Literatura académica sobre el tema "305.5/12"

ABSTRACT Human immunodeficiency virus (HIV)-infected children and adolescents who are failing antiretrovirals may have a better virologic response when drug exposures are increased, using higher protease inhibitor doses or ritonavir boosting. We studied the pharmacokinetics and safety of high-dose lopinavir-ritonavir (LPV/r) in treatment-experienced patients, using an LPV/r dose of 400/100 mg/m2 orally every 12 h (p.o. q12h) (without nonnucleoside reverse transcriptase inhibitor [NNRTI]), or 480/120 mg/m2 p.o. q12h (with NNRTI). We calculated the LPV inhibitory quotient (IQ), and when the IQ was <15, saquinavir (SQV) 750 mg/m2 p.o. q12h was added to the regimen. We studied 26 HIV-infected patients. The median age was 15 years (range, 7 to 17), with 11.5 prior antiretroviral medications, 197 CD4 cells/ml, viral load of 75,577 copies/ml, and a 133-fold change in LPV resistance. By treatment week 2, 14 patients had a viral-load decrease of >0.75 log10, with a median maximal decrease in viral load of −1.57 log10 copies/ml at week 8. At week 2, 19 subjects showed a median LPV area under the concentration-time curve (AUC) of 157.2 (range, 62.8 to 305.5) μg·h/ml and median LPV trough concentration (C trough) of 10.8 (range, 4.1 to 25.3) μg/ml. In 16 subjects with SQV added, the SQV median AUC was 33.7 (range, 4.4 to 76.5) μg·h/ml and the median SQV C trough was 2.1 (range, 0.2 to 4.1) μg/ml. At week 24, 18 of 26 (69%) subjects remained in the study. Between weeks 24 and 48, one subject withdrew for nonadherence and nine withdrew for persistently high virus load. In antiretroviral-experienced children and adolescents with HIV, high doses of LPV/r with or without SQV offer safe options for salvage therapy, but the modest virologic response and the challenge of adherence to a regimen with a high pill burden may limit the usefulness of this approach.

Reflection cracks are one of the most common problems in semi-rigid base pavement. Setting a stress absorption layer can effectively delay the occurrence of reflection cracks, but further improvement is still needed in its interlayer bonding performance and anti-reflection crack performance. Considering the excellent crack resistance of basalt fibers and the good elastic recovery ability of rubber asphalt, it is considered worthwhile to incorporate them into traditional stress absorption layers to improve performance. To simulate the actual pavement layer effect, composite specimens consisting of a cement-stabilized macadam base + basalt fiber rubber asphalt stress-absorbing layer + AC-20 asphalt mixture surface layer were prepared to evaluate their performance through interlayer direct shear tests, interlayer tensile tests, three-point bending tests, and overlay tests (OTs). To determine the optimal fiber blending combination, four fiber lengths (3 cm, 6 cm, 9 cm, 12 cm) and four fiber proportions (120 g/m2, 140 g/m2, 160 g/m2, 180 g/m2) were selected respectively. The specific effects of basalt fibers with different lengths and dosages were analyzed. The results show that compared with the absence of fibers, the improvement of interlayer bonding performance of rubber asphalt with basalt fibers is not significant, and it has certain limitations; however, the improvement of anti-reflective crack performance is significant, with an increase of up to 305.5%. This indicates that the network structure formed by basalt fibers and rubber asphalt stress absorption layer can effectively absorb and disperse external loads, causing an excellent crack resistance effect. Meanwhile, the results indicate that the main factor affecting its interlayer bonding strength and anti-reflective crack performance is the fiber content. Based on the comprehensive analysis of the performance and economy of the stress absorption layer of basalt fiber rubber asphalt, the optimal fiber parameter combination recommended is as fiber length 9 cm and fiber content 160 g/m2.These results can provide a reference for the design and performance evaluation of basalt fiber rubber asphalt stress absorption layer, and have certain application value.

