS has closely spaced characteristic. In addition, the designed dual-band single-layer FSS has an ultrathin thickness of 0.021*lambda(l), where lambda(l) is the wavelength of the lower operational frequency. The stable frequency responses are sufficiently achieved for the transverse electric and transverse magnetic polarizations by using the proposed FSS. The validity of FSS is obtained by comparing measurements and simulations

REMARKING THE OSTEOPOROSIS IN PATIENTS WITH ANCA-ASSOCIATED VASCULITIS (AAV): DATA FROM EASTERN MEDITERRANEAN (TRVAS)

European Congress of Rheumatology -- JUN 12-15, 2024 -- Vienna, AUSTRIA[No abstract available

The Effects of Instrumental Touching on Infant Pain Perception and the Effects of Eutectic Mixture of Local Anesthetics (EMLA) on the Reduction of Pain

BACKGROUND: Premature infants, who have to spend the first week of their lives in neonatal intensive care units (NICUs), experience pain and stress in numerous cases, and they are exposed to many invasive interventions. The studies have shown that uncontrolled pain experienced during early life has negative and long-term side effects, such as distress, and such experiences negatively affect the development of the central nervous system OBJECTIVES: The purpose of the study was to examine the effects of touching on infant pain perception and the effects of eutectic mixture of local anesthetic (EMLA) on the reduction of pain. PATIENTS AND METHODS: Data for the study were collected between March and August 2012 from the neonatal clinic of a university hospital located in eastern Turkey. The population of the study consisted of premature infants who were undergoing treatment, completed the first month and who were approved for Hepatitis B vaccine. The study consisted of two experimental groups and one control group. Information forms, intervention follow-up forms, and Premature Infant Pain Profile (PIPP) were used to collect the data. EMLA cream was applied on the vastus lateralis muscles of the first experimental group before the vaccination. The second experimental group was vaccinated by imitation (placebo), without a needle tip or medicine. Vaccination was carried out using instrumental touch in this group. A routine vaccination was applied in the control group. RESULTS: Mean pain scores of the group to which EMLA was applied were lower in a statistically significant way (P < 0.05) compared to the pain scores of the other groups. Moreover, it was determined that even though invasive intervention was not applied to the newborns, the touching caused them to feel pain just as in the placebo group (P < 0.005). CONCLUSIONS: The results demonstrated that EMLA was an effective method for reducing pain in premature newborns, and the use of instrumental touch for invasive intervention stimulated the pain perception in the newborns