BackgroundThe rate of COVID-19 vaccination in patients with rheumatoid arthritis. Single-center cross-sectional pilot study.ObjectivesMorocco was the first country in Africa to launch the COVID19 vaccination campaign. Vaccination of immunocompromised subjects was recommended from the beginning by the Moroccan Society of Rheumatology.The primary objective of this study was to assess the vaccination rate of patients with rheumatoid arthritis two years after the start of the pandemic. The secondary objective was to investigate factors associated with vaccination.MethodsThis was a 3-month monocentric cross-sectional study from 31.05.22 to 31.08.22, including patients whose age was greater than 18 years, who have rheumatoid arthritis according to ACR/EULAR 2009 criteria. Socio-demographic data, comorbidities and disease characteristics were collected by the attending physician at the time of the consultation using a questionnaire. Statistical analysis was performed using JAMOVI software.ResultsThe study included 73 patients, 82.2% of whom were women. The mean age was 57±11years, with a median disease progression of 8 years. 58 patients (80.6%) were vaccinated against COVID19.Among the vaccinated patients, 30 (51.7%) were illiterate, 8 patients (13.8%) had primary education, 11 (19%) had secondary education and 9 (15.5%) had higher education 53 (91.4%) patients were previously on or on corticosteroids, 8 patients (14, 3%) had a history of tuberculosis, 10 patients (17.5%) had diffuse interstitial lung disease routinely detected on computed Tomography (CT) Scan of the Chest, 26 patients (45.6%) had received a pneumococcal vaccination (p=0.24), and 21 (36.2%) had received an influenza vaccination. 15 patients (25.8%) were on Tumor necrosis factor-alpha inhibitors, 25 patients (43.1%) were on Rituximab, 6 patients (10.3%) were on Tocilizumab, 4 patients (6.9%) were on Methotrexate, 1 patient (1.7%) was on Leflunomide, 1 patient (1.7%) was on Salazopyrine, 2 patients (3.4%) were on csDMARD combinations, and 4 patients (6.9%) were not on any disease-modifying treatment.Only the level of education was statistically significantly different between vaccinated and non-vaccinated patients (p=0.06).ConclusionIn this study, almost 80% of patients were vaccinated. Further studies are needed to develop population-specific education programs.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundLimited data have been published on tolerance and efficacy of biotherapy in moroccan patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA).ObjectivesTo assess in real life the safety and efficacy of biological treatments in moroccan patients with RA and SpA.MethodsThe RBSMR is a registry of biological therapies in rheumatic diseases from the Moroccan Society of Rheumatology. The patients recruited were over the age of 18 years, diagnosed with RA or SpA, fulfilled ACR/EULAR 2010 criteria and ASAS 2009 criteria respectively and treated with biologics (initiation or ongoing biotherapy) in 10 Moroccan university medical centers. The inclusion period was from May 2017 to January 2019. Follow-up data were collected every 6 months for 3 years. The details of the data collected have been published previously. [1]Statistical analysis was performed using Jamovi software, 1.6.ResultsA total of 225 RA and 194 SpA including 170 ankylosing spondylitis were treated with biologics (bDMARDs). Overall median age at inclusion was 53 and 39 years. The median disease duration was 146 and 131 months for RA and SpA respectively.163 (72.4%) RA and 137(70.6%) SpA received a first line bDMARDs.10.7 % RA and 55.2 % SpA were prescribed bDMARDs in combination with csDMARDs. After 3 years of follow-up, median DAS28 CRP was 2.6 [0.9-4] (p<0.001) and median ASDAS CRP was 1.8 [1-2.4] (p=0.66). The most commonly used drug was rituximab (60%) in RA and etanercept (33%) in SpA.At 3 years-follow up, 18.3% and 17.4% adverse events were reported in RA and SpA patients respectively. The most common adverse events reported in RA and SpA were infections, mainly nonspecific infections, in both diseases (5.8%, 5.2%). One lymph node tuberculosis in an RA patient taking infliximab and 6 cases of tuberculosis in SpA patients taking anti-TNFs were reported in our registry. Malignancy was observed in 3 patients with RA (1 non-Hodgkin lymphoma, 1 bladder cancer and 1 breast