Barriga Maldonado, E.

Figueroa Parra, G.

Galarza Delgado, D.Á.

Pineda Sic, R.

Pérez Barbosa, L.

Riegatorres, J.C.

Skinner Taylor, C.M.

Vázquez, F.

Ángulo, J.D.

Skinner Taylor, Cassandra Michele

Pérez Barbosa, Lorena

Angulo, J. D.

Figueroa Parra, Gabriel

Pineda Sic, Rita Angélica

Riegatorres, Janett Carmen

Galarza Delgado, Dionicio Ángel

Repositorio Academico Digital UANL

Scientific Abstracts  1937AB1293-HPR DETERMINING FUNCTIONAL MOBILITY AND BALANCE FOR PATIENTS AFTER TOTAL KNEE ARTHROPLASTY: RELIABILITY OF L-TESTB. Unver1, E. Yuksel1, M. Eymir1, K. Sevik1, V. Karatosun2. 1Dokuz Eylul University, School of Physical Therapy and Rehabilitation, Izmir, Turkey; 2Dokuz Eylul University, Department of Orthopedics and Traumatology, School of Medicine, Izmir, TurkeyBackground: Total knee arthroplasty (TKA) is a very common procedure, particularly implemented for the treatment of knee osteoarthritis (OA). Patient expectations after TKA surgery now include being able to enjoy appropriate rec-reational activities representing ambulatory activities beyond that of just pain relief and adequate knee motion (1). Since recreational activity comprises of more complex functions and requires longer standing durations, walking for 6-meter in a straight line in the timed up and go test (TUG) does not fully reflect the functional capacity of patients with TKA, and TUG test may be limited to detect the balance and mobility capacity in TKA patients (2, 3). As such, there is a need to determine more effective and functional evaluation tools that better reflect realistic situations in order to assess ambulatory performance level for patients with TKA. However, no studies have been conducted in patients with TKA to examine the applicability of the L-test, which assesses ambulation of individuals and consists of complex mobilization activity.Objectives: The purposes of this study were to determine the test-retest relia-bility and the minimal detectable change (MDC) of the L-test for TKA patients.Methods: Twenty-four patients with TKA due to knee OA, operated by the same surgeon, were included in this study. Patients performed trials for L-test twice on the same day. Between the first and second trials, patients waited for an hour on sitting position to prevent fatigue. The tester recorded the performance time while the participant was asked to get up from a chair, walk 3 m in a straight line, turn right, continue walking for 7 m in a straight line, turn left, walk back along the same path and sit down in the chair at their usual walking speed. Prior to the real testing session, the L-test was demonstrated by the tester and all participants were allowed to a practice trial.Results: The L-test showed an excellent test-retest reliability (ICC2,1= 0,98) in this study. Standard error of measurement (SEM) and MDC95 for L-test were 1,01 second and 2,8 second, respectively.Conclusion: This study found that the L-test is a reliable test for patients follow-ing TKA. Overall, the excellent test-retest reliability of the L-test indicates that it may be an applicable standardized method to assess TKA patients who are able to walk greater distances and have better gait in more functional situations. Cli-nicians and researchers can be confident that changes in L-test time above 2,8 seconds, represent a “real” clinical change in an individual patient with TKA. We, therefore, recommend the use of L-test as complementary outcome measures for balance and functional evaluation in TKA patients.References: [1] Swinkels, A., & Allain, T. J. (2013). Physical performance tests, self-reported outcomes, and accidental falls before and after total knee arthroplasty: an exploratory study. Physiotherapy theory and practice, 29(6), 432-442.[2] Deathe, A. B., & Miller, W. C. (2005). The L test of functional mobility: meas-urement properties of a modified version of the timed “up & go” test designed for people with lower-limb amputations. Physical therapy, 85(7), 626-635.[3] Kim, J. S., Chu, D. Y., & Jeon, H. S. (2015). Reliability and validity of the L test in participants with chronic stroke. Physiotherapy, 101(2), 161-165.Disclosure of Interests: None declaredDOI: 10.1136/annrheumdis-2020-eular.4789AB1294-HPR LOW CONCENTRATIONS OF BIOLOGIC DMARDS IN BREASTMILK OF PATIENTS TREATED DURING LACTATIONA. Zbinden1, K. Eriksson1, F. Förger1. 