AB0563 DISCONTINUATION OF ANTI-TNFα IN PATIENTS WITH PSORIATIC ARTHRITIS: A SINGLE-CENTER EXPERIENCE

Background:TNF inhibitors have been largely demonstrated to be effective and reasonably safe for the treatment of psoriatic arthritis (PsA). Current EULAR guidelines recommend the use of an anti-TNF as first choice treatment in patients with PsA for whom a synthetic DMARD (usually methotrexate or leflunomide) is not efficacious or not well tolerated [1]. In a scenario where biologic treatments are easily available, and the treat to target strategy is widely accepted, a complete disease remission or at least a minimal disease activity are considered realistic goals to be achieved in a growing proportion of patients [2]. However, there remains very little research regarding anti-TNF discontinuation in patients who achieved a complete remission [3-5].Objectives:The primary aim of this study was to measure the disease-free interval after anti-TNF discontinuation, secondary it was investigated whether the use of Power Doppler Ultrasound (PDUS) and Contrast Enhanced Ultrasound (CEUS) could improve the diagnostic accuracy in the recognition of the relapse. Finally, we wanted to characterize the clinical features of the disease recurrence.Methods:From June 2018, 35 patients with PsA (27 males and 8 female) treated with anti-TNF, in stable remission were prospectively monitored for 1 year after treatment discontinuation. Remission was defined as documented absence of clinical and ultrasonographic signs of arthritis or enthesitis. Complete rheumatological and dermatological examinations were performed in all participants, at baseline and every 8-12 weeks: American College of Rheumatology (ACR) 66-68 joint count; Psoriasis Area Severity Index (PASI); patient pain visual analog score (VAS); patient global disease activity VAS; Health Assessment Questionnaire (HAQ); Leeds Enthesitis Index (LEI); Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Bath Ankylosing Spondylitis Functional Index (BASFI); Power Doppler Ultrasound (PDUS) of the involved joints and entheses, Contrast Enhanced Ultrasound (CEUS) of a selected joint or enthesis and laboratory inflammation tests.Results:31 out of the 35 enrolled patients, experienced a disease recurrence with an average disease-free interval of 27.9±21.1 weeks (Figure 1). In 3 patients the treatment was restored for a relapse of the skin psoriasis, 8 patients reported only axial symptoms of disease relapse and 20 patients had both axial and peripheral joints involvement (average DAPSA score of 23.6±11.1; average BASDAI score of 4.7±2.6; average BASFI score 4.5±2.9). In all cases the disease flare was moderate and all patients promptly regained remission after restarting the treatment. Both PDUS and CEUS were safe and reliable showing a good percentage of accordance (95,4%) in detecting synovitis and enthesitis.Conclusion:The rate of disease relapse of PsA after anti-TNF discontinuation is relevant. However the disease-free interval was not short. Retreatment with the same anti-TNF was effective and safe.References:[1]Gossec L, Baraliakos X, Kerschbaumer A, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis. 2020 Jun;79(6):700-712.[2]Dures E, Shepperd S, Mukherjee S, et al. Treat-to-target in PsA: methods and necessity. RMD Open. 2020 Feb;6(1):e001083.[3]Stober C, Ye W, Guruparan T, et al. Prevalence and predictors of tumour necrosis factor inhibitor persistence in psoriatic arthritis. Rheumatology (Oxford). 2018 Jan 1;57(1):158-163.[4]Huynh DH, Boyd TA, Etzel CJ, et al. Persistence of low disease activity after tumour necrosis factor inhibitor (TNFi) discontinuation in patients with psoriatic arthritis. RMD Open. 2017 Jan 16;3(1):e000395.[5]Ye W, Tucker LJ, Coates LC. Tapering and Discontinuation of Biologics in Patients with Psoriatic Arthritis with Low Disease Activity. Drugs. 2018 Nov;78(16):1705-1715.Disclosure of Interests:None declared

Phylogenetic analysis of the Pantomorus-Naupactus complex (Coleoptera: Curculionidae: Entiminae) from North and Central America