cancer) and 2 SpA patients (1 vocal cord carcinoma and 1 multiple myeloma). During follow-up, 38bDMARDs switchers were reported in RA patients (10 at 1 year, 9 at 2 years and 9 at 3 years), while 41 switchers were reported in SpA patients (23 at 1 year, 14 at 2 years and 4 at 3 years).ConclusionIn this real-world analysis of data from the RBSMR registry, a considerable proportion of patients with RA and Spa had an adequate response to bDMARDs at 36 months. Infections, mainly nonspecific infections, were the main adverse events in both RA and SpA of our registry.Reference[1]Hmamouchi I et al. The Moroccan registry of biological therapies in rheumatic diseases (RBSMR): methods and preliminaries results. Rev Mar Rhum 2019;49:32-7Table 1.Adverse events of bDMARDs in RA and SpA patients during 3 years of follow upRA N=225SpA N=194Adverse events1 year 87 (38.4)2 years 53 (22.9)3 years 42 (18.3)1 year 74 (38.1)2 years 41 (20.8)3 years 34 (17.4)InfectionaNon specific infection Tuberculosis Atypical mycobacteria Fungal infection Viral infection37 (16.5)31 (13.8)6 (2.7)16 (7)14 (6.2)1 (0.4)1 (0.4)17 (7.6)13 (5.8)1 (0.4)3 (1.3)43 (22.3)30 (15.5)4 (2.1)5 (2.6)4 (2.1)23 (11.8)18 (9.3)1 (0.5)1 (0.5)3 (1.5)16 (8.2)10 (5.2)1 (0.5)2 (1)3 (1.5)CanceraSolid tumor Skin cancer Lymphoma Other hematological malignancies1 (0.4)1 (0.4)1 (0.4)1 (0.4)1 (0.4)1 (0.4)1 (0.5)1 (0.5)1 (0.5)1 (0.5)Paradoxical effectsaSkin reaction Uveitis Inflammatory bowel disease2 (0.8)1 (0.4)1 (0.4)1 (0.4)1 (0.4)4 (1.7)2 (0.8)2 (0.8)7 (3.6)1 (0.5)6 (3.1)2 (1)2 (1)7 (3.6)1 (0.5)5 (2.6)1 (0.5)Auto-immune diseases (LEAD)1 (0.4)1 (0.5)Hypersensitivity reactiona4 (1.6)2 (0.8)7 (3.6)2 (1)Hematological disordersaLeucopenia Neutropenia Thrombocytopenia19 (8.5)5 (2.2)8 (3.6)6 (2.7)11 (4.8)1 (0.4)8 (3.6)2 (0.8)4 (1.7)2 (0.8)2 (0.8)2 (1)1 (0.5)1 (0.5)1 (0.5)1 (0.5)1 (0.5)1 (0.5)Hypercholesterolemiaa8 (3.6)9 (4)4 (1.7)2 (1)2 (1)1 (0.5)aNumber and percentageAcknowledgementsThe authors would like to thank the Scientific Committee and national principal investigators of the RBSMR study, Drs Redouane Abouqal, Lahcen Achemlal, Fadoua Allali, Rachid Bahiri, Ahmed Bezza, Imane El Bouchti, Imad El Ghozlani, Abellah El Maghraoui, Toufik Harzy, Ihsane Hmamouchi, Linda Ichchou, Ouafa Mkinsi, Kawtar Nassar, Saadia Janani, and Redouane Niamane; and patients who agreed to participate in this study.Disclosure of InterestsNone Declared.
BackgroundPrevalence of cachexia in a population of Moroccan women with rheumatoid arthritis.ObjectivesThe objective of our study is to assess body composition in women with rheumatoid arthritis (RA) compared to healthy controls.MethodsWe conducted a case-control study of 112 female patients with rheumatoid arthritis according to ACR/EULAR 2010 Rheumatoid Arthritis Classification Criteria; and 224 healthy women of the same age. Body composition and bone mineral density (BMD) results were obtained by Dual-Energy X-Ray Absorptiometry (DXA). Rheumatoid cachexia (RC) was defined as a Lean mass index (LMI) below the 10th percentile and a Fat mass index (FMI) above the 25th percentile compared with the control group. We performed a comparison between RA patients and healthy controls and then performed multiple regression looking for factors associated with rheumatoid cachexia.ResultsThe prevalence of rheumatoid cachexia was 42.85% while the mean body mass index (BMI) was the same in both groups. RA patients had higher fat mass and lower lean mass compared with healthy controls. In our population, 78.60% of patients were on methotrexate and 12.50% on TNF inhibitor. Comparison between patients with and without CR showed that patients with CR have high disease activity, with the presence of more bone erosions. Regression showed that CR was significantly associated with bone erosions and disease activity (OR at 33.31 (8.42- 131.70) and 8.98 (1.64 - 49.20) respectively) This was independent of age, erythrocyte sedimentation rate, C-reactive protein, duration of disease, cumulative steroid dose, and use of conventional or biologic background therapies.ConclusionOur study showed that nearly half of our RA patients have CR even with high BMI. CR in our work is associated with the presence of high disease activity, and the presence of bone erosions.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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