1University Hospital and University of Bern, Inselspital, Department of Rheumatology, Immunology and Allergology, Bern, SwitzerlandBackground: There is very limited information about the passage of biolog-ics into breast milk and into the peripheral blood of breastfed infants. However, based on pharmacological properties of biologic DMARDs (bDMARDs) lactation may not be discouraged in patients with chronic inflammatory rheumatic disease to treat or prevent postpartum relapses. We here report two cases treated with bDMARDs during lactation: one woman with Muckle-Wells syndrome (MWS) treated with canakinumab and one woman with microscopic polyangiitis (MPA) treated with rituximab. Objectives: To determine the level of rituximab and canakinumab in breast milk, in sera of breastfed infants as well as in sera of the mother and to calculate the average daily infant dose and the relative infant dose. Methods: Serum and milk levels of Rituximab were measured by ELISA using commercially available coating and detection antibodies. For Canakinumab an ELISA was established by coating of plates with recombinant human IL-1beta and detection of Canakinumab in samples by a polyclonal anti-human IgG cou-pled to HRP. In both cases separate standard curves for serum and milk were established. Serum samples and milk samples of unexposed healthy controls were used to determine the lower limit of quantification. Results: One patient with MWS received canakinumab 150 mg s.c. to treat a worsening of her disease ten days postpartum. She continued to breastfeed her child. The average concentration of canakinumab in milk samples collected on 10 consecutive days was 15.8 ng/ml. The average daily infant dose was 0.002 mg/kg/day. The relative infant dose, which refers infant to maternal exposure on a dose/weight basis, was 0.11%. There was no detectable canakinumab in the serum of the infant. One patient with MPA received rituximab 500 mg i.v. as a remission maintenance therapy four months postpartum. She continued to breastfeed her child. The average concentration of rituximab in milk samples collected on 4 consecutive days was 3.71 ng/ml. The average daily infant dose was 0.001 mg/kg/day. The relative infant dose was 0.01%. There was no detectable rituximab in the serum of the infant. Conclusion: Only minimal concentrations of canakinumab and rituximab can be detected in breastmilk. For both bDMARDs, the relative infant dose was below 1% of the maternal dose, which is considered unlikely to be of clinical concern. The lack of detectable levels of canakinumab and rituximab in the infants’ sera supports the notion of low oral bioavailability of large monoclonal antibod-ies. Together, the results are similar to those seen in TNF inhibitors which are regarded to be compatible with breastfeeding, yet more data are needed (1, 2, 3). References: [1] Götestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, da Silva J, Nelson-Piercy C, Cetin I, Costedoat-Chalumeau N, Dolhain R, Förger F, Khamashta M, Ruiz-Irastorza G, Zink A, Vencovsky J, Cutolo M, Caeyers N, Zumbühl C, Østensen M. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during preg-nancy and lactation. Ann Rheum Dis. 2016 May;75(5):795-810. doi: 10.1136/annrheumdis-2015-208840. Epub 2016 Feb 17.[2] Clowse ME, Förger F, Hwang C, Thorp J, Dolhain RJ, van Tubergen A, Shaughnessy L, Simpson J, Teil M, Toublanc N, Wang M, Hale TW. Minimal to no transfer of certolizumab pegol into breast milk: results from CRADLE, a prospective, postmarketing, multicentre, pharmacokinetic study. Ann Rheum Dis. 2017 Nov;76(11):1890-1896. doi: 10.1136/annrheumdis-2017-211384. Epub 2017 Aug 16.[3] Matro R, Martin CF, Wolf D, Shah SA, Mahadevan U. Exposure Concen-trations of Infants Breastfed by Women Receiving Biologic Therapies for Inflammatory Bowel Diseases and Effects of Breastfeeding on Infections and Development. Gastroenterology. 2018;155(3):696–704. doi:10.1053/j.gastro.2018.05.040Disclosure of Interests: Astrid Zbinden: None declared, Klara Eriksson: None declared, Frauke Förger Grant/research support from: Unrestricted grant from UCB, Consultant of: UCB, GSK, Roche, Speakers bureau: UCB, GSKDOI: 10.1136/annrheumdis-2020-eular.4431HPR Epidemiology and public health (including prevention) AB1295-HPR PREGNANCY RISK IN CHILDBEARING AGE WOMEN WITH RHEUMATIC DISEASESE. Barriga-Maldonado1, C. M. Skinner Taylor1, L. Pérez Barbosa1, J. D. Ángulo1, F. Vázquez1, G. Figueroa-Parra1, R. Pineda-Sic1, J. C. Riegatorres1, D. Á. Galarza-Delgado1. 1Hospital Universitario Dr. José Eleuterio González, Servicio de Reumatología, Monterrey, MexicoBackground: Rheumatic diseases (RD) are more frequent in women, affecting them during childbearing age. Medications used to treat can interfere with fertility or increase the risk of miscarriages and congenital abnormalities; Disease con-trol and therapy should be discussed with patients before and during pregnancy, in order to minimize adverse outcome (1). Barriers to adequate communication Protected by copyright, including for uses related to text and data mining, AI training, and similar technologies. de Nuevo Le?n Facultad de Medicinaat Universidad Aut?noma on January 24, 2025 http://ard.bmj.com/Downloaded from 13 June 2020. 