PURPOSE We report a multicenter controlled trial comparing renal recovery and tolerance profile of doublet versus triplet bortezomib-based regimens in patients with initial myeloma cast nephropathy (CN) and acute kidney injury (AKI) without need for dialysis. METHODS After symptomatic measures and high-dose dexamethasone, patients were randomly assigned to receive bortezomib plus dexamethasone (BD), or BD plus cyclophosphamide (C-BD). In patients with < 50% reduction of serum free light chains (sFLCs) after 3 cycles, chemotherapy was reinforced with either cyclophosphamide (BD group) or thalidomide (C-BD group). RESULTS Ninety-two patients were enrolled in each group. At random assignment, characteristics of the 2 groups were similar, including median age (68 years) and serum creatinine level (305.5 and 273.5 µmol/L in BD and C-BD group, respectively). At 3 months, renal response rate (primary end point) was not different (41 v 47 responders in the BD and C-BD groups, respectively; relative risk [RR], 0.87; P = .46). Very good partial response (free light chain reduction ≥ 90%) or more was achieved in 36 and 47 patients, respectively (RR, 0.76; P = .10). After 1 cycle of chemotherapy, 69 in the BD group and 67 patients in the C-BD group had achieved sFLC level ≤ 500 mg/L. Serious adverse events were recorded in 30 and 40 patients, respectively. At 12 months, 19 patients had died (9 in the BD group v 10 in the C-BD group), including 10 (6 in the BD group and 4 in the C-BD group) from myeloma progression and 3 (0 in the BD group and 3 in the C-BD group) from infection. Within median follow-up of 27 months, 43 and 42 patients switched to new therapy, respectively. Overall, 50 patients (24 in the BD group and 26 in the C-BD group) had died. CONCLUSION This randomized study did not show any benefit of C-BD compared with BD on renal recovery of patients with initial CN not requiring dialysis. Adding cyclophosphamide did not sufficiently improve the efficacy-toxicity balance. Patients with myeloma with AKI are fragile, and indication for doublet or triplet regimen should be adapted to frailty.

Immune therapy of T-cell lymphoma requires assessment of tumor-expressed programmed cell death protein-1 (PD-1). Herein, we developed an immuno-PET technique that quantitatively images and monitors regulation of PD-1 expression on T-cell lymphomas. Methods. Anti-PD-1 IgG underwent sulfhydryl moiety-specific conjugation with maleimide-deferoxamine and 89Zr labeling. Binding assays and Western blotting were performed in EL4 murine T-cell lymphoma cells. In vivo pharmacokinetics, biodistribution, and PET were performed in mice. Results. 89Zr-PD-1 IgG binding to EL4 cells was completely blocked by cold antibodies, confirming excellent target specificity. Following intravenous injection into mice, 89Zr-PD-1 IgG showed biexponential blood clearance and relatively low normal organ uptake after five days. PET/CT and biodistribution demonstrated high EL4 tumor uptake that was suppressed by cold antibodies. In EL4 cells, phorbol 12-myristate 13-acetate (PMA) increased 89Zr-PD-1 IgG binding ( 305.5 ± 30.6 %) and dose-dependent augmentation of PD-1 expression ( 15.8 ± 3.8 − fold of controls by 200 ng/ml). FACS showed strong PD-1 expression on all EL4 cells and positive but weaker expression on 41.6 ± 2.1 % of the mouse spleen lymphocytes. PMA stimulation led to 2.7 ± 0.3 -fold increase in the proportion of the strongest PD-1 expressing EL4 cells but failed to influence that of PD-1+ mouse lymphocytes. In mice, PMA treatment increased 89Zr-PD-1 IgG uptake in EL4 lymphomas from 6.6 ± 1.6 to 13.9 ± 3.6 %ID/g ( P = 0.01 ), and tumor uptake closely correlated with PD-1 level ( r = 0.771 , P < 0.001 ). On immunohistochemistry of tumor sections, infiltrating CD8α+ T lymphocytes constituted a small fraction of tumor cells. The entire tumor section showed strong PD-1 staining that was even stronger for PMA-treated mice. Investigation of involved signaling revealed that PMA increased EL4 cell and tumor HIF-1α accumulation and NFκB and JNK activation. Conclusion. 89Zr-PD-1 IgG offered high-contrast PET imaging of tumor PD-1 in mice. This was found to mostly represent binding to EL4 tumor cells, although infiltrating T lymphocytes may also have contributed. PD-1 expression on T-cell lymphomas was upregulated by PMA stimulation, and this was reliably monitored by 89Zr-PD-1 IgG PET. This technique may thus be useful for understanding the mechanisms of PD-1 regulation in lymphomas of living subjects.