We undertook the first cladistic analysis of the Pantomorus-Naupactus complex (Coleoptera: Curculionidae) from North and Central America, based on 35 species and 61 morphological characters, plus 1151 bp of the mtDNA COI and Cyt b genes. The morphological and the combined matrices analyzed with TNT yielded a single most parsimonious cladogram that allows recognition of two main lineages within the Pantomorus-Naupactus complex in North and Central America. One is represented by the species formerly placed in Phacepholis and the Pantomorus species group II sensu Sharp, ranging along the Pacific coast of Central America and Mexico and reaching the Great Plains of North America in the United States, yet not occurring in South America. The other lineage is represented by the species of Naupactus and Pantomorus: species group I, with closer relationships to the South American species of these genera. The Pantomorus group I includes the type species of the genus P. albosignatus Boheman whereas the Pantomorus group II includes the type species of Athetetes Pascoe, 1886 (A. globicollis Pascoe). Based on the results of our phylogenetic analysis, we recommend retaining the name Pantomorus Schoenherr for most species of the Pantomorus group I, except P. stupidus (Boheman) and P. femoratus Sharp which should be transferred to Naupactus Dejean. Moreover, we enlarge the previous concept of Phacepholis to include most species of the Pantomorus group II, and we establish the synonymy of Athetetes Pascoe, 1886 with Phacepholis Horn, 1876, being the latter the valid name, by priority.We undertook the first cladistic analysis of the Pantomorus-Naupactus complex (Coleoptera: Curculionidae) from North and Central America, based on 35 species and 61 morphological characters, plus 1151 bp of the mtDNA COI and Cyt b genes. The morphological and the combined matrices analyzed with TNT yielded a single most parsimonious cladogram that allows recognition of two main lineages within the Pantomorus-Naupactus complex in North and Central America. One is represented by the species formerly placed in Phacepholis and the Pantomorus species group II sensu Sharp, ranging along the Pacific coast of Central America and Mexico and reaching the Great Plains of North America in the United States, yet not occurring in South America. The other lineage is represented by the species of Naupactus and Pantomorus: species group I, with closer relationships to the South American species of these genera. The Pantomorus group I includes the type species of the genus P. albosignatus Boheman whereas the Pantomorus group II includes the type species of Athetetes Pascoe, 1886 (A. globicollis Pascoe). Based on the results of our phylogenetic analysis, we recommend retaining the name Pantomorus Schoenherr for most species of the Pantomorus group I, except P. stupidus (Boheman) and P. femoratus Sharp which should be transferred to Naupactus Dejean. Moreover, we enlarge the previous concept of Phacepholis to include most species of the Pantomorus group II, and we establish the synonymy of Athetetes Pascoe, 1886 with Phacepholis Horn, 1876, being the latter the valid name, by priority.Fil: Rosas, María V.. Universidad Nacional Autónoma de México; MéxicoFil: Morrone, Juan José. Universidad Nacional Autónoma de México; MéxicoFil: del Rio, Maria Guadalupe. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Lanteri, Analia Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; Argentin

Spatial distribution of hardpans in the Dosso region of Niger A remote sensing approach

Hardpan A soil layer with physical characteristics that limit root penetration and restrict water movement. Soil crust A transient soil-surface layer, ranging in thickness from a few millimeters to a few centimeters, that is either denser, structurally different or more cemented than the material immediately beneath it, resulting in greater soil strength when dry as measured by penetration resistance or other indices of soil strength

Paspalum stellatum Humb. & Bonpl. ex Flüggé

ResistenciapublishedVersio

Exploring CT Texture Parameters as Predictive and Response Imaging Biomarkers of Survival in Patients With Metastatic Melanoma Treated With PD-1 Inhibitor Nivolumab: A Pilot Study Using a Delta-Radiomics Approach

In the era of artificial intelligence and precision medicine, the use of quantitative imaging methodological approaches could improve the cancer patient’s therapeutic approaches. Specifically, our pilot study aims to explore whether CT texture features on both baseline and first post-treatment contrast-enhanced CT may act as a predictor of overall survival (OS) and progression-free survival (PFS) in metastatic melanoma (MM) patients treated with the PD-1 inhibitor Nivolumab. Ninety-four lesions from 32 patients treated with Nivolumab were analyzed. Manual segmentation was performed using a free-hand polygon approach by drawing a region of interest (ROI) around each target lesion (up to five lesions were selected per patient according to RECIST 1.1). Filtration-histogram-based texture analysis was employed using a commercially available research software called TexRAD (Feedback Medical Ltd, London, UK; https://fbkmed.com/texrad-landing-2/) Percentage changes in texture features were calculated to perform delta-radiomics analysis. Texture feature kurtosis at fine and medium filter scale predicted OS and PFS. A higher kurtosis is correlated with good prognosis; kurtosis values greater than 1.11 for SSF = 2 and 1.20 for SSF = 3 were indicators of higher OS (fine texture: 192 HR = 0.56, 95% CI = 0.32–0.96, p = 0.03; medium texture: HR = 0.54, 95% CI = 0.29–0.99, p = 0.04) and PFS (fine texture: HR = 0.53, 95% CI = 0.29–0.95, p = 0.03; medium texture: HR = 0.49, 209 95% CI = 0.25–0.96, p = 0.03). In delta-radiomics analysis, the entropy percentage variation correlated with OS and PFS. Increasing entropy indicates a worse outcome. An entropy variation greater than 5% was an indicator of bad prognosis. CT delta-texture analysis quantified as entropy predicted OS and PFS. Baseline CT texture quantified as kurtosis also predicted survival baseline. Further studies with larger cohorts are mandatory to confirm these promising exploratory results