10.1136/annrheumdis-2020-eular.5577 on Ann Rheum Dis: first published as 1938  Scientific Abstractsand counseling of women regarding reproductive health and family planning still exist among rheumatologists and increases the risk of complications(2).Objectives: To identify childbearing age women with RD and a high risk of pregnancy. Methods: A cross-sectional study was performed in the rheumatology clinic of the university hospital “Dr. Jose Eleuterio Gonzalez” in Monterrey, Mexico between October 2019 and January 2020. All non-pregnant childbearing age (18 to 45 years old) women any were included. A self-questionnaire of 10-items was applied. Demographic, data were collected from the electronic medical record. Results are shown in descriptive statistics. Analyses were performed with SPSS 22. A p< 0.05 was considered statistically significant.Results: 135 women were evaluated, median age was 33 (25-39) years. Patients characteristics are shown in table 1. 115 (85.1%) had initiated sexual activity earlier in life (median age 18 years). Regarding the question, did you have sex last month? 115 answered it, 69 (60%) said they had, 49 (42.6%) used a contraceptive and 20 (28.9%) did not. 135 patients, 68 (50.3%) had a desire for pregnancy, 12 (17.6%) in the next 12 months and 56 (82.3%) in more than one year, of which 37 (66%) were using a family planning method and 19 (34%) were not (Table 2). For the question about receiving contraceptional counselling 112 answered it, 80 (70.4%) say they had. When they were asked if they received family planning and reproductive health counseling by their rheumatologist, just 64 (57.1%) affirmed they did; There was no differences in the use of contraceptive methods among those who received contra-ceptive counselling and those who did not (p>0.05). Among the 67 (49.6%) patients who did not want to be pregnancy 16 (23.8%) did not use a contraceptive method.Table 1. Chracteristics n=135Age, years, median (IQR) 33 (25-39)Marital status n (%)  Single 58(42.9)Unmarried 19 (14.1)Married 49 (36.3)Divorced 9 (6.7)Education n (%)None12 (8.9)Elementary school 17 (12.6)High school 77 (57.0)University 28 (20.7)Diagnosis n (%)  Rheumatoid arthritis 63 (46.7)Systemic lupus erythematosus 39 (28.9)Other autoimmune diseases 32 (24.3)Onset of Sexual activity age, median (IQR) 18 (16-20)Onset of Sexual activity?, n (%)  Yes 115 (85.1)Table 2. Tool questions n=135 (%Did you have sex last month? (n= 115, %) 69 (60)Yes  Did you use any contraceptive method? (n=115, %)  Yes 49(42.6)Did you receive family planning and reproductive health counseling  by the rheumatologist? (n= 112, %) Yes 64 (57.1)Do you want to get pregnant after the next 12 months?  Yes 56 (41.1)Do you want to get pregnant in the next 12 months?  Yes 12 (8.9)Contraceptional counselling (n=112, %)  Yes 80 (71.4)Current treatment (n= 107, %)  Pregnancy Risk 65 (60.7)Conclusion: Using this short questionnaire, we identified that 35 (25.9%) of the patients had a risk of unintended pregnancy and that only 80 (70.4%) received reproductive health counseling from their rheumatologist. It is necessary to design and systematically apply questionnaires capable of detecting and eval-uating risks in this population.References: [1] Gayed, M., & Gordon, C. (2007). Pregnancy and rheumatic diseases. Rheu-matology, 46(11), 1634-1640.[2] Birru Talabi, M., Clowse, M. E., Blalock, S. J., Hamm, M., & Borrero, S. (2019). Perspectives of Adult Rheumatologists Regarding Family Planning Counseling and Care: A Qualitative Study. Arthritis Care & Research.Figure 1. Graphs 1. Graphs 2. Disclosure of Interests: None declaredDOI: 10.1136/annrheumdis-2020-eular.5577AB1296-HPR PREVALENCE OF COMORBIDITIES IN A COHORT OF PATIENTS IN AN EDUCATIONAL MULTIDISCIPLINARY PROGRAMM. Cabrera1, F. Rodriguez2, D. Buitrago-Garcia3, G. Sánchez3, P. Santos-Moreno4. 1Biomab - Center for Rheumatoid Arthritis, Data Administration, Bogota, Colombia; 2Biomab - Center for Rheumatoid Arthritis, Patient Education Program, Bogota, Colombia; 3Fundación Universitaria de Ciencias de la Salud, Epidemiology, Bogota, Colombia; 4Biomab - Center for Rheumatoid Arthritis, Rheumatology, Bogota, ColombiaBackground: Rheumatoid arthritis (RA) is a chronic inflammatory and com-plex disease. Patients with RA face other diseases that might lead to increase Protected by copyright, including for uses related to text and data mining, AI training, and similar technologies. de Nuevo Le?n Facultad de Medicinaat Universidad Aut?noma on January 24, 2025 http://ard.bmj.com/Downloaded from 13 June 2020. 10.1136/annrheumdis-2020-eular.5577 on Ann Rheum Dis: first published as 

Pregnancy risk in childbearing age women with rheumatic diseases

Pregnancy risk in childbearing age women with rheumatic diseases

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