The problem of food insecurity remains a challenge in developing countries, especially in rural areas. Despite the rising level of food insecurity, COVID-19 set in and was said to pose a threat to food security globally if adequate measures are not quickly put in place. This study, therefore, described the socio-economic characteristics of the respondents; examined the extent to which the rural households are food secure or otherwise during the COVID-19 pandemic and examine the drivers of food security status among rural households in South-East Nigeria. Primary data were collected from 200 households with the use of structured questionnaires. Data were analysed using descriptive statistics, food security index and logistics regression. Results of the findings revealed that the majority of the household heads were male (92%), married (93.5%), educated (87.5%) and had an average age of 54 years. They had an average household size of 7 persons, an average farming experience of 22 years, an average monthly income of N14, 305.5 and majority (83%) do not belong to a cooperative society. Majority (69.5%) of the households were food insecure, while only (30.5%) were food secure. The food-secure households had an average household size of 5 persons, while the food insecure households had 9 persons in their households. The headcount ratio of food secure households was 0.30, while it was 0.70 for food-insecure households. This shows that at least two out of three persons were food insecure in the study area. The surplus/shortfall index indicates that the food secure households exceeded the calorie requirement by 12%, while the food insecure fell short of the recommended calorie intake by 39%. Square food insecure gap or square shortfall index which indicate the severity of food insecurity among the food insecure household was 0.0056. The average calorie available (adult equivalent per day) for food secure households was 2523.5kcal, while average calorie available (AE/day) for food-insecure households was 1389.05kcal. The identified positive drivers of food security were marital status, educational level, cooperative members and annual income of the household heads. While, age of household head, household size and COVID-19 negatively influenced food security status. The study recommends, among others, putting in place immediate policy measures to reduce the effect of COVID-19 pandemic on rural household’s food security through the provision of enough palliatives which should be monitored so that it gets to the targeted population. Effective household size management and enlightenment programs on modern family planning techniques should be encouraged in rural areas. Rural households should also be educated on the nutritional implication of the various food items such as egg, milk, soybean and fish, especially for children to increase their protein intake and boost their immune system against COVID-19.

665 Background: Germline genetic testing is recommended for patients with pancreatic ductal adenocarcinoma (PDAC) and pre-diagnostic testing is offered to patients with a significant family history. However, only 36% of patients in our institution obtained genetic testing. We identified associations between patient social profiles (income, race, ethnicity, social work needs) and delays in obtaining germline genetic testing from New York’s largest healthcare system. Methods: Patients with PDAC were identified using billing records across our institution with an IRB-approved protocol. Median income was extrapolated using patient zip code. Date of diagnosis (DOD) was recorded as the date of biopsy or, if no biopsy was performed, the date of earliest lesion found on CT scan. Delays of testing was calculated as the difference between DOD and the date of germline sample collection. Results: Between Mar 2016 and Feb 2022, 305 patients with PDAC were identified, with 103 (36.3%) having reports found (F), and 202 (63.7%) not having reports found (NF). Availability of germline testing did not vary by median income (F: $95954, NF: $94368, t=0.414, p=0.68). There was no significant difference in the geographic distribution either (gender p=0.92, race p=0.92, ethnicity p=0.16). Pearson analysis between income (x) and delays of testing (y) showed a negative correlation (y=-0.0028x+316, r2=0.058, p=0.014). African American and Hispanic patients, grouped for this analysis as underserved (U), had a significant delay in obtaining germline genetic testing compared to the remainder of patients (not underserved, NU) (U: 92d, NU: 21d, u=305.5, p=0.0016). In addition, African American (AA) patients had a significant delay of testing compared to White (W) patients (AA: 92d, W: 13d, u=161.5, p=0.0002). Furthermore, all 11 patients (1 Asian, 10 White) who obtained pre-diagnostic testing were NU patients (χ2=5.005, p=0.025). Upon further analysis, patients who have social work (SW) needs have a significant delay in testing compared to patients without SW needs (SW: 109d, no SW: 23d, u=263, p=0.025). Of the 12 patients who have SW needs, the primary needs were home care, transportation, or financial assistance. In addition, there was a trend toward difference between English (E) and non-English (NE) speaking patients when comparing their delays in testing (E=26.5, NE=108.5, u=257, p=0.12). Conclusions: Analysis of germline and clinical data from our 305-patient cohort identified a striking and concerning negative correlation between patient income and delays in germline testing. In addition, underserved patients had significant delays in germline testing and did not obtain any pre-diagnostic testing. Furthermore, social needs and primary language may be barriers for germline testing. Interprofessional collaborations may be required to prompt germline testing at our institution or nationwide.

BackgroundTakayasu arteritis (TAK) is a chronic systemic vasculitis that mainly affects the aorta and its major branches. This chronic relapsing disease is relevant to significant morbidity and treatment remains challenging [1]. Early identification of refractory TAK is helpful to improve the long-term prognosis of the disease. In recent years, platelets have been recognized as important markers for various types of diseases [2]. Platelet counts may indicate the activity of autoimmune disease as well as responsiveness to anti-inflammatory therapy and presence of various comorbidities [3]. Multiple studies have demonstrated that platelet count of TAK patients was significantly increased, especially in the active phase, which was significantly higher than that in the inactive phase [4-8].ObjectivesPlatelets have been recognized as important markers for various types of diseases. The aim of our study was to investigate whether platelet count could be the risk factor of refractory Takayasu arteritis (TAK).MethodsIn this retrospective study, 57 patients were divided into groups with or without refractory TAK. We compared the clinical manifestations, laboratory parameters, and medication between the two groups. The logistic regression analysis was used to identify the risk factors of refractory TAK.ResultsAmong the 57 patients, 18 cases (31.6%) were considered to have refractory TAK within 1 year of initiation of medication in our hospital. Refractory TAK patients had higher level of platelet (PLT) than non-refractory TAK patients (305.5 vs. 272.0, 109/L, P=0.043). PLT was positively correlated with ESR (r=0.502, p＜0.001), hs-CRP (r=0.529, p＜0.001), IgA (r=0.322, p=0.016), IgG (r=0.419, p=0.001), IgM (r=0.343, p=0.010), C3 (r=0.554, p＜0.001). For PLT, the area under the ROC curve was 0.668 (95% CI 0.515 to 0.822, p=0.043) and the best cut-off value was 296.5×109/L. The level of PLT greater than 296.5×109/L was found to be statistically related to refractory TAK (OR [95%CI] 4.000 [1.233-12.974], p=0.021).ConclusionClinicians should pay close attention to platelet levels in patients with TAK. For TAK patients with elevated platelet levels, earlier and more aggressive treatment is needed, and antiplatelet therapy is recommended as appropriate.References[1]Abisror, N., et al., Tocilizumab in refractory Takayasu arteritis: A case series and updated literature review. Autoimmunity reviews, 2013. 12(12): p. 1143-1149.[2]Yun, S., et al., Platelet Activation: The Mechanisms and Potential Biomarkers. BioMed Research International, 2016. 2016: p. 1-5.[3]Gasparyan, A.Y., et al., The Platelet-to-Lymphocyte Ratio as an Inflammatory Marker in Rheumatic Diseases. Annals of Laboratory Medicine, 2019. 39(4): p. 345-357.[4]Pan, L., et al., Platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio associated with disease activity in patients with Takayasu’s arteritis: a case-control study. BMJ Open, 2017. 7(4): p. e014451.[5]Peng, Y., J. Guo and Y. Deng, The role of mean platelet volume in patients with Takayasu arteritis. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 2017. 54(2): p. 273-278.[6]Wang, X., et al., Inflammation Is Associated With Platelet Coagulation Function Rather Than Enzymatic Coagulation Function in Patients With Takayasu Arteritis. Int Heart J, 2017. 58(4): p. 589-592.[7]Chen, R., et al., Serum complement 3 is a potential biomarker for assessing disease activity in Takayasu arteritis. Arthritis Research & Therapy, 2021. 23(1).[8]Seringec Akkececi, N., et al., The C-Reactive Protein/Albumin Ratio and Complete Blood Count Parameters as Indicators of Disease Activity in Patients with Takayasu Arteritis. Medical Science Monitor, 2019. 25: p. 1401-1409.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Abstract Background: Post-transplant lymphoproliferative disorder (PTLD) is primarily diagnosed histologically using tissue biopsy. Free light chain (FLC) assay and serum protein electrophoresis (SPE) have both been studied as tools to screen and monitor PTLD. However, limited data are available to compare these two assays in a well characterized patient population. It is also not clear what reference ranges should be adopted for the FLC assay in a post-transplant population. Method: Blood samples from 169 patients receiving a variety of solid organ transplants were analyzed for FLCs and screened for gammopathies by SPE/IFE. Results: Compared with non-PTLD patients, PTLD patients had higher mean, median and upper 95 percentile range of both κ and λ FLCs (p ranging from 0.0002 to 0.024). The mean, median and 95 percentile range of κ:λ ratio were similar between the two groups. PTLD patients were more likely to have polyclonal or monoclonal FLC elevations (p = 0.04). They also showed a higher frequency of gammopathy abnormalities (p = 0.0052). Nonetheless, neither FLC assay nor SPE demonstrated a clear association with the timing of PTLD diagnosis. FLC concentrations in non-PTLD recipients were higher than those in the general healthy population (95 percentile range: κ, 0.60-8.33 mg/dL vs. 0.33-1.94 mg/dL; λ, 0.77-7.08 mg/dL vs. 0.571-2.63 mg/dL) but the κ:λ ratio was similar to that of the healthy group (0.26-1.65). Conclusions: Our results suggested that elevated FLC concentrations and gammopathy abnormalities were both associated with PTLD. Therefore, FLC assay and SPE should be used conjunctively for screening PTLD among solid organ transplant recipients. For this application, the data showed that a higher upper limit of κ and λ FLC levels and normal κ:λ ratio should be used as diagnostic reference ranges. Additionally, neither method was clearly associated with the timing of PTLD diagnosis, indicating that they may be unsuitable for monitoring PTLD in the post-transplant population. Table 1. Longitudinal measurements of serum/plasma free light chains and SPE/IFE in eight PTLD cases. Type of transplant and type of PTLD Samples Days from PTLD diagnosisa κ FLC, mg/dL λ FLC, mg/dL κ /λ SPE/IFE Liver transplant, B-cell PTLD 1.1 1.2 – 616 2.33b 1.82 4.96 6.01 0.47 0.303 no band –c Liver transplant, B-cell PTLD 2.1 2.2 2.3 2.4 2.5 -145* -126 84 141 428 0.338 0.79 0.335 0.476 2.53 0.62 1.02 1.06 1.15 1.98 0.545 0.775 0.316 0.414 1.28 no band no band 1 IgG ©µ, 1 IgG λ 1 IgG ©µ, 1 IgG λ no band Liver transplant, polymorphic hyperplasia 3.1 3.2 -77 208 4.19 7.18 5.9 3.38 0.71 2.12 2 IgG ©µ, 2 λ FLC– Liver transplant, B-cell PTLD 4.1 4.2 4.3 61 272 537 4.64 3.25 7.1 11.1 6.65 10.96 0.418 0.489 0.648 no band no band no band Liver transplant, B-cell PTLD 5.1 5.2 5.3 5.4 5.5 9 12 393 429 476 305.5 957 0.721 1.01 1.24 74.25 192 1.67 1.72 2.56 4.11 4.98 0.432 0.587 0.484 1 IgG ©µ, 1 λ FLC 2 IgM ©µ no band no band no band Liver transplant, B-cell PTLD 6.1 6.2 6.3 6.4 62 153 174 188 3.16 5.58 3.97 2.14 2.92 3.91 3.81 3.37 1.08 1.43 1.04 0.635 – 1 IgG ©µ 1 IgG ©µ 1 IgG ©µ Kidney transplant, PTLD 7.1 7.2 15 30 1.4 1.68 1.58 2.06 0.89 0.82 no band no band Lung transplant, Non-Hodgkin lymphoma 8.1 -60 4.28 4.58 0.94 no band a Positive values indicate time points before PTLD diagnosis, while negative values indicate time points after PTLD diagnosis. b Numbers in bold format indicates values above ULN. c SPE/IFE results not available due to insufficient sample volume. Disclosures Kuhn: The Binding Site, Inc: Employment.

BackgroundInterstitial lung disease in systemic sclerosis(SSc-ILD) is heterogeneous with limited therapeutic options. Mycophenolate mofetil (MMF) is the most commonly used first line agent for SSc-ILD. Tacrolimus has shown promising efficacy in few small case series, and large cohorts of patients with non-SSC-ILD[1], but has never been evaluated in the setting of a clinical trial.ObjectivesTo compare the safety and efficacy of Tacrolimus with MMF in patients with progressive SSc-ILD.MethodsIn this single center open labelled, prospective, two-arm parallel group, randomized controlled pilot study (INSIST) conducted between November 2021 to December 2022, patients with progressive ILD (FVC decline >10%) due to SSc, aged between 18-65 years, disease duration <10 years, without concomitant inflammatory myositis, with an FVC of 40-85%, and not having received active immunosuppression other than prednisolone <10mg/day in the last 6 months were randomized to receive either MMF (target dose 2gm/day) or tacrolimus (Max dose-0.075 mg/kg/day; target trough levels- 4-10ng/ml) for 24 weeks. The primary endpoint was the difference in change in FVC% at 24 weeks; secondary outcomes included absolute change in FVC, skin scores, 6-minute walk distance, Mahler’s transitional dyspnea index, ACR-CRISS and revised CRISS responses and adverse outcomes. (Trial Reg: CTRI/2021/11/037864)Results25 out of 26 patients (13 in each group) completed 24 weeks follow up. Majority had Anti-Scl 70 positivity (73%) and limited skin disease. At 24 weeks, the mean change in FVC was 4.4% (10.6) and 6.92%(8.4) in the MMF and tacrolimus groups respectively (difference 2.52%, 95% CI (-10.3 to 5.18); p-0.500). All patients on tacrolimus and 85% of patients on MMF had stabilization (ΔFVC% -5% TO 5%) or improvement (ΔFVC%>10%) in lung function. Secondary outcomes were similar between two groups. Subgroup analyses stratified by ILD type, skin involvement at baseline, and early vs late SSc yielded similar results. The mean tacrolimus levels were 4.9 ng/ml(1.47) and the median dose needed to achieve these levels was 4mg/d. No serious adverse events were noted in either group; use of tacrolimus did not result in renal dysfunction or renal crises.ConclusionTacrolimus resulted in comparable improvement to MMF across primary and secondary outcome measures at 24 weeks with a favorable safety profile in patients with SSc ILD. Larger studies with longer follow up are needed to investigate the role of calcineurin inhibitors in SSc.Reference[1]Ge Y, Zhou H et al. The efficacy of tacrolimus in patients with refractory dermatomyositis/polymyositis: a systematic review. Clin Rheumatol.2015 Dec 1;34(12):2097–103.Table 1.Primary and Secondary outcomes at 24 weeksMMF (n=13)Tacrolimus (n=13)P valueChange in FVC (% predicted), mean (SD)+ 4.4 (10.6)+ 6.92 (8.4)Difference 2.52%, 95% CI (-10.3 to 5.18); p-0.500Absolute change in FVC (ml), mean (SD)+ 176.8 (305.5)+130.7 (164.6)0.636Change in mRSS, median (IQR)-1 (-3 to -0.5)-1 (-1 to -0.5)0.209Change in 6MWD (metres), mean (SD)63.15 (56.72)32.67 (27.53)0.094Change in SGRQ score, mean (SD)-14.83 (12.40)-12.97 (11.78)0.698Focal Score TDI, median (IQR)3 (2-4)3 (2-4)0.979Change in SF-36 PCS, mean (SD)5.59 (4.89)4.72 (12.91)0.823Change in SF-36 MCS, mean (SD)3.46 (7.86)5.58 (5.54)0.446Change in PGA, median (IQR)-2.0 (-2.5 to -1.5)-2.0 (-2 to -1)0.364Change in HAQ-DI, median (IQR)-0.23 (-0.25 to -0.19)-0.125 (-0.25 to -0.125)0.393ACR-CRISS Improvement, n (%)5 (38.5)3 (23.1)0.395Revised ACR-CRISS responders; n (%)10 (76.9)7 (53.9)0.416FVC: Forced Vital Capacity; 6MWD- 6 minute walk distance; mRSS- Modified Rodnan Skin Score; SGRQ- St. George Respiratory Questionnaire; HAQ-DI- Health Assessment Questionnaire-Disability Index; TDI- Transitional Dyspnea Index; SF-36- Short Form 36; PCS- Physical component summary; MCS- Mental Component Summary; CRISS - Composite Response Index in Systemic SclerosisFigure 1.Changes in FVC% stratified by magnitude of changeAcknowledgements:NIL.Disclosure of InterestsNone Declared.

Abstract Background To verify whether serum levels of reactive oxygen metabolites (ROM) are predictive of future clinical remission in patients with rheumatoid arthritis (RA) receiving tocilizumab (TCZ) therapy. Methods A total of 46 patients with RA receiving TCZ therapy were enrolled in this study. Patients were divided into remission and non-remission groups based on disease activity score 28 (DAS28)-erythrocyte sedimentation rate (ESR) or clinical disease activity index (CDAI) at 52 weeks. Associations between serum levels of ROM, C-reactive protein (CRP), and matrix metalloproteinase-3 (MMP-3) at 4 and 12 weeks and the remission by DAS28-ESR and CDAI at 52 weeks were investigated. Results There were no significant differences in CRP and MMP-3 between DAS- or CDAI-remission and non-remission groups at 12 weeks. However, ROM in DAS-remission group were significantly lower than those in the non-remission group. For ROM, the area under the curve of the receiver operating characteristic curve was 0.735 and the cut-off value that distinguished DAS-remission group from non-remission group was 305.5 U. Carr (sensitivity: 70.0%, specificity: 72.2%). A multivariate logistic regression analysis revealed that ROM at 12 weeks was associated with DAS-remission at 52 weeks (odds ratio: 6.067, 95% confidence interval: 1.305–28.203). Conclusion Serum levels of ROM at 12 weeks during TCZ therapy may be predictive of DAS-remission at 52 weeks in patients with RA.